①供体授精:我们发现,在供体授精的效果方面,尚缺乏高质量证据.②胞浆内精子注射+体外授精:1篇系统评价发现,尚无足够的证据说明胞浆内精子注射+体外授精与单独使用体外授精何者效果更好.③宫腔内人工授精:两篇系统评价发现,宫腔内人工授精较宫颈内授精或自然性交,能明显增加每个周期的妊娠率.④体外授精与配子输卵管内移植:1个RCT显示,尚无足够证据证明体外授精与配子输卵管内移植何者效果更好.
Objective To retrieve, evaluate, and summarize evidence on the prevention and management of intracranial infections related to lumbar drainage (LD), in order to provide scientific references for clinical practice and decision-making. Methods The literature on the prevention and management of LD-related intracranial infections in LD-related websites and databases was systematically searched, with a search period from the establishment of databases to June 30, 2024. The included literature was evaluated for quality and integrated into evidence. Results A total of 9 articles were included, including 3 guidelines, 1 evidence summary, 1 expert consensus, 1 systematic review, and 3 original studies. A total of 30 pieces of evidence were formed, covering six aspects: risk management, catheter placement, catheter maintenance, extubation, diagnosis and treatment of intracranial infections, education and training. ConclusionsThe prevention and management of LD-related intracranial infections involve multiple pieces of evidence, and medical staff should selectively apply the best evidence based on patient and clinical conditions to reduce the incidence of intracranial infections and improve medical quality.
Objective To give an individualized treatment to a young woman with primary dysmenorrhea. Methods According to the basic principle and methods of evidence-base medicine, we searched The Cochrane Library (Issue 1, 2009), MEDLINE (PubMed, January 1950 to May 2009), ACP Journal Club (OVID, January 1991 to May 2007) for systematic reviews and randomized controlled trials (RCTs) to acquire the best clinical evidence on the treatment of primary dysmenorrhea. Results A total of 11 systematic reviews and 1 RCT were identified. A reasonable treatment plan was made through combining the patient’s will with her family members’. Conclusion The treatment effect on primary dysmenorrhea of the young woman is improved by an individualized treatment plan based on an evidence-based method.
Objective To define the attributes and priorities of evidence-based nursing curriculum needs of nursing students, so as to provide operational reference for the design and development of evidence-based nursing course in the future. Methods Questionnaire was designed based on Kano model, and convenient sampling method was adopted to investigate the nursing students who had received training or had experience in evidence-based nursing from September to November 2020. According to the Kano model attribute classification method, the need attribute of evidence-based nursing curriculum was defined. Results A total of 303 nursing students were investigated. Kano model analysis showed that 11 of the needs for evidence-based nursing courses were one-dimensional quality, which belonged to the dimension of teaching resources and teaching content, and 5 were indifference quality, which belonged to the course assessment dimension. The importance-satisfaction matrix showed that the need of evidence-based nursing curriculum was concentrated in the advantage area and minor excepting improvement area. Conclusions In the future curriculum design, evidence-based nursing teachers need to continue to maintain the demand items in the advantage area and constantly improve and perfect them. They also need to pay more attention to the demand items in the minor excepting improvement area. Combined with the current problems in evidence-based nursing practice and the evidence-based needs of students, teachers need to further put forward suggestions on evidence-based nursing curriculum.
Having searched The Cochrane Library (Issue 4, 2005), we found: fluoride can reduce the occurrence and severity of white spot lesions; removal of premature contacts of the primary teeth can prevent posterior crossbite; expanding the top teeth can decrease the risk of a posterior crossbite; CSF may help retaining teeth; clear overlay retainer may settle teeth quicker than Hawley retainer; adhesives for fixed orthodontic brackets is still in dispute.
Objective To search for, assess, and summarize the best evidence for antimicrobial allergy assessment in hospitalized patients, so as to provide an evidence-based basis for clinical nursing practice. Methods UpToDate, BMJ Best Practice, National Guideline Clearinghouse, Guidelines International Network, Yimaitong, JBI Evidence Synthesis, Cochrane Library, CINAHL, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Data, CQVIP, SinoMed, and related association websites were searched by computer for literature about clinical decisions, guidelines, expert consensuses, evidence summaries, systematic reviews and meta-analyses related to antimicrobial allergy assessment in hospitalized patients. The search time limit was from the establishment of the databases to September 2024. Two researchers trained in evidence-based practice screened the literature and evaluated the quality independently. Finally, the evidence-based research group extracted and integrated the evidence after discussion. Results Totally 8 articles were involved, including 6 guidelines and 2 systematic reviews. Finally, 25 pieces of best evidence were obtained across 6 aspects, including the importance of antimicrobial allergy assessment, the subjects of allergy assessment, the personnel conducting allergy assessment, the content of allergy assessment, the recording of allergy history, and assessment tips. Conclusion When applying and transforming evidence, medical staff should fully consider the actual clinical situation and explore the evaluation scheme of antimicrobial allergy history of hospitalized patients with local characteristics, to improve the accuracy of evaluation of antimicrobial allergy history of hospitalized patients, so as to strengthen the safety management of drug use and improve the level of rational drug use.
Objective To retrieve and summarize the best evidence for fall prevention after total hip arthroplasty in elderly patients. Methods BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Cochrane Library, PubMed, Web of Science, EBSCO, International Collaboration of Orthopaedic Nurisng website, American Academy of Orthopaedic Surgeons website, European Society for Trauma and Emergency Surgery website, Medlive, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were systematically searched. The retrieval time was from the establishment of the databases to June 30, 2024. The quality of literature was evaluated, and evidence was extracted, evaluated, and summarized. Results A total of 12 articles were included, including 4 guidelines, 2 randomized controlled trials, 2 cohort studies, and 4 expert consensus studies. A total of 18 pieces of evidence were extracted, including 13 A-level recommendations and 5 B-level recommendations. The evidence covers six major themes of risk factors, assessment, multidisciplinary team support, health education, medication management, safety environment, and assistive devices. Conclusions The fall prevention after total hip arthroplasty in elderly patients involves multiple factors, and the fall prevention should be based on multidisciplinary team cooperation, achieving linkage between the hospital and the family to jointly ensure patient safety. In the future, it is recommended to combine individual patient differences with actual clinical scenarios when applying evidence.
Rapid, living evidence-based points, as a new model promoting the rapid translation of evidence, aim to integrate the current best evidence, clinical status, public/patient preferences and values, and provide concise and practical guidance rapidly to important questions concerned in clinical medicine and public health. This paper introduces the methodological framework for the development of "Rapid, Living Evidence-Based Points" from 4 aspects: initiation and planning, evidence search and review, development, update, publication and dissemination of evidence-based points, in order to provide a reference for domestic scholars in developing rapid, living evidence-based points.
Network meta-analysis (NMA) is a statistical technique that integrates data from multiple clinical studies and compares the efficacy and safety of multiple interventions, which can provide pro and con ranking results for all intervention options in the evidence network and provide direct evidence support for clinical decision-making. At present, NMA is usually based on the aggregation of the same type of data set, and there are still methodological and software difficulties in achieving cross-study design and cross-data format data set merging. The crossnma package of R programming language is based on Bayesian framework and Markov chain Monte Carlo algorithm, extending the three-level hierarchical model to the standard NMA data model to achieve differential merging of varied data types. The crossnma package fully considers the impact of risk bias caused by the combination of different types of data on the results by introducing model variables. In addition, the package provides functions such as result output and easy graphing, which makes it possible to combine NMA across study designs and evidence across data formats. In this study, the model based on crossnma package method and software operation will be demonstrated and explained through the examples of four individual participant datasets and two aggregate datasets.