Objective To evaluate and summarize the relevant evidence on follow-up management of non-pregnant adult with pulmonary embolism, and provide a reference for optimizing the follow-up plan of non-pregnant adult with pulmonary embolism. Methods Clinical decision-making, guidelines, societies/associations websites related to follow-up of pulmonary embolism, and databases were searched for literature on follow-up management of non-pregnant adult with pulmonary embolism. The retrieval time limit was from databases establishment to December 2023. The included literature was evaluated for quality and summarized to form evidence. Results A total of 13 articles were included, including 3 clinical decision-making articles, 5 guidelines, 1 systematic review, and 4 expert consensus articles, forming 26 best pieces of evidence, involving 8 aspects of follow-up personnel and methods, follow-up time, physical assessment, activity guidance, contraception guidance, filter management, medication guidance, and lifestyle guidance. Conclusions The follow-up management of non-pregnant adult with pulmonary embolism is very important. When medical staff apply relevant follow-up management evidence, they should fully evaluate the patients’ willingness and medical environment, make full use of existing resources, optimize follow-up management strategies, reduce the occurrence of complications, and improve patient prognosis.
In the research process of uveal melanoma (UM), the Collaborative Ocular Melanoma Study (COMS) is a landmark and outstanding clinical study. Its research conclusions are the foundation for today's UM clinical work and guidelines. COMS is the first and largest randomized clinical trials conducted to date, comparing the survival outcomes of two or more treatment regimens for primary malignant intraocular tumors with high reliability. Its research design, methods, and conclusions are still widely cited in this day. Learning from the research experience of COMS, summarizing research data based on Asian populations, and studying treatment methods suitable for Asian UM patients is a powerful supplement to COMS data, but also an expansion of this global research, further improving the level of UM diagnosis and treatment in China.
Objective To summarize the best evidence for prevention of deep vein thrombosis (DVT) in lower limbs of patients with spinal cord injury (SCI), and provide a basis for medical staff to develop evidence-based prevention and management measures for DVT in the lower limbs of patients with SCI. Methods UpToDate, BMJ Best Practice, Guidelines International Network, National Institute for Health and Clinical Excellence, Registered Nurses’ Association of Ontario, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, New Zealand Guidelines Group, JBI evidence-based healthcare center database, Web of Science, Embase, Cochrane Library, CINAHL, Medlive, China guidelines network, SinoMed, China National Knowledge Infrastructure, and Wanfang were systematically searched. Evidence related to the prevention of DVT in lower limbs of patients with SCI has been collected. The search period was from January 1, 2019 to June 30, 2024, and the literature was screened, quality evaluated, evidence extracted, and summarized. Results Finally, 22 articles were included, including 3 guidelines, 2 clinical decision-making articles, 4 best practices articles, 7 evidence summaries, 4 expert consensus articles, and 2 systematic reviews. A total of 32 pieces of evidence were ultimately formed in six aspects of risk assessment, diagnosis and screening, prevention principle, drug prevention, mechanical prevention, and health education. Conclusions There is a lot of evidence involved in the prevention of DVT in lower limbs of patients with SCI. In the clinical implementation process, medical staff can carefully choose prevention plans based on the patients’ clinical condition to reduce the incidence of DVT in patients with SCI during hospitalization.
Objective To systematically search for evidence related to the prevention and management of kinesiophobia in patients undergoing total knee arthroplasty at home and abroad, evaluate and integrate the evidence, and to provide reference for clinical nursing practice. Methods Domestic and international evidence-based resource databases, including UpToDate, BMJ (British Medical Journal) Best Practice, National Institute for Health and Clinical Excellence guidelines network, JBI (Joanna Briggs Institute) evidence-based healthcare center database, Cochrane Library, Registered Nurses’ Association of Ontario website, China guidelines network, Web of Science, PubMed, SinoMed, China National Knowledge Infrastructure, and Wanfang were searched. Evidence related to the prevention and management of kinesiophobia after total knee arthroplasty was collected, and the search period was until June 30, 2023. The evidence extraction and integration were conducted on the literature that meets the requirements. Results A total of 10 papers were ultimately included, including 1 guideline, 1 expert consensus, 2 systematic evaluations, 4 randomized controlled studies, and 2 cohort studies. A total of 17 pieces of evidence were extracted from 5 aspects, including risk assessment, health education, intraoperative pain management, rehabilitation exercise, and patient participation. Conclusion The prevention and management of kinesiphobia after total knee arthroplasty include evidence from multiple aspects, which can provide evidence-based basis for orthopedic and rehabilitation medical staff to develop intervention plans for kinesiphobia and promote rapid recovery of patients with total knee arthroplasty.
ObjectiveTo select and obtain the related evidence of non-drug management of diarrhea after laparoscopic cholecystectomy (LC) at home and abroad and summarize the best evidence.MethodsWe systematically searched the PubMed, Cochrane Library, British Medical Journal best clinical practice, JBI evidence-based Health Care Center database, CINAHL database, Scottish inter-college Guide Network, American Guide Network, Ontario Nursing Society of Canada website, British National Institute of Clinical Medicine, and Chinese Biomedical Literature Database. All evidences on the non-drug management of diarrhea in the LC patients, including guidelines, system evaluation, expert consensus, etc. were retrieved. The retrieval time was limited from the establishment of the databases to November 9, 2019. The quality of the literature was independently evaluated by 2 researchers, and the data were extracted from the standard literature according to the judgment of professionals.ResultsThere were 15 literatures including 9 guidelines, 4 expert consensuses, and 2 systematic reviews. After the evaluation, 28 evidences for the non-drug management of diarrhea after LC were summarized.ConclusionsThe best evidences selected in this study could be applied to the practice of non-drug management of diarrhea after LC. However, the evidences should be selected according to the patients’ actual conditions and the individuation.
Objective To summarize the best evidence of preoperative prehabilitation for patients undergoing total joint replacement/total knee replacement (THA/TKA), and to provide reference for clinical work in the context of enhanced recovery after surgery (ERAS), in order to speed up the postoperative rehabilitation process of patients undergoing THA/TKA. Methods Up To Date, BMJ Practice, National Institute for Health and Care Excellence, Cochrane Library, JBI Evidence-Based Health Care Center Database, Guidelines International Network, www.guide.medlive.cn, PubMed, China National Knowledge Infrastructure, VIPdata, and WanFang Data were searched by computer for literature about preoperative prehabilitation of THA/TKA patients. The retrieval time was from the establishment of the databases to May 31, 2022. The quality of the included literature was evaluated by 2 researchers with evidence-based training. Results A total of 11 publications were included, including 1 guideline, 3 expert consensuses, 3 systematic reviews, and 4 randomized controlled trials, covering 6 aspects of multidisciplinary team, patient education, drug management, nutritional guidance, index control, and exercise intervention. A total of 16 best evidences of preoperative prehabilitation in patients with THA/TKA were extracted, including 9 A-level recommendations and 7 B-level recommendations. Conclusions THA/TKA prehabilitation includes various comprehensive interventions. With the development of ERAS in orthopaedics, the best evidence extracted can be used by clinical staff for THA/TKA. Evidence-based evidence is provided for patients to formulate prehabilitation programs.
With the development of computer technology, medical data has developed from traditional paper pattern into electronic mode, which could effectively promote the medical development. This paper at first presents the status and characteristics of medical data mining. Then, it discusses the critical method of medical data mining in classification, clustering and prediction, respectively. The paper focuses on the application and assessment of five algorithms which are designed for medical data mining, including decision tree, cluster analysis, association rule, intelligent algorithm and the mix algorithm. Finally, this paper outlooks the data mining application in medical domain.
Objective To search for, assess, and summarize the best evidence for antimicrobial allergy assessment in hospitalized patients, so as to provide an evidence-based basis for clinical nursing practice. Methods UpToDate, BMJ Best Practice, National Guideline Clearinghouse, Guidelines International Network, Yimaitong, JBI Evidence Synthesis, Cochrane Library, CINAHL, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Data, CQVIP, SinoMed, and related association websites were searched by computer for literature about clinical decisions, guidelines, expert consensuses, evidence summaries, systematic reviews and meta-analyses related to antimicrobial allergy assessment in hospitalized patients. The search time limit was from the establishment of the databases to September 2024. Two researchers trained in evidence-based practice screened the literature and evaluated the quality independently. Finally, the evidence-based research group extracted and integrated the evidence after discussion. Results Totally 8 articles were involved, including 6 guidelines and 2 systematic reviews. Finally, 25 pieces of best evidence were obtained across 6 aspects, including the importance of antimicrobial allergy assessment, the subjects of allergy assessment, the personnel conducting allergy assessment, the content of allergy assessment, the recording of allergy history, and assessment tips. Conclusion When applying and transforming evidence, medical staff should fully consider the actual clinical situation and explore the evaluation scheme of antimicrobial allergy history of hospitalized patients with local characteristics, to improve the accuracy of evaluation of antimicrobial allergy history of hospitalized patients, so as to strengthen the safety management of drug use and improve the level of rational drug use.
Objective To retrieve and summarize the best evidence for fall prevention after total hip arthroplasty in elderly patients. Methods BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Cochrane Library, PubMed, Web of Science, EBSCO, International Collaboration of Orthopaedic Nurisng website, American Academy of Orthopaedic Surgeons website, European Society for Trauma and Emergency Surgery website, Medlive, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were systematically searched. The retrieval time was from the establishment of the databases to June 30, 2024. The quality of literature was evaluated, and evidence was extracted, evaluated, and summarized. Results A total of 12 articles were included, including 4 guidelines, 2 randomized controlled trials, 2 cohort studies, and 4 expert consensus studies. A total of 18 pieces of evidence were extracted, including 13 A-level recommendations and 5 B-level recommendations. The evidence covers six major themes of risk factors, assessment, multidisciplinary team support, health education, medication management, safety environment, and assistive devices. Conclusions The fall prevention after total hip arthroplasty in elderly patients involves multiple factors, and the fall prevention should be based on multidisciplinary team cooperation, achieving linkage between the hospital and the family to jointly ensure patient safety. In the future, it is recommended to combine individual patient differences with actual clinical scenarios when applying evidence.
In this paper, we introduce theory and practice method about combining independent studies of Diagnostic test into a summary ROC curve. This is a useful and easily applied by clinicians to analyse the data of diagnostic test. It’s referance for user and doer of EBM in China.