With the rapid development of evidence-based medicine during the past two decades, evidence andevidence-based methods were not only used in the field of health care, but also applied to other non-medical fields. Asystematic literature search and a comparative study were conducted to investigate the definition of evidence. We also putforward our own definition of evidence: Evidence is the information from the systematic review process. We also discussedthe development of evidence-based paradigm and hope this will act as a reference for other subjects and industries.
Objective To compare and review worldwide journals titled “evidence-based” in order to provide an overview of these healthcare journals and suggestions for improving the quality of this type of journal in China and to introduce a quick way for healthcare professionals and patients to obtain high quality clinical evidence. Methods We searched PubMed, EMBASE, Ulrich’s Periodicals Directory, Wanfang and some relevant websites to identify journals titled “evidence-based”. The last issues in 2006 of these kind of journals were analyzed by bibliometric method. Results Twenty-four journals were included. Covering 12 disciplines such as clinical, nursing, health care, etc. They were divided into the primary journals and the secondary journals, published in two languages in six countries. These journals had differences and similarities in their aims, columns and contents, etc. Conclusions Evidence-based medical journals provide the latest developments and the best evidence for healthcare professionals in their own fields, save their time in searching for and reading information, and provide ideas for improving the quality of similar journals in our country.
David Eddy, one of the founders of evidence-based medicine, is a famous American expert in evidence-based medicine. He was first author on a key article in JAMA in 1990 and coined the term "evidence-based". He made great contributions in medical decision making, applied mathematics, health economics and devoted himself to the establishment and dissemination of evidence-based guidelines. In this article, the process of his striving and academic research is introduced and his unique insight into and new interpretion of evidence-based medicine are elaborated.
ObjectiveChinese practice guideline for therapeutic drug monitoring of vancomycin is the first therapeutic drug monitoring guideline in the framework of GRADE in China. The guideline panels met a recommendation consensus in December 21th, 2014 and finalized 14 recommendations. The aim of the current study was to assess the property of recommendations and revise them. MethodsWe commissioned an external review of recommendations by questionnaire. Physicians, clinical pharmacists and nurses above or equal to intermediate certificate were investigated for appreciations, clarity and feasibility of 14 recommendations as well as other suggestions about guideline. The guideline panels discussed the results and revised recommendations based on the result of external review. ResultsA total of 40 physicians, clinical pharmacist and nurses from 11 departments of 4 hospitals participated in the external review. The overall appreciation degree of recommendations was 70%, the overall clarity degree of recommendations was 88%, and the overall feasibility degree of recommendations was 70%. Among them, appreciation degree of 4 recommendations and feasibility degree of 5 recommendations were fewer than 50%. 165 subjective suggestions were received. After review of the results, the guideline panels reserved 6 recommendations while revised 8 (Deleted 4, combined 2 and improved 2). ConclusionOur external review is an exploration and attempt in the region of development of Chinese evidence-based practice guideline. More interest-related individuals are involved in the development of guideline. Clarity and feasibility of recommendations are ensured.
China Association of Chinese Medicine officially issued the Guidelines for Diagnosis and Treatment of Common Internal Diseases in Chinese Medicine-Headache (T/CACM 1271-2019) on January 30th, 2019. The guideline provided 27 recommendations, including clinical diagnosis, treatment, prevention and care of headache. This paper introduces the background of this guideline and interprets its contents of clinical diagnosis, treatment and prevention.
Decision-making is often a complex and hard-to-routinize process. Based on the decision-making experience of fighting COVID-19, policymakers have gradually realized that climate action, quality education, and other societal challenges, as well as the sustainable development goals (SDGs) need to be addressed with the best available evidence using an evidence-informed decision-making (EIDM) approach. The Global Commission on Evidence was established in 2021. In addition, the Evidence Commission issued reports in 2022 and 2023. A systematic methodology to address societal challenges with EIDM has been constructed in the report. Five types of domestic evidence (data analytics, evaluation, modeling, qualitative insights, and behavioural/implementation research) and four steps in decision-making process (understanding a problem and its causes, selecting an option for addressing the problem, identifying implementation considerations, and monitoring implementation and evaluating impacts) were used to support four types of decision-makers (government policymakers, organizational leaders, professionals and citizens) in EIDM, as demonstrated by the reports. To further disseminate the concept and methodology of EIDM globally, the secretariat works with 25 Evidence Commissioners to write the report, and continues to cooperate with Country Leads Group from 12 countries to conduct rapid evidence-support system assessments (RESSAs), and collaborates with Evidence Commission Implementation Council to accelerate the implementation of 24 recommendations. The main history, core methodology, and latest developments of the Global Committee on Evidence were systematically reviewed in this paper. We aimed to show decision-makers a new version of how to scientifically address the societal challenges of EIDM.
Objective To survey and analyze the quality assessment of the included studies in the Overviews of reviews (Overviews), so as to provide methodology references for Overviews authors. Methods A computerized search was performed for collecting Overviews in The Cochrane Library (Issue 1, 2010), PubMed, EMBASE, and CBM, and the search time ended by December, 2009. Then the relevant data, such as assessment standard etc, were extracted, and the staple standards were analyzed. Results A total of 43 typical Overviews were included. Thirty-two (74.4%) of them assessed the methodology quality of the included systematic reviews with different standards, including OQAQ (34.9%/15), AMSTAR (9.1%/3), Checklist from DARE (4.6%/2), Assendelft scale (4.6%/2), Effective Public Health Practice Project standards (2.3%/1), self-formulated standards (14.0%/ 6), syntaxic standards (2.3%/1), and other standards (4.6%/2). Ten Overviews (23.6%) assessed the quality of evidence, including eight (18.6%) applied the GRADE system. Only 7 studies (16.3%) assessed the quality of evidence and applied the GRADE system as well. Conclusion The quality assessment in Overviews includes the assessment of both methodological quality and evidence quality. But most Overviews do not assess comprehensively. The methodological quality standards applied in current Overviews are numerous and no standard is acknowledged. Yet, the OQAQ and AMSTAR are applied widely and recommended because they are comprehensive and easy to be conducted. It suggests that Overviews authors should choose appropriate methodological quality assessment standards according to concrete conditions. The GRADE system is much more comprehensive and systematic than other systems, so it is recommended that Overviews authors should apply GRADE to assess the quality of evidence in their studies in order to make the study results more comprehensive and easier for clinical application.
Testing Treatments is a book to help the public understand how to validate the efficacy of testing treatments and the possible bias and error in clinical trial, as well as to call for help to promote good study thus to improve the quality of health care. No matter for the first or the second edition, this book is very popular around the world, and its second edition has been translated into more than ten languages. To help the readers understand the content of the book, we established a website (www.testingtreatments.org) and other sibling sites in different languages. The website not only provided the full-texts to download, but also collected various popular science resources (videos, audios and cartoons) to help the readers assimilate more knowledge. The editors of all the different language websites have established an TTi Editorial Alliance to share experience and provide each other with mutual support, thus to promote health professionals, patients and public around the world to use reliable research to inform their health decisions.
Objective To evaluate quality of orthopedic clinical practice guidelines in China by AGREE Ⅱ Instrument. Methods A systematic search of relevant literature databases (CBM, WanFang Data, VIP and CNKI) was conducted to identify the orthopedic clinical practice guidelines of China published up to October 2016. Guidelines selection and data extraction were independently performed by two authors. AGREEⅡ instrument was used to evaluate the quality of the included guidelines. Intra-class correlation coefficient tests were performed to appraise the uniformity of the overall assessment scores. Results A total of 54 guidelines for orthopedics were finally included. The mean scores of six domains by AGREE Ⅱ instrument were 60.44%, 21.40%, 5.17%, 22.17%, 6.02% and 0.56%. The overall intra-class correlation coefficient was 0.84. Conclusion The quality of orthopedic clinical practice guidelines in China was low or moderate in general. The methodology of making guidelines, especially in terms of rigor of development, applicability and editorial independence, should be improved.