Objective To investigate baseline data of the current status of patients in China, and thus to develop strategies to get patients involved in evidence-based medicine (EBM). Method 300 questionnaires with 17 questions were distributed to the in-patients in West China Hospital, Sichuan University. Statistical software such as SPASS 10. 0 was applied to analyze all the data. Results No patients had ever heard of EBM. Most patients did not know much information about their diseases, but had a b desire to learn from their doctors. Most of them would like to be involved in the treatment decision-making and hoped that their doctors would care about their preference. The cost and the effectiveness of the treatment were the most important issues that patient concerned about. Conclusions The dissemination of health information is very limited for patients and the accessibility of effective health information depends much on the direct communication with their doctors. Promoting patient involved in EBM is fairly a hard and long way to go based on the actual reality of the country.
Participating in patients for patient safety program will help place patients at the center of efforts to improve patient safety. This paper presented a brief introduction to patients for patient safety program and its significance and functions.
ObjectiveTo provide the referencefor the guideline development and revision in China, we analyzed the composition of personnel who participated in developing Chinese clinical practice guidelines (CPGs)published in 2017. MethodsCNKI, WanFang Data, CBM and Google scholar were electronically searched to collect Chinese CPGs published from January 1st to December 31st, 2017. Two researchers independently screened literatures, extracted data of interest, such as composition and distribution of personnel, and analyzed the composition of personnel with Microsoft excel 2013. ResultsA total of 54 guidelines were included, and the majority of which are for treatment. Among which, 49 were developed by the associations accounting for 90.7%. Twenty-four (44.4%) guidelines reported the geographical distribution and unit ownership of the guideline developers, such as hospitals, schools, institutions (academies, institutes, laboratories, nursing homes, etc.). Almost all of the guidelines were developed by the cooperative work of experts from multidisciplinary clinical setting, 15 (27.8%) of which mentioned the participation of the methodologist. Among which, 13 (24.1%) of them involved literature retrieval experts, 2 (3.7%) of them involved epidemiologists, 2 (3.7%) of them involved evidence-based medicine experts, 1 (1.9%) of them involved statistical expert. Three of which mentioned external peer review. None of them has systematic review team. ConclusionIn China, the CPG formulation/revision organization is still not considering the importance of multidisciplinary collaboration, methodology researchers, and patients’ participation and external evaluation teams, which will affect the quality, practicability and maneuverability of CPG. We propose that multidisciplinary cooperation should be strengthened in the future while developing CPG, giving full consideration to the importance of medical personnel and the values of patients, and promoting the application of methodology.
Through summarizing the definition, concept, and development of patient registry, and also retrieving ClinicalTrials.gov, we introduce its application areas, application range, disease, research number. Based on the application situation, we present the challenges faced now and future development of direction.
Objective To explore the traumatic situation and transfer methods of the in-patients injured in Lushan Earthquake, and to provide evidence for treating injured mass in future. Methods The information of the patients injured in Lushan Earthquake who were admitted in Chengdu Military General Hospital were collected by “No. 1 Military Medical Project” hospital information system and a self-edited “Questionnaire for Hospitalized Patients Injured in 4.20 Lushan Earthquake”. Results A total of 65 patients were admitted in this hospital: 63 (96.92%) patients were injured in the main shock; 28 (43.08%) patients were injured by building collapse; 23 (35.38%) patients got injured due to falls or got bruised when escaping; and 14 (21.54%) patients were accidentally injured. Rescue methods: 32 (49.23%) patients were saved by themselves; 23 (35.38%) patients were mutually helped; 10 (15.38%) patients were rescued by local non-military rescue team; 34 (52.31%) patients were rescued by military rescue teams; and 26 (44.83%) patients were transferred by air transport. Conclusion In order to cope with emergencies and major disasters (e.g. earthquake) and to treat injured mass scientifically in the future, we should set up emergency wards scientifically and reasonably, carry out education on earthquake prevention and disaster mitigation widely, reinforce self-care and mutual aid in the stricken area, quickly send rescue and medical teams, and organize training for air transportation of patients.
Objective To systematically review the abroad studies on patients for patient safety, and compare them with the current status of domestic studies, so as to provide suggestions for evidence-based strategic decision about how to conduct the education of patients for patient safety and improve the medical quality. Methods The databases of MEDLINE, EMbase and Chinese Biomedical Literature Database (CBM) were searched to identify the relevant studies and their references. Literatures were screened with data extraction in accordance with the predefined inclusive and exclusive criteria. The quality of literatures was assessed with the standard of Cochrane Handbook 5.0 and Critical Appraisal Skills Programme, and the data were comprehensively analyzed with qualitative research methods.Results Among 28 included studies, 5 were Chinese literatures, 1 was RCT, and the others were cross-sectional studies. The results showed that: a) Generally, the patients at home and abroad were poor in the awareness of patient safety, but they were eager to participate in the patient safety; b) Factors affecting patients’ participation were their characteristics, disease-related, and emotional feelings; c) Three studies reported the methods of involving patients in patient safety from the aspects of infection, malpractice, and medication; d) Some studies showed that patients’ participation could effectively promote the standardized operation of medical staffs, prevent unsafe events, and reduce damages; and e) The research contents of the included Chinese literatures were just related to the patients’ awareness of patient safety, attitude to participation, and influencing factors. Conclusion The limited studies relevant to patients for patient safety are short of high-quality RCTs for proving the effectiveness of patient participation methods, so it indicates that the stress should be laid on evaluating the effectiveness of patients for patient safety in future research.
Objective To undertake a preliminary study of the concept and approach of patient value and preference and to learn how to understand and elicit patient preference in the light of evidence-based medicine so as to promote evidence-based practice and improve the relationship between clinicians and patients. Methods The searching key words were developed and pertinent data were retrospectively retrieved for the years of 1992-2002. MEDLINE and CBMdisc were searched along with handsearching 9 Chinese medical journals and 4 evidence-based medicine books. Data were scanned and analyzed. Results A total of 2 646 related articles were identified, most of which were found in MEDLINE (2 403), followed by CBMdisc (185) and the journals (58). Currently there is no original article to study in this field from a point of view of evidence-based medicine in China. Conclusion Patient value and preference have been emphasized in the approach of evidence-based medicine and it is a worthwhile topic for us to explore.
ObjectiveTo explore the influence of respiratory function training on pulmonary function of patients with pneumoconiosis.
MethodsOne hundred patients with pneumoconiosis hospitalized in our department between June 2011 and September 2012 were chosen as the research subjects. According to the method of random digits table, they were equally and randomly divided into contrast group and observation group. Patients in both the two groups were given routine treatment and nursing and health education, while patients in the observation group adopted respiratory training with lung functional exerciser in addition. Then we observed the forced expiratory volume in one second (FEV1), vital capacity, maximal voluntary ventilation, forced vital capacity, classification of conscious shortness of breath and shortness of breath as well as classification of activities of daily living in the patients before and after training in both the two groups.
ResultsAfter 6 months, lung function index, classification of conscious shortness of breath and shortness of breath as well as classification of activities of daily living of patients in the observation group improved a lot, which was significantly better than that in the contrast group (P<0.05). Compared with the contrast group, the FEV1 [(2.75±0.43) L], vital capacity [(3.29± 0.45)L] of patients in the observation group were significantly higher (P<0.05). Compared with the contrast group, classification of conscious shortness of breath and shortness of breath (2.10±0.67), classification of activities of daily living (2.19±0.66) were also significantly different (P<0.05).
ConclusionRespiratory function training with lung functional exerciser can improve lung function of patients with pneumoconiosis, alleviate the degree of dyspnea, and enhance the quality of life.
Objective
To evaluate the ambulatory surgery mode by using health economical mothods and provide reference for optimization and decision of surgical operation mode.
Methods
The patients who underwent unilateral flexible ureteroscopic holmium laser lithotriphy for ureteral calculi in Xiangya Hospital, Central South University between January 1st to December 31th, 2015 were selected in this study, including 59 with ambulatory surgery mode (the ambulatory group) and 65 with special in-hospital surgery mode (the special group). The differences in average bed occupancy time, cost, therapeutic effect, and satisfaction between the two operation modes were compared.
Results
The average bed occupancy time in the ambulatory group and the special group was (1.03±0.18) and (6.35±0.74) days, respectively, and the difference was statistically significant (P<0.05). The patients in both groups were followed up for one month after the operation, and the incidence of complications was 6.8% (4/59) in the ambulatory group and 6.2% (4/65) in the special group, without significant difference (P>0.05). The satisfaction score in the ambulatory group and the special group was 96.48±0.23vs. 96.53±0.18 without significant difference (P>0.05). The differences in direct medical cost [(17 738.28±1 027.85)vs. (21 307.67±554.41) yuan], direct non-medical cost [(103.39±18.25) vs. (630.76±78.90) yuan], indirect cost[ (266.93±47.12) vs. (1 640.44±190.55) yuan], and total cost [(18 128.10±1 037.76) vs. (23 558.29±619.20) yuan] between the ambulatory group and the special group were all statistically significant (P<0.05). The treatment effect index in the ambulatory group and the special group was 0.96 and 1.05, respectively; the cost-effect ratio was 18 883.44 and 22 436.47, respectively. Sensitivity analysis showed that the adjusted cost-effect ratio in the ambulatory group (16 629.64) was still lower than that in the special group (20 534.91).
Conclusions
The cost-effect ratio of ambulatory surgery mode is superior than that of special in-hospital surgery mode, and there is no obvious difference in patients satisfaction between the two modes. Ambulatory surgery mode can be recommended to patients who meet the indications of day surgery.
In order to better incorporate patient input in clinical trials, the US Food and Drug Administration has included "patient-focused drug development" in the selection and development of clinical outcome assessments, and formulated a series of guidelines. Based on the third guiding principle, "Selecting, Developing, or Modifying Fit-for-Purpose Clinical Outcome Assessments", this article summarizes the clinical outcome assessments from five aspects: concept, development process, scoring mechanism, interference factors and sensitivity, and introduces four different types of clinical outcome assessments, providing new ideas for "patient-focused drug development" efficacy evaluation in clinical trials.
