肾综合征出血热流行预警指标体系研究

目的 用德尔菲(Delphi)法征求专家意见,构建肾综合征出血热流行的预警指标体系.方法 通过文献检索和专家会议法初步拟定该病流行预警指标的初始框架和预警指标,对来自全国14个省(市)、自治区的25名专家进行两轮咨询,根据指标重要性的均值大小筛选指标,权重得分的均值大小确定其权重,并用权重法确定指标的相对重要程度.结果 专家从事肾综合征出血热防控工作的平均年限为(23.80±11.70)年,两轮咨询专家的积极系数分别为100%和72%.两轮咨询Kendall协调系数分别为0.50(x2R=148.95,P＜0.01)和0.54(x2R=212.63,P＜0.01),具有统计学意义,可认为全部专家对整个评价指标意见趋于一致,咨询已经满足预测的要求;肾综合征出血热预警指标体系共包括4个一级指标(宿主动物、高危人群、社会环境和病例指标)和14个二级指标,4个一级指标的权重系数分别是0.28、0.23、0.23和0.26.结论 初步建立了肾综合征出血热流行预警指标体系,可对该病的预测、预警工作提供参考.

Abstract：

Objective To establish an early-warning indicator system on outbreak of hemorrhagic fever with renal syndrome by Delphi method seeking expert advices. Methods Firstly,the literature review and the experts meeting method were used to formulate the initiatory frame work and indicators. A two-round consultation was used to filter indicators, discuss the boundary of indicators and determine the weighting coefficient among 25 experts from 14 provinces, municipalities and autonomous regions. The relative weightiness of indicators was determined by the weight coefficients method. Results The experts' average length of service in prevention and control of hemorrhagic fever with renal syndrome was (23.80 ± 11.70) years. The positivity coefficients of the two-round experts were 100% and 72%. Kendall's coefficients of the two-round consultation were 0. 50 ( x2R = 148.95, P ＜ 0. 01 ) and 0. 54 ( x2R = 212. 63, P ＜ 0. 01 ) andopinions among experts became consistent and the consultation had achieved the need of forecast. Four firstclgss indicators (host animals, risk population, social environment and case-related indicators) and 14 second-class indicators were filtered to develop the indicators system. The weight coefficients of the first-class indicators were 0. 28,0. 23,0. 23 and 0. 26. Conclusion The early-warning index system of hemorrhagic fever with renal syndrome has been established and it could provide a reference for the forest and warning of HFRS outbreak.     

医院应急医学救援能力评估指标体系构建

目的 构建医院应急医学救援能力评估指标体系,为各级医院提供应急医学救援能力评估工具.方法 采用情报调研、自由访谈、专家咨询和层次分析方法构建医院应急医学救援能力评估指标体系.结果 建立了由5个一级指标、16个二级指标组成的医院应急医学救援能力评估指标体系.结论 指标体系适用于不同类型和等级医院应急医学救援能力的评估,评估指标较好的代表了评估需求.

Abstract：

Objective To build an evaluation index system for emergency medical assistance capability of the hospitals and provide an evaluation means for hospital capability of emergency medical assistance(HCEMA).Methods Literature search,free interview,expert consultation,and analytic hierarchy process(AHP).were used to build an evaluation index system for emergency medical assistance capability of the hospitals Results The HCEMA evaluation system consists of 5 grade-1 indexes and 16 grade-2 indexes.Conclusion The evaluation system applies to evaluating the capability of medical rescue assistance of hospitals with varying types and gradas,as the evaluating indexes meet the demands satisfactorily.     

医院品牌效应的评估指标体系建立及应用

通过对国内外关于医院品牌的文献回顾,归纳和比较的方法收集资料、利用专家咨询方法完成评估指标的确定,运用"层次分析法"计算各级指标的权重系数,构建医院品牌效应评估指标体系.并应用指标体系和评价模型对医院品牌进行探索性的应用研究,从而为医院管理者提供管理决策科学依据.

Abstract：

Literature review of the world on hospital brands, data collection in summary and comparison, and specialist consultancy were used to set the appraisal indicators, while the stratum analysis was used to calculate the weight coefficients of individual indicators, for building the appraisal indicators system for hospital brand effect. In addition, the indicators system and appraisal model were called into play to explore the use of hospital brands, offering scientific references for hospital management.     

汶川地震灾区心理干预服务系统反应性评价

目的 了解汶川地震灾区居民对心理干预服务系统反应性的评价. 方法 采用分层、整群、多阶段抽样原则,以心理干预服务系统反应性评价问卷(包括保密性、自主权、服务的及时性等8个指标)为调查工具,对汶川、北川等4个地震极重灾区居民展开入户调查,共调查211人.采用层次分析法确定各指标权重,对心理干预服务系统反应性进行单指标评价与模糊综合评价,并采用Spearman秩相关和Binary logistic回归模型分析心理干预总满意度与反应性各指标的关系. 结果 分析得重要性和评分均较高的指标为尊敬和保密性;及时性和自主权的重要性较高但评分较低;交流的环境和选择性的重要性与评分均较低;重要性较低、评分较高的指标为交流的情况和社会支持网络;居民对心理干预系统反应性的综合评价介于"较好"与"很好"之间.除保密性外,反应性各指标与心理干预服务总满意度的秩相关系数均有统计学意义(rs=0.186～0.362,P＜0.05);1ogistic回归分析表明尊严(调整的OR=3.047,P＜0.001)、交流环境(调整的OR=1.619,P=0.019)和社会支持网络(调整的OR=1.527,P=0.005)是影响总满意度的重要因素. 结论 居民对心理干预服务的反应性综合评价较高,但仍需采取积极有效的措施提高心理干预服务获得的及时性、自主权、可选择性以及服务环境.

Abstract：

Objective To understand the mental intervention service system responsiveness. Methods A stratified,multi-stage random cluster sampling method was used,and a total of 211 residents in the central earthquake area were face to face interviewed by using the evaluating questionnaire of mental intervention service system responsiveness (including confidentiality,autonomy,prompt attention and so on,in sum of eight indicators).Analytic hierarchy process method was used to determine the weight of each index,carrying out a single index evaluation and fuzzy comprehensive evaluation on the mental intervention service system responsiveness,and using Spearman rank correlation and Binary logistic regression model to analyze the relationship of total satisfaction of mental intervention with each index. Results The dignity and confidentiality indicators were higher weight and rating.Prompt attention and the autonomy indicators were higher weight but lower rating,while surroundings and choice of providers indicators were lower weight and rating.It was also found that communication and social support network indicators were lower weight but higher rating.The overall assessment of mental intervention service system responsiveness ranged between "good" and "very good".All rank correlation coefficients of the indicators and the total satisfaction of mental interventions were significant (rs = 0.186-0.362,P ＜ O.05),except for confidentiality.The logistic regression analysis showed that the main factors of the individual variables influencing the total satisfaction were dignity (adjusted OR = 3.047,P ＜ 0.001),surroundings (adjusted OR = 1.619,P = 0.019),and social support network (adjusted OR = 1.527,P = 0.005). Conclusion The overall assessment of mental intervention service system responsiveness was high.Mental interventions should be taken positive and effective measures to improve the prompt attention,autonomy,the choice of providers and service environment.     

北京三级医院医疗质量推荐指标体系的构建

通过分析北京市多家医院的医疗质量评价指标,针对综合医院和专科医院的不同情况,结合文件、文献研究与现场考察、专家咨询,以病人诊疗过程为切入点,围绕"维护病人利益、保障病人安全、提高医疗质量",探索如何构建并优化一套医疗质量评价推荐性指标体系,重点介绍了推荐性指标体系的框架、指标遴选的原则等,并对推荐性指标体系构建的相关问题做了讨论.

Abstract：

To explore how to create and optimize a promotion index system of medical quality evaluation, this article focuses on the hospital visiting process from patients, using analyzing collected those index system from couples of Grade Ⅲ hospitals in Beijing, and combining the results of literal study, field study and specialist consult, according to the different situation of general hospitals and specially hospitals, with the spirit of "maintaining the patients benefits, safeguarding the patients safety,and enhancing the medical quality", introduces the framework of the promotion index system, the rules to select the indicator, and so on, and discusses several problerns related to creating the index system.     

戊型肝炎病毒IgG抗体诊断试剂盒的研制及初步应用

Objective To establish an EliSA kit for serum anti-hepatitis E virus IgG detection using recombinant antigen expressed in E. Coli. Methods Utilizing the recombinant protein ORF23 of REV expressed in E. Coli as a coating antigen, the ELISA kit for detecting serum anti-HEV IgG was established. The serum samples from 100 HEV patients and 150 negative serum samples were measured, and the detecting results was compared with those of other two HEV kits(the kits from Genelabs company and Wantai Corporation). The specificity, sensitivity and stability of the kit were evaluated. The serum samples from another 500 clinical hepatitis patients were detected to evaluate the clinical application value of this kit. Results Both the specificity and sensitivity of the kit were 100% and the consistency rates to other kits were more than 95%. The kit showed a good stability and could be stable for at least 6 months under 4 ℃. 500 samples were 145 positive in 150 hepatitis E patients, the consistency rates were 96.67% . Conclusions The ELBA kit prepared with HEV recombinant antigen has good specificity and sensitivity for detecting anti-HEV IgG in serum, and may have potential evaluation in clinical diagnosis and epidemiological investigation for hepatitis E.     

戊型肝炎病毒IgG抗体诊断试剂盒的研制及初步应用

Objective To establish an EliSA kit for serum anti-hepatitis E virus IgG detection using recombinant antigen expressed in E. Coli. Methods Utilizing the recombinant protein ORF23 of REV expressed in E. Coli as a coating antigen, the ELISA kit for detecting serum anti-HEV IgG was established. The serum samples from 100 HEV patients and 150 negative serum samples were measured, and the detecting results was compared with those of other two HEV kits(the kits from Genelabs company and Wantai Corporation). The specificity, sensitivity and stability of the kit were evaluated. The serum samples from another 500 clinical hepatitis patients were detected to evaluate the clinical application value of this kit. Results Both the specificity and sensitivity of the kit were 100% and the consistency rates to other kits were more than 95%. The kit showed a good stability and could be stable for at least 6 months under 4 ℃. 500 samples were 145 positive in 150 hepatitis E patients, the consistency rates were 96.67% . Conclusions The ELBA kit prepared with HEV recombinant antigen has good specificity and sensitivity for detecting anti-HEV IgG in serum, and may have potential evaluation in clinical diagnosis and epidemiological investigation for hepatitis E.     

Analysis of indicators related to visceral fat index based on the random forest modelCSCD

Objective To explore indicators related to visceral fat index by constructing a random forest model. Methods In this cross‑sectional study, the laboratory measures and body composition analysis records of 617 hospital employees (in‑service and retired) who underwent physical examination in Heilongjiang Provincial Hospital Health Management Center from March to September 2021 were selected. The subjects were divided into a training set (n=411) and a test set (n=206) with the ratio of 2∶1. A total of 110 predictors were included in the model. The model was constructed with the training set and was evaluated with the test set. The optimal number of nodes and decision trees were selected to evaluate the prediction performance of the optimal model. And the top 10 relatively important factors were selected for further investigation. The 617 participants were further divided in to groups according to the visceral fat index: the normal or high visceral fat index group, and the differences of the top 10 relatively important factors were further compared between the two groups. Results The optimal number of nodes of the final random forest model was 39 and the number of decision trees was 300. The accuracy, precision, sensitivity and specificity of the model was 83.3%, 73.9%, 89.4% and 78.7%, respectively. The area under the receiver operating characteristic curve and 95% confidence interval of the model was 0.881 (0.832-0.931). The top 10 relatively important factors in the model were body mass index, gender, age, serum uric acid, red blood cell count, monocyte cell count, C‑peptide, carcinoembryonic antigen, glycosylated hemoglobin and glutamyl transpeptidase. There were significant differences in the up‑mentioned 10 indicators between the subjects with normal and high visceral fat index (all P<0.05). Conclusions The random forest model built in this study has good performance in predicting visceral fat index, and visceral fat is related with changes in liver function, pancreas function and immune function. © 2022 Chinese Medical Journals Publishing House Co.Ltd     

Design of an Image - integrated Clinical Information Network Application for Specialised Clinical Procedures

This paper describes the design of an endoscopic image-integrated clinical information metwork using Intranet technology. It was developed for electronically managing integrated medical records of patients in a speccialised procedural clinic. Image capturing feature and voice atcivation are incorporated into the system to facilitate real-time operation during clinical procedures. A network prototype has been set up and the results support the feasibility of the proposed approach. It is envisioned that the proposed approach will enable doctors to use clinical information network to achieve intra-networking as     

Bangkok to Sendai and Beyond: Implications for Disaster Risk Reduction in Asia

The recently concluded World Conference on Disaster Risk Reduction(WCDRR) in Sendai, Japan and the Sendai Framework for Disaster Risk Reduction2015–2030(SFDRR) have set renewed priorities for disaster risk reduction(DRR) for the next 15 years. Due to Asia's high exposure to natural hazards, the implications of the new SFDRR have major significance for the future development of the region. The 6th Asian Ministerial Conference on Disaster Risk Reduction(AMCDRR), held in Bangkok in 2014, was a regional preparatory meeting for the WCDRR, and proposed various targets and indicators for DRR in Asia. The AMCDRR recommended inclusion of these goals in the SFDRR. This study focuses on the WCDRR negotiations, particularly outcomes that affect four major groups: local authorities; children and youth;science and technology; and business and industry. An analysis is undertaken of the overlaps and gaps in the outcomes of the 6th AMCDRR and other preceding conferences that fed into the WCDRR. A set of recommendations has evolved from this examination for consideration at the upcoming 7th AMCDRR in 2016. The areas that merit consideration in the upcoming AMCDRR2016 are:(1) development of baseline data and quantitative indicators for monitoring progress in DRR;(2) creation of a common stakeholder platform;(3) construction of city typologies for consideration in all future local level planning;(4) promotion of a culture of safety by linking large enterprises with small and medium enterprises; and(5) exchange and sharing of information and databases between regions at all scales.     

临床医学科技成果评价指标体系的实证研究

目的 以某省科技成果评审为例,对前期所建立的临床科技成果评价指标体系进行验证.方法 制定各评价指标的详细评分准则,由5位专家对某省2010年度20份科技成果申报材料进行模拟评分.采用加权求和法计算各评审项目的 总得分,考核指标体系的信度和效度.结果 指标体系的克朗巴赫α系数为0.91.各实测指标评分与总得分以及所属一级...     

儿童专科医院科室科技评价指标体系构建研究

目的构建儿童专科医院科室科技评价指标体系。方法基于文献研究法初步构建儿童专科医院科室科技评价指标体系框架。采用德尔菲法,邀请21名专家进行三轮专家咨询,确定儿童专科医院科室科技评价指标体系。通过层次分析法确定各指标权重。采用统计学方法计算专家积极系数、权威系数与协调系数。结果三轮专家咨询积极系数分别为100%、100%和76.19%,专家权威系数为0.79~1,专家协调系数分别为0.39、0.37。初步构建的儿童专科医院科室科技评价指标体系,包括4个一级指标、15个二级指标、40个三级指标。结论专家咨询结果可靠性较好,初步构建的科室科技评价指标体系科学性较好,可为我国儿童专科医院科研决策提供信息支持,但仍需进一步开展实证研究。     

大型综合医院科技持续创新能力评价指标体系的构建

目的大型综合医院科技持续创新能力评价指标体系的构建及权重确定。方法在文献调研和专家访谈的基础上，通过目标分解和归类合并，初步建立大型综合医院科技持续创新能力评价指标体系，并确定最终的评价指标。基于层次分析法中Saaty权重法设计权重判断表，确定各级指标权重。用数理统计的方法建立群组决策模型，求出综合权重。结果构建了一套反映大型综合医院科技持续创新能力的综合评价指标体系，含一级指标3个，二级指标15个，三级指标37个，并确定了各级指标权重。结论指标体系设计将定性评价与定量评价相结合，时段性评价与持续性评价相结合，重点突出支撑大型综合医院科技创新能力持续发展的关键因素，采用科学的咨询方法、分析步骤和计算方法，由权威的专家得出比较集中的咨询意见，结果真实可信。     

贵州省慢性呼吸适宜技术推广效果评价指标体系研究

目的 构建贵州省慢性呼吸适宜技术推广效果评价指标体系,为呼吸适宜技术推广效果评价提供客观参考。方法 结合我国和贵州省政策,通过文献研究、专题小组、德尔菲法等初步构建评价指标体系,经两轮Delphi法确定各指标权重。结果 构建了以推广前期、推广中期和推广后期为一级指标且包含8个二级指标和26个三级指标的指标体系,两轮专家积极系数为92%和100%,总体专家权威系数为0.808,Kendall-W协调系数为0.437（P<0.05）,各指标变异系数均小于0.3,专家积极性、权威性、协调性均较高。结论 本研究所构建指标体系各指标内容和权重合理,具有一定科学性,可为后期评价适宜技术推广效果提供参考。     

方舱医院护理质量评价指标体系构建

目的构建方舱医院护理质量评价指标体系。方法研究小组基于三维质量模式拟定初始指标,邀请来自江苏省、海南省、广东省、浙江省、山东省的17名专家进行两轮咨询筛选指标,并采用层次分析法确定指标权重。结果形成了包含3个一级指标、 12个二级指标、39个三级指标的方舱医院护理质量评价指标体系。两轮咨询专家积极系数分别为94.44%和100%,专家权威系数均为0.883,第二轮咨询一级指标肯德尔和谐系数Kendall’s W值为0.176,二级指标Kendall’s W值为0.250,三级指标Kendall’s W值为0.155。三级指标权重在0.003 5～0.186 9之间。结论构建的方舱医院护理质量评价指标体系具有一定科学性,可用于方舱医院的护理质量评价。     

我国基本药物循证遴选评价指标体系的构建

目的:建立我国基本药物循证遴选指标体系和量化方法。方法:(1)文献研究:通过文献学习建立初步指标体系,经专家论证后,对指标进行调整,构建最终指标体系;(2)层次分析法:通过专家调查法,由专家对指标所构成的判断矩阵进行两两打分,确定各指标的权重。结果:对一级指标作出调整,同时对二级指标进行细化,提高其可操作性,最终建立的指标体系中包括一级指标8个,二级指标18个。结论:本研究建立的评价指标体系可用于评价基本药物目录收录的药品,为我国遴选基本药物目录的专家提供遴选证据。     

传染病暴发事件应急处置效果评价体系研究

目的 构建科学规范的传染病暴发事件应急处置效果综合评价指标体系,建立评价模型。方法 采用文献研究、德尔菲法和层次分析法,通过Excel 2007和SPSS 15.0软件,构建传染病暴发事件应急处置效果综合评价指标体系,确定各级指标权重,建立评价模型。结果 选取来自卫生管理、高校、科研及疾控部门的专家15名,进行2轮专家咨询,专家积极系数为100%,各指标专家意见变异系数均小于0.1,第二轮总体协调系数为0.478,克朗巴赫α系数= 0.965。所构建的评价指标体系包括4个一级指标、12个二级指标和56个三级指标。一级指标为疫情处置准备、疫情调查过程、疫情控制措施和疫情控制效果,权重系数分别为0.1468、0.2598、0.3492和0.2442。结论 初步构建一个能够体现传染病暴发事件应急处置效果的评价指标体系,提供作为应急处置效果的衡量工具,具备合理性和有效性。     

医疗事故与医学科技成果鉴定的比较及启示

文章就医疗事故技术鉴定和医学科技成果鉴定进行比较，从专家库、专家亲疏、利益博弈、鉴定材料、鉴定后事项等5个方面进行分析。指出了目前我国医学科技成果鉴定存在的问题，并提出了改进建议。     

危重新生儿转运质量评价指标体系构建研究

目的 构建危重新生儿转运质量评价指标体系。方法 研究小组通过回顾文献,参考相关政策、指南,结合临床实际等构建指标体系框架,邀请来自北京市19名专家进行两轮咨询以筛选指标,运用层次分析法计算各级指标权重。结果 形成了包含3项一级指标、11项二级指标、33项三级指标的危重新生儿转运质量评价指标体系。两轮咨询专家积极系数分别为95%和100%,专家权威系数分别为0.892、0.887,专家协调系数分别为0.393、0.382。三级指标权重在0.004 7～0.115 6之间。结论 构建的危重新生儿转运质量评价指标体系具有一定科学性,可为评价危重新生儿转运工作质量提供参考。     

全国卫生应急培训工作评估指标体系的研究

目的研究制定全国卫生应急培训工作评估指标体系。方法采用核心专家组讨论、现场专家运用德尔菲法对指标进行问卷评价与咨询、全国省级卫生行政部门征求意见等相结合的组合式方法。结果首先,根据文献由核心专家制定指标框架;其次,根据问卷得到的平均分值和核心专家意见筛选指标,确定指标体系包括一级指标5项、二级指标19项、三级指标46项;第三,依据问卷得到的指标权重和核心专家调整意见,分别为3个层次的指标赋予分值;最后,形成由卫生部下发全国执行的评估指标体系。结论组合式方法在评估指标体系研究制定中得到应用,该评估指标体系内容全面、适用于评估省级工作,但应注意评估后的工作改善。