It has been 36 years since the first version of essential medicine list (EML) was released by WHO in 1977,when 18 versions of WHO-EML and four versions of children essential medicine list have been released. In 1982, the first version of national essential medicine list (NEML) was released in China. Till 2012, there were eight versions of NEML in total. This paper introduces WHO-EML in aspects of origin, idea, definition, design, and innovation of selection methodology,principle, and workflow; compares the evolution, design, selection methodology between WHO-EML and Chinese NEML; and points out the challenges of evaluation and decision making of Chinese NEML.
The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) has been widely accepted in the assessment of diagnostic accuracy and quality. However, it is not suitable for assessing risk of bias in studies comparing diagnostic accuracy. The current common practice in systematic reviews is to derive comparative accuracy from non-comparative diagnostic accuracy studies, which is inherently biased. The QUADAS group developed the QUADAS-Compare (QUADAS-C) tool for assessing the risk of bias in comparative diagnostic accuracy studies. It was officially launched in October 2021. QUADAS-C retains the same 4-domain structure as QUADAS-2: patient selection, index test, reference standard, and flow and timing. It also includes an additional 14 signaling questions and 4 risk of bias questions. This allows researchers to identify high-quality research evidence and avoid bias in research design and conduct. This article interpreted the basic situation, evaluation items, evaluation standards, and usage methods and procedures associated with QUADAS-C to provide references for domestic users.
【摘要】 目的 通过关键词共现分析和作者共现分析的方式，研究国内外循证心血管领域的研究热点、学科分支和发展趋势。 方法 通过检索中国生物医学数据库和Medline数据库，分别收集相关研究文献，并提取关键词词频、作者发文数和核心研究单位，对核心关键词和核心发文作者建立共现矩阵，使用Ucinet绘制可视化网络图。 结果 成功得到核心关键词和核心作者可视化网络。中文可视化网络包括循证医学、治疗和护理3个方面，英文可视化网络包括evidence-based medicine、therapy和treatment outcome 3个方面。而在作者合作可视化网络中，国内作者合作关系较为松散，合作团体较小，国外作者合作关系较为紧密，合作团体较大。国内核心研究机构分布于循证研究重点高校，国外则以发达国家为主。 结论 国内循证心血管研究领域总体发展趋势较好，但较国外相比仍存在一些不足，需要进一步加强重点研究，调整研究规划。【Abstract】 Objective To research on the hot issues, branch system and development trend of evidence-based cardiovascular medicine in and out of china by using co-word analysis of keywords and authors. Methods By Searching the CBM database in Chinese and Medline database in English, we collected the related articles and picked out the frequency of keywords, authors and core administrations, and built the matrix of keywords and authors. Finally we completed the visualized network by Ucinet. Results We successfully obtained the visualization of this subject. Chinese network contained three parts: evidence-based medicine, therapy and nursing, while English network also contained three parts: evidence-based medicine, therapy and treatment outcome. In the authors′ visualized network, Chinese authors had less cooperation and looser relationship compared with their counterparts overseas. The core administrations in china located in outstanding universities, and developed countries had the dominated roles in the world. Conclusions The development trend of evidence-based cardiovascular medicine in china is good, but still has some limitations compared with overseas studies. More emphasis should be put on strengthening core-area researching and research plan adjustment.
目的 通过关键词共现分析和作者共现分析的方式，研究国内外循证医学教育领域的研究热点、学科分支和发展趋势。 方法 通过检索中国学术期刊数据库（CNKI）和Medline数据库，分别收集相关研究文献，并提取关键词词频、作者发文数、核心期刊和核心研究单位，对核心关键词和核心发文作者建立共现矩阵，使用Ucinet绘制可视化网络图。 结果 成功得到核心关键词和核心作者可视化网络。中文可视化网络包括“循证医学”、“护理”、“教育”、“教学”4个方面，英文可视化网络包括“evidence-based medicine”、“nursing”、“education”、“organization amp; administration”4个方面，国内外该学科发展趋势相似。国内循证医学教育以四川大学为核心，合作网络较大。同时国内核心期刊与国外侧重点不同。 结论 国内循证医学教育研究领域总体发展趋势良好，在医学教育中起着极为重要的作用。Objective To built visualized networks of evidence-based medical education in and out of China by using co-occurrence analysis of key words and authors. Methods We searched the China National Knowledge Infrastructure (CNKI) database in Chinese and Medline database in English, collecting the related articles, and took out the core key words, core authors and core administrations. Then we built the matrix of key words and authors, and finally finished visualized network by Ucinet. Results We successfully obtained the visualization of this subject. Chinese network contained four parts: “evidence-based medicine”, “nursing”, “education” and “teaching”; while English network also contained four parts: “evidence-based medicine”, “nursing”, “education”, “organization” and “administration”. In China, Sichuan University located in the center of the network of authors, and also leading in the administrations. The network of authors in China showed a larger cooperation than overseas. And the core-periodicals had different emphases. Conclusion The evidence-based medical education develops well in China, and plays an important role in the medical education.
ObjectiveTo analyze publications of the application of artificial intelligence related methods in medicine.MethodsPubMed and EMbase databases were electronically searched. Pathfinder Networks (PFNETs) algorithm, co-word network analysis and visualization technology were applied to analyze the time trend, journal distribution, and co-word structure of high-frequency medical keywords in key journals.ResultsThe amount of literature published on the application of artificial intelligence related methods in the medical field had been increasing annually. Nowadays, the number of studies published in the United States was the largest, and that in China, it was the sixth (first in developing countries). The number of the first author from the United States or China were among the top two, which were significantly more than any other regions. In 2012, IEEE Trans Neural Netw Learn Syst in the computer field became one of the major contributing journals. In recent years, the methods and applications proposed in the medical field were closely related to natural language processing, neural networks, and support vector machines.ConclusionsAt present, the United States is in a leading position in terms of artificial intelligence in medicine, and China has also abundant research strength. The number of medical literature published in interdisciplinary journals is increasing gradually, showing that the research and application of artificial intelligence related methods in medicine have become a research hotspot in recent years.
Hospital-based health technology assessment (HB-HTA) is an indispensable method and measure to improve the level of fine management and establish a value-based medical service system. This paper introduces the differences between HB-HTA and HTA, four organizational management models, assessment process, assessment steps and HB-HTA reporting standardization, which provides a reference for evaluating organizations.
The QUADAS-2, QUIPS, and PROBAST tools are not specific for prognostic accuracy studies and the use of these tools to assess the risk of bias in prognostic accuracy studies is prone to bias. Therefore, QUAPAS, a risk of bias assessment tool for prognostic accuracy studies, has recently been developed. The tool combines QUADAS-2, QUIPS, and PROBAST, and consists of 5 domains, 18 signaling questions, 5 risk of bias questions, and 4 applicability questions. This paper will introduce the content and usage of QUAPAS to provide inspiration and references for domestic researchers.
Currently, the medical imaging methods based on artificial intelligence are developing rapidly, and the related literature reports are increasing year by year. However, there is no special reporting standard, and the reporting of the results is not standardized. In order to improve the report quality of this kind of research and help readers and evaluators evaluate the quality of this kind of research more scientifically, a checklist for artificial intelligence in medical imaging (CLAIM) was put forward abroad. This paper introduces the content of CLAIM and explains its items.
Objective To evaluate and select essential medicine for community-acquired pneumonia (CAP) using evidence-based methods based on the burden of disease. Methods By means of the approaches, criteria, and workflow set up in the second article of this series, we referred to the recommendations of evidence-based or authority guidelines from inside and outside China, collected relevant evidence from domestic clinical studies, and recommended essential medicine based on evidence-based evaluation. Data were analyzed by Review Manager (RevMan) 5.1 and GRADE profiler 3.6 to evaluate quality of evidence. Results (1) Eleven guidelines were included (nine foreign guidelines, two domestic guidelines; nine based on evidence, two based on expert consensus). For CAP, amoxicillin amp; clavulanate potassium had efficiencies of 77.1% and an incidence of 18.8% as to adverse reaction that mainly included gastrointestinal reaction, skin rashes, etc. Piperacillin/tazobactam had an efficiency of 92.1% and a bacterial clearance rate of 88.9%. Cefuroxime had an efficiency of 89% and a bacterial clearance rate of 85.5%. There was no statistical significance between azithromycin and cefuroxime for CAP (RR=0.98, 95%CI 0.9 to 1.06); however, azithromycin was superior to cefuroxime in shortening fever-relief time (MD=–0.98, 95%CI –1.24 to –0.55) and cough-relief time (MD=–1.36, 95%CI –1.94 to –0.78). Efficiencies of ceftriaxone, cefotaxime, moxifloxacin and lavofloxacin were all more than 80% and among the three, moxifloxacin was the most efficient (RR=1.08, 95%CI 1.02 to 1.13, P=0.004). Meropenem had an efficiency of 90%, a bacterial clearance rate of 83.3% and an incidence of 3.33% as to adverse reaction that mainly included diarrhea. Conclusion (1) We offer a b recommendation for antibiotics such as amoxicillin, amoxicillin amp; clavulanate potassium, ampicillin/sulbactam, piperacillin/tazobactam, doxycycline, azithromycin, clarithromycin, cefuroxim, ceftriaxone, cefotaxime, lavofloxacin, moxifloxacin, ertapenem, meropenem, imipenem and vancocin. (2) We offer a weak recommendation for penicillin G, ciprofloxacin and erythromycin. (3) We propose that doctor should choose optimal antibiotics based on commonly-seen pathogenic bacteria that cause CAP, local criteria of antibiotic susceptibility, severity of CAP, and risk factors of patients.
ObjectivesTo compare and analyze the differences between local and the national indicator systems, so as to provide reference for the improvement of health city indicator system in various regions and the implementation of national health city evaluation.MethodsWe performed electronic searches of the CNKI, WanFang Data, VIP, website of WHO, website of Commission of Health &Family Planning prior to March, 2018. We included documents of Chinese healthy city indicator system. Literature selection and data extraction were performed by two reviewers independently, and the included indicator systems were systematic reviewed.ResultsA total of 26 documents were included, involving 14 dimensions and 1 531 indicators. Health (population/level) dimension was used by 24 healthy city indicators systems and included 82 indicators. Health services dimension had been used by 22 healthy city indicators systems and including 113 indicators. Health environments dimension was used by 22 healthy city indicators systems and included 121 indicators. Health society was used by 19 systems and included 113 indicators. Health culture dimension had been used by 4 systems and included 17 indicators. The specific indicators in the two dimensions of health environment and health population were relatively consistent with the national indicator system, while the dimensions of health society, health service and health culture were highly different.ConclusionsHealth (population/level), health services, healthy environment, and healthy society are most used in each healthy city indicator system. Compared with the national indicator system, the dimension structure is highly consistent, while the formulation of specific indicators and the ownership of dimensions are quite different. Each city should improve its existing indicator system based on its own urban development status and problems.