Shared decision making (SDM), as a healthcare service model, requires clinical practice to follow the “patient-centred” medical principle and emphasizes patient participation in the medical decision-making process, which promotes medical equality and improves the quality and effectiveness of healthcare services. However, its methodology has not yet been introduced into the field of Chinese medicine (CM), and there is still a lack of clear guidance on how to implement SDM in clinical practice. This study provided the method of establishing the conceptual framework of SDM in CM, introducing multiple methods according to evidence-based medicine, and conducing an implementation study to explore the applicability of SDM model in CM clinical practice, with the aim of providing references for the application of the SDM in the clinical practice of CM in the future.
This paper introduced definition of right care, presented the evidences of overuse and underuse in the world and pointed out the importance of dissemination of evidence-based medicine to right care. Not only evidence production but also concepts of evidence-based practical are important. It is important to disseminate evidence-based medicine not only among academic societies but also among the public. These are critical for achieving right care and preventing overuse and underuse of medical care.
Objective To investigate evidence retrieval, appraisal, and reevaluation during evidence-based clinical decision making in China. Also, to analyze the related factors, so as to find the problems in the course of evidence-based clinical decision making and put forward corresponding solutions. Methods We searched Chinese Biomedical Literature Disc (CBM) and China Journal Full-text Database (Medical sciences) of the China National Knowledge Infrastructure (CNKI) to collect clinical evidence-based case reports. Relevant information was extracted from these reports by a selfdesigned investigation form.Then statistical analyses were performed. Results The search tools used in the course of evidence-based clinical decision making varied. The most frequently used were MEDLINE/PubMed (82.08%) and The Cochrane Library (60.38%). 30.63% of evidence-based case reports described the search strategy in detail, and 9.01% described how they modified their search strategy. All doctors evaluated the association between evidence and disease, but few of them integrated patient factors and relevant external factors when evaluating evidence. The scientific nature and validity of the evidence was evaluated in 74 evidence-based case reports (66.67%), and such evaluation was mainly based on the criteria of evidence grading (50.00%). Reevaluation was mentioned in 85.59% of evidence-based case reports. Conclusion In China, the application of evidence-based decision making varied in different clinical departments. Problems existed in the course of evidence retrieval, appraisal, and reevaluation. This revealed the low information diathesis level of doctors and their lack of evidence-based medicine knowledge. It is suggested that information education and evidence-based medicine education should be strengthened to improve doctors’ ability to use evidence-based clinical decision making. It is also recommended that the search tools, relevant search strategy, the modification of search strategy, and reevaluation on practice results of each case should be mentioned in evidence-based case reports.
Evidence-based dentistry has been established for more than a decade, and described as ‘the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients＇. However, Orthodontic clinicians in China still tend to base their treatment protocols on the ‘it works in my hands＇evidence provided by their peers, mainly due to their weak experience in searching and applying clinical evidences. In this article, authors are willing to share their experience with their Chinese peers, and to promote the dissemination and application of evidence-based orthodontics in clinical practice.
The analysis of big data in medical field cannot be isolated from the high quality clinical database, and the construction of first aid database in our country is still in the early stage of exploration. This paper introduces the idea and key technology of the construction of multi-parameter first aid database. By combining emergency business flow with information flow, an emergency data integration model was designed with reference to the architecture of the Medical Information Mart for Intensive Care III (MIMIC-III), created by Computational Physiology Laboratory of Massachusetts Institute of Technology (MIT), and a high-quality first-aid database was built. The database currently covers 22 941 medical records for 19 814 different patients from May 2015 to October 2017, including relatively complete information on physiology, biochemistry, treatment, examination, nursing, etc. And based on the database, the first First-Aid Big Data Datathon event, which 13 teams from all over the country participated in, was launched. The First-Aid database provides a reference for the construction and application of clinical database in China. And it could provide powerful data support for scientific research, clinical decision making and the improvement of medical quality, which will further promote secondary analysis of clinical data in our country.
Objective To investigate the basic status of adult cleft lip and palate patients and the social perception of different populations towards cleft lip and palate diseases in the Chinese Mainland, and provide a scientific basis for further improving the public awareness of cleft lip and palate diseases. Methods A questionnaire survey on basic demographic information was conducted among cleft lip and palate patients who were aged 18 or above and received diagnosis and treatment in the Department of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University between January 2022 and October 2023. Simultaneously, another questionnaire survey was conducted among cleft lip and palate specialists, genetic and prenatal counsellors, ultrasound staff, general medical staff, families of cleft lip and palate patients, and the general population, to investigate their level of knowledge regarding prenatal diagnosis, treatment, and prognosis of cleft lip and palate, as well as their corresponding decision-making choices. Results A total of 489 copies of questionnaire were distributed to patients with cleft lip and palate who were 18 years old or above, and 440 valid copies were collected, with an effective response rate of 90.0%. Among the 440 patients, 90.0% were aged 18-30 years, 57.7% were males, 65.7% were residing within Sichuan Province, 53.8% had an associate degree, bachelor’s degree or above, 71.6% had no fixed occupation, 75.0% had siblings, and 86.8% had a monthly family income of ≤10000 yuan. In terms of the questionnaire on social perception of cleft lip and palate among different populations, a total of 1513 copies of questionnaire were collected, among which 1437 were valid copies, with an effective response rate of 95.0%. There was no statistically significant difference (P>0.05) in the understanding and perception among different populations regarding the questions “Does cleft lip and palate affect the quality of life and future development of affected children?” or “Do you think families of children with cleft lip and palate experience significant pressure?”, while there were statistically significant differences (P<0.05) in the understanding and perception of the remaining eight questions. Conclusions People with cleft lip and palate have certain difficulties in employment and need more attention and help from the society. There are differences in social perception related to cleft lip and palate among different groups of people.
In the realm of data mining based on modern acupuncture clinical research, the impact of literature features such as literature quality, evidence level, sample size, and clinical efficacy on the quality of data mining outcomes remains uncertain. These issues are significant factors restricting the translational application of data mining research results. We suggest employing both entropy weight and linear weighting techniques to assess the specified indicators. This assessment results in a comprehensive weighted score for acupuncture prescriptions, serving as the foundation for our ensuing data mining endeavors. In this study, migraine research serves as an example to contrast the efficacy of weighted algorithms against that of classical algorithms. The findings demonstrate that the algorithm introduced in this research significantly contributes to studies focusing on the dispersed selection of acupuncture points. Its superiority lies in cluster analysis, where it adeptly discerns potential patterns in the amalgamation of acupoints. This algorithm amalgamates evidence-based acupuncture with data mining processes, providing innovative perspectives that augment the caliber of research in acupuncture data mining. Nonetheless, additional research is essential to corroborate these results.
