Objective To observing about how effect is the education prescription using by the medical students, looking into whether the manner can attach the students attention and improve on the retrieval ability for them. Methods Choosing one of the cases come from PubMed and drawing out a clinical question. Asking total 100 students to search literature and write search strategy, search results and the reason about the results by chosen (similar to appraisal evidence), and their self-evaluation of this process. Results Of the 100 students, 96 (96%) searched PubMed/MEDLINE, and 79 (79%) searched second research database, 28 (28%) searched Science Citation Index (Web of Science), 38 (38%) chosen one of ten articles according with the articles chosen by the overseas doctors. We found no students weren’t interesting in the education prescription, but 65 (65%) didn’t think the education prescription be easy achieved, at the same time they mentioned that the retrieval problems were solved or profited came from the practice. Conclusions Filling education prescription can attract students attention and induct them to learn the basic concept of EBM, and to practice how to searching evidence and the feedback of students can help improve on teaching work.
IDEAL framework and recommendations provide a scientific and integrated evaluation pathway for surgical innovations and other complex therapeutic interventions, and underline that the preliminary studies are needed to prepare for a successful randomized controlled trial. IDEAL framework provides a series of recommendations in terms of nature stages of surgical innovation. We have reported the introduction and reporting guidelines of the IDEAL framework and recommendations in our IDEAL series paper. This paper aimed to provide some empirical evidence, focusing specifically on stages 2a and 2b, to help surgeons and researchers to understand how to imply IDEAL framework and recommendations into their clinical practice.
Although anaphylaxis induced by vitamin K1 seldom happens, 4 allergic cases were observed in the patients we treated recently who were given intramuscular injection of vitamin K1 before renal biopsy. To provide the best clinical evidence, we searched MEDLINE （-May 2005） and evaluated the studies. The studies were only case reports and retrospective reviews which showed the anaphylaxis were mainly allergic dermatitis with different manifestation and reaction time. The serious reactions such as allergic shock was very rare. We conclude that although vitamin K1 anaphylaxis is rare, strict indications should be followed and the drug surveillance on adverse events should be strengthened.
Objective To give an individualized treatment to a young woman with primary dysmenorrhea. Methods According to the basic principle and methods of evidence-base medicine, we searched The Cochrane Library (Issue 1, 2009), MEDLINE (PubMed, January 1950 to May 2009), ACP Journal Club (OVID, January 1991 to May 2007) for systematic reviews and randomized controlled trials (RCTs) to acquire the best clinical evidence on the treatment of primary dysmenorrhea. Results A total of 11 systematic reviews and 1 RCT were identified. A reasonable treatment plan was made through combining the patient’s will with her family members’. Conclusion The treatment effect on primary dysmenorrhea of the young woman is improved by an individualized treatment plan based on an evidence-based method.
Objective To summarize the best evidence for improving adherence to exercise therapy in non-surgical patients with knee osteoarthritis (KOA), so as to provide an evidence-based basis and reference for healthcare professionals, managers, patients, and caregivers. Methods Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses Association of Ontario, National Guideline Clearinghouse, American College of Rheumatology, Osteoarthritis Research Society International, Turkish League Against Rheumatism, European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, System for Information on Grey Literature in Europe, Cochrane Library, PubMed, Joanna Briggs Library, www.guide.medlive.cn, China National Knowledge Infrastructure, and WanFang Data were searched by computer for literature about improving exercise therapy compliance in non-surgical patients with KOA. The retrieval time limit was from January 1, 2017 to April 20, 2022. The quality of the included literature was evaluated by 2 researchers with evidence-based training, and ultimately evidence was extracted from the literature that met the quality evaluation criteria. Results A total of 12 publications were included, including 5 guidelines, 4 systematic reviews, and 3 expert consensuses, covering 6 aspects of multidisciplinary teamwork, development of individualized exercise plans, external support, interventions, health education, and follow-up management. A total of 18 best evidences for improving exercise therapy compliance in non-surgical patients with KOA were summarized, with 8 A-level recommendations and 10 B-level recommendations. Conclusions When applying the evidence, clinical staff should fully assess and develop exercise plans with individual patients, strengthen multidisciplinary communication and writing, make full use of external support resources and do health education and full follow-up management. Through comprehensive consideration and selection of the best evidence for implementation, the compliance of KOA non-surgical patients with exercise therapy can be improved.
Objective To retrieve, evaluate, and summarize evidence on the prevention and management of intracranial infections related to lumbar drainage (LD), in order to provide scientific references for clinical practice and decision-making. Methods The literature on the prevention and management of LD-related intracranial infections in LD-related websites and databases was systematically searched, with a search period from the establishment of databases to June 30, 2024. The included literature was evaluated for quality and integrated into evidence. Results A total of 9 articles were included, including 3 guidelines, 1 evidence summary, 1 expert consensus, 1 systematic review, and 3 original studies. A total of 30 pieces of evidence were formed, covering six aspects: risk management, catheter placement, catheter maintenance, extubation, diagnosis and treatment of intracranial infections, education and training. ConclusionsThe prevention and management of LD-related intracranial infections involve multiple pieces of evidence, and medical staff should selectively apply the best evidence based on patient and clinical conditions to reduce the incidence of intracranial infections and improve medical quality.
①住院與門診患者治療比較：缺乏比較急性單純性腎盂腎炎女性住院與門診患者治療的隨機對照試驗（RCT）。②靜脈用抗生素治療單純性感染女性住院患者（氨芐西林，增效復方磺胺）：缺乏靜脈用抗生素與不用抗生素治療比較的RCT；然而，這種RCT不可能實施。1個在女性單純性腎盂腎炎住院患者中進行的RCT發現，靜脈用氨芐西林＋慶大與靜脈用增效復方磺胺＋慶大相比，在臨床反應或尿細菌復現上無明顯差異。1個在女性單純性腎盂腎炎住院患者中進行的RCT發現，在臨床治療成功率方面，單劑靜脈用妥布霉素＋口服環丙沙星與口服環丙沙星＋安慰劑相比無明顯差異。缺乏設計良好的比較新、老靜脈用抗生素的試驗。③口服抗生素治療單純性感染婦女（增效復方磺胺、co-fimoxiclav或fluoroquinolone）：缺乏口服抗生素與不用抗生素比較的RCT；然而，這種RCT不可能實施。1篇有關單純性腎盂腎炎女性患者的系統評價及隨后的1篇RCT發現，在細菌學或臨床治愈率方面，口服增效復方磺胺、co-amoxiclav或afluoroquinolone（環丙沙星、諾氟沙星、左氧氟沙星或洛美沙星）之間無差別。
Objective To provide evidence of the role of helicobacter pylori eradication in the treatment of functional dyspepsia. Methods We searched VIP, CBMdisc, MEDLINE and The Cochrane Library for systematic reviews, meta-analysis, randomized controlled trials and clinical guidelines involving helicobacter pylori and functional dyspepsia, so as to provide the best evidence for clinical practice. Results We included two systematic reviews, one meta-analysis and eleven randomized controlled trials. The evidence identified showed that helicobacter pylori infection was more prevalent in functional dyspepsia than in asymptomatic patients, but the effect of H pylori infection in the pathogenesis of functional dyspepsia remained controversial. H pylori eradication therapy had a relatively weak effect in H pylori positive functional dyspepsia. An economic model suggested that this modest benefit may still be cost-effective, but more studies are needed to assess this. Conclusion According to the current evidence, it can be concluded that helicobacter pylori eradication for the treatment of functional dyspepsia should be individualized.