Methodological quality and transferability will be important issues for the credibility and usefulness of both published studies and administrative methods for evaluating the socio-economic value of marketed medicines in China. This paper critically examines factors commonly contributing to, or inhibiting, the quality and transferability of socio-economic evidence of the value of medicines, with specific reference to the Chinese community. It discusses appropriate approaches to design, performance, and reporting of published economic evaluation studies, as well as guides on assessment of quality of economic evaluations and recommends two internationally established methods that may be suitable for training in this setting.
ObjectiveTo evaluate the reliability and validity of Guideline Implementation Success Assessment Tool (A-GIST). MethodsWith the guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition) as the target guideline, health care providers and patients from different hospitals across the country were investigated by questionnaire using A-GIST. Spearman-Brown coefficient and Cronbach's α coefficient were used to evaluate the split-half reliability and internal consistency reliability, while the structural validity, convergent validity and discriminant validity were investigated by confirmatory factor analysis based on structural equation. ResultsThe internal consistency reliability and split half reliability coefficients of the whole tool and each dimension ranged from 0.650 to 0.986. The scale-level content validity index (S-CVI/Ave) of content validity was 0.846. Confirmatory factor analysis showed that, the χ2/df of two sections of the tool were 8.695 and 6.123, respectively. The root mean square residual (RMR), the standard root mean square residual (SRMR) and the root mean square error of approximation (RMSEA) were under or almost under the threshold. Besides, the goodness-of-fit index (GFI) of them were 0.901 and 0.822, the adjusted goodness-of-fit index (AGFI) were 0.836 and 0.787, and the parsimonious normed fit index (PNFI) were 0.545 and 0.788, respectively. ConclusionGuideline Implementation Success Assessment Tool (A-GIST) was proved to be valid and reliable, and it shows that it is necessary to optimize the items under the dimensions of maintenance and evaluation of diagnosis and treatment effect in the future.
ObjectiveTo systematically review the effects of the promotion of appropriate health technology in China and provide reference for improving the promotion of appropriate health technologies. MethodsDatabases including CBM, VIP, CNKI and WanFang Data were searched for studies about the appropriate health technology in China from inception to August 2014. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies by the evaluation criteria for descriptive studies of MAStARI, an assessment tool developed by JBI Evidence-Based Health Care Center. And then, qualitative descriptive analysis method was used to comprehensively analyze the data from four aspects: medical institutions, regulators, technology promotion medical staff and patients. ResultsA total of 23 cross-sectional studies and one before-after study were included. The results of qualitative analysis showed that: 1) the technology utilization rate of appropriate health technology extension institutions was more than 70%, the number of outpatients of township and village organizations increased significantly than that of the county level institutions; 2) director of technology extension and managers of hospital were in favor of the promotion of appropriate technology for its good effectiveness, safety, lower medical costs, and skill improvement of medical staff; 3) medical staff mastered the appropriate health technology, they were willing to promote appropriate technology and spoke highly of it for its safety, feasibility and economic effect, and improved their level of technology; 4) in patients' opinion, the appropriate technology reduced the disease course and cost, they spoke highly of it for its acceptance, efficacy and safety. ConclusionCurrent evidence shows that the promotion of appropriate health technology has achieved good effects. The satisfaction of medical institutions, managers, health service staff and patient is high, but these research results are of poor quality, mostly subjective evaluation, lack of scientific, rational, objective and consistent evaluation criteria, which cannot be used as evaluation evidence for the promotion of appropriate health technology.
目的 探讨经阴道B型超声(B超)在诊断早期宫外孕中的临床应用价值。 方法 回顾分析2011年5月-2012年3月应用阴道B超与腹部B超对78例宫外孕患者进行对比检查的临床资料并回顾性分析,评价两种检查方法的临床效果。 结果 78例宫外孕患者,应用经阴道B超检查诊断准确率为97.44%,应用腹部B超准确率为61.54%,差异具有统计学意义(χ2=6.472,P<0.05);经阴道B超检查诊断附件包块、宫内假孕囊、心血管搏动、胚芽、盆腔积液的检出率明显高于经腹部B 超检查的检出率(P<0.05)。 结论 阴道B超具有操作简单、快速、无副作用、无需充盈膀胱等优点,在宫外孕的早期诊断中具有绝对的优越性,为临床提供了更方便、更快捷的诊断手段,减轻了患者痛苦,提高了诊断的准确率,值得临床广泛推广和应用。
ObjectiveTo evaluate the clinical efficacy of medical absorbent pads in the treatment of wouds. MethodsA total of 200 patients treated in the Wound Treating Center of a first-class hospital between November 2014 and August 2015 were randomly divided into trial group and control group with 100 patients in each. Patients in the trial group received medical absorbent pads, while patients in the control group received the treatment of Zetuvitò E. All patients received four times of treatment. Then we used self-made observation record form to evaluate such indexes as water absorption and compliance of the dressing, patients' pain and secondary trauma scores and the score of skins around the wounds. ResultsThere was no significant difference in water absorption property and compliance between the two groups (P>0.05). But the score of visual analogue scale was lower in the trial group than that in the control group at the fourth dressing changing (P<0.05), and the score of secondary trauma was also lower in the trial group than that in the control group at the third and fourth dressing changing (P<0.05). ConclusionThe medical absorbent pads used in the trial group can relieve pain and promote wound healing. It can be used for the treatment of wounds, and also has better effectiveness and safety.
Objective To evaluate the application effect of epilepsy prevention and management project in rural areas of Neijiang City. MethodsAccording to the requirements of the "Rural Epilepsy Prevention and Management Project Work Manual" (2021 edition) of the National Epilepsy Prevention and Management Project Office, the follow-up data of patients in rural areas of Neijiang City from the beginning of the epilepsy prevention and management project to December 2023 were collected, and the patient treatment effect of the project was evaluated. Results The total effective rate was more than 70% after 3 months of treatment, As the treatment time is extended, the total efficiency is upward. Adverse drug reactions occurred mainly in the first 3 months of treatment.The patients dropped out of the group because they did not achieve the expected effect, poor treatment compliance and could not tolerate serious adverse reactions. Conclusion The prevention and treatment of epilepsy in rural areas of our city has a good effect of promotion.The follow-up management of patients in the first 3 months of treatment should be strengthened to ensure the continuity and standardization of treatment.