Perineal care is a classic topic for obstetrics. After thousands of years of practice, we have accumulated some experience and meanwhile, we are also taking some attempts. The effectiveness and reliability of these methods need evaluation. Nowadays, the best evidence comes from randomized controlled trials (RCT) and systematic reviews (SR). We searched The Cochrane Library (Issue 3, 2007), MEDLINE (Jan. 1980 to May 2007) databases and CBM-disc (Jan. 1980 to May 2007) to obtain current best evidence for perineal care.
ObjectiveTo systematically review the research issues related to evidence quality grading methods for public health decision making. MethodsPubMed, Web of Science, CNKI, WanFang Data, CBM and VIP databases were electronically searched to collect studies related to the application of evidence quality grading methods for public health decision making from inception to December 2022. The questions were constructed according to the SPIDER model. The quality of the included literature was evaluated by using the CASP checklist, and a three-level interpretation analysis of the questions on the application of quality rating methods for public health decision making was conducted using the thematic synthesis method to establish a pool of question entries. ResultsA total of 14 papers were included, covering seven countries. GRADE was the commonly used method for grading the quality of evidence. CASP evaluation results showed eight high quality studies, four medium quality studies and two low quality studies. The thematic synthesis method summarized 13 question entries in 7 categories. ConclusionThe existing methodology for grading the quality of evidence for public health decision making suffers from the diversity of evidence sources and the underestimation of the level of evidence from complex intervention studies.
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.
Objective To investigate the current status of randomized controlled trials (RCTs) and clinical controlled trials (CCTs) on pressure sore in China. Methods We searched Chinese Journal of Nursing, Chinese Journal of Practical Nursing and Journal of Nurses Training in CNKI and VIP (January 2000 to December 2005) for Chinese articles on pressure sore, using "pressure sore", "bed sore", "nursing", "treatment", "prevention", "evaluation" and "management" as search terms. The retrieved articles were summarized. Results We identified 16 reports (10 RCTs and 6 CCTs). The studies were judged to be of low quality.There was one study on the evaluation, two on the prevention, and 13 on the treatment of pressure sores. Conclusion The current studies on pressure sore in China are focusing on treatment. Randomized controlled trials of large sample size of pressure sore are needed to improve nursing quality.
Rapid, living evidence-based points, as a new model promoting the rapid translation of evidence, aim to integrate the current best evidence, clinical status, public/patient preferences and values, and provide concise and practical guidance rapidly to important questions concerned in clinical medicine and public health. This paper introduces the methodological framework for the development of "Rapid, Living Evidence-Based Points" from 4 aspects: initiation and planning, evidence search and review, development, update, publication and dissemination of evidence-based points, in order to provide a reference for domestic scholars in developing rapid, living evidence-based points.
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 define the attributes and priorities of evidence-based nursing curriculum needs of nursing students, so as to provide operational reference for the design and development of evidence-based nursing course in the future. Methods Questionnaire was designed based on Kano model, and convenient sampling method was adopted to investigate the nursing students who had received training or had experience in evidence-based nursing from September to November 2020. According to the Kano model attribute classification method, the need attribute of evidence-based nursing curriculum was defined. Results A total of 303 nursing students were investigated. Kano model analysis showed that 11 of the needs for evidence-based nursing courses were one-dimensional quality, which belonged to the dimension of teaching resources and teaching content, and 5 were indifference quality, which belonged to the course assessment dimension. The importance-satisfaction matrix showed that the need of evidence-based nursing curriculum was concentrated in the advantage area and minor excepting improvement area. Conclusions In the future curriculum design, evidence-based nursing teachers need to continue to maintain the demand items in the advantage area and constantly improve and perfect them. They also need to pay more attention to the demand items in the minor excepting improvement area. Combined with the current problems in evidence-based nursing practice and the evidence-based needs of students, teachers need to further put forward suggestions on evidence-based nursing curriculum.
目的 為避免選擇和發表偏倚,系統評價者應采用多種查詢技術,并盡力獲得未發表的研究.本文試圖探討,英特網檢索對鑒定未發表和正在進行的臨床試驗是否有用.研究設計 利用七個Cochrane系統評價的查詢策略回顧性地在英特網上檢索未納入的隨機對照試驗.方法 檢索策略 以普通檢索式"研究方法學 NEAR干預措施NERA 條件"、用AltaVista在英特網上搜索.測量指標包括搜索時間、英特網搜索已發表研究的回溯率、精確度(已發表和未發表的隨機臨床試驗鏈接的網頁比例)、英特網檢索到的未納入的未發表和正在進行的研究數.結果 用21小時查詢了429個網頁,找到14個鏈接到未發表的、正在進行的或最近完成的試驗,至少有9個與4篇系統評價相關.英特網檢索已發表研究文獻的回溯率在0～43.6%,其鏈接已發表和未發表研究的精確度在0～20.2%.結論 未發表尤其是正在進行的試驗的信息可在英特網上找到.潛在的問題是如何評價未經同行評審的電子出版物的質量.急需更強的搜索工具.建議用"Open Trial Initiative"定義英特網發表試驗的語法,以加強試驗登記的共同操作性.因此,專門的搜索引擎可找到更多有關正在進行和已完成的臨床試驗信息.