Background AIDS (acquired immune deficiency syndrome) has become the most devastating disease which humankind has ever encountered. Human immune-deficiency virus (HIV) is transmitted through blood, sexual behavior and mother-to-baby, with more efficient transmission through blood transfusion. HIV risk among blood transfusion was severe due to lack of effective and correctly applied screening method and rigorous management, especially in some developing countries. Since the first HIV screening reagent was approved by FDA to screen the blood in 1985, the fourth generation test has been produced till now. Initially, HIV test was primarily used to screen the blood supply, it also became an important aspect of HIV prevention, especially screening among people donating blood. Today, HIV testing is seen as an integral part of both the nation’s prevention and treatment efforts. Objective To assess the effectiveness of any intervention tests for HIV screening among people donating blood, and find appropriate tests for HIV screening to decrease the risk of HIV transmission by blood transfusion. Search strategy MEDLINE, Cochrane Controlled Trials Register (CENTRAL/CCTR), AIDSLINE, EMBASE, CBM were be searched with the terms: "HIV", "AIDS", "screening", "test", "blood donor", "blood bank" and the detailed screening method. The websites of WHO, UNAIDS, CDC, FDA, and their related links were searched. Letters were mailed to various agencies and experts in this field to acquire unpublished reports. Inclusion criteria RCT and CCT for screening HIV among blood. donors will be included. Observational studies such as cohort studies, cased-control studies, and historical controlled studies will be used for sensitivity analysis. Method of the review According to the principles of Cochrane Review, selection of trials for inclusion, quality assessment of studies, data extraction and syntheses were conducted by reviewers.
Objective To assess the effect of a new educational model for evidence-based medicine (EBM), which is called "2+N" model with the main characteristic of classroom teaching plus volunteer practice. Methods Questionnaire survey was conducted to collect data. Results There were averagely 39 volunteers participated in this activity per year, with an increasing trend. Most of them were sophomore and junior undergraduates from different specialties in medical filed. All participates acquired a better understanding of EBM knowledge; more than 60% of them could handle data searching, collecting and assessing by themselves in the end of the activity. Conclusion Our five years’ experience of EBM education practice for medical students suggested that the new educational model has a promising future.
Objective To investigate present status of health care in peri-brain-death and analyze its effectiveness and health economic characteristics. Method Retrospective analysis of case series was conducted and a total of 940 patients from surgical intensive care unit (SICU) were reviewed on treatment and part of direct medical expenditure. The patients admitted from Jun. 1999 to Dec. 2000 and Nov. 2001 to Jun. 2002 were included in this study. Data were processed by SPSS 10.0. Results Patients were included if they had two of the three symptoms for at least one hour: deep coma, pupillar light reflex disappear, and no autonomic respiratory. Ultimately 115 patients were included, with a total cost of ￥2 515.9 per day for each case, whereas mortality was 99.10%. Mortality increased with the state of peri-brain-death prolonged. Eighty percent of patients included were dead within 72 hours after admission. Conclusions Attempts to resuscitate patients of peri-brain-death have been the most widely applied in China, however, it resulted in great unnecessary consumption of health resources. It is of great importance to promote legislation of brain death in China.
Objective In light of problems related to the accessibility and affordability of healthcare, we aimed to investigate the status and causes for the shortage of qualified health human resources in the rural and primary health care setting, and to propose solutions to these problems at the level of health policy system. Methods The principles and methods of evidence-based medicine were applied. We developed the study selection criteria on the basis of the proposed questions, and identified relevant literature from biomedical databases and other additional sources. We graded eligible studies, extracted data, and summarized the data to draw conclusions. In addition, we conducted a survey to refine the proposed solutions. Results We identified 147studies from PubMed and CNKI, of which 30were in English. After summarizing the information, and using knowledge about the human resources for health in primary healthcare in China, we proposed a model of resident doctor aid healthcare. The survey that we conducted to assess such a model included interviewees of top level policy makers, medical students and staff in medical universities. Most of the interviewees (85%) thought it was feasible to develop an aid healthcare system. Among those who disagreed, the lack of corresponding policy was the most common factor. Conclusions It is suggested that the government develop relevant policies and make an attempt to practice the aid healthcare system. Emerging problems could be identified and addressed in practice.
Objective To investigate the accurateness and rapidity of information on SARS , and to provide evidence for decision-making in the construction of the public health information system of China, including information collection, identification and release. Method SARS related information was systematically collected, from ① databases including Medline, CBMdisc and Cochrane Library; ② official websites including WHO, MOH and CDC; ③ non-governmental websites including Sina, Sohu, Yahoo; ④ eleven Chinese Journals and ⑤ gray literatures, These evidence were graded based on their scientific sense, and were analyzed according to their rapidity of release. Results A total of 11 955 pieces of related information were collected. Non-governmental websites were the agents that released the largest number of information (46.7%). Regarding the scientific sense of evidence, hand searched journal was at the top of the evidence pyramid, and followed by Medline, gray literature, CBMdisc, official and non-governmental websites. Regarding the rapidity, official website achieved the most rapid information release, which was followed by nongovernmental website, journal, and database. 71.8 percent of information from official websites was in Chinese, while 65 percent was from database. Conclusions The SARS information from China has contributed enormously to the global information release. Although the amount and rapidity of the information were satisfied, management and deep processing of information should be improved.
Objective To provide scientific evidence for the establishment of medical specialist system in China by investigating the history, current situation, problems and countermeasures of medical specialties training at home and aboard. Method The principle and theroy of evidence-based medicine were adopted. The information before Dec. 31, 2003 of Pubmed, CBM, official website, some journals, most frequently used search engines and medical monograph were systematically reviewed. Included literatures were assessed and graded according to the pre-defined criterias. Results A total of 1 319 studies (1 298 in English, 21 in Chinese) were included, among which only 6 were related to the classification of medical specialties. Based on the information from official website of USA, Canada, UK, Singapore, Australia and China (including HK and Taiwan), it showed that China has the largest number of medical specialties, followed by that of USA. In China, the number of medical specialties has more than that of the disciplines in clinical field, which was followed by resident training programs. Some specialties were duplicate, or not international standardized. Conclusions The classification of medical specialties should be developed consecutively, which comprehensively considered the international trend, characteristics of doctor training and the current situation. Specialties whose training program are well-established and developed should initiate firstly. Others will be put into practice gradually after being fully exprienced.
Objective To provide evidence for the construction of municipal public health system in Chengdu based on the existing problems. Method Using the priniple and method of evidence-based medicine, epicemiology and health care management, and the data searching, extraction and envaluation to analyse the current situation and problems of Chengdu’s public health system. also referring such research results from home and abroad with the hope of resolving such problems and make suggestions as to how to deal with this. Results There is a few literatures on the municipal public health system. The insufficient financial support, hardware and software condition deteriorated the serious situation of public health in Chengdu. Conclusions It is suggested that we should establish a managing committee of the public health system of Chengdu, make comprehensive plan to set up 6 professional centers, fund the research on main diseases and key techniques, increase financial appropriations by improving financing mechanism and establish a center for education and staff training.
Objective To provide evidence for establishing medical specialist training system in China by evidence-based evaluation on the comparison of medical specialists training programs in different countries in Europe, America and Asia. Methods The principle and method of evidence-based science were adopted. Pubmed, official website (such as Ministry of Health, and medical board), homepages of famous medical universities or teaching hospitals and most frequently used search engines were systematically searched till Mar. 31, 2004. Included literatures were evaluated according to pre-defined standards. Results A total of 878 studies (827 in English, 51 in other languages) were included. The main contents covered clinical courses (43.3%), training quality assessment (13.5%) and existing problems (12.7%). Based on these and information from official website, the process of doctor training could be divided into three stages: residency training, specialist training and continuing medical education, with the characteristics of critical standards and strict examination in each stage. Training programs for neurosurgeon and family practitioner were analyzed. Conclusions Medical specialists training is a systematic project, which needs comprechensive planning and taking all factors (such as requirement of medical care market, diseaseburden) into account . To establishing a connterpart in China, priority should be given to training quality, feasibility and improvability. At the same time, we should change our mind, face the reality, and deal with problems during the interim.