Objective To learn the current situation of traditional Chinese medicine (TCM) systematic reviews/meta-analyses published in Chinese journals. Methods All TCM systematic reviews/meta-analyses published from 1978 to July 31, 2009 were searched in the Chinese Biomedical Database (CBM). According to the inclusion and exclusion criteria, relevant information was extracted on the basis of research purpose. Meanwhile, publication year, journal name, author’s district, number of authors and their articles, types of diseases and interventions were took as the indexes, and then descriptive analysis was performed using SPSS 15.0 software. Results A total of 245 articles including 238 in Chinese and 7 in English were included. All of them were published in 117 different journals from 1998 to 2008, showing an accelerating growth trend of article number. In addition to only one article with first author from Germany, the first author of other 244 were from 24 domestic provinces (autonomous regions and municipalities); the number of authors ranged from 1 to 11; a total of 186 people had published articles as first author, and the number of their published articles ranged from 1 to 29. There were 16 types of diseases according to the International Classification of Diseases 10th Edition (ICD-10). Totally, 218 articles took drugs as interventions (including 106 listed drugs, 25 self-made prescriptions, 70 related to both listed drugs and self-made prescriptions, and 17 without reporting detailed interventions), accounting for 89%; and 27 articles were about non-drug interventions (including 26 about acupuncture and 1 about massage), accounting for 11%. Most (95.8%) of the articles about self-made prescriptions and listed drugs/self-made prescriptions adopted inappropriate pooled analyses. Conclusion Evidence-based medicine has been spread into the field of TCM, the number of TCM systematic reviews/meta-analyses shows an accelerated growth trend. The types of diseases discussed in the literature were almost the same as the diseases those could be effectively treated by TCM, but there existed imbalance in districts. In the future, systematic review/meta-analysis on drug intervention should aim at Chinese patent medicines and single medicines rather than self-made prescriptions, and should pay more attention to advantageous drugs and advantageous treatments of diseases. Moreover, importance should be also attached to clinical heterogeneity controlling when using acupuncture as a non-drug intervention.
Objective To investigate the effect of problem-based learning (PBL) used in the course of evidencebasedmedicine.Methods Totally eight classes were randomly assigned to the lecture based learning (LBL) group(n=4) and PBL group (n=4). The examination scores, questionnaire, and seminars were used to evaluate the teaching effectiveness. SPSS 11.5 software was used for statistical analysis. Results More than 50% of students in each group believed that the teaching method of PBL could activate learning enthusiasm and interest, improve problem analysis and independent study abilities. There were significant differences between the two groups in terms of comprehensive analysis, learning efficiency, digesting the contents of study and strengthening the teacher-student communication, and whether or not to perform PBL teaching. Apart from single choice questions, other types of examination questions and total scores have significant differences. Conclusions The PBL teaching model can effectively train undergraduateclinical thinking, cultivate the abilities of deconstructing problem, comprehensive analysis, literature retrieval, language expression, exploration innovation; and overall improve the teaching quality of evidence based medicine.
Objective Investigate the effectiveness of problem-based learning (PBL) in teaching of evidence-based medicine for undergraduates.Methods Participating students from four of eight classes with major of clinical medicine in Grade 2006 were assigned to the lecture-lased learning (LBL) group (50 students) and the PBL group (46 students), and each group had two classes. The examination scores, questionnaire, and seminars were used in combination to evaluate the teaching effectiveness. SPSS 11.5 software was used for statistical analyses. Results The baseline characteristics were balanced between the two groups because no difference was found in aspects of taking part in literature or information retrieval training, research project, undergraduate starting an undertaking plan and social survey, as well as getting known of evidence-based medicine, clinical epidemiology and PBL. The evaluation results of teaching effectiveness showed that, a) About the examination score, there was a significant difference between the two groups (Plt;0.05); the score of the PBL group was higher than that of the LBL group in aspects of fundamental knowledge, issuing question, retrieving evidence, evaluating evidence, applying evidence and total score; and b) About the attitude towards LML, there was a significant difference between the two groups about whether the LBL was beneficial or not to improve positive study, study interest, participation willingness, aggregate analysis ability, speech ability, self-study ability, information acquisition ability, information analyses and utilization ability, problem analyses and solving ability, combination of theory and clinic, communication between teachers and students, team cooperation and so on; but there was no significant difference between the two groups (Pgt;0.05) in aspects of improving learning efficiency, better understanding theory leader from class, improving writing ability and practicing ability; 97.83% of the students in the PBL group thought that PBL was suitable for themselves which should be introduced into other course teaching; 48.00% of the students in the LBL group thought that the current LBL teaching mode was not suitable for undergraduate, while 28.00% of the students in the LBL group thought that the current teaching mode should get reformed. Conclusion The PBL teaching mode is beneficial for undergraduates to better training clinical thinking, improve the ability of problem construction, aggregate analyses, literature retrieval, language express and exploratory innovation, and fully improve the quality of evidence-based medicine teaching. The PBL teaching method is suitable for teaching of evidence-based medicine for undergraduate medical students.
Objective To investigate inpatient disease constitution in Traditional Chinese Medicine (TCM) Hospital of Xinjiang Uygur Autonomous Region from 2008 to 2010, in order to provide baseline data for medicine allocation of hospitals in western China and development of TCM hospitals. Methods A questionnaire combined with a subject interview was carried out, and the case records of inpatients from 2008 to 2010 were collected. The diseases in discharge records were classified according to International Classification of Diseases (ICD-10) based on the first diagnosis. Data including general information of the inpatients, discharge diagnosis etc. were rearranged and analyzed by Excel software. Results a) The top four systematic diseases seen commonly from 2008 to 2010 were as follows: circulatory system diseases, musculoskeletal system and connective tissue diseases, respiratory system diseases and digestive system diseases. The top four single diseases were hypertension, intervertebral disc disease, diabetes, bronchitis, emphysema and other chronic obstructive pulmonary diseases. Respiratory system diseases ranked the third in 2009 and 2010 from the fourth in 2008, and circulatory system diseases had ranked the first during the past three years; b) The following diseases as hypertension, bronchial emphysema and other chronic obstructive pulmonary diseases, diabetes, fractures, airway (bronchus, lung) cancer, and viral hepatitis were commonly seen in males rather than in females. By contrast, intervertebral disc disease, gallstone disease and cholecystitis, and anemia were commonly seen in females; and c) Hypertension was commonly seen in the aged above 60 years old; intervertebral disc disease mainly focused on the patients at the age of 15 to 59; and bronchial emphysema and other chronic obstructive pulmonary diseases, airway (bronchus, lung) cancer involved in the patients who were mostly over 60 years old. Conclusion a) The top four systematic diseases seen commonly from 2008to 2010 are as follows: circulatory system diseases, musculoskeletal system and connective tissue diseases, respiratory system diseases and digestive system diseases. The top four single diseases are hypertension, intervertebral disc disease, diabetes, bronchitis, emphysema and other chronic obstructive pulmonary diseases. So these diseases should be taken into well consideration when making development plans by hospital and complementing essential drugs list by local development; b) Chronic diseases become the main disease for troubling Xinjiang population; and c) Male and female are susceptible to different diseases which should be rationally avoided in order to prevent the induced occurrence.
Traditional Chinese Medicine (TCM) standardization is an important carrier for TCM inheriting and innovating. As an important content of TCM standardization system, TCM clinical practice guidelines' designation and revision play an important role for medical staff to regulate medical behavior, and improve the quality of health services. This paper expounds the significance and function of the TCM guidelines, analyzes the present situation, opportunities and challenges, and puts forward the strategies and suggestions to promote the development of evidence-based TCM guidelines.
ObjectiveTo understand the current situation and challenges of basic research on respiratory diseases in China.MethodsTo summarize and analyze the application and projects funded in the field of respiratory medicine (Code: H01 and H1615) from National Natural Science Foundation of China (NSFC) during 2010 to 2017.ResultsA total of 2 191 projects of 11 766 applications were funded by NSFC in the field of respiratory medicine and the total subsidy fund reached ￥981 279 000. A total of 1 130 projects of 5 915 applications were funded in the Research Projects, including 1 021 General Program projects, 14 Key Program projects, 16 Major Research Plan projects, 1 Major Research Program project, 2 Program projects of Joint Funds, 30 International (Regional) Cooperation and Exchange Program projects, and 46 Emergency Management Program projects. A total of 1 061 projects of 5 851 applications were funded in the Talent Projects, including 853 Young Scientists Fund projects, 191 projects of Fund for Less Developed Regions, 4 projects of Distinguished Young Scholars, 4 projects of Excellent Young Scientists Fund, and 9 projects of the Research Fund for International Young Scientists. The projects funded were mainly distributed in the field of respiratory inflammation and infection, asthma, chronic obstructive pulmonary disease, pulmonary circulation and pulmonary vascular disease. The top three research directions were asthma (19.0%), acute lung injury and acute respiratory distress syndrome (15.4%), chronic obstructive pulmonary disease (12.7%), pulmonary circulation and pulmonary vascular disease (12.7%) in sequence. Average funding rate of respiratory tumor (application code: H1615) was 17.2%.ConclusionsSince the Department of Health Science of NSFC was established in 2009, with the increasing of NSFC budget, the basic research in the field of Respiratory Medicine has been developed rapidly. With the efforts of scientific researchers and clinical medical workers, research in the field of respiratory medicine will achieve rapid development in China.
Objective To investigate the methodological characteristics of observational studies on the correlation between drug exposure during pregnancy and birth defects. Methods The PubMed database was searched from January 1, 2020 to December 31, 2020 to identify observational studies investigating the correlation between drug use during pregnancy and birth defects. Literature screening and data extraction were conducted by two researchers and statistical analysis was performed using R 3.6.1 software. Results A total of 40 relevant articles were identified, of which 8 (20.0%) were published in the four major medical journals and their sub-journals, 21 (42.5%) were conducted in Europe and the United States, and 4 were conducted (10.0%) in China. Cohort studies (30, 75.0%) and case-control studies (10, 25%) were the most commonly used study designs. Sixteen studies (40.0%) did not specify how the databases were linked. Sixteen studies (40.0%) did not report a clear definition of exposure, while 17 studies (42.5%) defined exposure as prescribing a drug that could not be guaranteed to have been taken by the pregnant women, possibly resulting in misclassification bias. Six studies (15.0%) did not report the diagnostic criteria for birth defects and 18 studies (45.0%) did not report the types of birth defects. In addition, 33 studies (82.5%) did not control for confounding factors in the study design, while only 19 studies (47.5%) considered live birth bias. Conclusion Improvements are imperative in reporting and conducting observational studies on the correlation between drug use during pregnancy and birth defects. This includes the methods for linking data sources, definition of exposure and outcomes, and control of confounding factors. Methodological criteria are needed to improve the quality of these studies to provide higher quality evidence for policymakers and researchers.
ObjectivesTo investigate sources of evidence of the clinical pathways approved by the Chinese government.MethodsThe approved clinical pathways were obtained from the website of the National Health and Family Planning Commission. Two reviewers independently extracted the basic information, approval date, types of evidence of the clinical pathways and time of evidence. The variance analysis was performed for the diagnosis and treatment parts of clinical pathways and the LSD method was further used for comparison.ResultsThe main types of evidence were guidelines, textbooks, standard indicators and consensus views. Approximately 80% of the pathways cited clinical practice guidelines and 36% cited the textbooks. The median number of evidence for each clinical pathway was 2. Approximately 85% of the evidence could be obtained the time when the evidence published. The average time interval (between the time when the pathways released and the time when the evidence published) was 5.2 years. Specifically, textbooks constituted the largest proportion in all evidence that was over 15 years of time interval. In addition to the textbook comparison standard indicators, there were significant differences in time interval between guidelines or consensus and textbooks or standard indicators.Conclusions The evidence types selection is based on the concept of evidence-based medicine, yet the time span of the referred evidence is larger. Therefore, developing clinical pathways not only need to refer to the latest research evidence comprehensively and enhance transparency of clinical pathways, but also use evidence quality evaluation standards to evaluate and select the referred evidences.
Objective To compare the survey results of the 8-year program students of clinical medicine discipline before and after the implementation of system-based integrated course reform, to provide feedback for system-based integrated course reform. Methods The questionnaire survey was continuously conducted for 2 years among the 8-year program students in grade of 2005 and 2006, so as to investigate their attitudes towards the integrated clinical courses, then relevant improvement of teaching measures were performed according to their feedback, and the difference of teaching effects between those 2 years was finally compared. Results A total of 79 students in grade 2005 and 78 students in grade 2006 were investigated. The baseline data were matched between the 2 grades. The results of statistical analysis showed that, the overall cognition (χ2=32.924, Plt;0.000 1) and assessment (t=?2.900, P=0.004) of integrated courses among students in grade 2006 got more improved in comparison with the students in grade 2005, and more students tended to select integrated courses, but there was no statistical difference. Conclusion Although system-based integrated clinical course as a new thing has its limitations, the reform idea and direction are still approved by students, so it is worth popularizing.