Objective To formulate a medical endoscopy service evaluation system, so as to guide the hospitals to select products, provide advices for manufacturers to improve the service, and finally improve the overall service capacity of medical endoscopy industry. Methods The whole study was conducted from January to December 2018. Firstly, Delphi method was used to establish the evaluation indexes, which helped to get the evaluation scenario. Secondly, the evaluation mechanism was established through the association of three central hospitals with their medical treatment partnerships and collaborative hospitals. Thirdly, the popular medical endoscopy brands in China were evaluated for a long time by means of information technology. Results Finally, more than 80% of the provinces of China were covered by the medical endoscopy services evaluation, and 51 hospitals participated in the evaluation. At the end of 2018, 1 450 valid data were collected, of which the annual average abnormal data was less than 5%. With the score ranking, the highest score was 4.45, the lowest score was 3.27, and the average score was 3.85. The preliminary evaluation results were sent to medical endoscopy manufacturers. Conclusions The " multi-center hospital” medical endoscopy service evaluation system established in this study has the characteristics that the indexes are scientific, and the evaluation is comprehensive and wide-coverage. It provides a feasible and effective solution for medical endoscopy service evaluation and plays an important role in improving the whole medical endoscopy service level and brand value.
BY the method of clinical epidemiology and evaluation ,the comprehensive evaluation of laparoscopic cholecystectomy (LC) including safety,effect and satisfaction of patients has been given in this paper. The comparative study was done between the LC and the traditional opened cholocystectomy (OC). The conclusion suggests that this therapy would have evry important significance to improve the efficiency of utility of medical resources and the benefit of health care and the quality of life of the patient. Some information had been furnished in this study to extend laparoscopic operation appropriately in our country.
Objective To summarize and analyze the working experience of hospital performance evaluation and reporting system in America, so as to provide decision support to China on such work as establishing objective, scientific and effective hospital performance evaluation system, strengthening government’s supervision to health service, and promoting hospitals’ sound development.Methods American official websites and databases were searched to include relative policies, reports and documents on hospitals’ performance evaluation. Results Typical hospital performance evaluation and reporting system in America included National Healthcare Quality Report (NHQR), Consumer Assessment of Healthcare Providers and System (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS), Leapfrog Group Evaluation System and Thomson Reuters 100 Top Hospitals. Conclusion The enlightenments of American performance performance evaluation systems to China include: a) more attention should be paid to performance evaluation; b) combined evaluation models and results application methods should be considered; c) comparatively scientific evaluation methods and comprehensive evaluation contents should be established.
Objective To evaluate evidence from American medical risk monitoring and precaution system (AMRMPS) which may affect the construction of Chinese medical risk monitoring and precaution system (CMRMPS). Methods We searched relevant databases and Internet resources to identify literature on AMRMPS, medical errors, and patient safety. We used the quality evaluation system for medical risk management literature to extract and evaluate data. Results In 1999, a report from the Institute of Medicine (IOM) not only showed the severity and cause of medical errors in America but also gave the solution of it. In 2000, the Quality Interagency Coordination Task Force (QuIC) was appointed to assess the IOM report and take specific steps to improve AMRMPS. After 5 years, a well-developed medical risk management system was established with the improvement in the public awareness of medical errors, patient safety, performance criteria of medical safety, information technology and error reporting system. There was still some weakness of this system in risk precaution and prevention. Conclusion The experience from AMRMPS can be used to establish the CMRMPS. Firstly, we should disseminate and strengthen the awareness of medical risk and patient safety in public. Secondly, we should establish hospital audit system which includes auditing of medical staff and course of medical risk in continuing and academic education. Thirdly, we should develop regulations and guidelines on health care, medical purchase and drug supply which will benefit in management of regular work. Fourthly, we should develop computer information system for hospital which will regulate the management without the disturbance from human. Lastly, we should emphasize outcome evaluations and strive for perfection during the process.
Our country has been using maturity grading method, which was proposed by Grammum in 1979, to evaluate the placental function. However, this method is subjective to consequence because it totally depends on the observation and experiences of clinicians. With the development of ultrasound technology, therefore, we reviewed more novel applications in other aspects of placenta (such as blood flow, vascularization, etc). Over the past years, scholars in the world have done a lot of research around these topics. In this review we introduce placental maturity grading with B-mode ultrasound, placental vascularization qualitative and quantitative analysis with three-dimensional Doppler ultrasound and placental volume measurement, respectively.
Objective To evaluate on immunogenicity and safety of measles-mumps-rubella-varicella vaccine. Methods The PubMed, BIOSIS Previews, CDSR, The Cochrane Library, CBM, CNKI and VIP were searched between Jan. 1990 and April 2010. Studies were included in the review if they were randomized controlled trials (RCTs) about measles (M) – mumps (M) – rubella (R) and varicella (V) vaccine. Trial screening, data exaction and quality assessment of the included trials were conducted by the method recommended by Cochrane Collaboration. Statistical analyses were conducted by using RevMan 4.2.10 software. Results Five RCTs were included. Among those there were 2 trials of B degree and 3 trials of C degree. Meta-analyses showed that to different inoculation methods, (MMRV or MMR+V) the rate of pain was not significantly different with RR 0.94 and 95%CI 0.83 to 1.05 (P=0.28). The rate of redness was not significantly different with RR 1.08 and 95%CI 0.90 to 1.29 (P=0.40). The rate of hardening was not significantly different with RR 1.16 and 95%CI 0.95 to 1.43 (P=0.14). The rate of fever was significantly different with RR 1.20 and 95%CI 1.12 to 1.29 (Plt;0.000 01). The rate of skin rash was not significantly different with RR 1.18 and 95%CI 1.00 to 1.41 (P=0.05). The serum measles antibody positive rate was not significantly different with RR 1.00 and 95%CI 0.99 to 1.01 (P=0.68). The serum mumps antibody positive rate was not significantly different with RR 0.99 and 95%CI 0.50 to 1.01 (P=0.11). The serum rubella antibody positive rate was not significantly different with RR 1.00 and 95%CI 0.99 to 1.01 (P=0.68). The se-rum varicella antibody positive rate was not significantly different with RR 1.00 and 95%CI 0.99 to 1.01 (P=0.58). Conclusion Compared with MMR+V vaccine, the MMRV vaccine has the same immune effect. In respect of immune safety, in addition to higher rate of fever after vaccination, other local or systemic reaction is good. For the role of reducing vaccination times and good performance on immune effect and safety, the MMRV vaccine can be regarded as candidate vaccine for children. The fever caused by the new component should be strengthened in the following study. Limited to the quality and account for the current original documents, citing evidence of this systematic review would be cautious. Future studies would expand the sample size, fulfill the test design, increase indicators to improve the quality of research and demonstration intensity.
ObjectiveTo biliometric analysis of the status quo of tracking rural health service quality, evaluation and supervision mechanism, in order to improve the quality of rural health service, optimize the allocation of resources and increase the quality and level of health service of rural medical staff. MethodsWe searched PubMed, The Cochrane Library (Issue 3, 2016), The Campbell Library, Web of Science, CBM, CNKI, and WanFang Data, as well as relevant websites up to March 2016. EndNote X7 software and Excel 2007 software were used for screening literature and analysis data. ResultsA total of 39 studies were included in the biliometric analysis. Eighteen studies were cross-sectional studies (46.2%), 18 were reviews (46.2%), 2 were cluster randomized trials (5.1%) and 1 was randomized controlled trial (2.6%). Thirteen studies were published in journals indexed by Science Citation Index, 3 were published in journals indexed by Chinese Science Citation Database, 18 were published on other peer-review journals, and 5 were thesis's. The involved theoretical models were as follows: 10 mechanisms (30.8%), 4 frameworks (18%), 11 systems (30.8%) and 12 methods (30.8%). The serviceable range included village clinics (n=3, 7.7%), town-level hospitals (n=3, 7.7%), and community (n=2, 5.1%). The research topics included public health (n=19, 48.7%), clinical care (n=16, 41%), medical insurance (n=4, 10.3%). ConclusionThe studies for rural health service quality tracking, research evaluation and supervision mechanism are still lack of systematic, pertinence and practicability, and the level of evidence is still low. We suggest pay attention and strengthen the rural health service quality tracking, research evaluation and supervision mechanism, and to provide effective evidence for effective evaluation and supervision to promote rural health service quality, and to promote the reasonable optimization the allocation of health resources in rural areas, and to greatly improve the quality and level of rural health service.
Large Language Models (LLMs) are highly sophisticated deep learning models pre-trained on massive datasets, with ChatGPT representing a prominent application of LLMs in the field of generative models. Since the release of ChatGPT at the end of 2022, generative chatbots have become widely employed across various medical disciplines. As a crucial discipline guiding clinical practices, the usage of generative chatbots like ChatGPT in Evidence-Based Medicine (EBM) is gradually increasing. However, the potential, challenges, and intricacies of their application in the domain of EBM remain unclear. This paper aims to explore and discuss the prospects, challenges, and considerations associated with the application of ChatGPT in the field of EBM through a review of relevant literature. The discussion spans four aspects: evidence generation, synthesis, assessment, dissemination, and implementation, providing researchers with insights into the latest developments and future research suggestions.
Precision medicine is a personalized medical system based on patients' individual biological information, clinical symptoms and signs, forming a new clinical research model and medical practice path. The basic idea of traditional Chinese medicine and the concept of precision medicine share many similarities. The basket trial developed for precision medicine is also suitable for clinical trials and evaluation of the efficacy of traditional Chinese medicine syndrome differentiation and treatment systems. Basket trials are used to evaluate the efficacy of a drug in the treatment of multiple diseases or disease subtypes. It has the advantages of sharing a master protocol, unifying management of subsidiary studies, simplifying the test implementation process, unifying statistical analysis, saving resources, reducing budgets and accelerating the drug evaluation progress. This is similar to the concept of using the "same treatment for different diseases" found in traditional Chinese medicine. This paper introduced the concept and method of basket trials and explored their application and advantages in clinical research into traditional Chinese medicine. This study is expected to provide references for the methodological innovation of clinical research into traditional Chinese medicine.
