Researches in evidence-based medicine have provided important evidence for family planning doctors to guide their clinical practice. With examples of clinical researches, the practical methods of evidence-based medicine in family planning service are discussed in this paper.
Objective To explore the methods of evidence-based individualized treatment for a patient with oral pemphigus. Methods According to chnical problems, we searched The Coehrane Library （Issue 1,2005 ） , MEDLINE （1966 -Jan. 2005 ）, SUMSEAR.CH （Jan. 2005 ）, TRIPDATABASE （1997 - 2005 ）, CMCC （1994 - 2004 ）and handsearched four Chinease journals （starting pubhcation -2004）. Results No Systematic review was found. Six randomised controlled trials, two reviews of high quality and one guidehne were identified. We found that corticosteroid was the firsthne medicine in the treatment of pemphigus. However, corticosteroid at higher dose did not work more effectively than that at lower dose. Corticosteroid at middle-dose was preferred in treating oral pemphigus. Additionally, corticosteroid combined with immunosuppressants led to lower mortality. Among them, cyclophosphamide and azathioprine were recommended, and methopterin should be avoided. Plasma exchange in combination with corticosteroid at lowor middle-dose should not be recommended in conventional therapy. Chinese traditional treatment combined with Western medicine might work. A treatment with prednisone at the dose of 60 mg/d and in combination with azathioprine 100mg/d was made based on the evaluation of the data available and was proved optimal by 6 months following-up. Conclusions The therapeutic effect of pemphigus has been improved by evidence-based treatment.
We summarized and analyzed the researches of the workshop on Evidence-Based Medicine for Medical Editors which was recently held concerning its teachers, training method, trainee distribution and recent progress. We hope to provide a new approach to improving the level of medical editors and clinical trials.
ObjectiveTo systematically review the predictors of enteral nutrition feeding intolerance in critically ill patients. MethodsThe PubMed, Web of Science, Cochrane Library, Embase, CNKI, WanFang Data, VIP and CBM databases were searched to collect relevant observational studies from the inception to 6 August, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. ResultsA total of 18 studies were included, including 28 847 patients. The results of the meta-analysis showed that gender, age, severity of illness, hypo-albuminemia, length of stay, postpyloric feeding, mechanical ventilation and mechanical ventilation time, use of prokinetics, use of sedation drugs, use of vasoactive drugs and use of antibiotics were predictors of enteral nutrition feeding intolerance in critically ill patients, among which postpyloric feeding (OR=0.46, 95%CI 0.29 to 0.71, P<0.01) was a protective factor. ConclusionAccording to the influencing factors, the medical staff can formulate a targeted enteral nutrition program at the time of admission to the ICU to reduce the occurrence of feeding intolerance. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To provide evidence-based therapeutic schedule for an adult patient with Lumber Isthmic Spondylolisthesis grading II. Methods Based on fully assessing the patient’s conditions, the clinical problems were put forward according to PICO principles. Such database as The Cochrane Library (2005 to April 2011), DARE (April 2011), CENTRAL (April 2011), MEDLINE (April 2011), EMbase and CBM were searched to collect high quality clinical evidence, and then we told a patient information about treatment plans. The plan was chosen by the patient for she knew her conditions and the plans. Results We included 1 meta-analysis, 3 randomized controlled trials, 5 systematic reviews and 1 prospective study on the natural course of isthmic spondylolisthesis were included. Literature evidence indicated that the prognosis of isthmic spondylolisthesis was good. Surgery should be selected when there was neither no remission of symptom, nor progression of lumber olisthy with conservative treatment. The long-term effect of surgery may be good, but it cannot change the natural course of the disease. Based on literature evidence, the patient chose the conservative treatment. After one year’s treatment the patient recovered, her sciatica relieved, and CT showed no progression of lumber olisthy. Conclusion Patient with low grand isthmic spondylolisthesis chose conservative treatment may achieves good effects, whereas on the process of the treatment, regular follow-up to monitor the progression of lumber olisthy should be conducted.
This is the sixth paper in the evidence-based medicine glossary series. In this paper, We mainly introduced the concept of research synthesis, systematic review and meta-analysis and review developing process of these glossary.
Science is a system of knowledge that reflects the essential connections and laws of the objective world. Classification of disciplines is a subsystem of science, which involves the development of human cognition which evolved from the scientific category to the department of higher education, and then formation of a complex management system. Nowadays with the rapid development of science and technology which triggering numerous complex social problems, an increasing trend of scientific integration calls for multidisciplinary and interdisciplinary research and education. In the 1990s, evidence-based medicine was emerged in the self-doubting of medical science, and extended to other fields of medicine, health policy and social sciences, forming an interdisciplinary evidence-based science system. Evidence-based science is an embodiment of scientific integration, and also the carrier and mechanism of cross-disciplinary convergence. It attempts to break through barriers of disciplines and management, and promotes interdisciplinary research, during which it has encountered many difficulties due to limitations of traditional disciplines. Evidence-based science does not provide an intrusion or transformation of thinking paradigm into other disciplines, but rather an equal dialogue to promote broader discipline collaboration and a new round of self-improvement, so as to constantly explore novel methods and theories to solve emerging problems, achieve continuous improvement, and pursue excellence.
Objective Evidence-based medicine was used to make an individualized treatment plan for newly diagnosed prostatic hyperplasia in an elderly patient. Methods After clinical problems were discovered, evidence was collected from CBM, CNKI, The Cochrane Library, PubMed, EMBASE, ScienceDirect, Springer, and ProQuest databases according to our predefined search strategy. The search was done through 2008. The internal and external validity of the evidence was assessed. The evidence, combined with the patient value, was applied to the patient. Results A total of 39 systematic reviews involving 137 randomized controlled trials were identified. A rational treatment plan was made upon a critical evaluation of the data. After one year follow-up, the treatment protocol was proven correct. Conclusion The treatment efficacy in newly diagnosed prostatic hyperplasia in the elderly has been improved by determining an individualized treatment protocol according to evidence-based methods.
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.
