Evidence-based medicine emphasizes that treatment must be based on the following elements ： the latest and best evidence, clinicians＇ expertise and patients＇ preference. Evidence-based medicine embodies the ethos both to explore medical science and to respect patients＇ values. Evidence-based medicine is an integration of the scientific and the humanistic spirit.
Gout is caused by abnormal metabolism of purine. Its most common symptom attack of intense pain and swelling in the joints. Attacks of gout can according to the alteration if it is in acute interval periods. How can we get the optimal effect? The development of methodology has provided much convincing evidence for us to choose the most appropriate treatment.
Objectives To analyze the effect of improved oven for defluorination in coal-burning endemic fluorosis areas in China, and to provide evidence for the prevention and control of fluorosis. Methods Electronic databases including CNKI, CBM, VIP and CDMD-D (1989 to 2005), were searched. We also checked the reference lists of relevant articles. We selected relevant articles according to the predefined inclusion and exclusion criteria. The methodological quality was assessed . Data on room heat preservation and the effect of improved oven for defluorination were collected in the surveillance spots of Three Gorges Reservoir. Correlation analyses were conducted between the improved oven and its effect parameters. Results Twelve articles of low quality met the selection criteria, of which 9 were graded C and 3 were graded D in terms of the methodological quality. A negative correlation was found between the decreasing rate of normal oven use and the decreasing rate of dental fluorosis as well as of urine fluorine (Pearson correlation coefficient r = – 0.87, – 0.63, Plt;0.01, lt;0.05, respectively). Analysis also revealed a positive correlation between room heat preservation and the decreasing rate of dental fluorosis as well as of normal oven use (the two Spearman correlation coefficients and P values were the same: r = –1.00, Plt;0.01). Conclusion High-quality studies on the effect of improved oven for defluorination in China are not available. Based on the current evidence, the improved oven for defluorination and the correct use, maintenance and house rebuilding for heat preservation may help to prevent fluorosis.
Based on the site visit on the current application and practice of evidence-based medicine in USA, we find the difference between China and USA so as to further promote and plan the development of evidence-based medicine in China.
Objective To review the current status of evidence-base medicine (EBM) research on traditional medicine in Japan. Methods Serial reports of EBM special committee of Japan Society for Oriental Medicine (JSOM) were reviewed. Results EBM special committee of JSOM was established earlier and carried out systematic reviews of Kampo treatment throughout Japan. The quality of preparations was standardized and reliable. Evidence Reports of Kampo Treatment 2009 (EKAT 2009) may be a promising promotion for Kampo treatment in Japan. Conclusion For the promotion and development of evidence-based Chinese medicine in China, we need to learn from EBM research projects of JSOM. Based on the current status of EBM research in China, special efforts should be made in validity of research data and scientific analysis and reports of non-randomized trials. According to the characteristics of traditional Chinese medicine, EBM research should be systematically carried out from simple to complex.
Objective To study the methodology of Chinese literature retrieval. Methods The manual review of the literature was served as the “gold standard” against database search strategies (the diagnostic tests). We selected original articles about treatment, rehabilitation and randomized controlled trials from 31 journals. The articles were downloaded from the Chinese Biomedical Database (CBM). We selected potentially useful words through a word frequency analysis and determined the frequency of all the words in the titles, abstracts, and subject indexes. All the selected journals functioned as a closed database. The sensitivity, specificity and precision of all the high frequency words were calculated and the high frequency words of large sensitivity×precision were considered as final searching words. All the searching strategies were produced by computer programe which consisted of all searching words, title field and abstract field. Meanwhile, the sensitivity, specificity, precision and NNR (number needed to read) were calculated. Among the strategies, those comprised of all searching words would be used in CBM disc database, those of title and abstract words in Chinese Web Databases. The best strategies were those of high sensitivity and high specificity. Results 2 570 articles were selected and 45 articles met the gold standard. The strategies emphasized sensitivity were “therapeutic use OR random OR control(for CBM disc) and multicenter OR therapeutic outcome OR random (for Chinese online databases)”. The strategies emphasized specificity were “placebo OR prospective study(MH) OR double blind OR random controled trial (MH) (for CBM disc) and placebo OR prospective) OR double blind OR efficiency (for Chinese online databases).”Conclusions The method is optimal for Chinese literature databases