Objective To evaluate the quality of evidence of systematic reviews or meta-analyses regarding outcomes in nursing field in China using the Grade system, so as to get known of the status of the quality of evidence and promote the application of the evaluation of the quality of evidence of systematic reviews. Methods The quality of evidence regarding the included outcomes was input, extracted and qualitatively graded, using GRADEpro 3.6 software. Then, we carefully analyzed and elaborated the factors of downgrading and upgrading that affects the quality of evidence in the process of evaluation. Results 53 systematic reviews or meta-analyses involving 188 outcomes were identified and evaluated. The results showed that high, moderate, low and very low levels of quality of evidence were 2.7%, 27.1%, 51.1%, and 19.1%, respectively; and low-level quality of evidence accounted for the most. Conclusion The quality of evidence produced by systematic reviews or meta-analyses in nursing field in China is poor and urgently needs improvement. The reviewers should abide by the methodological standards in the process of making systematic reviews or meta-analyses. The quality of evidence in terms of each outcome should be evaluated and fully reported.
Objective To survey the current situation of the systematic review (SR)/ meta-analysis (MA) related to interventions published in the Chinese medical journals entitled with evidence-based. Methods According to the inclusion and exclusion criteria, the Journal of Evidence-Based Medicine (2001.1 to 2011.12), the Chinese Journal of Evidence-based Medicine (2001.1 to 2011.12), the Chinese Journal of Evidence Based Pediatrics (2006.1 to 2011.12) and the Chinese Journal of Evidence-Based Cardiovascular Medicine (2008.1 to 2011.12) were searched for SRs/MAs related to interventions. Two reviewers extracted data independently using predesigned a data extraction form, crosschecked data, and discussed to solve discrepancy. Excel software was used to for statistical analysis. Results A total of 487 SRs/MAs were included. 379 (77.82%) SRs/MAs were published in the Chinese Journal of Evidence-Based Medicine, 70 (14.38%) in the Journal of Evidence-Based Medicine, 30 (6.17%) in Chinese Journal of Evidence-Based Pediatrics, and 8 (1.63%) in the Chinese Journal of Evidence-Based Cardiovascular Medicine. The number of SRs/MAs published generally increased during 2001 to 2011. The number of author of SRs/MAs was 5±2, the number of studies that included randomized controlled trials (RCTs) of SRs/MAs varied from 1 to 129 (median: 8), involving 20 diseases. 83 (17.04%) SRs/MAs focused on neoplasms, 64 (17.04%) on diseases of the circulatory system, and 54 (11.09%) on diseases of the genitourinary system. 82.75% of the included 487 SRs/MAs assessed the methodological quality of included RCTs. 44 (9.03%) SRs/MAs mentioned the methods of quality assessment, without reporting the results. The Cochrane Collaboration’s tool for assessing risk of bias was the most frequently used for evaluation (314 SRs/MAs, 64.48%). Conclusion The number of SRs/MAs related to interventions published in the journals entitled with evidence-based is increasing generally and their topics are extensive. However, further studies should be improved in the aspects of selecting and applying the quality assessment criteria of randomized controlled trials.
Objective To review the clinical evidence of Pingxiao Capsule for tumor adjuvant treatment so as to provide some decision-making references for clinical practice. Methods We electronically searched CBM, CNKI, VIP, WanFang Data and MEDLINE (from inception to Feb, 2013) to collect the randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) about Pingxiao Capsule for tumor adjuvant treatment. Then, the included studies were summarized and evaluated according to the classification of diseases. Results 1 097 potential relevant articles were searched. We included 41 RCTs and 15 non-RCTs. The results showed that Pingxiao Capsule used as an adjuvant therapy in treating tumor improved the efficacy and reduced the side effects of radiation and chemotherapy, and also improved the quality of survival. Conclusion Current evidence showed that the effectiveness and safety of Pingxiao Capsule combined with radiation or chemotherapy in the tumor treatment is superior to radiation monotherapy or chemotherapy monotherapy. But due to the limited quality of the included studies, the results needed to be further verified by high-quality studies.
Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means to integrate individual clinical expertise with the best available external clinical evidence from systematic research. So evidence and its quality is the key issue of evidence-based medicine. The purpose of this article is to introduce to the healthcare professionals the sources of evidence and how to search for evidence for them.
Objective To assess the effectiveness and safety of one kind of ACEI—Ramipril, for providing proofs for clinical implement and we also tried to explore the practical method of evidence-based drug assessment. Method By using the methods and principles of systematic review (SR), and health technology assessment (HTA), we searched Medline and Cochrane Library, together with related materials provided by pharmaceutics and collected all the published clinical research reports on Ramipril. Based on principles of SR and HTA, we assessed all the included reports comprehensively. Results We totally collected 214 articles about Ramipril, in which there were 18 articles meeting the inclusion criteria and 31 139 patients were enrolled in these studies. The research contents include: hypertension, diabetes mellitus, heart failure, myocardial infarction, nephropathy and secondary prevention for cardio-cerebral vascular disease. Conclusion According to our clinical evidence assessment, Ramipril is an effective, safe and easy to take drug and is worthy to spread.
Objective To investigate problems in applying clinical epidemiology and evidence-based medicine in the field of dentistry in China. Method In early April of 2001, about 200 copies of a questionnaire were sent to chief editors of dental journals, directors and famous experts of the university dental schools and/or dental departments of the provincial/metropolitan hospitals located in the mainland of China. The sent back questionnaires were summarized and analysized. Results At the end of June, 2001, 40 replies from the experts of 12 universities and one metropolitan dental hospital were received. The main points are summarized as following: EBM in China is at starting stage of "anti-illiteracy" campaign. There are 6 out of 12 universities having delivered clinical epidemiology courses to postgraduates (2 to undergraduates), only 3 added lectures on evidence-based medicine to dental students and/or professionals, only one university held intensive training courses on EBM to clinicians. In dental practice there are still scram dentists making decisions simply by experiences. In the research practice some dentists are eager for quick success, and instant benefits, ignoring, scientific design aid quality control of the studies. Randomized controlled clinical trials are seldom appeared in Chinese dental journals. To popularize EBM in all dental clinicians is important for them to use and produce the best evidences. Conclusions EBM in dental field of China is at starling stage. Collection and dissemination of best dental evidences in dental professionals is a key to raise the dental care levels in China.
Evidence and its quality are of the key issues in evidence-based medicine. The Cochrane Library is an electronic publication, updated quarterly every year in CD-Rom and internet format, designed to provide high quality evidence to inform people receiving care, and those responsible for treating, teaching, research and administration at all levels. This paper aims to help readers how to access its information as well.
In this paper, we introduce meaning and purpose of confidence interval (CI) in evidence-based medicine, For example, RRR ,ARR ,NNT. It s referance for user and doer of EBM in China.
With the dissemination and popularization of EBM around the world, the evidence-based laboratory medicine has boomed gradually. However, the substantial researches in tbe field are still inadequale now. Based on the facts of hospital laboratory medicine, this article discussed the feasibility that apply the rationale and methods to orient the laboratory quality control.
To overview the methodology and procedure used in developing evidence-based guidelines for migraine headache, the article described the two procedures systematically: 1. the Methods used in the Agency for Health Care Policy and Research’s Technical Reviews. 2. US Headache Consortium’s Methods used in developing clinical guidelines