Liver cancer is one of the world’s most prevalent malignancies, and is also the third leading cause of cancer death in China. Hepatitis and cirrhosis background is a major feature of liver cancer patients in China, which makes specific requirements that suits the national conditions in many aspects of prevention and control like screening diagnosis, treatment options, and prognosis follow-up. The Specifications for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition), which is based on China’s practice, proposes liver cancer staging in line with China’s national conditions and forms a multi-disciplinary joint diagnosis and treatment model based on surgical treatment. Liver transplantation is included in liver cancer as one of the surgical treatments option. It also emphasizes the support of evidence-based medicine. The Specifications for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition) may have laid a solid foundation for future diagnosis and treatment of liver cancer in China.
Objective The purpose of this study, which focuses on the number of the Cochrane Systematic Review’s (CSR) full texts, protocols and registered titles from Chinese authors, is to show the development of evidence-based medicine (EBM) and promote EBM’s further development in China. Methods On the basis of The Cochrane Library (Issue 1, 2009) and the Cochrane Collaboration (March 2009) periodicals, we performed statistical analysis of different countries that released CSR’s full texts, protocols and registered titles, as well as the time, authors and distribution of the CSR’s full texts, protocols and registered titles in China. Results The publishing rates of the CSR’s full texts, protocols and registered titles in China ranked the seventh, fifth and second, respectively. Although the number of CSR’s full texts and protocols showed an increased annual trend in China, the development of area distribution was unbalanced. Moreover, China’s published articles contained 47 Cochrane collaboration groups, without effective practice and health care groups, consumers and communication groups, and methodology and multiple stenosis groups. Conclusions The current Chinese EBM situation has a great potential in writing CSR. However, there are still many problems that need to be resolved.
Objective To seek the best evidence on communication between physicians and patients so as to improve the physician-patient relationship in China. Methods We used the key words ‘physician-patient relationship’ and ‘communication’ to identify related systematic reviews and meta-analyses, and then evaluated them with the Overview Quality Assessment Questionnaire (OQAQ) checklist. Results Seventeen studies were included for final evaluation. According to the OQAQ checklist, the score range of the study quality was 3 to 9. 41.29% (7/17) of the included studies scored 7 to 9, 23.5% (4/17) scored 6, and 35.3% (6/17) scored 3 to 5. Factors influencing physician-patient communication primarily included communication targets, time, contents, and approaches. Conclusion There are not enough studies on physician-patient communication in China. We need to identify the problems affecting communication behavior, encourage patients to express their preferences, choose appropriate training strategies, and make timely evaluation so as to better satisfy the needs of patients and physicians.
Objective To investigate the current situation of clinical studies on puerarin for angina pectoris and assess whether it is adequate to provide evidence for clinical practiice. Methods We collected all the published clinical studies on puerarin for angina pectoris from 1966 to October 2003, and assessed all the included reports according to international clinical epidemiological standard. Results 106 RCTs, 8 non-randomized controlled studies and 24 case series were included and analyzed. 126 studies reported diagnosis criteria, 10 desccribed inclusion criteria; 3 studies were quasi-random, 1 double blind, 4 single blind; no study reported follow-up; 117 studies reported adverse effects. Conclusions Currently the quality of studies on puerarin for angina pectoris is not good enough to provide reliable evidence for clinical practice.
Objective To compare and review worldwide journals titled “evidence-based” in order to provide an overview of these healthcare journals and suggestions for improving the quality of this type of journal in China and to introduce a quick way for healthcare professionals and patients to obtain high quality clinical evidence. Methods We searched PubMed, EMBASE, Ulrich’s Periodicals Directory, Wanfang and some relevant websites to identify journals titled “evidence-based”. The last issues in 2006 of these kind of journals were analyzed by bibliometric method. Results Twenty-four journals were included. Covering 12 disciplines such as clinical, nursing, health care, etc. They were divided into the primary journals and the secondary journals, published in two languages in six countries. These journals had differences and similarities in their aims, columns and contents, etc. Conclusions Evidence-based medical journals provide the latest developments and the best evidence for healthcare professionals in their own fields, save their time in searching for and reading information, and provide ideas for improving the quality of similar journals in our country.
1992年,循证医学(evidence-based medicine,EBM)倡导者提出新"范式",即卫生研究证据是对个体病人及卫生系统决策的最好基础.该方法原意是拟除去传统医学知识体系仅关注疾病本身的病理生理过程及临床经验的积累,因此在2001年被lt;纽约时代杂志gt;评为最具影响力的理论之一.本文回顾了循证医学的产生、发展、哲学局限性和临床实践的挑战.指出EBM的演变、发展早已超出它原来(误解的)概念,即EBM有可能替代传统医学.EBM现正力求去增强而不是替代个人的临床经验及了解疾病的机制.并且EBM一定要继续发展、并探讨一系列的问题包括加强科学基础,伦理道德的重要性及其有关传播及应用的实际事务.例如,为了促进科学研究成果用于临床,证据往往都是从经选择过的人群的不完整证据而来,这些人群仅能从那些贵重技术中得到一些边缘性的好处.而证据的应用就会把这些有限的好处普遍化,由此引发出一系列问题即有多少人和谁能用得起这些新的疗法.因此循证医学的倡导者希望医生及用户关注那些来自临床研究、有效且适于临床应用的好证据.而要达到此目标还需做很多的工作.