Basing on the special geographical environment, population, economic level and medical conditions of the areas along the plateau railway, as well as the policy requirements of primary healthcare institutions in China, combining the reality and early practice of the areas along the plateau railway in China, the High Altitude Medicine Committee of Sichuan Medical Association gathered the experts in the field of high altitude medicine in China, and launched the Expert Consensus on Basic Requirements for Primary Healthcare Institutions in Areas Along the Plateau Railway. Its content covers the scale and layout, infrastructure, personnel allocation and service capacity, material allocation of primary healthcare institutions in areas along the plateau railway, and provides professional guidance for primary healthcare institutions in these areas.
ObjectiveTo evaluate the methodological quality of clinical practice guidelines and expert consensus of chronic heart failure domestically and abroad.MethodsPubMed, EMbase, SinoMed, CNKI, WanFang Data, and VIP databases, and related websites were searched to collect guidelines and expert consensus on chronic heart failure published from January 1st, 2011 to December 31st, 2020. Four reviewers evaluated the methodological quality of the guidelines and expert consensus with the AGREE Ⅱ tool after the consistency evaluation training.ResultsA total of 17 studies were included (consisting of 11 English and 6 Chinese studies). The recommended levels were B level (recommend after modification) for 10 studies and C level (not recommended) for 7 studies. The AGREE Ⅱ standardized mean scores for various fields were 69.61% (scope and purpose), 34.20% (stakeholder involvement), 33.13% (rigor of development), 84.53% (clarity and presentation), 42.40% (applicability), and 37.09% (editorial independence). The methodological quality of English guidelines was generally high (level B for 10 and level C for 1), while all scores of Chinese guidelines or consensus in the 6 fields were mostly lower than the average (level C for 6).ConclusionsThe guidelines for the diagnosis and treatment of chronic heart failure requires further improvement in terms of stakeholder involvement and rigor of development. It should develop standards and methods to improve the quality for Chinese guidelines and expert consensus to better serve clinical practice.
Spina bifida and tethered spinal cord are congenital diseases that can lead to severe disability. At present, most doctors in relevant specialties in China still have insufficient understanding of spina bifida, resulting in high incidence and aggravation of its complications. To provide guidance for the diagnosis and treatment of spina bifida and tethered spinal cord in China, experts from neurosurgery, urology, orthopedics, spine surgery, and rehabilitation departments who have experiences in the diagnosis and treatment of spina bifida discussed and summarized their experiences, and referred to the relevant literature on the diagnosis and treatment of spina bifida at home and abroad. Expert consensus was formed in the following aspects: concept, classification, and pathological changes of spina bifida; diagnosis; treatment process and operation timing; principles and methods of treatment; rehabilitation; and follow up. This expert consensus can provide reference for relevant care providers of spina bifida in China.
Novel coronavirus pneumonia is a new type of respiratory infectious disease that has rapidly spread in many countries or regions around the world. The World Health Organization (WHO) named it “coronavirus disease 2019 (COVID-19)”. Glucocorticoids (GC) have certain application value in patients with COVID-19, but they need to be used with caution and strict indications and dosage. Application of large doses of GC can also cause osteonecrosis of femoral head (ONFH). On the basis of the latest literature and evidence-based medical evidence on the fight against COVID-19 epidemic and steroid ONFH diagnosis and treatment, the Bone Circulation and Osteonecrosis Professional Committee, Shockwave Medical Specialty Committee of Chinese Research Hospital Association organized Chinese bone necrosis related experts to jointly write this consensus, focusing on the prevention strategy and the protective management measures in the ONFH diagnosis and treatment process during the prevention and control of COVID-19, which can provide reference for hospitals at all levels to carry out early prevention and treatment of ONFH.
Diabetes retinopathy (DR) is listed as one of the chronic diseases that should be focused on in the “14th Five-Year” National Eye Health Plan (2021-2025). Early screening is one of the effective measures to reduce blindness caused by DR. Establishing an efficient and practical community screening model is a powerful guarantee for completing early screening. The Ocular Fundus Diseases Group of the Ophthalmology Branch of the Chinese Medical Association has led the development of Expert consensus on community screening of diabetic retinopathy among DR community screening experts that is suitable for the current national situation, in order to guide and promote the further improvement of DR community screening work in China. This Expert Consensus provides detailed specifications on the current domestic trend of DR, the necessity of screening, the role of artificial intelligence grading, screening process, and quality control. This interpretation further emphasizes the importance of DR community screening, while emphasizing the responsibilities of different departments in the screening process. Finally, recommendations are provided for the sustainability of DR community screening. It is hoped that the screening rate of DR in China can be improved and blindness can be reduced by DR through Expert consensus on community screening of diabetic retinopathy and interpretation of the content.
With the advancement of research on rare ocular diseases such as inherited retinal dystrophy (IRD) has advanced in recent years, especially breakthroughs in therapeutic approaches represented by cell and gene therapy, potential intervention strategies have emerged for these conditions. Establishing standardized endpoints and evaluation methods for visual function in patients with IRD has become crucial for assessing disease progression, safety, and therapeutic efficacy of innovative treatments. Best corrected visual acuity (BCVA) is widely recognized as one of the primary endpoints for assessing visual function. However, for IRD patients with severe rod photoreceptor dysfunction, who often present with profound low vision or even legal blindness, the applicability of BCVA as a traditional visual function indicator is limited. The multi-luminance mobility test (MLMT) has emerged as a functional visual assessment tool that evaluates the ability to navigate obstacle courses under varying illumination levels. By establishing graded evaluation standards, MLMT objectively quantifies the impact of lighting conditions on patients’ nobility and spatial orientation, providing a novel quantitative tool for assessing visual function in IRD clinical trials. Currently, there is a lack of unified and standardized guidelines for the use of MLMT in China, posing challenges to its implementation in practical clinical research. To address this, Ocular Fundus Disease Society of Chinese Medical Association and Chinese Medical Doctor Association convened a multidisciplinary team comprising clinical experts in genetic retinal diseases, statisticians, and optical specialists to investigate the current applications and technical characteristics of MLMT, ultimately formulating consensus recommendations for its use as a clinical trial endpoint for IRD gene therapies. This consensus aims to provide a set of MLMT operating norms applicable to China's national conditions, guide clinical practice and research in ophthalmology and related disciplines, and promote the standardization process of IRD clinical trials in China, so as to better serve the IRD patient population and promote the development of related fields.
It is very important to develop and revise expert panel consensus on Chinese patent medical clinical application. The contents of the expert panel consensus include determination of the subject, clarity of the application scope, indications, dosage and administration, and safety of Chinese patent medicine. In the process, clinical researchers establish project team, formulate clinical management questions, select the outcome index, retrieve and make the evidence, and develop expert consensus with consensus methods strictly according to the requirements of methodology.
Retinopathy of prematurity (ROP) is a blinding eye disease of neonates. Early screening and regular follow-up can prevent the disease from leading to serious functional impairment. Rop is classified by the World Health Organization as the prevention target of avoidable blindness in neonates. Since the National Health Commission of the People's Republic of China issued "Guidelines for the treatment of oxygen and the prevention and treatment of retinopathy in prematurity" in 2004, the Ophthalmology Group of the Chinese Academy of Ophthalmology has actively promoted the screening and treatment of ROP, and updated "Guidelines for screening retinopathy of prematurity" in China in 2014. After nearly 20 years of hard work, the disease of stage 5 ROP in China has basically disappeared. In order to reasonably grasp the classification criteria of ROP and the indications of drug treatment, Fundus Disease Group of Ophthalmological Society of Chinese Medical Association, Fundus Disease Group of Ophthalmologist Branch of Chinese Medical Doctor Association organize experts in related fields to reach consensus opinions through serious, comprehensive and full discussion, and update the classification of ROP in China and the Chinese translation of new terms with reference to international standard terms. The standard of anti-vascular endothelial growth factor drug treatment indication is also added to provide reference for clinicians in clinical practice.
Families are important venues for nutritional management of the elderly, and there is an increasing demand for continuous nutritional management services from hospital to home. It has been 7 years since the publication of the "Chinese expert consensus on home nutrition administration for the elderly (2017 edition)", and with the publication of more research evidence and the practice of home nutrition administration, there is an urgent need to update the 2017 edition of the consensus. A total of 35 recommendations or consensus opinions have been proposed in this consensus update, aiming to guide grassroots related professionals to provide scientific, reasonable and standardized home nutrition management services for the elderly population at home or in the community.
Day surgery wards have advantages such as the ability to quickly free up beds and possessing necessary medical resources, making them a focal department for the integration of emergency and routine medical care within healthcare institutions. The Day Surgery Nursing Committee of Sichuan Tianfu New Area Medical Association gathered experts from relevant fields, took into account the actual situation and previous practices of integrating emergency and routine medical care in day surgery wards, and developed this expert consensus. It covers the aspects of emergency plans, process mechanisms, spatial preparations, personnel preparations and deployment, material preparations, and information sharing and coordination of the management model of integrating emergency and routine medical care in day surgery wards, so as to provide professional guidance and references for the management model of integrating emergency and routine medical care in day surgery wards, and offer new ideas and methods to maximize patient treatment during emergency situations.
