ObjectiveTo systematically review the hemostatic effect of traditional class Ⅲ hemostatic powder and aggregate absorbable hemostat in surgeries. MethodsThe PubMed, Embase, CENTRAL, CNKI, VIP and WanFang Data databases were electronically searched to collect controlled studies related to the objectives from inception to September 18th, 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. ResultsA total of 7 randomized controlled trials, 5 cohort studies and 9 animal experiments were included. The results of analysis showed that the group with traditional class Ⅲ hemostatic powder or aggregate absorbable hemostat had a higher hemostatic success rate and shorter hemostatic time than those with no hemostatic material in animal surgeries. And the group with aggregate absorbable hemostat had a higher 10 min hemostatic success rate than those with traditional hemostatic measures. The application of traditional class Ⅲ hemostatic powder in human cardiothoracic surgeries shortened the hemostatic time and reduced drainage after surgeries, but caused more blood loss during knee arthroplasties. Aggregate absorbable hemostat caused less blood loss than traditional hemostatic measures in human hip arthroplasties, and the 5 min and 10 min success rates of aggregate absorbable hemostat group were not worse than those of hemostatic gauze. ConclusionCurrent evidence shows that the hemostatic effect of both traditional class Ⅲ hemostatic powder and aggregate absorbable hemostat are better than that of no hemostatic material in animal and human surgery, but the comparison results between the two and with other hemostatic measures are still not clear. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo construct a comprehensive value evaluation index system for the hospital admission of predicate consumables, providing a reference for the admission evaluation of predicate consumables in hospitals. MethodsAn initial pool of comprehensive value evaluation indexes for the hospital admission of predicate consumables was established through literature research and expert consultation. The evaluation indexes were screened and optimized via two rounds of Delphi expert consultation, and the final admission evaluation index system was determined through an expert consensus meeting, and the analytic hierarchy process was adopted to determine the weights of the indexes. ResultsThe final comprehensive value evaluation index system comprised six first-level indexes: clinical effectiveness (0.372 3), reliability (0.273 3), economic efficiency (0.113 8), hospital management (0.093 1), values and preferences (0.087 2), and enterprise services (0.060 3), along with 14 second-level indexes. Among these, "failure rate" (0.273 3), "safety" (0.215 5), and "effectiveness" (0.156 8) carried relatively higher weights. The effective response rates for the two rounds of expert consultation were 80% and 100%, with expert authority coefficients of 0.86 and 0.92, and Kendall's coefficients of concordance of 0.208 and 0.205, respectively. ConclusionThe hospital admission evaluation system constructed in this study integrates multi-dimensional indexes, which can provide a scientific reference for the admission of predicate consumables in hospitals.
ObjectiveTo establish a hospital admission evaluation process for predicate consumables. MethodsAn initial evaluation process for predicate consumables was constructed through a combination of literature review and expert consultation. Subsequently, two rounds of Delphi expert consultation were conducted with 20 specialists to revise and refine the specific steps of the admission evaluation process. Finally, the definitive version of the process was confirmed via an expert consensus conference. ResultsThe finalized hospital admission evaluation process for predicate consumables consisted of 14 specific steps under three core phases: equivalence evaluation, evidence collection, and comprehensive evaluation of consumables. The two rounds of Delphi expert consultation yielded effective response rates of 80% and 100%, and expert authority coefficients (Cr) of 0.86 and 0.92, respectively. In the final consensus voting, the approval rate for all steps reached 100% except for two steps, which achieved an approval rate of 95%. ConclusionThe admission evaluation process established in this study is detailed, scientifically rigorous, and practically applicable, which can provide a decision-making framework for the standardized admission of predicate consumables.