Primary bronchopulmonary carcinoma occurs in the bronchial mucosa epithelium, also called lung cancer (LC), and has currently become the first cause of death of malignant tumors in China. With constant efforts of Chinese physicians, the diagnosis and management of LC has made certain progress, but standardized surgery for LC still varies to a great extent due to difference regions, nature of medical centers, and technical levels. Complete and standardized surgical resection can provide good long-term survival for patients with stageⅠ, Ⅱand partly ⅢA LC, and cannot be a substitute for other treatment, which shows the importance of standardized surgery. As the most solid member, surgery plays a decisive role in comprehensive multidisciplinary treatment of LC. Today's medical development requires thoracic surgeons to provide most standardized and individualized treatment with principles of evidence-based medicine. This review focuses on progress of standardized surgery for stage Ⅰto ⅢA LC.
The American Thoracic Society Committee Task Force on Standards for Pulmonary Function had recommended a standardized reporting format for pulmonary function tests due to considerable variability in pulmonary function reports presented to end users, which might lead to potential confusion and miscommunication. This recommendation includes seven parts: overview, introduction, methods, report format, selecting and reporting reference values, grading the quality of pulmonary function tests and conclusions. This document presents a reporting format in test-specific units for spirometry, lung volumes, and diffusing capacity that can be assembled into a report appropriate for a laboratory’s practice. Recommended reference sources are updated, with especially emphasizing to adapt lower limit of normal (LLN) or z score instead of percent of prediction to estimate the abnormal results. This document provides detail and clear explanation on the recommendations, which might improve the interpretation, communication, and understanding of test results. However, parts of recommendation might not be used directly in our clinical practice owing to some specific conditions in China. We suggest to use appropriate normal predictions from Chinese population, to include small airway parameters such as mid-maximal expiratory flow for early detection of pulmonary function deterioration, and to include inspiratory flow volume curve, as well as strengthen the quality control data and figures in the report format.
The diagnosis and treatment of gastric cancer is a systematic and frameworking medical task in a multidisciplinary manner. New models, new technologies, new regimens, and new drugs have been developed to explore the best strategies to improve the survival of patients with gastric cancer. Here we discussed the research progress and guideline updates in four aspects, including the accurate staging-classification-based treatment strategy, the quality control in the surgery, the rational perioperative neoadjuvant-adjuvant therapies, and molecular classification joint with precision medicine. The purpose is to further promote the standardized gastric cancer management in China and emphasize its importance. From the updates of knowledge and the transformation of understanding and recognition, to the quality improvement, it’s critical to reduce the heterogeneity of the quality of gastric cancer management in China, as well as enhance adherence to guidelines and consensuses.
Data management system is a major factor affecting the quality of clinical trial. Development of data management system include a steering group and data safety and monitoring board, data collection, database, performance of the data safety and monitoring, as well as locking of database. This article provides key issues of the five parts so as to help researchers understand the clinical trial data management system.
ObjectiveTo explore the application effect of standardized management on video-electroencephalogram (VEEG) monitoring.MethodsIn January 2018, a multidisciplinary standardized management team composed with doctors, technicians, and nurses was established. The standardized management plan for VEEG monitoring from outpatient, pre-hospital appointment, hospitalization and post-discharge follow-up was developed; the special quilt for epilepsy patients was designed and customized, braided for the patient instead of shaving head, standardized the work flow of the staff, standardized the health education of the patients and their families, and standardized the quality control of the implementation process. The standardized managemen effect carried out from January to December 2018 (after standardized managemen) was compared with the management effect from January to December 2017 (before standardized managemen).ResultsAfter standardized management, the average waiting time of patients decreased from (2.08±1.13) hours to (0.53±0.21) hours, and the average hospitalization days decreased from (6.63±2.54) days to (6.14±2.17) days. The pass rate of patient preparation increased from 63.14% to 90.09%. The capture rate of seizure onset increased from 73.37% to 97.08%. The accuracy of the record increased from 33.12% to 94.10%, the doctor’s satisfaction increased from 76.34±29.53 to 97.99±9.27, and the patient’s satisfaction increased from 90.04±18.97 to 99.03±6.51. The difference was statistically significant (P<0.05).ConclusionStandardization management is conducive to ensuring the homogeneity of clinical medical care, reducing the average waiting time and the average hospitalization days, improving the capture rate and accuracy of seizures, ensuring the quality of medical care and improving patient’s satisfaction.
Real-world data studies have experienced rapid development in recent years, however, misunderstandings persist. This paper aims to improve practice and promote standardization by updating the categorization of real-world data, proposing two conceptual frameworks for conducting real-world data studies, developing the concepts of research data infrastructure and clarifying the misconceptions on registry database, and discussing future development.
Objective To improve the satisfaction of standardized remote consultation of epilepsy center in patients with refractory epilepsy, and initially establish a standardized remote consultation model of three-level comprehensive epilepsy center. Methods Based on the characteristics of our epilepsy center, we designed a set of standardized remote consultation process of epilepsy center in tertiary hospitals, including sorting out patient data before consultation, improving examination, application of multi-modal technology during consultation, notification of results after consultation, and decision of operation time and method. A total of 209 patients who received remote consultation in our epilepsy center from January 2022 to June 2023 were selected as the observation group, and 150 patients who received offline consultation in our epilepsy center during the same period were randomly selected as the control group. The satisfaction of patients in the two groups on the service of doctors and nurses in consultation and the consultation results were compared. Results Through the application of the new multi-modal remote consultation mode, the number of consultations gradually increased, Compared with the offline consultation mode, there was no significant difference in patients' satisfaction with the service of doctors and nurses in remote consultation mode (P<0.05). Conclusion The establishment of standardized remote consultation mode in epilepsy center has effectively reduced the economic burden of patients, simplified the medical treatment process and improved the service quality, but the consultation quality has not been affected.
Traditional Chinese medicine equipment plays an indispensable role in the prevention, diagnosis, treatment and rehabilitation of traditional Chinese medicine from the needs of people's life and health, and provides technical support for the simple, convenient, cheap and effective clinical practice of traditional Chinese medicine. The traditional Chinese medicine equipment industry has the development advantages of large demand gap, strong policy support and emerging technology empowerment. At the same time, there are also bottlenecks such as lagging standardization construction, weak industrial foundation, insufficient characteristics of traditional Chinese medicine and immature evidence-based evaluation research. The coming of the era of digital intelligence has brought new opportunities for the development and reform of the traditional Chinese medicine equipment industry. This paper provides development ideas for the transformation of traditional Chinese medicine equipment from traditional to modern from the aspects of standardization construction, digital intelligence industry upgrading, improvement of evidence-based evaluation system and in-depth international exchanges and cooperation.