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1.
Chinese Medical Journal ; (24): 1920-1929, 2021.
Article in English | WPRIM | ID: wpr-887628

ABSTRACT

BACKGROUND@#The global pandemic coronavirus disease 2019 (COVID-19) has become a major public health problem and presents an unprecedented challenge. However, no specific drugs were currently proven. This study aimed to evaluate the comparative efficacy and safety of pharmacological interventions in patients with COVID-19.@*METHODS@#Medline, Embase, the Cochrane Library, and clinicaltrials.gov were searched for randomized controlled trials (RCTs) in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/SARS-CoV. Random-effects network meta-analysis within the Bayesian framework was performed, followed by the Grading of Recommendations Assessment, Development, and Evaluation system assessing the quality of evidence. The primary outcome of interest includes mortality, cure, viral negative conversion, and overall adverse events (OAEs). Odds ratio (OR) with 95% confidence interval (CI) was calculated as the measure of effect size.@*RESULTS@#Sixty-six RCTs with 19,095 patients were included, involving standard of care (SOC), eight different antiviral agents, six different antibiotics, high and low dose chloroquine (CQ_HD, CQ_LD), traditional Chinese medicine (TCM), corticosteroids (COR), and other treatments. Compared with SOC, a significant reduction of mortality was observed for TCM (OR = 0.34, 95% CI: 0.20-0.56, moderate quality) and COR (OR = 0.84, 95% CI: 0.75-0.96, low quality) with improved cure rate (OR = 2.16, 95% CI: 1.60-2.91, low quality for TCM; OR = 1.17, 95% CI: 1.05-1.30, low quality for COR). However, an increased risk of mortality was found for CQ_HD vs. SOC (OR = 3.20, 95% CI: 1.18-8.73, low quality). TCM was associated with decreased risk of OAE (OR = 0.52, 95% CI: 0.38-0.70, very low quality) but CQ_HD (OR = 2.51, 95% CI: 1.20-5.24) and interferons (IFN) (OR = 2.69, 95% CI: 1.02-7.08) vs. SOC with very low quality were associated with an increased risk.@*CONCLUSIONS@#COR and TCM may reduce mortality and increase cure rate with no increased risk of OAEs compared with standard care. CQ_HD might increase the risk of mortality. CQ, IFN, and other antiviral agents could increase the risk of OAEs. The current evidence is generally uncertain with low-quality and further high-quality trials are needed.


Subject(s)
COVID-19 , Humans , Medicine, Chinese Traditional , Network Meta-Analysis , Pandemics , SARS-CoV-2
2.
Article in English | WPRIM | ID: wpr-781415

ABSTRACT

Objective@#To evaluate the effects of incretin-based therapies on body weight as the primary outcome, as well as on body mass index (BMI) and waist circumference (WC) as secondary outcomes.@*Methods@#Databases including Medline, Embase, the Cochrane Library, and clinicaltrials.gov (www.clinicaltrials.gov) were searched for randomized controlled trials (RCTs). Standard pairwise meta-analysis and network meta-analysis (NMA) were both carried out. The risk of bias (ROB) tool recommended by the Cochrane handbook was used to assess the quality of studies. Subgroup analysis, sensitivity analysis, meta-regression, and quality evaluation based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were also performed.@*Results@#A total of 292 trials were included in this study. Compared with placebo, dipeptidyl-peptidase IV inhibitors (DPP-4Is) increased weight slightly by 0.31 kg [95% confidence interval ( ): 0.05, 0.58] and had negligible effects on BMI and WC. Compared with placebo, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) lowered weight, BMI, and WC by -1.34 kg (95% : -1.60, -1.09), -1.10 kg/m (95% : -1.42, -0.78), and -1.28 cm (95% : -1.69, -0.86), respectively.@*Conclusion@#GLP-1 RAs were more effective than DPP-4Is in lowering the three indicators. Overall, the effects of GLP-1 RAs on weight, BMI, and WC were favorable.

3.
Article in Chinese | WPRIM | ID: wpr-773212

ABSTRACT

In 2013,China pharmaceutical regulatory department issued guiduance on postmarketing drug safety monitoring for industry. It aimed to encourage industry to carry out postmarketing drug safety monitoring including hospital-based intensive monitoring of postmarketing Chinese patent medicine. Subsequently,more and more such kind of studies have been performed all over China. However,in view of the current situation in this field,the development of hospital-based intensive monitoring of postmarketing Chinese patent medicine lacks standardization,such as unreasonable design,omission of reports about adverse drug reactions,inadequate process of quality control,non-standardized interpretation of adverse reactions,etc. Therefore,it is necessary to formulate relevant technical specifications to guide this area. The developing of this technical specification refered to the international post-marketing safety monitoring model and advanced design concepts and methods. We developed it under the guidance of relevant laws,regulations and technical documents in China. Meanwhile the characteristics of Chinese patent medicines and the real situation in this area were considered. The aim of this technical specification is to obtain the incidence,type,degree and clinical manifestation of adverse drug reactions of Chinese patent medicines,to find new risk signals of adverse reactions,to identify risk factors,and to provide a basis for the formulation of risk management and control plans. This specification has been approved by China association of Chinese medicine which is numbered T/CACM011-2016.


Subject(s)
Adverse Drug Reaction Reporting Systems , China , Hospitals , Medicine, Chinese Traditional , Nonprescription Drugs , Product Surveillance, Postmarketing
4.
Article in Chinese | WPRIM | ID: wpr-773209

ABSTRACT

Diemailing~® Kudiezi Injection( DKI) is widely used in the treatment of cerebral infarction,coronary heart disease and angina pectoris. Long-term clinical application and related research evidence showed that DKI has a good effect in improving the clinical symptoms of cardiovascular and cerebrovascular diseases. However,this injection has not been included in any clinical practice guideline. It has been found that the use of DKI is in wrong way in clinical practice in recent years. Therefore,clinical experts from the field of cardiovascular and cerebrovascular diseases nationwide are invited to compile this expert consensus in order to guide clinicians.GRADE system is used to grade the quality of evidence according to different outcomes according to degrading factors. Then it forms the recommendation or consensus suggestion through the nominal group method. The formation of expert consensus mainly considers six factors: quality of evidence,economy,efficacy,adverse reactions,patient acceptability and others. Based on these six aspects,if the evidence is sufficient,a " recommendation" supported by evidence is formed,and GRADE grid voting rule is adopted. If the evidence is insufficient,a " consensus suggestions" will be formed,using the majority voting rule. In this consensus,the clinical indications,efficacy,safety evidences and related preliminary data of DKI were systematically and comprehensively summarized in a concise and clear format,which could provide valuable reference for the clinical use of DKI. This consensus has been approved by China association of Chinese medicine which is numbered GS/CACM 202-2019.


Subject(s)
Angina Pectoris , Drug Therapy , Cerebral Infarction , Drug Therapy , China , Consensus , Coronary Disease , Drug Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Humans , Injections , Medicine, Chinese Traditional
5.
Article in Chinese | WPRIM | ID: wpr-773208

ABSTRACT

Xiyanping Injection is a commonly used medicine in clinical treatment,which is recommended by many pediatric disease guidelines/consensus. However,the instraction is relatively simple and lack of guidance for clinical application,which affects the efficacy and brings safety risks. Therefore,more detailed clinical guidance is urgently needed. This consensus is formulated by clinical experts of traditional Chinese medicine and Western medicine in pediatrics. This consensus follows Manual for the clinical experts consensus of Chinese patent medicine which published by China Association of Chinese Medicine. The study identified clinical problems using clinical investigation,searched the literature based on PICO clinical problems,using GRADE system to carry out evidences evaluation,classification and recommendation,and adopted the nominal grouping method to reach expert consensus. The consensus combines evidence-based evidence with expert experience,sufficient evidence of clinical problems would lead to " recommendations",and clinical problems with insufficient evidence will lead to " consensus suggestions". This expert consensus recommends the indications,intervention time for treatment,route of drug administration,dose conversion,the indications of being used alone,suitability and taboos of medicine combination,and introduces the safety and clinical application,to provide reference for clinical using.


Subject(s)
Child , China , Consensus , Drugs, Chinese Herbal , Therapeutic Uses , Humans , Injections , Medicine, Chinese Traditional , Nonprescription Drugs , Pediatrics
6.
Article in Chinese | WPRIM | ID: wpr-773206

ABSTRACT

Hugan Tablets is a Chinese patent medicine,it has the function of anti-inflammation and reducing transaminase. Based on questionnaire investigation of doctors and a systematic review of research literature on Hugan Tablets,using international clinical practice guidelines' developing methods,with the best available evidence and fully combining expert experience,and following the principle of " evidence-based,consensus-based and experience-based",Expert consensus statement on Hugan Tablets in clinical practice was developed by more than 30 multidisciplinary experts from the nationwide,aimed at guiding and standardizing the rational use of Hugan Tablets by clinicians and to improve clinical efficacy and safety. The expert consensus adopts internationally recognized recommendation criteria for classification of evidence: GRADE. The formation of expert consensus adopts the nominal group technique. Six main considerations are quality of evidence,curative effect,safety,economical efficiency,patient acceptability and other factors. If there is sufficient evidence,a " recommendation" is formed,using GRADE grid voting rule. If there isn' t sufficient evidence,a " consensus opinion" is formed,using majority counting rule. Focus on the indication,usage and dosage,drug use in special population and safety of Hugan Tablets,two recommendations and eight consensus opinions were put forward. Through expert meetings and correspondence,a nationwide consultation and peer review was conducted. This consensus applies to clinicians in hospitals and grass-roots health services,to provide guidance and reference for the rational use of Hugan Tablets.


Subject(s)
Consensus , Drugs, Chinese Herbal , Therapeutic Uses , Humans , Inflammation , Drug Therapy , Nonprescription Drugs , Tablets
7.
Article in Chinese | WPRIM | ID: wpr-691513

ABSTRACT

Cohort study is one of the important epidemiological methods which plays an irreplaceable status and role in etiological study.Using cohort study design,we can accurately and continuously collect genetic and environmental information,and identify and validate omics biomarkers to provide evidences for precision public health and medicine.However,results from a new cohort would not be available for at least ten years,as five years would be needed for funding,planning and enrolment,and another five for following up even the earliest analyses of the most common diseases;results for most cancers would take longer,with an unaffordable budget for many research investigators or institutions.That brings an alternative strategy of using existing cohort studies by sharing data between each other.Data sharing of cohort studies would be beneficial in many ways.Data sharing of cohort studies has the potential to make large samples unattainable in a single study,increase statistical power,enable more accurate and detailed subgroup analysis,increase the generalizability of results.It would also facilitate exchange of experiences and learning from each other,avoid for duplicated research and effectively promote the second use of existing data (i.e.using old data to discover new results).The data sharing would save staff recruitment,follow-up,laboratory analysis of the cost,with a high cost-benefit returns and economies of scale.Data sharing enables cross-validation and repeated verification across different data.Many international research funding agencies or leading research groups have also reached consensus on the principles and goals for promoting the sharing of medical research data.Due to rapid development of cohort studies in the past decades,China already has the basis for data sharing of cohort studies.Unfortunately,most of the existing cohort studies are self-contained,independent,lack of visibility,with insufficient co-operation and data sharing between each other.The academic value of the existing data collected in these cohort studies have not been fully exploited and utilized so far.Therefore,the China Cohort Consortium is trying to establish a multi-level three-dimensional cooperation and data sharing strategy.We hope that it will encourage researchers from public health,clinical and other related fields to work more closely through providing data management,data integration,data interaction,tools development,data repositories and other functions.

8.
Article in Chinese | WPRIM | ID: wpr-305297

ABSTRACT

A systematic review was undertaken, including studies that evaluated the incidence of the blood system adverse events of Tripterygium wilfordii (TWP). Medline, Embase and the Cochrane library were searched for relevant studies, including RCT, cohort studies and case series, of patients treated with TWP published in English and Chinese from inception up until May 25th, 2013 with the keywords including "Tripterygium wilfordii", "toxicity", "reproductive", "side effect", "adverse", "safety" and "tolerability". Relevant information was extracted and the incidence of the blood system adverse events was pooled with MetaAnalyst software. Besides, subgroup and sensitivity analyses were performed based on age, mode of medicine, observation time and disease system. According to inclusion and exclusion criteria, a total of 49 articles were included in the meta-analysis, they were split into 54 researches incorporated in the analysis. There is a large degree of heterogeneity among the studies, so data was analyzed using random-effects model and the summary estimates of incidence of the blood system adverse events was 6.1%. The weighted combined incidence of three major blood system adverse events were white-blood cells decreasing 5.6% (95% CI, 4.3% - 7.3%), hemoglobin decreasing 1.7% (95% CI, 0.5% - 5.0%) and platelet decreasing 1.8% (95% CI, 1.0% - 3.1%), respectively . Sensitivity analyses based on 45 studies with high quality showed the combined value was close to the summary estimate of total 54 studies. The current evidence indicates that the incidence of the blood system adverse events induced by TWP was high; attentions should be paid on to the prevention and treatment of the blood system adverse events.


Subject(s)
Blood Cells , Hemoglobins , Humans , Tripterygium
9.
Article in Chinese | WPRIM | ID: wpr-636099

ABSTRACT

Background Recently,the number of randomized controlled trials on ophthalmic diseases that published in international journals from mainland China has increased gradually.There is no systematic summary in this field.Objective To systematically search and analyze the distribution of ophthalmic diseases related randomized controlled trials (RCT) published in SCI journals from mainland China up to November,2012.Methods The search was performed on Pubmed using “Ophthalmology”,“Eye” and all of their inferior subjective terms,with type of literature being limited as randomized controlled trial,and country as China.All retrieved papers were screened,data extracted and analyzed.Results There were 68 ophthalmic diseases related RCT papers published from mainland China since 1989.After 2005,the number of RCT papers from mainland China increased quickly with 7 in 2006,11 in 2009,and 15 in 2011.The 68 RCT papers were focused on cataract,optometry,glaucoma,corneal and conjunctival diseases,ophthalmic immune and pharmacology,and fundus diseases.The RCT papers were published in a total of 35 SCI journals including most kinds of ophthalmic journals such as Ophthalmology,IOVS and a few journals on other specialty.The journal Clin Experiment Ophthalmol had the maximum RCT papers from China (8 papers).The 68 RCT papers came from 26 departments in mainland China,mainly from the hospitals affiliated to medical university in Guangzhou,Beijing,Shanghai,Wenzhou and Hangzhou.Conclusions The number of ophthalmic diseases related RCT papers published in SCI journals from mainland China increased continuously.The papers were mainly focused on cataract,optomctry and glaucoma.The number of these papers,however,was still small and imbalance between districts existed.

10.
Article in Chinese | WPRIM | ID: wpr-318710

ABSTRACT

<p><b>OBJECTIVE</b>To summarize the application of diagnosis criteria on drug induced liver injury in China from 2005 to 2012 in China.</p><p><b>METHOD</b>We systematically searched the journals included in four commonly accepted Chinese electronic databases for medical research, i.e. CNKI, CBM, VIP and Wanfang database, for articles published from 2005 to 2012. The articles meeting the inclusion criteria were considered eligible for our analysis. Relevant information was extracted using a standardized form in Excel 2007.</p><p><b>RESULT</b>Overall,273 studies were included for the present review. 199 Case Series and 74 Case Report. There are 15 various standard of diagnosis using in 199 Case Series for DILI. Chinese general standard, 1997 Maria Criteria, and Medical records are generally used. The use of the three standard has no trend with time and various journals in 199 Case Series. 74 Case Report all use medical records as criteria on DILI diagnosis.</p><p><b>CONCLUSION</b>We don't have the consolidate criteria on DILI diagnosis at present, so when we choose the standard of diagnosis, we should consider many factors in order to avoid missed diagnosis and misdiagnosis.</p>


Subject(s)
Chemical and Drug Induced Liver Injury , Diagnosis , China , Diagnosis, Differential , Diagnostic Techniques and Procedures , Reference Standards , Humans , Periodicals as Topic
11.
Chinese Journal of Epidemiology ; (12): 307-310, 2013.
Article in Chinese | WPRIM | ID: wpr-318408

ABSTRACT

<p><b>OBJECTIVE</b>To study the association between the clustering manifestation of factors as overweight and central obesity, family heredity, immoderate alcohol drinking, tobacco smoking, hyperlipidemia, hyperglycemia and the prevalence of hypertension.</p><p><b>METHODS</b>Data was from a program related to the comprehensive prevention and control strategies on cardiac-cerebral vascular disease carried out in the communities of Shanghai, to describe the relationship between the clustering of risk factors and hypertension. This program included 15 158 people with complete data at the age of 35 - 74, from 2008 - 2011. Both single factor and multi-factor analysis were used and longitudinal study was performed to further explore the causal relationship.</p><p><b>RESULTS</b>The overall prevalence of hypertension at the baseline survey was 41.9%. The associated ORs (age-adjusted) of hypertension parallelly increased with the number of risk factors under clustering. The associated OR of the males with 1, 2, 3, 4 as well as 5 and above risk factors were 3.157 [95% confidence interval (CI): 2.152 - 4.630], 6.428 (95%CI: 4.435 - 9.319), 11.797 (95%CI: 8.135 - 17.105), 19.723 (95%CI: 13.414 - 29.000), 33.051 (95%CI: 21.449 - 50.930) respectively. In females with 1, 2, 3 as well as 4 risk factors, the associated ORs were 2.917 (95%CI: 2.374 - 3.585), 6.499 (95%CI: 5.307 - 7.959), 15.717 (95%CI: 12.609 - 19.591) and 31.719 (95%CI: 21.744 - 46.270), respectively. For longitudinal study, the 2-year incidence of hypertension in males and females were 1.9% and 1.6%, respectively. Compared to those people without risk factors, the incidence was higher in the people with a larger number of clustering. When the clustering number reaching 2 or 3 in females, the relative risk (RR) were 2.111 (95%CI: 1.024 - 4.350) and 3.000 (95%CI: 1.287 - 6.995) respectively, with statistically significant difference.</p><p><b>CONCLUSION</b>The risk of hypertension parallelly increased with the clustering number of relevant risk factors. Comprehensive prevention and control on related risk factors was required.</p>


Subject(s)
Adult , Aged , Aged, 80 and over , Bias , China , Epidemiology , Female , Humans , Hypertension , Epidemiology , Longitudinal Studies , Male , Middle Aged , Prevalence , Residence Characteristics , Risk Factors
12.
Chinese Journal of Epidemiology ; (12): 874-878, 2013.
Article in Chinese | WPRIM | ID: wpr-320982

ABSTRACT

Objective This study aimed to provide an epidemiological modeling method to evaluate the risk of metabolic syndrome (MS) development in the coming 5 years among 35-74 year-olds from Taiwan.Methods A cohort of 13 973 subjects aged 35-74 years who did not have metabolic syndrome but took the initial testing during 1997-2006 was formed to derive a risk score which tended to predict the incidence of MS.Multivariate logistic regression was used to derive the risk functions and using the ‘check-up center' (Taipei training cohort) as the overall cohort.Rules based on these risk functions were evaluated in the remaining three centers (as testing cohort).Risk functions were produced to detect the MS on a training sample using the multivariate logistic regression models.Started with those variables that could predict the MS through univariate models,we then constructed multivariable logistic regression models in a stepwise manner which eventually could include all the variables.The predictability of the model was evaluated by areas under curve (AUC) the receiver-operating characteristic (ROC) followed by the testification of its diagnostic property on the testing sample.Once the final model was defined,the next step was to establish rules to characterize 4 different degrees of risks based on the cut points of these probabilities,after being transformed into normal distribution by log-transformation.Results At baseline,the range of the proportion of MS was 23.9% and the incidence of MS in 5-years was 11.7% in the non-MS cohort.The final multivariable logistic regression model would include ten risk factors as:age,history of diabetes,contractive pressure,fasting blood-glucose,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,body mass index and blood uric acid.AUC was 0.827 (95% CI:0.814-0.839) that could predict the development of MS within the next 5 years.The curve also showed adequate performance in the three tested samples,with the AUC and 95% CI as 0.813 (0.789-0.837),0.826(0.800-0.852) and 0.794(0.768-0.820),respectively.After labeling the degrees of the four risks,it was showed that over 17.6% of the incidence probability was in the population under mediate risk while over 59.0% of them was in the high risk group,respectively.Conclusion Both predictability and reliability of our Metabolic Syndrome Risk Score Model,derived based on Taiwan MJ Longitudinal Health-checkup-based Population Database,were relatively satisfactory in the testing cohort.This model was simple,with practicable predictive variables and feasible form on degrees of risk.This model not only could help individuals to assess the situation of their own risk on MS but could also provide guidance on the group surveillance programs in the community regarding the development of MS.

13.
Article in English | WPRIM | ID: wpr-247163

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the incidence of Ketoconazole associated hepatotoxicity and related factor.</p><p><b>METHODS</b>Literature retrieval was conducted by using multi-databases for meta-analysis on Ketoconazole associated hepatotoxicity. The data were collected with a standardized form. Overall estimation of incidence of hepatotoxicity for specific study type was calculated by using a DerSimonian-Laird random-effects model owing to the substantial differences among the studies.</p><p><b>RESULTS</b>Totally 204 eligible studies were included in the analysis. The incidence of Ketoconazole associated hepatotoxicity was 3.6%-4.2%. The dosage and duration specific subgroup analyses did not show any significant difference among groups, while the age specific subgroup analysis showed the incidence in children and people aged >60 years was 1.4% (95% CI: 0.5%-4.2%) and 3.2% (95% CI: 1.1%-8.7%) respectively. Additionally, the incidence of the hepatotoxicity was higher in people who had oral administration of ketoconazole beyond the provisions of the usage instructions, and the incidence was 5.7% (95% CI: 4.5%-7.2%).</p><p><b>CONCLUSION</b>Ketoconazole associated hepatotoxicity was common. Off-label use might increase the risk of liver damage. Well-designed large sample studies are needed to identify the risk factors in future.</p>


Subject(s)
Antifungal Agents , Chemical and Drug Induced Liver Injury , Humans , Ketoconazole , Off-Label Use
14.
Article in Chinese | WPRIM | ID: wpr-338038

ABSTRACT

In recent years, there has been a great increase in production of systematic reviews of traditional Chinese medicines (TCM). However,some researchers indicated that their methodology and reporting quality were unsatisfactory. This article offered some recommendations for performing high-quality systematic reviews of TCM.


Subject(s)
Humans , Medicine, Chinese Traditional , Reference Standards , Meta-Analysis as Topic , Publications , Reference Standards , Quality Control , Review Literature as Topic
15.
Chinese Journal of Epidemiology ; (12): 921-925, 2012.
Article in Chinese | WPRIM | ID: wpr-289612

ABSTRACT

Objective This study aimed to provide an epidemiological modeling in evaluating the risk of developing obesity within 5 years in Taiwan population aged 30-59 years.Methods After excluding 918 individuals who were obesitive at baseline,a cohort of 14 167 non-obesity subjects aged 30-59 years in the initial year during 1998-2006,was formed to derive a Risk Score which could predict the incident obesity (IO).Multivariate logistic regression was used to derive the risk functions,using the check-up center (Taipei training cohort,n=8104) of the overall cohort.Rules based on these risk functions were evaluated in the left three centers (testing cohort,n=6063).Risk functions were produced to detect the IO on a training sample using the multivariate logistic regression models.Starting with variables that could predict the IO through univariate models,we constructed multivariable logistic regression models in a stepwise manner which eventually could include all the variables.We evaluated the predictability of the model by the area under the receiver-operating characteristic (ROC) curve (AUC) and to testify its diagnostic property on the testing sample.Once the final model was defined,the next step was to establish rules to characterize 4different degrees of risk based on the cut points of these probabilities after transforming into normal distribution by log-transformation.Results At baseline,the range of the proportion of normal weight,overweight and obesity were 50.00% 60.00%,26.47%-31.11% and 5.76%-7.24% respectively in tour check-up centers of Taiwan.After excluding 918 obesity individuals at baseline,we ascertained 386 (2.73%,386/14 167) cases having IO and 2.66%-2.91% of them having centered obesity in the four check-up centers respectivcly.Final multivariable logistic regression model would include five risk lactors:sex,age,history of diabetes,weight deduction ≥4 kg within 3 months and waist circumference.The area under the ROC curve (AUC) was 0.898 (95%CI,0.884-0.912) that could predict the development of obesity within 5 years.The curve also had adequate performance in testing the sample [AUC=0.881 (95%CI,0.862 0.900) ].After labeling the four risk degrees,16.0% and 2.9% of the total subjects were in the mediate and high risk populations respectively and were 7.8 and 16.6 times higher,when comparing with the population at risk in general.Conclusion The predictability and reliability of our obesity risk score model,derived based on Taiwan MJ Longitudinal Health-checkup-based Population Database,were relatively satisfactory,with its simple and practicable predictive variables and the risk degree form.This model could help individuals to self assess the situation of risk on obesity and could also guide the community caretakers to monitor the trend of obesity development.

16.
Chinese Medical Journal ; (24): 2499-2504, 2012.
Article in English | WPRIM | ID: wpr-283733

ABSTRACT

<p><b>BACKGROUND</b>Pain is a common post-operative complication. Incidence of pain directly affects patients' quality of life in terms of patient physiology, psychology, and social characteristics. This study was to understand clinical attitudes with regards to Beijing surgeons, and patients' attitude towards pain treatment after orthopedic surgery.</p><p><b>METHODS</b>A hospital-based cross-sectional and cluster sample survey of 40 hospitals in Beijing was conducted, including 20 level III (tier three) and 20 level II (tier two) general hospitals. Enrolled subjects completed a specifically designed interview-questionnaire.</p><p><b>RESULTS</b>The prevalence of pain 2 weeks post-orthopedic surgery was high in Beijing (96.1%). Meanwhile, collected data indicated most subjects in Beijing suffered moderate to severe pain, 45.1% and 41.4%, respectively, post-surgery. And for the concern of patients before surgery, most subjects chose full recovery from surgery (78.6%), as well as, the pain after operation was 39.2% ranked the third. According to the data from the study, Tramadol use was more common in Level III hospitals, where Somiton was preferred in Level II hospitals. When it came to the education of pain before and after operation, more patients get educated before operation than after it. In our study, case physicians or attending physicians enacted education before and after surgery. Related to the sense of patients, among the surgeons preferring post-operative analgesia, 67.6% considered administration when receiving complaints of moderate level pain, 50.0% indicated they will terminate analgesic treatment once pain degree scale wise decreases to benign pain.</p><p><b>CONCLUSIONS</b>The majority of orthopedic patients experience post-operative pain. Identification of post-operative pain will facilitate future awareness on pain treatment and nursing care in Beijing hospitals, with pain relief through regulated improvements in strategic pain management.</p>


Subject(s)
Adult , Cross-Sectional Studies , Female , Humans , Male , Orthopedics , Pain, Postoperative , Drug Therapy , Postoperative Period , Surveys and Questionnaires , Tramadol , Therapeutic Uses , Young Adult
17.
Article in Chinese | WPRIM | ID: wpr-635601

ABSTRACT

Background Whether the wearing of bifocal lenses can delay the development of myopia in school childhood is in controversy.To assess the effect of bifocal lenses using evidence-based medicine method is of important significance.Objective Present study was to compare the effect of bifocal lenses with single vision lenses in retarding myopia progression in school-aged myopic children.Methods This was a evidence-based medicine study.The systematical literature search was performed from MEDLINE(1966 to October 2010),EMBASE(1974 to October 2010),Cochrane Library,Chinese Biomedical Database(1978 to October 2010),and Chinese Clinical Trial Registry combined with hand searching of related bibliographies of journals and books were applied to collect the randomized-controlled clinical trial about bifocal lenses.Screening,evaluation and data extraction of the retrieved literature were performed by two investigators independently.Mata-analysis was used to assess the progression of refraction and axial length among included randomized clinical trials.Results Three high-quality randomized-controlled clinical trials meeting the inclusion criterion were included in this meta-analysis.The results showed that the weighted mean difference in progression of refraction was 0.22D between bifocal lenses and single vision lenses(95% CI:-0.24-0.67),and the difference was statistical insignificance(P=0.35).The weighted mean difference in progression of refraction during the follow-up durations of 6,12,18,24 and >30 months were 0.15(95% CI:-0.09-0.38),0.17(95% CI:-0.05-0.39),0.42(95% CI:-0.14-0.98),0.23(95% CI:-0.21-0.66) and 0.03(95% CI:-0.40-0.46),respectively without statistical significance.The weighted mean difference in elongation of axial length between two interventions was -0.17mm(95% CI:-0.26-0.08) with a statistically significance(P=0.000).Conclusion Based on currently available studies,bifocal lenses could not significantly slow the progression of myopia in myopic school-aged children in comparison with single vision lenses.Because only few high-quality studies are currently available,this conclusion need to be supported by more large-sample-size clinical trials.

18.
Article in Chinese | WPRIM | ID: wpr-326656

ABSTRACT

Some problems are confronted in the development of Chinese medicine (CM) evidence-based clinical practice guidelines in the aspects of individualized treatment, quality of research, reporting bias, safety assessment, and so on. After comprehensive retrieving of current methods for developing evidence-based clinical practice guidelines in the field of complementary and alternative medicine, and an optimal combining with widely accepted standardized methods in evidence-based clinical practice guidelines for allopathic medicine, we put forward strategies for these aforesaid problems. In terms of individualized treatment, practical randomized control trials could be considered for inclusion. In terms of quality of research, the method to formulate guideline recommendations was proposed in case of insufficient evidence. In terms of reporting bias, commonly used databases in complementary and alternative medicine were listed. In terms of safety evaluation, GRADE system was suggested to adopt.


Subject(s)
Evidence-Based Medicine , Humans , Medicine, Chinese Traditional , Phytotherapy , Practice Guidelines as Topic
19.
Article in Chinese | WPRIM | ID: wpr-308788

ABSTRACT

<p><b>OBJECTIVE</b>To assess and compare the effectiveness and safety of methylphenidate immediate-release tablets (IR-MPH), methylphenidate controlled release tablets (OROS-MPH) and atomoxetine (AHC) for attention deficit hyperactivity disorder (ADHD) in Chinese children.</p><p><b>METHODS</b>Randomized or clinical controlled trials on the effectiveness and safety of IR-MPH, OROS-MPH and AHC for ADHD were searched in electronic databases of CNKI, VIP, CBMDISC online, PubMed, Embase and MEDLINE. Two reviewers independently extracted the data and assessed the quality of the included literatures.</p><p><b>RESULTS</b>Eight trials were finally included. IR-MPH, OROS-MPH and AHC were effective for ADHD. OROS-MPH was superior to IR-MPH in the improvement of peer relationship, CGI-I score, mother satisfaction and psychosomatic problems. There were no significant differences in the effectiveness between the AHC and IR-MPH groups. The adverse events related to the therapy with IR-MPH, OROS-MPH or AHC were mild and the incidence rates of adverse events were not significantly different among the three groups.</p><p><b>CONCLUSIONS</b>The effectiveness of OROS-MPH for the treatment of ADHD is probably superior to IR-MPH, and the effectiveness between AHC and IR-MPH is similar. The three drugs demonstrate the safety and well tolerance.</p>


Subject(s)
Atomoxetine Hydrochloride , Attention Deficit Disorder with Hyperactivity , Drug Therapy , Delayed-Action Preparations , Humans , Methylphenidate , Therapeutic Uses , Propylamines , Therapeutic Uses , Randomized Controlled Trials as Topic , Tablets
20.
Article in Chinese | WPRIM | ID: wpr-267433

ABSTRACT

In this article, two research cases are employed to show the rationale of the stepped-wedge design, under what situations that such a design is desirable, and how it can be implemented. Stepped-wedge design seems to suit to randomized controlled trials in which the entire study population will receive intervention programs as they would "provide more advantages than harm". When intervention can not be given to all the targets simultaneously due to limited resources, this design is particularly useful. The stepped-wedge design is also relevant when there is a hope to detect or control the time trend effect on the effectiveness of the intervention strategy. On the other hand, however, this design requires longer trial duration and presents a number of statistical challenges. Hence, careful planning and monitoring are essential to ensure that a robust evaluation is undertaken.

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