The social needs, disciplinary development and humanistic reflection has promoted the emergence and development of evidence-based medicine. Moreover, evidence-based medicine-problems oriented research, evidence based decision, transferring results to practice and outcome evaluation-continues to meet society demands, promote the development of discipline and show humanist concern. The application of evidence-based medicine has gradually extended from the field of clinical medicine to the public health, society, management, economy, policy research and education in the process of solving various problems. The high quality evidence has also been important to decision-making in these fields. Our study explored the emergence and development of evidence-based medicine from the perspective of social needs, disciplinary development and humanistic reflection for the first time.
ObjectiveTo systematically evaluate the effect of combination of motherwort injection and oxytocin for promoting the involution of uterus. MethodsData of randomized controlled trials (RCTs) of motherwort injection and oxytocin in promoting the effect of postpartum involution of uterus were collected by searching the electronic databases including PubMed, EMbase, CNKI, WanFang Data, CENTRAL and WHO ICTRP from inception to August 26th, 2016. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies. Meta-analysis was conducted by RevMan 5.3 software. ResultsA total of 18 RCTs involving 6 468 patients were included. The results of meta-analysis showed that:Compared with the oxytocin alone group, the combination group of motherwort injection and oxytocin was higher on promoting the drop height of uterus (MD=1.33, 95%CI 1.03 to 1.63), lower on the height of uterus (MD=-2.12, 95%CI -2.64 to -1.61) and duration of lochia (MD=-7.11, 95%CI -8.84 to -5.38). There was no statistical difference in adverse effect rate between the two groups (OR=0.87, 95%CI 0.64 to 1.19, P=0.38). ConclusionsMotherwort injection combined with oxytocin is superior to oxytocin alone in promoting the drop height of postpartum uterus and shortening the duration of lochia. Because of the low quality of the included studies, more high quality RCTs are needed to prove the above conclusion.
Science is a system of knowledge that reflects the essential connections and laws of the objective world. Classification of disciplines is a subsystem of science, which involves the development of human cognition which evolved from the scientific category to the department of higher education, and then formation of a complex management system. Nowadays with the rapid development of science and technology which triggering numerous complex social problems, an increasing trend of scientific integration calls for multidisciplinary and interdisciplinary research and education. In the 1990s, evidence-based medicine was emerged in the self-doubting of medical science, and extended to other fields of medicine, health policy and social sciences, forming an interdisciplinary evidence-based science system. Evidence-based science is an embodiment of scientific integration, and also the carrier and mechanism of cross-disciplinary convergence. It attempts to break through barriers of disciplines and management, and promotes interdisciplinary research, during which it has encountered many difficulties due to limitations of traditional disciplines. Evidence-based science does not provide an intrusion or transformation of thinking paradigm into other disciplines, but rather an equal dialogue to promote broader discipline collaboration and a new round of self-improvement, so as to constantly explore novel methods and theories to solve emerging problems, achieve continuous improvement, and pursue excellence.
The majority of problems are comprehensive and complex in the modern society, which leads to the increasing contradictions in the specialization and comprehensiveness of knowledge. Interdisciplinary cooperation is one approach to improve the effectiveness and transferability. The primary principle of evidence-based medicine is its scientific and transparent procedures. It combines the patient’s preferences with clinical experience and the best evidence. Meanwhile, evidence-based medicine is focused on how to transfer research outcomes into practice and the re-evaluation of the result of practice in order to striving for perfections. Combining this practical pattern of evidence-based medicine with other disciplines can have a significant improvement on scientific methods and thinking patterns, and become an effective way to improve the quality of scientific research and promote the transformation.
Medicine bears the responsibility for human health. Technical competence, service standards, professional ethics and social accountability constitute the soul of this profession. The principles of nonmaleficence, beneficence, respect for autonomy and justice help to establish good doctor-patient relationship and regulate medical services, which has been fixed by international and domestic professional norms. Besides to ensure its truth, effectiveness and safety, medical research also should require certain rendering of subject's autonomy, minimizing risks and maintaining social justice. Some procedures have established for supporting it. Modern medical education furnishes suitable human resources for medical profession, which directly affects the accessibility and outcomes of health services. Its objectives, operations and assessments are increasingly taking shape. Faced with the current issues of healthcare equity, worsening doctor-patient relationship, scandals and ethical controversies in medical research, and the failing of medical education to fully match social needs, evidence-based medical methodology is extending to policy and social sciences for identifying and creating high-quality scientific evidence to improve the quality of decision-making.
The increasing deteriorative trend of doctor-patient relationship (DPR) have destroyed patient safety, doctor safety and social stability in China. DPR is a complicated social problem related to multidisciplinary and multi-factor interactions. A series of researches providing different views on how to improve DPR in China have been published in recently years. Evidence-based medicine (EBM) aims to deal with massive information by producing, synthesizing and disseminating evidence from complex interventions. We tried to explore the trait of DPR by EBM methods. We provided evidence on research trends, topics and methods by systematic database retrieval, classification by screening, and quality assessment. Through dissection, attribution, and visualization of interactions and relationships between factors, we provided an evidence-supported framework for improvement of DPR. We identified gaps, defects or deficiencies in existing research, and promoted further research. We continued to follow up the research and faced a challenge: Reflection and frustration in the process of establishing the quality evaluation system of qualitative research. We found that the study of complex humanities and social sciences by reference to evidence-based methodology might be: providing a structured, panoramic perspective for complex social problems on " de-fragmentation”, providing a framework for social governance through classification and hierarchy, and calling for a more tolerant attitude and more comprehensive application of methodologies.
Lifestyle medicine is an emerging medical specialty of 20-year-history. It is more cost effective and environmentally friendlier in managing chronic health conditions of individuals and populations than the conventional allopathic medicine. By summarizing the development, implementation and prospects of lifestyle medicine in America, this paper aims to contribute to the advancement of lifestyle medicine in China.