中国循证医学中心上海循证医学培训班圆满结束

中国循证医学中心李幼平教授、刘鸣教授、李静副教授、刘建平副教授和邓可刚副研究员应上海中医药大学邀请于2001年7月18～20日赴上海举办循证医学培训班。上海中医药大学童瑶副校长在开幕式上高度评价了循证医学对中医药及其现代化的意义和作用,提出了对本次培训的要求和     

南通大学循证医学理论与实践培训班掠影

“南通大学循证医学理论与实践培训班”2008年12月27日在南通大学启秀校区顺利开班。 培训历时两天，由中国循证医学中心、循证医学教育部网上合作研究中心主任李幼平教授及吴泰相、刘关键教授为学员开设循证医学概论、系统评价、循证医学常用统计学指标、临床试验透明化与临床试验注册、循证医学合理用药与上市药物评价、循证医学与医疗质量管理等共12个讲座。     

循证医学研究生学术专场报告在浙江中医药大学远志大讲堂举行

2010年12月1日下午,浙江中医药大学"远志大讲堂"循证医学研究生学术专场报告会在23号楼学术报告厅举行,邀请中国循证医学中心主任李幼平教授作了题为     

WHO项目第一期循证医学培训班圆满举办

20 0 1年 2月 2 8～ 3月 2日 ,由世界卫生组织 (ＷＨＯ)项目资助 ,中国循证医学 /Ｃｏｃｈｒａｎｅ中心承办的“ＷＨＯ项目第一期循证医学培训班”在四川大学华西医学中心附一院天使宾馆圆满举办。学员来自全国 14个省市 15 0余名临床医生、管理工作者、杂志编辑及相关人员。培训方式由课堂讲授、上机练习及讨论相结合。项目负责人刘鸣教授简要介绍了本期培训目的、要求 ,学习循证医学和系统评价的基本知识 ,了解文献及临床试验检索策略及系统软件的使用 ,结束时完成一份系统评价计划书的撰写。中心主任李幼平在教授介绍了中国Ｃｏｃｈｒａ…     

安徽省循证医学学会成立大会于2009年9月25日在合肥召开

2009年9月25日安徽省循证医学学会（一级学会）成立大会在合肥召开。安徽省委副秘书长、省保健委专职副主任沈干,省民政厅副厅长王佛生,省科协学会部部长田万龙,中国循证医学中心主任、教育部网上合作研究中心主任李幼平,中国循证医学中心江西省分中心主任、井冈山大学循证医学研究中心主任黄玉珊应邀出席了大会,省直有关部门、省级综合医院、地市级医院领导及学术团体的代表共100余人参加了大会。     

继往开来,推进循证医学向临床实践转化 四川省医学会第六次循证医学学术会议纪实

循证医学引入中国已达16年,国内越来越多的专家、学者、决策者和研究人员已意识到循证医学的理念和方法学对实践的重要性。为进一步推进循证医学在四川省医学实践的普及转化,2012年12月3～4日,在四川省医学会循证医学专委会领导下,四川省医学会第六次循证医学学术会议在成都市大成宾馆圆满举办,来自四川省各市、地、州相关单位的128名代表参加了会议。3日晚进行了循证医学专委会换届改选,选举产生了第三届四川省循证医学专委会。华西医院刘鸣教授当选为专委会主任委员,成都中医药大学梁繁荣教授、四川省人民医院周晓芳教授、川北     

中国医师协会成立,循证医学为唯一主题的学术报告

中国医师协会第一次全国会员代表大会暨成立大会于2002年1月9日在北京召开。中国医师协会筹备委员会特邀卫生部科教司卫生技术管理处于修成处长和中国循证医学中心主任李幼平教授到会做有关循证医学的学术讲座,这是此次会议唯一的专题学术报告。     

基于共词分析的循证心血管可视化研究

目的通过关键词共现分析和作者共现分析的方式,研究国内外循证心血管领域的研究热点、学科分支和发展趋势。方法通过检索中国生物医学数据库和Medline数据库,分别收集相关研究文献,并提取关键词词频、作者发文数和核心研究单位,对核心关键词和核心发文作者建立共现矩阵,使用Ucinet绘制可视化网络图。结果成功得到核心关键词和核心作者可视化网络。中文可视化网络包括循证医学、治疗和护理3个方面,英文可视化网络包括evidence-based medicine、therapy和treatment outcome 3个方面。而在作者合作可视化网络中,国内作者合作关系较为松散,合作团体较小,国外作者合作关系较为紧密,合作团体较大。国内核心研究机构分布于循证研究重点高校,国外则以发达国家为主。结论国内循证心血管研究领域总体发展趋势较好,但较国外相比仍存在一些不足,需要进一步加强重点研究,调整研究规划。     

中国循证医学/Cochrane中心的建设和发展

1995年3月原华西医科大学附一院神经内科副主任刘鸣副教授受WHO资助赴英国学习,接受了Cochrane协作网(Cochrane Collaboration,CC)和循证医学的系统培训,与英国Cochrane中心主任Iain Chalmers博士讨论了筹建中国Cochrane/循证医学中心的可行性。1996年7月刘鸣副教授     

循证医学教育部网合中心南通大学分中心（筹）验收顺利完成

2010年8月12日，循证医学教育部网合中心南通大学分中心（筹）验收汇报会在启秀校区举行。验收专家组由中国循证医学中心、循证医学教育部网合中心主任李幼平教授、安徽省循证医学中心主任胡世莲教授、广西医科大学循证医学中心主任徐静教授、新疆医科大学循证医学中心副主任杨新玲教授等组成。徐州医学院副院长郑葵阳教授、苏州大学医学部副主任龚政教授、扬州大学医学院副院长季明春教授等专家参加了评审会。     

Discriminant validity and test-retest reliability of a self-administered Internet-based questionnaire testing doctors' knowledge in evidence-based medicine

Aims and objectives This study aimed to determine the discriminant validity and the test–retest reliability of a questionnaire testing the impact of evidence‐based medicine (EBM) training on doctors' knowledge and skills. Methods Questionnaires were sent electronically to all doctors working as residents and chief residents in two French speaking hospital networks in Switzerland. Participants completed the questionnaire twice, within a 4‐week interval. The discriminant validity was examined in comparing doctors' performance according to their reported EBM previous training. Proportion of agreement between both sessions of the questionnaire, Cohen's kappa and ‘uniform kappa’ determined its test–retest reliability. Results The participation rate was 9.8%/7.1% to first/second session. Performance increased according to the level of doctors' previous training in EBM. The observed proportion of agreement between both sessions was over 70% for 14/19 questions, and the ‘uniform kappa’ was superior to 0.60 for 15/19 questions. Conclusion The discriminant validity and test–retest reliability of the questionnaire were satisfying. The low participation rate did not prevent the study from achieving its aims.     

Human milk fortification and gastric emptying in the preterm neonate

Fortification of expressed breast milk (EBM) is widely recommended for preterm feeding. Fortification of EBM results in increased caloric density and osmolarity, both of which may retard gastric emptying. As gastric emptying is a major determinant of feed tolerance, we investigated the effect of fortification (with Lactodex HMF) of EBM on gastric emptying in preterm neonates. The half gastric emptying time was measured using real time ultrasonography in 25 consecutive preterm neonates first on EBM alone, then on EBM + Lactodex HMF. Each baby served as its own control. The students t-test was used for statistical analysis. The mean gestation age was 34.48 +/- 0.77 weeks. The mean birth weight was 1.92 +/- 0.14 kg. The mean half gastric emptying time at an age of 5.4 +/- 0.86 days on EBM was 24.00 +/- 5.00 min and 24.40 +/- 5.06 min on EBM + human milk fortifier (HMF). The same at 2nd assessment (15.2 +/- 1.79 days), with EBM was 22.80 +/- 4.58 min vs. 23.60 +/- 4.89 min when given EBM + HMF. These differences were not statistically significant. Fortification of EBM with Lactodex HMF does not affect the gastric emptying in preterm neonates and therefore is unlikely to affect feed tolerance in them.     

Taking stock of evidence-based medicine: opportunities for its continuing evolution

Tough but constructive criticisms of evidence-based medicine (EBM) have without doubt informed the evolution and serial reconstitutions of this approach to clinical decision making and behaviour. Yet, concerns about EBM persist and as EBM changes in response to reflection and criticism, so too do the criticisms themselves. This paper describes our current understanding of EBM and, to identify opportunities for the continuing evolution of EBM, discusses some key attributes of EBM that still or now cause us concern. Specifically, these attributes are the nature of evidence in EBM; the unknown effectiveness of EBM; the clinician-centric focus of EBM; and the potential of EBM to harm patients.     

将循证医学引入神经病学教学改革初探

循证神经病学是随着世界循证医学和临床神经病学的进步而发展的。循证医学的引入对神经病学的教学提出了新的要求。循证医学在现代医学教育模式中的应用将对促进循证神经病学的进一步发展、培养高素质的医学人才和提高医疗质量产生重大影响。     

临床医学生对循证医学课程认知和态度分析

目的 对首都医科大学临床医学生学习循证医学课程的效果进行调查和评估,进而提出教学建议.方法 采用事先设计的调查问卷对该校2006级临床5年制和7年制医学生开设循证医学课程前、后在文献检索利用、循证医学常用术语掌握、学科认知态度方面进行调查,并辅以访谈法收集学生的意见进行统计分析.结果 开设循证医学课程后,医学生的文献平均阅读时间和文献检索次数较开设前明显增加(P＜0.05);循证医学实践涉及的术语理解程度在课程后也明显提高(P＜0.05);学生文献严格评价能力在5年制学生中也有明显提高(P＜0.05).在访谈中,学生建议增加文献检索和筛选文献课时,并对医学统计学内容进行复习.结论 循证医学课程的学习对学生认知和行为均有较大改变,结合案例教学法进行循证医学课程讲授具有较好的教学效果,循证医学理念和技能的学习对于临床医学生应用医学研究证据、自我学习和临床中付诸实践均有较大意义.     

Evidence-based medicine: revisiting the pyramid of priorities

Evidence-based medicine (EBM) is beset with numerous problems. In addition to the fact that varied audiences have each customarily sought differing types of evidence, EBM traditionally incorporated a hierarchy of clinical research designs, placing systematic reviews and meta-analyses at the pinnacle. Yet the canonical pyramid of EBM excludes numerous sources of research information, such as basic research, epidemiology, and health services research. Models of EBM commonly used by third party payers have ignored clinical judgment and patient values and expectations, which together form a tripartite and more realistic guideline to effective clinical care. Added to this is the problem in which enhanced placebo treatments in experimentation may obscure verum effects seen commonly in practice. Compounding the issue is that poor systematic reviews which comprise a significant portion of EBM are prone to subjective bias in their inclusion criteria and methodological scoring, shown to skew outcomes. Finally, the blinding concept of randomized controlled trials is particularly problematic in applications of physical medicine. Examples from the research literature in physical medicine highlight conclusions which are open to debate. More progressive components of EBM are recommended, together with greater recognition of the varying audiences employing EBM.     

循证医学教学--高等医学创新教育实践

目的：对循证医学教学实践进行总结，为改革传统的医学教育方法，培养创新型高等医学人才奠定基础。方法：引入循证医学中教材；分层次开设循证医学课程；以问题为基础的自我教育教学方式；多元化评估教学手段。结果：已注册Cochrane协作网系统评价题目36个，已在Cochrane图书馆上发表Cochrane系统评价计划书17篇，已完成并在Cochrane图书馆上发表Cochrane系统评价6篇。先后在《中国循证医学杂志》发表循证医学各类研究章62篇。循证医学研究生教学反馈结果显示：77．6％和22．4％的学生认为本课程很有帮助和有帮助；通过本课程的教学，14．3％的学生完全达到预期目的，80％学生大部分达到目的；未全部达到目的的主要原因是时间紧，18．4％的学生希望调整开课时间。61．2％-80％和16．3％～32．7％的学生认为该课程讲授内容选择好和较好；61．2％～75．5％和12．3％～28．6％的学生认为讲授方式好和较好；44．9％学生希望增加课时，增加讨论，增加实践；10．2％学生认为考试内容偏难。结论：我校的循证医学教学达到了预期目的，尚须在今后的教学实践活动中不断完善。     

‘All the King's horses …’: the problematical fate of born‐again evidence‐based medicine: commentary on Greenhalgh,T., Snow,R., Ryan,S., Rees,S., and Salisbury,H. (2015) six ‘biases’ against patients and carers in evidence‐based medicine. BioMed Central Medicine, 13:200

The phrase ‘evidence‐based medicine (EBM)' is being used by both EBM advocates and adversaries to broadly denote the production and use of clinical research throughout the healthcare system. Recently, this trend was joined by a call for a general expansion and rebirth of EBM to encompass a diverse range of healthcare activities otherwise corresponding to person‐centred care. The call asserts that EBM is to blame for anti‐patient biases within clinical practice and in policy and public health domains. Effective critique of either EBM or of the healthcare system requires that EBM itself be properly identified as a research literacy movement that grew out of clinical epidemiology of the 1970's and 1980's. We demonstrate the ineffectiveness of inappropriately targeted critiques of healthcare under the banner of born‐again EBM. We identify the strengths and weaknesses of EBM as an educational movement drawing on the concept of literacy associated with the Brazilian educator Paolo Freire. We consider the relationship of EBM to clinical epidemiology and conclude that it cannot fruitfully divorce itself from the latter. We briefly consider existing precedents for philosophically sound conceptual platforms for advocacy of person‐centred healthcare and broad based critique of the healthcare system including relationship‐centred care. We conclude that traditional EBM, as a framework for research literacy training of both clinicians and policy makers, must continue to play a subsidiary role within an expanding patient‐centred healthcare system and that advocacy efforts on behalf of patient voice and engagement are best pursued unencumbered by subsidiary agendas.