现况调查在营养调查中的应用

现况调查是研究在特定时间与特定范围内人群有关变量与疾病或健康状况的关系,是营养流行病学常用的一种方法,我们在配合“中国健康与营养调查”时就应用了现况调查。“中国健康与营养调查”是在不同时期了解我国不同地区城乡居民的生活水平、食物结构、营养状况的变化趋势,以及与这些变化有关的卫生、经济、文化、人口等家庭及社会因素的相关关系,为国家制定食物发展政策及相应的城乡卫生、经济和社会发展政策提供依据。1做好调查前准备工作1.1协调关系争取配合现况调查与分析,就是收集调查点居民的营养状况及与之有关的各种资料,这项工作要…     

世界健康调查—中国调查中的调查数据分析

目的 对世界健康调查中的调查数据进行分析，以获得卫生系统总体绩效的合理评估。方法 用抽样权重作为调整值，采用Taylor级数线性化技术和重复技术估计总体参数及相应的方差。结果 对于健康状况指标和卫生系统反应性指标的排序，几个抽样点通过普通统计方法和调查数据分析方法所获得的结果间存在明显差异。研究人员采用来自于调查数据分析方法的结果去建立对抽样地区的综合绩效评估。结论 多阶段抽样设计使得抽样调查的分析变得复杂，调查数据分析方法可以计算总体参数的点估计和方差估计的近似值，这种方法减少了由于背离独立同分布(independent and identical distribution，IID)假设所产生的偏倚。     

云端在线调查平台在患者满意度调查中的应用价值分析

目的分析云端在线调查平台在患者满意度调查中的应用价值。方法选取2016年9—11月西藏自治区人民政府驻成都办事处医院收治的住院患者300例作为研究对象,按照随机数表法分为对照组和观察组,各150例。两组调查问卷内容一致,对照组采用传统纸质版问卷进行患者满意度调查,观察组采用云端在线调查平台进行患者满意度调查,比较两组调查的人均耗时及患者满意度。结果对照组调查及统计分析总耗时38 593 s,人均耗时(257.38±105.74)s;观察组调查总耗时28 756 s,人均耗时(191.71±75.16)s。观察组调查人均耗时短于对照组,差异有统计学意义(P<0.05)。观察组患者满意度高于对照组(96.0%比94.1%),差异有统计学意义(P<0.05)。结论应用云端在线调查平台进行患者满意度调查可缩短调查时间,提高调查效率和患者满意度,值得推广应用。     

入户调查结合线索调查在社区药物滥用流行病学调查中的可行性分析

目的 了解入户调查结合线索调查在社区选点药物滥用流行病学研究中的可行性.方法 与湖南省第五次人口普查资料比较,分析样本的代表性;对370例阿片类物质滥用者信息来源线索进行描述性分析.结果 (1)样本资料收集质鼍较高,有效问卷率高达99.7%,具有较好代表性.(2)新发现阿片类物质滥用者130例,实际吸毒人员数量与登记在册吸毒人员之比是1.49:1.(3)阿片类药物滥用者信息来源以单一渠道为主(55.1%),2种或以上渠道者44.9%.(4)调查仅发现33例新型毒品滥用者,且多为多药滥用者(20/33例).结论 入户调查结合线索调查进行社区居民阿片类物质滥用流行病学调查切实可行,但不适于新型毒品.     

应用德尔菲调查法对甘肃省结核病漏报情况调查的探讨

目的 探讨德尔菲调查法在流行病学领域应用的可行性.方法 利用德尔菲调查法对结核病漏报情况进行调查.结果 本项调查与实际漏报情况较为吻合.结论 证实德尔菲调查法可较为准确地反映结核病漏报实际情况.     

美国卫生统计调查制度综述

健康数据的收集与分析对了解国家和地区的卫生情况有重大意义,美国在卫生统计工作方面起步较早,已经形成了较为完善的调查制度。文章从卫生统计工作实施机构、法律、调查现状和数据收集与发布4方面介绍和分析美国的制度,为完善我国卫生统计工作提供一定借鉴。美国卫生统计调查制度具有明确分工的组织机构和详细全面的法律体系,常规调查和专项调查相互补充提供全面的健康数据,调查设计和抽样方法不断更新和改进,通过访问调查、电话调查和医疗记录调查等多种方式进行,网络和出版物发布数据信息及时。     

回顾性调查分析

1.引言回顾性调查和前瞻性调查是两种最重要的流行病学调查方法,流行病学家用它来进行病因的分析研究。两种研究方法各自的出发点明显不同。在前瞻性调查中,以一组暴露于被怀疑为增大(或减少)某病危险性的因素的人与     

本刊调查研究栏目介绍

报道与医药卫生、健康相关的研究报道,内容包括卫生统计学,身体发育调查与统计,寿命的调查与研究,疾病的调查与研究,药品相关的调查与研究等。     

全球青少年烟草调查与上海市青少年吸烟调查研究进展

烟草危害是当今世界上可预防的最严重的公共卫生问题之一。目前,全球有11亿吸烟者,每年死于与吸烟相关疾病的人数近500万。我国约有3.5亿吸烟者,每年可归因于吸烟的死亡人数达120万,预计到2030年将达到200万,占总死亡人数的30%。为了采取有针对性的预防控制措施,必须要掌握人群吸烟现况及其主要影响因素。为此,世界卫生组织、美国疾病控制与预防中心以及加拿大公共卫生联合会于1998年合作开发研制了全球烟草调查系统,帮助世界各国采用统一可比较的调查工具研究人群吸烟现况及其影响因素。我国部分城市分别参加过两次世界卫生组织发起的全球青少年烟草调查。上海市参加了2004年的第二次全球青少年烟草调查,发现中学生的尝试吸烟率为23.8%,吸烟率为5.5%。由于上海市仅作为中国样本的一个组成城市,实际调查样本量比较小,仅有1 964人。为了克服样本量过小,调查样本难于进行深入分析的不足,2007年又对9 347名中学生(初中生、高中生和职校学生)进行了调查,发现上海青少年总吸烟率为19.5%。为了即时掌握上海市青少年烟草利用现况及其影响因素,在比尔和梅林达盖茨基金资助下,课题组于2011年11月—2012年3月组织了大样本的调查研究,并将初步的调查研究结果组织汇编。该文主要对烟草的危害、全球青少年烟草调查方案和内容以及上海市青少年吸烟调查研究的特点和进展进行系统性评述。     

药品生产OOS调查

目的:对药品生产过程中的OOS结果如何调查进行分析.方法:结合美国药品OOS结果调查的行业指南,探讨在药品生产企业内出现OOS结果时进行调查的方法.结果与结论:在药品生产过程中,进行科学、及时、有效的OOS结果调查是保证药品质量的重要工作.     

敏感问题随机应答技术模型分层整群抽样下参数的估计

目的:为敏感性问题提供科学的较复杂抽样调查方法及其统计量的计算公式。方法:使用Cochran W.G.的经典抽样理论,2种随机应答技术(RRT)模型,全概率公式,均数、方差的性质等理论与方法进行公式推导。结果:推导出二分类敏感问题双无关问题RRT模型分别在整群抽样、分层整群抽样下总体比例的估计量及其估计方差的计算公式;推导出数量特征敏感问题加法RRT模型分别在整群抽样、分层整群抽样下总体均数的估计量及其估计方差的计算公式;并在苏州大学学生婚前性行为、考试作弊次数的调查中取得了成功的应用效果。结论:本研究提供的敏感性问题2种RRT模型的整群抽样、分层整群抽样调查方法与统计量的计算公式信度较高。     

Can Cognitive Biases during Consumer Health Information Searches Be Reduced to Improve Decision Making?

Objective

To test whether the anchoring and order cognitive biases experienced during search by consumers using information retrieval systems can be corrected to improve the accuracy of, and confidence in, answers to health-related questions.

Design

A prospective study was conducted on 227 undergraduate students who used an online search engine developed by the authors to find health information and then answer six randomly assigned consumer health questions. The search engine was fitted with a baseline user interface and two modified interfaces specifically designed to debias anchoring or order effect. Each subject used all three user interfaces, answering two questions with each.

Measurements

Frequencies of correct answers pre- and post- search and confidence in answers were collected. Time taken to search and then answer a question, the number of searches conducted and the number of links accessed in a search session were also recorded. User preferences for each interface were measured. Chi-square analyses tested for the presence of biases with each user interface. The Kolmogorov-Smirnov test checked for equality of distribution of the evidence analyzed for each user interface. The test for difference between proportions and the Wilcoxon signed ranks test were used when comparing interfaces.

Results

Anchoring and order effects were present amongst subjects using the baseline search interface (anchoring: p < 0.001; order: p = 0.026). With use of the order debiasing interface, the initial order effect was no longer present (p = 0.34) but there was no significant improvement in decision accuracy (p = 0.23). While the anchoring effect persisted when using the anchor debiasing interface (p < 0.001), its use was associated with a 10.3% increase in subjects who had answered incorrectly pre-search, answering correctly post-search (p = 0.10). Subjects using either debiasing user interface conducted fewer searches and accessed more documents compared to baseline (p < 0.001). In addition, the majority of subjects preferred using a debiasing interface over baseline.

Conclusion

This study provides evidence that (i) debiasing strategies can be integrated into the user interface of a search engine; (ii) information interpretation behaviors can be to some extent debiased; and that (iii) attempts to debias information searching by consumers can influence their ability to answer health-related questions accurately, their confidence in these answers, as well as the strategies used to conduct searches and retrieve information.     

中医药自动问答系统中关于问题理解的研究

介绍中医药自动问答系统功能及结构,详细阐述中医药自动问答系统中自然语言问句的理解方法和流程,包括问题预处理、问题分类、关键词提取与扩展、问题模型等。     

基于中医药学语言系统的知识问答系统的设计与构建

问答系统能用准确、简洁的自然语言回答用户用自然语言提出的问题，便于普通用户获取更加精准的中医药知识。基于中医药学语言系统，采用构建知识图谱的方法对用户用自然语言提出的问题进行解析。利用信息搜索功能找出相似度高的病案并为用户提供辅助诊疗建议，可以更好地帮助用户在互联网上获取所需的中医药知识、获得更便捷更准确的网络诊疗体验。     

Out of sight, out of mind: making involuntary community treatment visible in the mental health system

Most specialised mental health services in Australia are delivered in community settings and one in six services comprise involuntary treatment. Despite a growing demand for community treatment orders (CTOs) worldwide - and comparatively high rates of use in Australia - the clinical, legal and ethical aspects of CTOs remain contentious. This article examines federal, state and territory mental health policy documents and discovers little reference to CTOs. The "invisibility" of CTOs in mental health policy raises questions about the transparency and accountability of the mental health system, and about whether this policy silence ultimately entrenches the marginalisation of, and discrimination against, people living with mental illness.     

网络健康社区用户的新冠肺炎信息需求

搜集网络健康社区用户中关于新冠肺炎的提问记录,利用LDA模型对提问主题进行建模生成"主题-词"分布概率矩阵和分析主题一致性.结果显示网络健康社区用户对新冠肺炎的临床症状、检查诊断、用药治疗、疫区防控等方面关注较多.对网络健康社区用户关注的新冠肺炎热点主题进行分析发现,用户对新冠肺炎的信息需求与国家相继颁布的诊疗方案及防...     

基于知识图谱的中医养生知识智能问答APP构建研究与实践

分析公众对中医养生知识智能问答APP的需求,详细阐述基于知识图谱的中医养生知识智能问答APP设计方案和具体功能实现,指出其有助于为公众提供权威、可靠、便捷的中医养生保健知识服务,提升公众养生保健能力。     

Using Wireless Handheld Computers to Seek Information at the Point of Care: An Evaluation by Clinicians

Objective

To evaluate: (1) the effectiveness of wireless handheld computers for online information retrieval in clinical settings; (2) the role of MEDLINE® in answering clinical questions raised at the point of care.

Design

A prospective single-cohort study: accompanying medical teams on teaching rounds, five internal medicine residents used and evaluated MD on Tap, an application for handheld computers, to seek answers in real time to clinical questions arising at the point of care.

Measurements

All transactions were stored by an intermediate server. Evaluators recorded clinical scenarios and questions, identified MEDLINE citations that answered the questions, and submitted daily and summative reports of their experience. A senior medical librarian corroborated the relevance of the selected citation to each scenario and question.

Results

Evaluators answered 68% of 363 background and foreground clinical questions during rounding sessions using a variety of MD on Tap features in an average session length of less than four minutes. The evaluator, the number and quality of query terms, the total number of citations found for a query, and the use of auto-spellcheck significantly contributed to the probability of query success.

Conclusion

Handheld computers with Internet access are useful tools for healthcare providers to access MEDLINE in real time. MEDLINE citations can answer specific clinical questions when several medical terms are used to form a query. The MD on Tap application is an effective interface to MEDLINE in clinical settings, allowing clinicians to quickly find relevant citations.     

A study of clinical questions in primary care

This is a prospective study of clinical questions generated in primary care consultations and a comparison of two approaches to answering those clinical questions. Twenty-one doctors in a university-based primary care clinic submitted 78 clinical questions arising from patient consultations during 24 clinic days (0.01 question per patient encounter). These doctors subsequently found answers to 40% of their questions but were satisfied with only 67% of these answers. The investigators were able to provide answers for 95% of the questions asked and the doctors rated these answers as satisfactory in 86% of instances. Answers obtained by investigators had significantly higher satisfaction score than those obtained by doctors' search (p = 0.002). The two main findings of this study are (1) almost all questions arising in clinic setting could be answered by intensive search; (2) answers found by intensive searches were judged to be more satisfactory than those found routinely by doctors. Provision of an information retrieval service in addition to training in the searching and appraisal of medical literature are possible solutions to the information needs of busy clinicians.     

Evaluation of generic medical information accessed via mobile phones at the point of care in resource-limited settings

Objective

Many mobile phone resources have been developed to increase access to health education in the developing world, yet few studies have compared these resources or quantified their performance in a resource-limited setting. This study aims to compare the performance of resident physicians in answering clinical scenarios using PubMed abstracts accessed via the PubMed for Handhelds (PubMed4Hh) website versus medical/drug reference applications (Medical Apps) accessed via software on the mobile phone.

Methods

A two-arm comparative study with crossover design was conducted. Subjects, who were resident physicians at the University of Botswana, completed eight scenarios, each with multi-part questions. The primary outcome was a grade for each question. The primary independent variable was the intervention arm and other independent variables included residency and question.

Results

Within each question type there were significant differences in ‘percentage correct’ between Medical Apps and PubMed4Hh for three of the six types of questions: drug-related, diagnosis/definitions, and treatment/management. Within each of these question types, Medical Apps had a higher percentage of fully correct responses than PubMed4Hh (63% vs 13%, 33% vs 12%, and 41% vs 13%, respectively). PubMed4Hh performed better for epidemiologic questions.

Conclusions

While mobile access to primary literature remains important and serves an information niche, mobile applications with condensed content may be more appropriate for point-of-care information needs. Further research is required to examine the specific information needs of clinicians in resource-limited settings and to evaluate the appropriateness of current resources in bridging location- and context-specific information gaps.