Science is a system of knowledge that reflects the essential connections and laws of the objective world. Classification of disciplines is a subsystem of science, which involves the development of human cognition which evolved from the scientific category to the department of higher education, and then formation of a complex management system. Nowadays with the rapid development of science and technology which triggering numerous complex social problems, an increasing trend of scientific integration calls for multidisciplinary and interdisciplinary research and education. In the 1990s, evidence-based medicine was emerged in the self-doubting of medical science, and extended to other fields of medicine, health policy and social sciences, forming an interdisciplinary evidence-based science system. Evidence-based science is an embodiment of scientific integration, and also the carrier and mechanism of cross-disciplinary convergence. It attempts to break through barriers of disciplines and management, and promotes interdisciplinary research, during which it has encountered many difficulties due to limitations of traditional disciplines. Evidence-based science does not provide an intrusion or transformation of thinking paradigm into other disciplines, but rather an equal dialogue to promote broader discipline collaboration and a new round of self-improvement, so as to constantly explore novel methods and theories to solve emerging problems, achieve continuous improvement, and pursue excellence.
The social needs, disciplinary development and humanistic reflection has promoted the emergence and development of evidence-based medicine. Moreover, evidence-based medicine-problems oriented research, evidence based decision, transferring results to practice and outcome evaluation-continues to meet society demands, promote the development of discipline and show humanist concern. The application of evidence-based medicine has gradually extended from the field of clinical medicine to the public health, society, management, economy, policy research and education in the process of solving various problems. The high quality evidence has also been important to decision-making in these fields. Our study explored the emergence and development of evidence-based medicine from the perspective of social needs, disciplinary development and humanistic reflection for the first time.
Medicine bears the responsibility for human health. Technical competence, service standards, professional ethics and social accountability constitute the soul of this profession. The principles of nonmaleficence, beneficence, respect for autonomy and justice help to establish good doctor-patient relationship and regulate medical services, which has been fixed by international and domestic professional norms. Besides to ensure its truth, effectiveness and safety, medical research also should require certain rendering of subject's autonomy, minimizing risks and maintaining social justice. Some procedures have established for supporting it. Modern medical education furnishes suitable human resources for medical profession, which directly affects the accessibility and outcomes of health services. Its objectives, operations and assessments are increasingly taking shape. Faced with the current issues of healthcare equity, worsening doctor-patient relationship, scandals and ethical controversies in medical research, and the failing of medical education to fully match social needs, evidence-based medical methodology is extending to policy and social sciences for identifying and creating high-quality scientific evidence to improve the quality of decision-making.
Objective To systematically review current status of Chinese DRIs, and compare the similarities and differences between Chinese and global DRIs, so as to provide references for regulating Chinese DRIs. Methods Such database as PubMed, ISI Web of knowledge, The Cochrane Library, CBM, WanFang Data, CNKI and VIP were electronically searched from inception to May 31st, 2013. The reviewers independently screened studies according to inclusion and exclusion criteria, extracted data. Then, descriptive analysis was performed for basic information of literature, formulation of different DRIs, and DRIs distribution by different ages. Results Initially, a total of 588 articles were retrieved, 42 of which were finally included, involving 14 guidelines, 12 systematic reviews (SRs), and 16 original studies. The results showed that, WHO guidelines and global systematic reviews focused on iron and fat-soluble vitamins (A and D); the original studies in China focused not only on iron and vitamin A but also on protein, calcium, zinc, and selenium. The included guidelines focused mainly on population aged 3-18 years old and pregnant women; and except for those two kinds of population, SRs also paid attention to adults aged more than 18 years. The original studies of Chinese DRIs were concerned about all kinds of population, mainly focused adults aged 18-45 years and school children aged 6-12 years. Among 16 included original studies, 4 were concerned about men and 2 about women. Conclusion Chinese DRIs need urgent updates and supplement. As the largest developing country, China has different disease burdens, consumption levels, dietary patterns, nutrients’ content, and security levels, compared with developed countries and other developing countries. To develop evidence-based Chinese DRIs that are suitable for native health and Chinese local conditions, we should drawing lessons from the currently available best DRIs standards, methods and evidence based on Chinese actual conditions, disease burden, and expert opinion.
The majority of problems are comprehensive and complex in the modern society, which leads to the increasing contradictions in the specialization and comprehensiveness of knowledge. Interdisciplinary cooperation is one approach to improve the effectiveness and transferability. The primary principle of evidence-based medicine is its scientific and transparent procedures. It combines the patient’s preferences with clinical experience and the best evidence. Meanwhile, evidence-based medicine is focused on how to transfer research outcomes into practice and the re-evaluation of the result of practice in order to striving for perfections. Combining this practical pattern of evidence-based medicine with other disciplines can have a significant improvement on scientific methods and thinking patterns, and become an effective way to improve the quality of scientific research and promote the transformation.
Lifestyle medicine is an emerging medical specialty of 20-year-history. It is more cost effective and environmentally friendlier in managing chronic health conditions of individuals and populations than the conventional allopathic medicine. By summarizing the development, implementation and prospects of lifestyle medicine in America, this paper aims to contribute to the advancement of lifestyle medicine in China.
ObjectiveTo systematically evaluate the effect of combination of motherwort injection and oxytocin for promoting the involution of uterus. MethodsData of randomized controlled trials (RCTs) of motherwort injection and oxytocin in promoting the effect of postpartum involution of uterus were collected by searching the electronic databases including PubMed, EMbase, CNKI, WanFang Data, CENTRAL and WHO ICTRP from inception to August 26th, 2016. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies. Meta-analysis was conducted by RevMan 5.3 software. ResultsA total of 18 RCTs involving 6 468 patients were included. The results of meta-analysis showed that:Compared with the oxytocin alone group, the combination group of motherwort injection and oxytocin was higher on promoting the drop height of uterus (MD=1.33, 95%CI 1.03 to 1.63), lower on the height of uterus (MD=-2.12, 95%CI -2.64 to -1.61) and duration of lochia (MD=-7.11, 95%CI -8.84 to -5.38). There was no statistical difference in adverse effect rate between the two groups (OR=0.87, 95%CI 0.64 to 1.19, P=0.38). ConclusionsMotherwort injection combined with oxytocin is superior to oxytocin alone in promoting the drop height of postpartum uterus and shortening the duration of lochia. Because of the low quality of the included studies, more high quality RCTs are needed to prove the above conclusion.
The primary principle of evidence-based medicine is that the best clinical decision-making is derived from clinical problems with combination of patient’s preferences with clinical experience and the best evidence. Evidence-based medicine by its nature, is a specific application on the evaluation of medical hypothesis. It also emphasize the importance of humanism in clinical practice. Our study explored the scientific and humanistic characteristics of evidence-based medicine from the prospective of philosophy, so as to facilitate the extensive application of evidence based practice paradigm in other fields.