Objective To explore the methods of evidence-based individualized treatment for a patient with oral pemphigus. Methods According to chnical problems, we searched The Coehrane Library （Issue 1,2005 ） , MEDLINE （1966 -Jan. 2005 ）, SUMSEAR.CH （Jan. 2005 ）, TRIPDATABASE （1997 - 2005 ）, CMCC （1994 - 2004 ）and handsearched four Chinease journals （starting pubhcation -2004）. Results No Systematic review was found. Six randomised controlled trials, two reviews of high quality and one guidehne were identified. We found that corticosteroid was the firsthne medicine in the treatment of pemphigus. However, corticosteroid at higher dose did not work more effectively than that at lower dose. Corticosteroid at middle-dose was preferred in treating oral pemphigus. Additionally, corticosteroid combined with immunosuppressants led to lower mortality. Among them, cyclophosphamide and azathioprine were recommended, and methopterin should be avoided. Plasma exchange in combination with corticosteroid at lowor middle-dose should not be recommended in conventional therapy. Chinese traditional treatment combined with Western medicine might work. A treatment with prednisone at the dose of 60 mg/d and in combination with azathioprine 100mg/d was made based on the evaluation of the data available and was proved optimal by 6 months following-up. Conclusions The therapeutic effect of pemphigus has been improved by evidence-based treatment.
Due to the complexity of etiology and a lot of complication of diabetes mllitus, the reliable conclusion of studies of etiology and treatment of diabtets mellitus should rely on randomized controlled trial and systematic review. Alongside the development of meta-analysis, systematic reviewes have provided many beneficial information, including gene mutation and diabetes mellitus, evaluation of risk factors, diagnostic test and treatment of diabets mellitus.
Objective To evaluate the published case-reports of evidence-based practice(EBP) over three years,and to improve the quality of the papers and provide a recommended writing model. Methods Collecting the published 20 case-report of EBP and assessing their writing quality in 5 aspects according to the steps of EBP. Results Many Abstracts did not reflect entire context, and convey the overall information to readers, a formative structured Abstract should be taken. Most case-reports only involved with therapy,few diagnostic,harm and prognostic case-reports were republished,few EBP of surgery and other specialties, such as ENT,ophthalmology were mentioned.Searching strategies were not sufficiently described.Most authors only search The Cochrane Library and PubMed,while predigested sources were seldom used.Critical appraisal of evidence was difficult to each author,most papers were lack of appraisal or simply evaluated the validity of used evidence,and applicability of evidence was not clearly explained.All the papers did not conduct post evaluation.Conclusions Much needs to be done in improving the quality of published case-reporters of EBP,a standardized writing model should be recommended.
Objective To investigate the academic journals indexed by 6 international index systems so as to provide scientific evidence for the development of academic journals. Methods The principle and approach of evidence-based medicine were adopted. Information about Chinese academic journals indexed by 6 index systems was obtained by WEB searching and database retrieval. Details of academic journals in the charge of the Ministry of Education of China( MOE) were sought and assessed by six well-trained reviewers using a blind method. Results Seventy-six academic journals were indexed by SCI which was about 1.52% of total journals published in China and six of them were in the charge of MOE (about 1.46% of the total). Citation impact of academic papers indexed by ISI ranged from 0.9 to 2.2, and average impact ranged from 0.2 to 0.5. Approximately 4.8%, 1.6%, 1.28% and 11.32% academic journals were indexed by EI, IM, EM, AJ respectively. Conclusions The number of Chinese academic journals indexed by key international index systems was small, and the quality of journals should be greatly improved in future.
Objective To make an individualized therapeutic regimen for a patient with stage III relapsed ovarian cancer guided by evidence-based medicine.Methods According to the clinical problems this patient showed and the PICO (patient, intervention, comparison and outcome) principle, the best clinical evidence associated with relapsed ovarian cancer was retrieved and evaluated. Results The current evidence showed that the relapsed ovarian cancer with platinum resistance tended to be treated by pharmacotherapy. Consequently, on the basis of combining the recommended guidelines, randomized controlled trials (RCTs), systematic reviews or meta-analyses on RCTs, clinical experience from doctors and willingness of patient, the regimen of Irinotecan plus Pegylated Liposomal Doxorubicin for interventional chemotherapy was recommended for this patient. After three courses of the treatment, the disease got some relieved; the medical team would like to keep conducting the same regimen for another six to eight courses, and the follow-up visit was undergoing. Conclusion For patients with relapsed ovarian cancer with platinum resistance, an individualized therapeutic regimen under the guidance of evidence-based methods can not only improve the therapeutic efficacy but also guide both doctors and patients to take the indeterminate risk of medicine.
This paper introduces the background, significance, definition and types of clinical audit and describes five stages of clinical audit, including preparing for clinical audit, selecting criteria, measuring performance and sustaining improvement. This paper also introduces the international and national status quo of implementing clinical audit in nursing practice and describes the reporting guideline for articles of clinical audit. Finally, this article suggests that providing methodological training and creating a supportive environment are crucial strategies to promote the implementation of clinical audit and bridge the gaps between evidence and practice.
Objective To investigate baseline data of the current status of patients in China, and thus to develop strategies to get patients involved in evidence-based medicine (EBM). Method 300 questionnaires with 17 questions were distributed to the in-patients in West China Hospital, Sichuan University. Statistical software such as SPASS 10. 0 was applied to analyze all the data. Results No patients had ever heard of EBM. Most patients did not know much information about their diseases, but had a b desire to learn from their doctors. Most of them would like to be involved in the treatment decision-making and hoped that their doctors would care about their preference. The cost and the effectiveness of the treatment were the most important issues that patient concerned about. Conclusions The dissemination of health information is very limited for patients and the accessibility of effective health information depends much on the direct communication with their doctors. Promoting patient involved in EBM is fairly a hard and long way to go based on the actual reality of the country.