With vigorous development of the Evidence-Based Practice (EBP), systematic review as a reliable basis for decision making is becoming more and more important, especially in emergent and significant situation under the influence of various interferences. But there are many misunderstandings and fallacies in systematic review beyond medical field, which block the spread and application of systematic review in health system decisions. This paper takes the evidences of health intervention practice as examples, explores the functions of systematic review in health system decisions, tries to clarify these misunderstandings and fallacies, and so as to promote the development of systematic review.
ObjectivesTo survey the domestic research situation of evidence-based education through visual studies. To summarize the utilization of education evidence in China and promote the process of evidence-based practice concepts and methods application in social science fields, so as to facilitate the domestic evidence-based research towards more scientific and practical. Methods WanFang Data and CNKI databases were searched to collect evidence-based education literatures from inception to December, 2017. Tableau and UCINET software were used to conduct visual and co-word analysis of study types, regions, staff, time, foundation/government support and key words. The social evidence based research situation was sketched. Results A total of 54 literatures were included. Beijing and Guangdong province published the most literatures, followed by Zhejiang province and Tianjin municipality. The quantity of literatures published in 2014 reached the peak of 11 articles, followed by 2016 and 2017, and relatively few in remaining years. We found that " evidence-based pedagogy” owned the highest frequency through building core keywords matrix. Conclusions Evidence-based education in China is still at an early stage. Introduction and promotion is currently the main content. There exists problems remaining in the development of evidence-based education, for instance disjointedness of theory and practice, regional unbalance, and deficiency of original-research. It is still a long way to go.
Objective To get known the existing problems in rural primary physicians training in Gansu province, so as to explore an appropriate training mode for Gansu province. Methods This study conducted a comprehensive analysis by combining literature analysis, on-site survey and interview. Such databases as CNKI, VIP and CBM were searched to include literature published before November 2011, and the references of the included literature were also retrieved. The qualitative analysis was performed after assessing the methodological quality of the included literature according to self-designed criteria. Additionally, the rural primary hospitals in Gansu province were classified according to their geographical position and economic development level, total 10 township hospitals were randomly selected by cluster sampling, and the following stuffs participated various trainings in past 3 years were on-site-investigated: clinical doctors, nurses, medical technicians, and medical administrators, in aspects of training time, place, contents, modes, and effects. Results The existing problems in primary physicians training modes in Gansu were as follows: uneven training levels, lack of targeted contents, neglect of skill training and process management, and absence of quality assessment of training processes and effects. Conclusion The training modes require that: a) specific plans and schemes; b) unified organization to integrate educational resources effectively; c) reasonable arrangement of implementation process, and d) innovation of training methods and contents to fully play the role of general hospitals and universities; and well control and feedback to promote the integration and perfection of training modes.
Objective To review published literature on telemedicine in China using qualitative analysis. Methods Such databases as CBM, VIP, CNKI, and CSSCI were electronically and comprehensively searched for clinical studies related to telemedicine from inception to March 2013. References of the included studies were also retrieved. Two reviewers independently identified the literature according to inclusion and exclusion criteria, extracted data, and assessed the quality of the included studies. Then, qualitative analysis was performed in aspects of the application fields, range, and effects of the included studies. Result Finally, 19 studies were eligible for the analysis, including 16 quasi-randomized controlled trials and 3 observational studies. According to methodological evaluation standards (JBI, 2005), among 16 quasi-randomized controlled trials, 12 were of medium quality and four were of low quality; and 3 observational studies were all of low quality. The results of qualitative analysis showed that, literature on telemedicine had increased by year since 1995. However, the literature on relevant research of telemedicine had been published since 2002. The number of literature increased evenly and sporadically in journals. According to the classification of the application fields of telemedicine, 15 (80%) related to remote monitoring, especially related to remote fetal monitoring, 4 (21%) were remote consultation, and 3 (16%) were remote treatment. The results of 19 studies showed that, telemedicine had better effects than traditional medicine. Conclusion In China, literature related to telemedicine increases by year but the quality of them are low. High quality studies are further needed. The distribution of the application fields of telemedicine is uneven, most of which focuses on remote monitoring. The quality of research is low and need high-quality research in future. The therapeutic effects of telemedicine are better with accurate monitoring data and convenience to patients..
Objective To assess the effectiveness and safety of Weifuchun for chronic atrophic gastritis. Methods Trials were located through electronic searches of The Cochrane Library (Issue 3, 2007), EMbase (1974 to June 2007), PubMed (1966 to June 2007), CBM (1978 to June 2007), CNKI (1994 to June 2007) and VIP (1989 to June 2007). Randomized controlled trials (RCTs) and quasi-RCTs of Weifuchun for chronic atrophic gastritis were included. A critical quality assessment and Meta-analysis were performed for the included studies. RevMan 4.2.2 was used for statistical analysis. Results A total of 8 trials involving 816 patients were included. Meta-analysis showed that compared with the control group, Weifuchun for the CAG treatment group had superiority in many aspects such as effective rate according to Gastroscopy (RR 1.54 and 95%CI 1.31 to 1.81), effective rate according to Patho-check (RR 1.99 and 95%CI 1.54 to 2.58), adverse events, remission rate based on clinical symptoms (RR 1.47 and 95%CI 1.30 to 156), remission rate based on a single symptom, curative effect with IM/ATP, HP darkening rate (RR 1.26 and 95%CI 1.02 to 1.56), situation of hemoglobin change and so on. No RCTs were found to describe the safety of Weifuchun for CAG. Conclusion Because of low quality and small samples, there is no enough evidence on Weifuchun for chronic atrophic gastritis. More largescale multi-center randomized trials are needed to investigate the role of Weifuchun for chronic atrophic gastritis.
Objectives To systematically review the efficacy and safety of non-systemic lymph dissection (NSMLD) vs. systemic lymph dissection (SMLD) for early stage non-small cell lung cancer (NSCLC). Methods PubMed, EMbase, Web of Science and The Cochrane Library databases were searched online to collect randomized controlled trials (RCTs) and non-randomized controlled studies (NRCTs) of NSMLD vs. SMLD for NSCLC patients from inception to October, 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 16 studies (4 RCTs and 12 NRCTs) involving 4 718 patients were included. The results of meta-analysis showed that: Compared with the SMLD group, the NSMLD group had higher mortality (HR=1.23, 95%CI 1.11 to 1.37, P<0.000 1). There were no significant differences in disease-free survival, local recurrence rate, distant metastasis rate, and safety between two groups. In addition, the NSMLD group had shorter operation time, and lower drainage and blood loss. Subgroup analysis was performed according to operation methods. The results showed that: NSMLD group by lymph node sampling (LN-S) had higher mortality than SMLD group (HR=1.43, 95%CI 1.17 to 1.75,P=0.004), NSMLD group by lobe-specific lymph node dissection (L-SLD) did not have higher mortality. Conclusions Current evidence shows that: compared with SMLD, NSMLD by L-SLD do not have higher mortality in early stage NSCLC patients, while NSMLD by LN-S have higher mortality. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
Since the appearance of the concept of evidence-based medicine in 1992, its advanced conception and scientific method has been widely applied in various social science fields, and several sub-disciplines were formed such as evidence-based management, evidence-based education, and evidence-based social work and so on. However, there has been no studies to review its history and condition until now. The purpose of this study was to introduce the evidence-based social science in terms of its origin, development conditions, challenges and strategies. We hope it can serve as reference for research and policy makings in the fields of social science in China.
The main task of Campbell Collaboration is to collaborate with Cochrane Collaboration so as to produce high quality evidence for the social welfare, education, justice and criminal, international development policy and other social sciences. This article systematically introduces Campbell Collaboration, its origins, achievements and development, with the purpose of allowing more scholars understand evidence-based ideas and methods of social science, providing evidence-based methodology basis for China's social policy.
ObjectiveTo systematically review the efficacy of discharge preparation service in elderly patients with chronic diseases.MethodsCNKI, WanFang Data, VIP, Web of Science, The Cochrane Library, PubMed and EMbase databases were electronically searched to collect randomized controlled trails (RCTs) on the discharge preparation service for elderly patients with chronic diseases from January, 2000 to January, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 7 RCTs, involving 884 patients were included. The results of meta-analysis showed that: after the hospitalization preparation service, the incidence of acute complication (RR=0.38, 95%CI 0.15 to 0.98, P=0.04), patient compliance behavior (SMD=0.54, 95% CI 0.25 to 0.83, P=0.000 3), exercise capacity (SMD=2.65, 95%CI 0.25 to 5.04, P=0.03), and nursing satisfaction (SMD=0.71, 95%CI 0.10 to 1.33, P=0.02) significantly improved. However, there were no significant differences in emergency hospital admission for acute complications (RR=0.25, 95%CI 0.06 to 1.11, P=0.07), self-care ability (SMD=2.18, 95%CI −1.02 to 5.38, P=0.18), activity of daily living (ADL) (SMD=0.56, 95%CI −0.47 to 1.59, P=0.28).ConclusionsThe current evidence shows that after implementation of the discharge preparation service, the incidence of acute complication, compliance behavior, exercise ability, and service satisfaction of the elderly patients with chronic diseases are significantly improved. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.
The development of evidence-based social care guidelines need to follow certain standards and procedures, the process must be objective, fair, and transparent to ensure that guidelines are developed, scientific, timely, and available. Currently, many organizations have issued standard methods for developing guidelines, but the methods are mainly focused on clinical practice, and few methodological studies on the development of social care guidelines. To promote the development of evidence-based social care guidelines in China and strengthen the transformation from research to practice, this article is based on the "Social Care Guidance Manual" published on the NICE website, combined with the actual situation of domestic social care, inviting domestic evidence-based social science research experts to discuss and specifically introduce the development methods of evidence-based social care guidelines, and this article takes the "Guidelines for Providing Social Work Services to Adults with Complex Needs" as an example, interpreting the process for developing guidelines to make the guide development method more transparent.