ObjectivesTo develop a real-world-data-based monitoring system for diagnostic large medical equipment, and to use PET/CT as a carrier for validation. MethodsWe used literature survey, site investigation, and two-rounds of modified Delphi methods to develop the indicator system, and used the analytic hierarchy process method to determine the weight of each indicator. We collected real-world PET/CT data from four tertiary hospitals from July to December 2022, and monitored the use of PET/CT in each hospital. ResultsQuestionnaire recovery rates of 2 rounds were 100% and 88%, respectively, the expert authority coefficient was greater than 0.70, and the coordination coefficients of experts in the total index were 0.307 and 0.471 (P<0.001). A three-level indicator system was established to monitor the use of large medical equipment, with three first-level indicators (clinical use, implementation, and other efficiencies), eight second-level indicators, and 15 third-level indicators. Empirical experiment found different hospitals vary in efficiency (of clinical use), staff status, and economic and research efficiency, while remained similar in other indicators. ConclusionWe developed a monitoring system for diagnostic large medical equipment based on real-world data, and used PET/CT as a carrier for validation. These findings provided theoretical and empirical foundations for the management of diagnostic large medical equipment in China.
Objective To explore the nursing quality standards of joint surgery based on “structure-process-outcome” three-dimensional quality evaluation model, and provide a reference for improving the quality of joint surgery nursing. Methods From March to July 2023, based on the “structure-process-outcome” three-dimensional quality structure model as the theoretical framework, combined with systematic literature review and semi-structured interviews, the quality standards of joint surgery specialist nursing were preliminarily formulated. The Delphi method was used for screening, demonstration, and correction, then the analytic hierarchy process was used to determine the weights. Results The recovery rates of the two rounds of expert letter consultation were 93.75% and 100.00%, respectively. The expert authority coefficients of both rounds were 0.95. The positive coefficients of experts in the two rounds were 0.93 and 1.00, respectively. The coefficients of variation after the second round of correspondence were 0-0.20. In the second round of correspondence inquiry, the Kendall harmony coefficients of primary standards, secondary standards and tertiary standards were 0.156, 0.115 and 0.285, respectively, with statistical significance (P<0.05). Finally, the quality standards of joint specialty nursing included 3 primary standards, 23 secondary standards and 99 tertiary standards. Conclusion The construction process of nursing quality standards of joint surgery specialty based on “structure-process-outcome” three-dimensional quality structure model is scientific and reliable, the index evaluation results are less volatile, and the opinions are concentrated, which can provide a basis for comprehensively, accurately and pertinently improving the quality of joint surgery specialty nursing.
Objective To analyze the research hotspots and trends of Chinese literature on medical quality evaluation indicators in China in recent years. Methods We searched for relevant Chinese literature on medical quality evaluation indicators on China National Knowledge Infrastructure from January 2000 to December 2024, and analyzed the annual publication volume, authors and institutions, research hotspots and frontiers. Results Finally, 177 articles were included in the literature. From 2000 to 2024, the number of Chinese literature on medical quality evaluation indicators in China showed a fluctuating upward trend, reaching 15 articles per year in both 2015 and 2024. The issuing units mainly included the National Institute of Hospital Administration, the School of Public Health of Peking University, Huazhong University of Science and Technology, etc. The publishing team mainly included author teams such as MA Xiemin, LIANG Minghui, XIA Ping, etc. The high frequency keywords and top 10 keywords for centrality ranking included medical quality, evaluation indicators, indicator system, Delphi method, evaluation, evaluation system, quality evaluation, indicators, clinical pathways, and hospital management. “Case classification” was the earliest emerging term in the study of medical quality evaluation indicators. In terms of burst intensity, the top 5 keywords for burst intensity included Delphi method, case classification, problem, data quality, and evidence-based evaluation. Conclusion The publishing institutions and research teams of Chinese literature on medical quality evaluation indicators in China are relatively loose, and there are still problems such as insufficient practical application of medical quality evaluation indicators and single research tools and methods.
ObjectiveTo evaluate the efficacy and toxicity of TEC and CEF regimen in preoperative chemotherapy for patients with breast cancer. MethodsA total of one hundred breast cancer patients undergoing preoperative chemotherapy were divided into TEC group (n=50) and CEF group (n=50) by the pairgroup method and received surgical therapy after three courses of chemotherapy. The efficacy and toxicity of preoperative chemotherapy of patients in two groups were analyzed. ResultsFour patients with stage ⅢB breast cancer quit from CEF group after two courses of treatment because of the worse satisfaction. Clinical complete remission (cCR) was 7 cases, clinic partial remission (cPR) was 34 cases, stable disease (SD) was 9 cases, therefore, the remission rate (RR) was 82.0% (41/50), and reduction rate of tumor was 64.0% (32/50) in TEC group. cCR was 2 cases, cPR was 32 cases, SD was 12 cases, thus the RR was 680% (34/50), and reduction rate of tumor was 40.0% (20/50) in CEF group. The clinical efficacy and reduction rate of tumor of patients in TEC group were significantly superior than those in CEF group (Plt;0.05). The negative conversion ratio of lymph nodes were 54.1% (20/37) and 57.1% (20/35) in TEC group and CEF group, which was not statistically different (Plt;0.05). The occurrence of hair loss and leukopenia of patients in TEC group were significantly higher than those in CEF group (Plt;0.05), while the differences in thrombocytopenia, low concentration of hemoglobin, nausea, vomiting, diarrhea, cardiac toxicity, and neurotoxicity were not significant (Pgt;0.05). ConclusionTEC regimen is better than CEF regimen in the efficacy and safety of neo-adjuant therapy for patients with breast cancer, and well tolerated.
Objective To evaluate the quality of Chinese literatures on the methodology of D-dimer diagnostic test. Method We searched CNKI (1994 to 2006) and CBM (1978 to 2006) for articles involving the diagnostic tests of D-dimer for coagulation disorders. Result A total of 63 relevant articles were retrieved and 7 were included in our review. Only one of these provided useful data on two two table for the evaluation of diagnostic accuracy. Conclusions Few studies on the diagnostic tests of D-dimer have been performed and publ ished in China, all of poor quality. Further studies should focus on clinical diagnostic sensitivity and specificity, so as to provide more valuable information for readers.
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.
The Technical Specifications for Evaluation of Age-friendly Medical Institutions is a set of evaluation standard for admittance of age-friendly medical institutions. The standard was prepared by Beijing Geriatric Hospital, organized by Beijing Municipal Health Commission and issued by Beijing Municipal Bureau of Market Supervision and Administration in 2021. The standard evaluates the construction of age-friendly medical institutions in four profiles, involving age-friendly culture, age-friendly management, age-friendly service, and age-friendly environment, and standardizes the specific links in the medical institutions evaluation and acceptance, displaying important guiding value for construction activities of national age-friendly medical institutions.
Objective To evaluate and select essential medicine for children with fever and adult gastrointestinal flu caused by common cold using evidence-based approaches based on the burden of disease for township health centers located in eastern, central and western regions of China. Methods By means of the approaches, criteria, and workflow set up in the second article of this series, we referred to the recommendations of evidence-based or authority guidelines from inside and outside China, collected relevant evidence from domestic clinical studies, and recommended essential medicine based on evidence-based evaluation. Data were analyzed by Review Manager (RevMan) 5.1 and GRADE profiler 3.6 to evaluate quality of evidence. Results (1) 12 guidelines were included, 11 of which were evidence-based or based on expert consensus. We offered a recommendation for medicines used in the treatment including analgesics and antipyretics, decongestants, antihistamines, cough-relieving drug, phlegm-removing drug and drug for gastrointestinal symptoms. (2) A result of four RCTs (very low quality) indicated that in the treatment of children with cold, ibuprofen suspension had an antipyretic effect similar to paracetamol solution (for oral use) with a pooled result of 6-hour efficiency in relieving fever (RR 1.48, 95%CI 0.66 to 3.30, P=0.34). The major adverse effects of ibuprofen suspension included gastrointestinal reaction and profuse sweats (RR=1.23, 95%CI 0.72 to 2.11, P=0.45). With good applicability, ibuprofen suspension (for oral use with no need to be supervised) cost 1.93 yuan daily. (3) A result of three RCTs (low quality) indicated that after given for 30 minutes and one hour, paracetamol solution (suppository) was fairly superior to ibuprofen suspension in lowering the high temperature caused by fever (given for 30 min: MD= –0.16°C, 95%CI –0.21 to –0.11, Plt;0.01; given for one hour: MD= –0.19°C, 95%CI –0.28 to 0.10, Plt;0.01). As to adverse reaction, paracetamol solution (suppository) mainly included anal irritation, skin rashes and profuse sweats, which had a comparative result of incidence with ibuprofen suspension (RR=1.84, 95%CI 0.62 to 5.44, P=0.27). For children with fever, paracetamol solution (suppository) cost 0.90 yuan daily. With good applicability, paracetamol solution (suppository) was administered via the anus. Conclusion (1) We offer a b recommendation for ibuprofen suspension (2 g/100 mL) or acetaminophen (0.1 g/suppository) as symptomatic treatment used in children with fever, pain and discomfort caused by common cold, and for Huo Xiang Zheng Qi Jiao Nang (0.3 g/ capsule) used in adults with gastrointestinal flu. We also offer a weak recommendation for acetylcysteine (injection, 300 mg/mL, 10 mL/ampoule) used in patients with paracetamol poisoning. (2) In order to produce high-quality local evidence, we proposed that large-scale, well-designed, high-quality clinical and pharmacoeconomic studies on ibuprofen suspension and acetaminophen suppository in the treatment of children with fever, pain and discomfort caused by common cold should be further carried out. Besides, we proposed that large-scale, well-designed, high-quality clinical and pharmacoeconomic studies on Chinese patent drugs of Huo Xiang Zheng Qi used in chidren and Huo Xiang Zheng Qi Jiao Nang used in adults should further carried out. Moreover, we suggest that epidemiological investigation as well as clinical and pharmacoeconomic studies of acetylcysteine injection for paracetamol poisoning should be carried out and the instructions of acetylcysteine injection should be added in the guidelines of essential medicine in China. Finally, further studies on evidence of oxymetazoline, dextromethorphan and other Chinese patent drugs with the effect of relieving cough and treating cold should be carried out.
Interpretation of the complete scientific connotation of functional foods accurately prior to approval and registration based on animal tests and small sample size human food tests is challenging. Further technical evaluation after market introduction should be carried out on safety, health function and other aspects of those widely used commercial scale production products. According to the analysis report on the consumption situation of post-marketing population submitted when applying for product registration extension since the implementation of the functional food registration and filing management measures more than 3 years ago, the post-marketing evaluation report of functional food still lacks systematic and perfect evidence support. Based on the successful experience of evidence-based medicine and post-marketing evaluation evidence, this paper analyzes the post-marketing evaluation content, evidence source construction, evidence classification and classification of functional food, and puts forward the preliminary idea of constructing post-marketing evaluation evidence body of functional food safety and health function technology from multiple view points, so as to provide insights into evidence system research in this field in the future.
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.