Traditional Chinese medicine has been used for the treatment of many diseases including acute infections often associated with public health emergencies for thousands of years. However, clinical evidence supporting the use of these treatments is insufficient, and the mechanism for using Chinese medicine therapy in the public health setting has not been fully established. In this report, the Evidence-based Traditional and Integrative Chinese medicine Responding to Public Health Emergencies Working Group proposed five recommendations to facilitate the inclusion of Chinese medicine as part of our responses to public health emergencies. It is expected that the Working Group’s proposals may promote the investigation and practice of Chinese Medicine in public health settings.
ObjectiveThe purpose of this study was to translate the U-CEP scale into Chinese, and evaluate the reliability and validity of the Chinese version of the U-CEP, in order to provide a measurement and evaluation tool for clinical epidemiology education and research. MethodsThe U-CEP scale was translated and adapted using the Brislin translation model. A nationwide survey of clinicians was conducted using the Chinese version of the U-CEP. Item analysis, reliability analysis, and validity analysis were performed using SPSS 26.0 software. ResultsThe discriminant validity analysis showed that except for item 4, the critical value (CR) of the other twenty-four items differed significantly between high and low groups (P<0.01), with CR values ranging from 2.902 to 14.609. The ITCs of the 25 items were all positive, with 5 items having an ITC<0.15(20%), 2 items having ITC≥0.15~0.20 (8%), 6 items having ITC≥0.20~0.40 (24%) and 12 items having ITC≥0.40 (48%). In terms of reliability, the overall Cronbach’s α coefficient of the Chinese version of the U-CEP was 0.80, with Cronbach’s α coefficient ranging from 0.752 to 0.805 when deleting each item one by one. The test-retest reliability was 0.848 (P<0.001). The alternative-form reliability was 0.838 (P<0.001). In terms of validity, expert analysis showed that the content validity of the Chinese version of the U-CEP was good. The construct validity analysis showed that the cumulative contribution rate of the 25 items was 57.50%. No respondent scored full marks or zero marks, indicating that no ceiling or floor effects were found. There were statistically significant differences in the total scores among clinicians with different educational backgrounds or with or without systematic learning of relevant knowledge (P<0.05). ConclusionThe Chinese version of the U-CEP has good reliability and validity, as well as good cultural adaptability. It can effectively assess a physician's knowledge of clinical epidemiology.
With vigorous development of the Evidence-Based Practice (EBP), systematic review as a reliable basis for decision making is becoming more and more important, especially in emergent and significant situation under the influence of various interferences. But there are many misunderstandings and fallacies in systematic review beyond medical field, which block the spread and application of systematic review in health system decisions. This paper takes the evidences of health intervention practice as examples, explores the functions of systematic review in health system decisions, tries to clarify these misunderstandings and fallacies, and so as to promote the development of systematic review.
The consolidated framework for implementation research (CFIR) extracted, analyzed and integrated many published theories, frameworks and models of implementation research, and provided a comprehensive and practical theoretical framework for researchers to explore the influencing factors in the implementation of evidence. This paper introduces the origin, core content and application examples of CFIR in evidence-based nursing practice, in order to provide reference for researchers to use CFIR to carry out implementation research.
Objective To evaluate the rationality of drug treatment for cardiovascular diseases in aged people and the effects of evidence-based practice. Methods Descriptive study was conducted to compare the therapies for the patients suffering from cardiovascular diseases before and after evidence-based practice by investigating drug use during 1998-1999 (211 cases) and 2002-2003 (211 cases). Results Among antihypertensive drugs, the ACEIs and diuretics played a more important role than before. CCBs and ACEIs were still the most frequently used drugs, and drug combination was more common, comparing to that before evidence-based practice. Lipid lowering drugs and ACEIs were used more common in coronary heart disease. Quality of life of patients was more emphasized and combination use of anti-anxiety drugs was adopted. When treating heart failure, β-receptor blockers, aldadinc and ACEIs were more frequently used. Conclusions After evidence-based practice, drug use is much more based on evidence instead of experience and textbook. As a result, the rate of reaching ideal blood pressure is higher than before. The rate of rational drug use before and after evidence-based practice has increased from 42% to 78%, respectively.
ObjectiveIn order to summarize the best evidence, evaluate the efficacy and safety of interventions for the treatment of COVID-19, and provide practical guidance for medical workers, public health workers, and COVID-19 patients, we formulated the evidence-based practice points. MethodsWe followed the "Evidence-based practice points: methods and processes of development", with comprehensively considering the pros and cons of evidence, quality of evidence, public and patient preferences and values, cost of interventions, acceptability, and feasibility based on systematic reviews. Practice points Finally, 12 practice points were formed for non-severe, severe and critical COVID-19 patients. Non-severe: ① Consider Hanshiyi formula or Gegenqinlian pills for patients with nausea, vomiting and diarrhea; ② Consider Huashibaidu granules (decoration), Jinyinhua oral liquid, Jinhuaqinggan granules, Xuanfeibaidu granules (decoration), Lianhuaqingwen capsules (granules), or Reyanning mixture for patients with sore throat, fever, muscle aches or cough; ③ Consider Qingfeipaidu granules (decoration) for patients with nasal congestion, runny nose, cough, low-grade fever, aversion to wind and cold, and fatigue; ④ Consider Toujiequwen granules for patients with fever, chills, itchy throat, cough, dry mouth and throat, and constipation; ⑤ Consider Reduning injection or Xiyanping injection for patients with high fever, mild aversion to wind and cold, headache and body pain, cough, and yellow phlegm; ⑥ Consider molnupiravir, nirmatrelvir–ritonavir (Paxlovid), remdesivir or VV116 for patients within 5 to 7 days of the onset of symptoms and at high risk for progressing to severe disease. Severe: ① Consider Shenhuang granules or Xuebijing injection for patients with high fever, irritability, and thirst; ② Consider remdesivir used as soon as possible for patients with severe symptoms. Critical severe: Consider corticosteroids, IL-6 receptor inhibitors, and baricitinib for patients 7 days after the onset of symptoms.
As evidence-based practice (EBP) continues to be valued, the guideline implementation has become an important field for research and practice in health care. In order to better guide the guideline implementation in the field of health care, this paper combines the EBP experience gained from several EBP programs carried out in our hospital those years, in aim of exploring and sharing the methodology of guideline implementation in domestic clinical settings.