ObjectiveTo investigate the effects of two different oxygen therapies (oxygen time<4 h/d, oxygen flow>6 L/min versus oxygen time>4 h/d, oxygen flow<6 L/min) on conservative treatment of spontaneous pneumothorax by meta-analysis.MethodsThe following electronic databases as PubMed, The Cochrane Library, Web of Science, Chinese Biomedical Literature Database, WanFang Database and China National Knowledge Database were retrieved on computer for randomized controlled trials (RCTs) of comparing two different oxygen therapies (oxygen time<4 h/d, oxygen flow>6 L/min versus oxygen time>4 h/d, oxygen flow<6 L/min) on conservative treatment of spontaneous pneumothorax. The retrieval time was from inception of each database to December 2017. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then data were analyzed by RevMan 5.3 software.ResultsA total of 4 RCTs involving 226 patients were included. The meta-analysis showed that compared with lower oxygen flow (oxygen time>4 h/d, oxygen flow<6 L/min), the higher oxygen flow (oxygen time<4 h/d, oxygen flow>6 L/min) could obviously decrease the degree of pulmonary compression after oxygen therapy for 5 days (MD=–2.81, 95%CI –4.18 to –1.44, P<0.05), shorten duration of hospital stay (MD=–3.26, 95%CI –6.05 to –0.47, P<0.05) and duration of recruitment maneuvers (MD=–2.78, 95%CI –5.27 to –0.28, P<0.05), but there was no significant difference in oxygen partial pressure after oxygen therapy for 5 days (MD=10.68, 95%CI –7.03 to 28.39, P=0.24).ConclusionThe higher oxygen flow (oxygen time<4 h/d, oxygen flow>6 L/min) can obviously decrease the degree of pulmonary compression after oxygen therapy for 5 days, shorten duration of hospital stay and duration of recruitment maneuvers, but the results are influenced by the number and quality of RCT.
Objective To analyze the research status and development trend of evidence-based social sciences, and to explore the synergistic relationship among branches of various fields. Methods A comprehensive search for research related to evidence-based social sciences published between the establishment of the database and September 2022 was conducted on the Web of Science, China Science Citation Database (CSCD), and Chinese Social Sciences Citation Index (CSSCI). The VOSviewer software was used to analyze the author and keywords and to perform the visualization. Results A total of 6 969 papers were included, 195 of which were in Chinese. The first paper, published in 1995, was on evidence-based management. The number of papers published on evidence-based social science research presented a trend of increasing continuously. The country with the most papers published was the United States; the institution outside China with the most papers published was McMaster University; and the institution in China with the most papers published was Sichuan University. The analysis of keywords showed that evidence-based policy, evidence-based practice, evidence-based management, and evidence-based decision-making appeared more frequently; research questions focused on evidence-based health policy development, application of big data in the context of COVID-19, evidence of climate change-induced disease, and real world research. Conclusion All the fields of evidence-based social sciences are closely related to each other in terms of research content and methods, and it presents a multi-level and multi-field crossover with evidence-based medicine. However, evidence-based social sciences in China are still in their infancy. Therefore, it is necessary to improve the methodological system of evidence-based social sciences, enrich the research content of social sciences, speed up the filling of evidence gaps in various fields, and promote the improvement and sustainable development of evidence-based social sciences.
Objective The effectiveness of systematic identification, description and evaluation of dietary sugar reduction strategies through the evidence diagram method. Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Web of Science and Cochrane Library database were electronically searched to collect systematic reviews/meta-analysis on the effectiveness of dietary sugar reduction strategies from inception to November 10, 2022, AMSTAR-2 was used to evaluate the methodological quality of the included studies. Microsoft Excel 2019 was used to design a data extraction table to extract relevant key information. Bubble charts were used to comprehensively present information such as study population, intervention type, number of primary studies included, and outcome measures. Results A total of 11 papers were included, all of which were systematic reviews/meta-analysis. The studies included ten interventions. Among them, the research ending of behavioral changes strategies, healthy diet, sugar tax, material substitution, sugar label, and community intervention showed obvious effectiveness, while social cognitive models, sugar reduction guidelines, health literacy, and knowledge attitude behavior models had not shown a clear and beneficial effect, indicating that the intervention effect on the theoretical basis was very small. Conclusion The current evidence diagram shows that the sugar reduction strategy is effective, but there are also intervention conclusions that the effectiveness of the conclusion is not clear and intervention blank. And based on the theoretical dietary sugar reduction strategy, the validity evidence is relatively scarce. In the future, high quality research will still be required.
Objective To systematically review the differences of selenium levels in environment between endemic and normal regions and in patients with Kaschin-Beck disease and health people. Methods Such databases as PubMed, The Cochrane Library (Issue 8, 2013), EMbase, ISI Web of Knowledge, CNKI, CBM, VIP and WanFang Data were electronically searched to August 16th, 2013 for all observational studies about the differences of selenium levels in environment (including soil, water, and cereal) between endemic and normal regions, and in patients with Kaschin-Beck disease and health people (including blood, urine, and hair) were included. Meta-analysisi was performed using RevMan 5.2 software. Results Forty-six controlled studies were included. The results of meta-analysis showed that, selenium levels in water (SMD= –0.99, 95%CI –1.31 to –0.66), soil (SMD= –1.20, 95%CI –1.92 to –0.49), cereal (SMD= –1.94, 95%CI –2.63 to –1.26) and corn (SMD= –1.66, 95%CI –2.33 to –0.98) in endemic region were lower than those in normal region. The selenium in blood (SMD= –1.03, 95%CI –1.54 to –0.53), blood serum (SMD= –0.66, 95%CI –1.01 to –0.31), red blood cell (SMD= –2.75, 95%CI –4.13 to –1.37), urine (SMD= –0.99, 95%CI –1.43 to –0.55) and hair (SMD= –1.67, 95%CI –2.14 to –1.20) of Kaschin-Beck disease patients were lower than those in healthy people. The results of subgroup analysis also showed that significant differences were found between patients and healthy people in endemic region. The selenium in blood (SMD= –6.12, 95%CI –8.58 to –3.66), blood serum (SMD= –1.02, 95%CI –1.34 to –0.69), red blood cell (SMD= –3.37, 95%CI –5.38 to –1.35), urine (SMD= –1.94, 95%CI –2.54 to –1.34), and hair (SMD –3.49, 95%CI –5.32 to –1.66) of healthy people in endemic region were lower than those in normal region. After removing the specific studies on every pooling outcome with high risk of heterogeneity, the results of sensitivity analysis showed that the results were of robustness and the impact due to heterogenicity was fairly low. Conclusion Selenium levels in external environment in endemic region are significantly lower than those in normal region, and patients’ selenium levels in the body are also significantly lower than the healthy in endemic region. The selenium levels of the healthy in endemic region are also significantly lower than those of the healthy in normal region. Current evidence indicated that lack of selenium in external environment might be related to Kaschin-Beck disease.
ObjectivesTo conduct a bibliometric analysis to research the status of disease burden domestically and overseas so as to understand the status of diseases burden, and to provide scientific and reasonable reference for health disease prevention, control strategies formulation and future research.MethodsPubMed, Web of Science, EMbase, The Cochrane Library, WanFang Data, CBM and CNKI databases were electronically searched to collect literature on disease burden from inception to October, 2018. Two reviewers independently screened literature and extracted data. EndNote X7 software was used for literature management, Excel 2016 software and VOS viewer software were also used to analyze data. Literature was classified by the aspects of literature publication characteristics, diseases, background areas, influencing factors, evaluation indicators and poverty caused by illness.ResultsA total of 325 studies were included in the bibliometric analysis. 41 articles (12.6%) were published in journals indexed by SCIE; original research evidence accounted for 97.0% (315 articles); 272 articles were from China (83.7%). The main diseases involved were malignant tumors (58 articles, 17.8%), diabetes (29 articles, 8.9%) and hypertension (24 articles, 7.4%). Factors affecting the disease burden primarily included hospitalization days (9 articles, 2.8%), complications (5 articles, 1.5%), delays in treatment (5 articles, 1.5%), and economic income (4 articles, 1.2%). Sixity-one articles (18.8%) reported poverty due to illness, and related diseases were chronic obstructive pulmonary disease (12 articles, 3.7%), hypertension (10 articles, 3.1%), diabetes (10 articles, 3.1%), malignant tumors (9 articles, 2.8%) and hepatitis B (6 articles, 1.8%).ConclusionsAt present, the disease burden research are focusing more on the burden of chronic non-communicable diseases such as malignant tumors, hypertension, diabetes, cardiovascular and cerebrovascular diseases in developing countries and regions. Medical costs vary from different diseases and treatment, different demographic characteristics of patients, and the coverage medical security of different population are the primary reasons for the " expensive in medical treatment” of current residents and the heavy burden of disease. DALY and total direct medical expenses are the main evaluation indexes of epidemiological burden and economic burden of disease, respectively. Future researches should focus on strengthening the scientific nature of study design to improve the quality of research, as well as paying more attention to diseases and aspects that are rarely involved, such as major diseases caused by poverty due to illness, comprehensive analysis of multiple diseases and aspects of health investment measurement, and comprehensively use the evaluation indicators of disease burden to strengthen the research on the comparability index of disease economic burden.
ObjectiveTo systematically review the efficacy and safety of acupuncture on postpartum depression (PPD).MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of acupuncture in treatment of PPD from inception to February 2021. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using Stata16.0 software.ResultsA total of 13 RCTs involving 899 patients were included. The results of meta-analysis showed that there was no significant difference between hand acupuncture and fluoxetine hydrochloride in HAMD score (MD=0.45, 95%CI −0.52 to 1.41, P=0.36), clinical effective rate (RR=0.93, 95%CI 0.70 to 1.23, P=0.59), and clinical cure rate (RR=0.88, 95%CI 0.44 to 1.76, P=0.73). However, hand acupuncture was superior in safety to fluoxetine hydrochloride (RR=0.04, 95%CI 0.01 to 0.28, P<0.05). There was no significant difference in clinical effective rate (RR=1.08, 95%CI 0.87 to 1.36, P=0.49) and cure rate (RR=1.31, 95%CI 0.84 to 2.04, P=0.24) between both groups.ConclusionsThe current evidence shows that there are no differences between hand acupuncture and non-acupuncture in reducing HAMD score, improving the clinical effective rate and clinical cure rate. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
N-of-1 trials are prospective clinical randomized cross-over controlled trials with multiple rounds of trial phase alternation designed with regard to a single patient. N-of-1 trials can provide clinical decision-makers with high-level evidence of the comparison of effect of intervention measures. Recently, an international team composed of many scholars published a SPIRIT extension for N-of-1 trials list (SPENT 2019) on the BMJ, with the purposes of clarifying the content design and improving the integrity and transparency of N-of-1 trial protocols. This article showed a detailed interpretation of the 14 main extension sub-items of the SPENT 2019 list with specific cases, aiming to further standardize the publication of domestic N-of-1 trials.
ObjectiveTo select the key questions of the reporting quality of acupuncture therapy network meta-analysis. MethodsA question pool about reporting quality of acupuncture therapy network meta-analysis was conducted by preliminary literature research and qualitative systematic review. A correspondence questionnaire was designed and the selection of key questions was carried out through two rounds of expert consultation using the Delphi method. ResultsA total of 21 key questions were selected for the network meta-analysis report standard of acupuncture, including whether to report details of acupuncture interventions (e.g., needle type, acupoints used, number of needles inserted, depth of needle insertion, retention time, needling techniques, and treatment duration), diagnostic criteria for diseases or traditional Chinese medicine syndromes, and qualifications of acupuncture practitioners. Of these, the only three key questions answered by the preferred reporting items for systematic reviews and network meta-analysis (PRISMA-NMA) were summary, protocol and registration, and source of funding, while the remaining 19 were specific to acupuncture-related report standards. ConclusionThe conducted key question on reporting guideline of acupuncture network meta-analysis can improve the standardization and rigor of relevant research and better utilize its academic and clinical value.
ObjectiveTo biliometric analysis of the status quo of tracking rural health service quality, evaluation and supervision mechanism, in order to improve the quality of rural health service, optimize the allocation of resources and increase the quality and level of health service of rural medical staff. MethodsWe searched PubMed, The Cochrane Library (Issue 3, 2016), The Campbell Library, Web of Science, CBM, CNKI, and WanFang Data, as well as relevant websites up to March 2016. EndNote X7 software and Excel 2007 software were used for screening literature and analysis data. ResultsA total of 39 studies were included in the biliometric analysis. Eighteen studies were cross-sectional studies (46.2%), 18 were reviews (46.2%), 2 were cluster randomized trials (5.1%) and 1 was randomized controlled trial (2.6%). Thirteen studies were published in journals indexed by Science Citation Index, 3 were published in journals indexed by Chinese Science Citation Database, 18 were published on other peer-review journals, and 5 were thesis's. The involved theoretical models were as follows: 10 mechanisms (30.8%), 4 frameworks (18%), 11 systems (30.8%) and 12 methods (30.8%). The serviceable range included village clinics (n=3, 7.7%), town-level hospitals (n=3, 7.7%), and community (n=2, 5.1%). The research topics included public health (n=19, 48.7%), clinical care (n=16, 41%), medical insurance (n=4, 10.3%). ConclusionThe studies for rural health service quality tracking, research evaluation and supervision mechanism are still lack of systematic, pertinence and practicability, and the level of evidence is still low. We suggest pay attention and strengthen the rural health service quality tracking, research evaluation and supervision mechanism, and to provide effective evidence for effective evaluation and supervision to promote rural health service quality, and to promote the reasonable optimization the allocation of health resources in rural areas, and to greatly improve the quality and level of rural health service.
Evidence-based medicine (EBM) is a compulsory course for clinical medicine. How to use massive open online courses (MOOC) to improve teaching of EBM and teaching effect is what we should think and explore. Based on the practical applications and features of MOOC, this paper introduces conciseness of knowledge points for MOOC of EBM, design of the videos for MOOC of EBM, the preliminary exploration of MOOC in teaching practice. It is hopefully that using application of MOOC to promote the teaching effect for EBM, and promote the educational reform.