循证卫生政策研究的必要性及伦理学研究

通过分析循证卫生政策研究的概念,论述了我国及国际的循证卫生政策研究现状,讨论了现阶段卫生系统环境设定下循证卫生政策研究的必要性与重要性.并通过进一步分析国内外循证卫生决策中面临的伦理学问题,认为我国在进行循证卫生决策研究时,可汲取国际经验,将研究嵌入决策过程,加强决策者使用证据的能力,建立广泛的证据基础,加大伦理审查力度,在具体决策过程中始终坚持伦理思维.     

EBL联合PBL综合教学法在急诊医学临床教学中的应用

目的 观察并分析以问题为基础（PBL）联合以循证医学为基础（EBL）教学法在急诊科临床教学中的应用效果及价值.方法 选取53名五年制临床专业实习生,应用PBL＋ EBL的联合教学法进行临床教学.教学结束后进行教学效果的问卷调查和理论考试,并与45名接受传统讲授教学法的实习生考试成绩进行比较.结果 PBL＋EBL联合教学法能够有效提高学生的学习兴趣、学习效率、自学能力、文献检索能力和分析解决问题的能力;77.4％的学生认为这种新的教学模式具有很好的教学价值;理论考试成绩的优秀率显著高于传统讲授教学组（41.5％vs15.6％,x2=7.868,P=0.007）.结论 PBL＋ EBL联合教学法能够克服传统教学的缺点,有效提高学生的学习兴趣、自学能力和教学质量,适合在临床教学中推广应用.     

将循证医学引入外科学以问题为基础学习教学方法中的探索与实践

在外科学教学中开展以问题为基础学习(PBL)结合循证医学的教学实践,是对传统教学模式的改革和创新,是一种有益的和成功的尝试.它有助于培养学生自主学习能力,促进学生掌握正确的临床思维方法,提高学生文献检索、语言表达和探索创新能力,对于培养创新型医学人才具有重要意义.     

循证医学用于膀胱癌灌注化疗患者护理的效果观察

目的 探讨循证医学用于膀胱癌灌注化疗患者护理的临床效果.方法 选取2015年10月至2019年10月间山东省立第三医院收治的60例膀胱癌灌注化疗患者,采用双盲选法抽签分为观察组和对照组,每组30例.对照组患者采用常规护理,观察组患者采用循证医学护理,比较两组患者总体健康状况得分、各功能评分及功能子量表得分.结果 干预前...     

Los 6 pasos necesarios para elaborar Critically Appraised Topics

Different types of critically appraised topics (CATs) can be elaborated in diagnostic imaging: comparison of diagnostic tests, evaluation of techniques for early detection (screening), economical analyses, or therapeutic aspects, among others. Their design will vary in function of the question they aim to answer. For example, for treatment evaluation, clinical trials are the best, but if there are secondary studies (systematic reviews or meta-analyses) that synthesize information from several studies, the results will be more important and the scientific conclusions will be more relevant. Regardless of the study design used, the elaboration of a CAT will involve six steps: 1) question; 2) systematic and efficient bibliographic search; 3) levels of evidence (choosing the articles that have the best level); 4) critical reading of the articles chosen; 5) applying conclusions to the context, and 6) recommendations. In this article, we will describe these steps and the nuances for different types of studies in each step.     

循证护理对预防恶性肿瘤患者化疗并发症的作用

目的探讨循证护理对预防恶性肿瘤患者化疗并发症的作用。方法选择2012年2月至2013年11月间收治的186例恶性肿瘤患者,随机分为常规护理组和循证护理组,每组93例。常规护理组患者给予恶性肿瘤化疗的常规护理,循证护理组患者则在常规护理基础上给予循证护理。结果循证护理组患者的胃肠道反应、局部组织损害和肝肾功能损害发生率明显低于常规护理组,差异有统计学意义(P<0.05)。两组患者的骨髓抑制情况比较,差异无统计学意义(P>0.05)。结论临床应用循证护理既可以避免或降低恶性肿瘤患者化疗并发症的发生,同时还可以极大地提高护理质量。     

循证护理在预防呼吸机相关性肺炎的效果探讨

目的 探讨循证护理在预防呼吸机相关性肺炎的效果,为临床提供护理经验.方法 将2010年3月一2012年3月收治的采用呼吸机治疗的患者168例随机分为对照组与循证组,每组各84例,对照组采用一般的护理策略,循证组采用循证护理,其中循证组提出问题并循证原因,制定护理策略,观查两组患者治疗后呼吸机相关性肺炎的发生率.结果 两组患者一般资料比较,差异无统计学意义;呼吸机相关性肺炎对照组发生率为27.4％,循证组发生率为6.0％,两组呼吸机相关性肺炎发生率差异有统计学意义(P＜0.05).结论 运用循证护理能降低呼吸机相关性肺炎的发病率,应在临床进行推广.     

Early Intensive Family Intervention and Evidence of Effectiveness: Lessons from the South West Autism Programme

Intervention strategies in autistic spectrum disorder (ASD) have emanated from a range of theoretical perspectives with a consensus view that the greatest impact on children's subsequent development is likely to occur when this work is early, intensive and focuses on young children in the context of the family. Controversies in ASD intervention have arisen in relation to claims for effectiveness, particularly for versions of Applied Behavioural Analysis. Taking account of user perspectives, the evidence base for ASD intervention is considered, distinguishing between experimental work that identifies a treatment effect and research that establishes ecological validity. In order to move practice forward, research is required to address which programme components are helpful for which children and which families in which contexts. Drawing on current intervention research (South West Autism Programme), this paper concludes by outlining some of the factors that need to be considered in shaping future ASD research and ASD service provision.     

Autopsy practice in forensic pathology – Evidence-based or experience-based? A review of autopsies performed on victims of traumatic asphyxia in a mass disaster

Current autopsy practice in forensic pathology is to a large extent based on experience and individual customary practices as opposed to evidence and consensus based practices. As a result there is the potential for substantial variation in how knowledge is applied in each case. In the present case series, we describe the variation observed in autopsy reports by five different pathologists of eight victims who died simultaneously from traumatic asphyxia due to compression during a human stampede. We observed that there was no mention of the availability of medical charts in five of the reports, of potentially confounding resuscitation efforts in three reports, of cardinal signs in seven reports and of associated injuries to a various degree in all reports. Further, there was mention of supplemental histological examination in two reports and of pre-autopsy radiograph in six reports. We inferred that reliance on experience and individual customary practices led to disparities between the autopsy reports as well as omissions of important information such as cardinal signs, and conclude that such reliance increases the potential for error in autopsy practice. We suggest that pre-autopsy data-gathering and the use of check lists specific to certain injury causes are likely to result in less deviation from evidence-based practices in forensic pathology. Pre-autopsy data-gathering and check lists will help ensure a higher degree of standardization in autopsy reports thus enhancing the quality and accuracy of the report as a legal document as well as rendering it more useful for data-gathering efforts.