Venous thromboembolism (VTE) carries a high risk of recurrence, making precise identification of high risk individuals crucial for optimizing anticoagulation strategies. This review summarizes current evidence on risk factors and prediction models for recurrent VTE. Recurrence is driven by a combination of baseline characteristics (e.g., male sex, non-O blood group), acquired clinical factors (e.g., initial proximal deep vein thrombosis or pulmonary embolism), and laboratory markers (e.g., D-dimer). Although multiple prediction models have been developed across diverse populations, they vary considerably in variable composition, target cohorts, and extent of external validation, and generally lack dynamic predictive capabilities. Future efforts should prioritize enhancing model generalizability, dynamic risk assessment, and clinical utility to guide individualized anticoagulation decisions and ultimately reduce recurrence rates.
Under the background of high-quality development of public hospitals and from the perspective of medical technology management, this paper discusses the high-quality development path of medical technology management in West China Hospital, Sichuan University. By sorting out the development context of restricted medical technology management in this medical institution, it concludes that there are four problems in restricted medical technology management at present: lack of standardized management system, non-unified surgery grading management, technology management information level to be improved, and the after-effect evaluation and transformation mechanism of medical technology being not perfect. It is proposed that establishing standardized management system, unifying surgical grading catalogue, constructing intelligent information system and establishing achievement transformation mechanism are important ways to strengthen medical technology management.
In order to explore an effective path for the high-quality development of public hospitals, West China Hospital of Sichuan University had taken core measures such as clarifying personnel ownership, reconstructing the diagnosis and treatment process, formulating disease-specific paths, promoting the integration of clinical and scientific research, promoting the collaboration of multi-disciplinary talent echelons, and strengthening the guidance of performance appraisal, successfully operated the six entity disease-specific centers and achieved phased results, realizing the collaborative optimization of high diagnosis level, high treatment level, high operation efficiency, and low medical costs. Combined with the above disease-specific centers construction practice, this paper systematically combs the key problems faced in the transformation of medical service mode, and provides reference for the construction of disease-specific centers in large public hospitals.
ObjectiveTo analyze the quality of the randomized controlled trials (RCTs) included in the systematic review in the anti-infection field in the elderly.MethodsA comprehensive and systematic literature search in PubMed, EMbase, CNKI, The Cochrane Library, WanFang Data, VIP and CBM was conducted to collect systematic review or meta-analysis which involoved anti-infection RCTs in the elderly from inception to February 17th, 2020. The results of Cochrane risk of bias assessment of the included RCTs were analyzed.ResultsA total of 8 systematic reviews were included, involving 19 RCTs and 6 735 participants. The sample size of the RCTs ranged from 23 to 2538, and the published date were from 1980 to 2020. The included RCTs focused on postoperative infection, urinary tract infection, Clostridium Difficile infection and so on. The included RCTs had methodological quality issues. Among the assessment results of low risk of bias, the domains of selection bias (random sequence generation) and selection bias (allocation hiding) had the lowest proportion (47.3%, 36.8%). Among the assessment results of unclear risk of bias, the domains of selection bias (random sequence generation) and selection bias (allocation hiding) had the highest proportion (42.1%, 52.6%). Among the assessment results of high risk of bias, the domains of measurement bias and performance bias had the highest proportion (21.1%, 21.1%).ConclusionsThe quality of RCTs in the field of anti-infection in the elderly requires further improvement. High-quality anti-infection RCTs for the elderly should be developed in future to better guide clinical practice.
