Network meta-analyses (NMA) of survival data often rely on the proportional hazards (PH) assumption, however, this assumption fails when survival curves intersect. With the emergence of innovative therapies such as immunotherapy, the importance of NMA based on non-proportional hazards (non-PH) in the current evidence-based medicine evaluation of oncology drugs has become increasingly prominent. Fractional polynomial (FP) models do not rely on the assumption of PH, which can flexibly capture the characteristics of survival curves, and the corresponding fitting effects are better than those of the PH models. This study introduced a complete workflow in R for NMA using FP models with non-PH.
The construction of national regional medical centers is a significant measure in China to deepen the reform of public hospitals and promote the downward flow of high-quality medical resources and their balanced distribution across regions. This article explores the high-quality development path of national regional medical centers in West China Hospital of Sichuan University, a large comprehensive hospital in Southwest China. It clearly states that the implementation path for the output hospital to carry out the national regional medical center construction project includes scientifically conducting demand research, comprehensively clarifying functional positioning, uniformly setting up organizational structures, establishing an expert dispatch mechanism, homogenously training self-recruited personnel, and fully participating in infrastructure construction. It also proposes to take the establishment of a management system and mechanism adapted to local conditions as the core, build a flexible and organic management model, set up a targeted “group-based” operation mechanism, and innovatively establish a comprehensive assessment and evaluation system to support the construction of a hierarchical medical system.
