This paper is to discuss the research of heterogeneity in Meta-analysis, including the definition of the heterogeneity in Meta-analysis and classification it into clinical heterogeneity, methodological heterogeneity and statistical heterogeneity, the strategies for diminishing clinical heterogeneity and methodological heterogeneity, the five testing methods in statistical heterogeneity (Q statistic, I2 statistic, H statistic, Galbraith plot and L’Abbe plot) and the examples and applying conditions of the five testing methods, classification of meta-analysis into exploratory meta-analysis and analytic meta-analysis according if the meta-analysis has heterogeneity, and the strategies and the flowchart when existing the heterogeneity in meta-analysis.
The teaching team of the Department of Laboratory Medicine, West China School of Medicine, Sichuan University takes scientific spirit, craftsmanship spirit, and medical humanities spirit as the goal, combines the core knowledge of clinical microbiology laboratory technology course with cases of coronavirus disease 2019 prevention and control, drug resistance monitoring, and scientists’ deeds, and adopts strategies such as hot debate and special report to achieve the integration of knowledge and value. The actual effectiveness of this model has been verified through the assessment of students’ abilities and values. This article introduces the course-based ideological and political education construction mentioned above, aiming to explore the integration path of course-based ideological and political education in the clinical microbiology laboratory technology, and construct a new teaching model that combines professional competence and value guidance.
探讨医院检验科工作人员的生物安全预防教育,生物安全防护意识,生物安全防护措施,使实验室每个工作人员不仅成为生物安全的受益者,又是合格的管理者。
Dose-response meta-analysis, as a subset of meta-analysis, plays an important role in dealing with the relationship between exposure level and risk of diseases. Traditional models limited in linear regression between the independent variables and the dependent variable. With the development of methodology and functional model, Nonlinear regression method was applied to dose-response meta-analysis, such as restricted cubic spline regression, quadratic B-spline regression. However, in these methods, the term and order of the independent variables have been assigned that may not suit for any trend distribution and it may lead to over fitting. Flexible fraction polynomial regression is a good method to solve this problem, which modelling a flexible fraction polynomial and choosing the best fitting model by using the likelihood-ratio test for a more accurate evaluation. In this article, we will discuss how to conduct a dose-response meta-analysis by flexible fraction polynomial.
The conclusions of meta-analyses are susceptible to various of biases, and publication bias is one of such main bias. Therefore, Checking for evidence of publication bias should be undertaken routinely at the preliminary stage of a meta-analysis. Begg’s test, Egger’s test, and Macaskill’s test are usually used to objectively identify publication bias in meta-analyses. In order to conveniently use these methods, the SAS program of these three tests was designed in this paper. In order test practical data, the fact that the output of this program of SAS software was consisted with the output of STATA software was validated. So, this program is an alternative way to do such hypothesis tests to identify the publication bias in meta-analyses.
Objective To investigate an evaluation method of medical literature applicability to clinical work， and provide a convenient way for physicians to search for the best evidence. Methods Delphi method was used to choose appropriate evaluating indexes， analytic hierarchy process was performed to determine the weighing of each index， and the formula to calculate medical literature applicability was formed. The practicability of this formula was evaluated by consistency checking between the formula’s results and experts’ opinions on literature applicability. Results Five evaluating indexes were determined， including literature’s publishing year （X1）， whether the target questions were covered （X2）, sample size （X3）， trial category （X4）， and journal level （X5）. The formula to calculate medical literature applicability was Y=3.93 X1＋11.78 X2＋14.83 X3＋44.53 X4＋24.93 X5. The result of consistency checking showed that the formula’s results were highly consistent with experts’ opinions （Kappa=0.75， P＜0.001）. Conclusion The applicability formula is a valuable tool to evaluate medical literature applicability.
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.
While proposing evidence-based medical decision, we analyzed the existing problems in laboratory medicine, discussed the necessity and probability and explored the practicing way of evidence-based laboratory medicine, in order to follow the latest developing of clinical medicine and provide the best clinical laboratory technique and clinical laboratory service for good patient care.