Objective To evaluate and summarize the relevant evidence of early enteral nutrition in patients with severe acute pancreatitis (SAP), and provide evidence-based support for the clinical practice of early enteral nutrition in SAP patients. Methods The evidence on early enteral nutrition in SAP patients from relevant databases and websites was retrieved using computer. The retrieval deadline was from the establishment of the databases to December 31, 2024. Two researchers independently conducted literature screening and quality evaluation, extracted and summarized evidence. Results A total of 14 articles were included, including 6 systematic reviews, 7 guidelines, and 1 expert consensus. A total of 19 pieces of evidence were compiled and summarized from 9 aspects, including early enteral nutrition feeding assessment, start timing, feeding route, catheterization method, infusion method and speed, energy and protein targets, nutrient preparation selection, complication prevention and management, and health education. Conclusion The overall quality of evidence for early enteral nutrition in SAP patients is good and has strong generalizability. Medical staff should select evidence based on clinical contexts and develop safe, scientific, and personalized enteral nutrition plans for patients to promote their recovery.
Objective To summarize the best evidence of preoperative prehabilitation for patients undergoing total joint replacement/total knee replacement (THA/TKA), and to provide reference for clinical work in the context of enhanced recovery after surgery (ERAS), in order to speed up the postoperative rehabilitation process of patients undergoing THA/TKA. Methods Up To Date, BMJ Practice, National Institute for Health and Care Excellence, Cochrane Library, JBI Evidence-Based Health Care Center Database, Guidelines International Network, www.guide.medlive.cn, PubMed, China National Knowledge Infrastructure, VIPdata, and WanFang Data were searched by computer for literature about preoperative prehabilitation of THA/TKA patients. The retrieval time was from the establishment of the databases to May 31, 2022. The quality of the included literature was evaluated by 2 researchers with evidence-based training. Results A total of 11 publications were included, including 1 guideline, 3 expert consensuses, 3 systematic reviews, and 4 randomized controlled trials, covering 6 aspects of multidisciplinary team, patient education, drug management, nutritional guidance, index control, and exercise intervention. A total of 16 best evidences of preoperative prehabilitation in patients with THA/TKA were extracted, including 9 A-level recommendations and 7 B-level recommendations. Conclusions THA/TKA prehabilitation includes various comprehensive interventions. With the development of ERAS in orthopaedics, the best evidence extracted can be used by clinical staff for THA/TKA. Evidence-based evidence is provided for patients to formulate prehabilitation programs.
Objective To search for, assess, and summarize the best evidence for antimicrobial allergy assessment in hospitalized patients, so as to provide an evidence-based basis for clinical nursing practice. Methods UpToDate, BMJ Best Practice, National Guideline Clearinghouse, Guidelines International Network, Yimaitong, JBI Evidence Synthesis, Cochrane Library, CINAHL, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Data, CQVIP, SinoMed, and related association websites were searched by computer for literature about clinical decisions, guidelines, expert consensuses, evidence summaries, systematic reviews and meta-analyses related to antimicrobial allergy assessment in hospitalized patients. The search time limit was from the establishment of the databases to September 2024. Two researchers trained in evidence-based practice screened the literature and evaluated the quality independently. Finally, the evidence-based research group extracted and integrated the evidence after discussion. Results Totally 8 articles were involved, including 6 guidelines and 2 systematic reviews. Finally, 25 pieces of best evidence were obtained across 6 aspects, including the importance of antimicrobial allergy assessment, the subjects of allergy assessment, the personnel conducting allergy assessment, the content of allergy assessment, the recording of allergy history, and assessment tips. Conclusion When applying and transforming evidence, medical staff should fully consider the actual clinical situation and explore the evaluation scheme of antimicrobial allergy history of hospitalized patients with local characteristics, to improve the accuracy of evaluation of antimicrobial allergy history of hospitalized patients, so as to strengthen the safety management of drug use and improve the level of rational drug use.
With the development of computer technology, medical data has developed from traditional paper pattern into electronic mode, which could effectively promote the medical development. This paper at first presents the status and characteristics of medical data mining. Then, it discusses the critical method of medical data mining in classification, clustering and prediction, respectively. The paper focuses on the application and assessment of five algorithms which are designed for medical data mining, including decision tree, cluster analysis, association rule, intelligent algorithm and the mix algorithm. Finally, this paper outlooks the data mining application in medical domain.
Objective To retrieve, evaluate, and summarize evidence on the prevention and management of intracranial infections related to lumbar drainage (LD), in order to provide scientific references for clinical practice and decision-making. Methods The literature on the prevention and management of LD-related intracranial infections in LD-related websites and databases was systematically searched, with a search period from the establishment of databases to June 30, 2024. The included literature was evaluated for quality and integrated into evidence. Results A total of 9 articles were included, including 3 guidelines, 1 evidence summary, 1 expert consensus, 1 systematic review, and 3 original studies. A total of 30 pieces of evidence were formed, covering six aspects: risk management, catheter placement, catheter maintenance, extubation, diagnosis and treatment of intracranial infections, education and training. ConclusionsThe prevention and management of LD-related intracranial infections involve multiple pieces of evidence, and medical staff should selectively apply the best evidence based on patient and clinical conditions to reduce the incidence of intracranial infections and improve medical quality.
Objective To retrieve and summarize evidence of non-pharmacological interventions for sleep disorders in patients with osteoarthritis (OA), and to organize and evaluate the extracted evidence to provide evidence-based interventions for sleep disorders in patients with OA. Methods The relevant literature on non-pharmacological interventions for sleep disorders in patients with OA in BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Registered Nurses’ Association of Ontario, Guidelines International Network, Medlive guidelines network, Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure and Wanfang was systematically searched. The search deadline was June 30th, 2024. The retrieved results were integrated and analyzed to form evidence of non pharmacological interventions for sleep disorders in patients with OA. Results A total of 13 articles were included, including 1 evidence report, 5 guidelines, 2 expert consensus papers, 3 systematic reviews, and 2 randomized controlled trials. The summarized evidence involves six aspects of sleep screening, specialist visits, assessment tools, cognitive behavioral therapy, exercise therapy, and other measures, totaling 20 pieces of evidence. Conclusion Non-pharmacological interventions for sleep disorders of patients with OA include multiple aspects, and this evidence can provide theoretical basis for developing intervention plans for sleep disorder of patients with OA, thereby improving their sleep quality and enhancing quality of life.
Objective To search, evaluate and summarize the relevant evidence of the treatment and management of patients with acute myocardial infarction (AMI) under the chest pain center mode by using the evidence-based medicine method, so as to provide references for optimizing the clinical pathway, improving the medical quality and improving the prognosis of patients. Methods Relevant evidence on the treatment and management of AMI patients in relevant databases and websites at home and abroad was retrieved, and the retrieval time limit was from the establishment of databases to January 1, 2025. The quality of the included literature was evaluated, and the evidence was extracted and summarized. Results A total of 15 articles were included, including 2 clinical decisions, 2 systematic reviews, 8 guidelines, and 3 expert consensuses. Finally, 23 pieces of best evidence were extracted, including the basic conditions of chest pain center, the evaluation and treatment of patients with acute chest pain, the integration of pre-hospital emergency system and hospital green channel, and training and education. Conclusions The best evidence for the treatment and management of AMI under the chest pain center mode can provide evidence-based basis for clinical practice. It is necessary to combine the situation of the chest pain center, fully consider the validity and feasibility of the evidence, and help the chest pain center improve the medical quality and improve the prognosis of patients in a standardized and scientific way.
ObjectiveTo screen the current optimal evidence for early removal of urinary catheters in patients after gastrointestinal surgery both domestically and internationally. MethodsWe systematically searched the following databases or website, including the UpToDate, the British Medical Journal Best Practice, the Jonna Briggs Institute Evidence-Based Healthcare Center, the Guidelines International Network, the National Institute for Health and Clinical Excellence Guidelines, the Registered Nurses’ Association of Ontario, the Scottish Intercollegiate Guidelines Network, the European Association of Urology Nurses, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, ClinicalKey, Embase, PubMed, Web of Science, CNKI, Wanfang, and VIP. The literature was evaluated, and the evidence was extracted and summarized. ResultsA total of 27 articles were included, including 3 clinical decisions, 4 guidelines, 18 systematic reviews, 1 practice recommendation, and 1 expert consensus. The 23 evidence items were classified into five categories: pre-catheterization assessment (6 items), institutional and personnel requirements (2 items), strategies to shorten catheter indwelling time (8 items), bladder recovery strategies (5 items), and timing of catheter removal (2 items). These items were classified 5 evidence levels ccording to the 2014 JBI Evidence-Based Healthcare System Evidence Pre-Grading and Recommendation Level System: level 1 (6 items), level 2 (8 items), level 3 (1 item), level 4 (0 items), and level 5 (8 items). Recommendation grades: grade A (strong recommendation, 14 items) and grade B (weak recommendation, 9 items). ConclusionsThe high-quality evidence identified in this study regarding early urinary catheter removal can be effectively applied in the clinical management of patients after gastrointestinal surgery. However, there are few studies on this in China. These best evidence should be adaptively implemented according to the specific situation after gastrointestinal surgery in China.
Objective To summarize the best evidence for prevention and management of joint dislocation after total hip arthroplasty (THA) and provide evidence-based support for reducing the occurrence of joint dislocation after THA. Methods The databases and websites related to prevention and management of joint dislocation after THA were searched, mainly including clinical decisions, guidelines, expert consensuses, evidence summaries, systematic reviews. The search period was from January 1, 2020 to April 30, 2025. Results Finally, 12 articles were included, including 2 guidelines, 4 systematic reviews, 4 clinical decisions, and 2 evidence summaries. The 5 dimensions of evaluation, preventive measures, early dislocation identification, daily activity recommendations, and health education were summarized and organized into 25 pieces of evidence. Conclusions The overall quality of the evidence related to the prevention and management of joint dislocation after THA summarized in this study is good. Medical staff should selectively apply the evidence based on clinical situations to develop safe, scientific, and personalized anti-dislocation plans for patients, in order to reduce the occurrence of joint dislocation and improve patient prognosis.
Objective To evaluate and summarize the relevant evidence on follow-up management of non-pregnant adult with pulmonary embolism, and provide a reference for optimizing the follow-up plan of non-pregnant adult with pulmonary embolism. Methods Clinical decision-making, guidelines, societies/associations websites related to follow-up of pulmonary embolism, and databases were searched for literature on follow-up management of non-pregnant adult with pulmonary embolism. The retrieval time limit was from databases establishment to December 2023. The included literature was evaluated for quality and summarized to form evidence. Results A total of 13 articles were included, including 3 clinical decision-making articles, 5 guidelines, 1 systematic review, and 4 expert consensus articles, forming 26 best pieces of evidence, involving 8 aspects of follow-up personnel and methods, follow-up time, physical assessment, activity guidance, contraception guidance, filter management, medication guidance, and lifestyle guidance. Conclusions The follow-up management of non-pregnant adult with pulmonary embolism is very important. When medical staff apply relevant follow-up management evidence, they should fully evaluate the patients’ willingness and medical environment, make full use of existing resources, optimize follow-up management strategies, reduce the occurrence of complications, and improve patient prognosis.
