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The online and offline hybrid teaching model of evidence-based medicine (EBM) is currently in the stage of development. Previous teaching focused on the teaching process in the classroom, and did not organically combine all the course contents before, during, and after class. The BOPPPS model can be used to establish coherence and integrity in the EBM teaching process. Considering the discipline characteristics and teaching objectives of EBM, this study initially explored and designed a BOPPPS-based online and offline hybrid teaching model. Taking the "diagnostic evidence" module as an example, the teaching implementation details were introduced. A pre-designed questionnaire was used to conduct baseline survey and follow-up survey on students before and after class to evaluate the teaching model and effect. The surveys showed that half of the students (77/154) preferred the new online and offline hybrid teaching model of EBM. The students found that all aspects of BOPPPS teaching were generally acceptable and satisfactory. Compared with before teaching, the students' proficiency in EBM was significantly improved after the teaching ( P<0.001), particularly in their ability to retrieve literature and evaluate the quality of evidence, which is of great significance for expanding their knowledge and clinical thinking.
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Objective This study aims to summarize and evaluate clinical evidence of randomized controlled trial(RCT)of Chinese patent medicine published in 2021 and providing reasonable suggestions.Methods The collection literatures of Evidence Database System of TCM(EVDS)was main source,and CNKI,Wan Fang Data,VIP,SinoMed,Cochrane Library,PubMed,and EMbase databases were supplement.Obtaining the RCT of Chinese patent medicine published in 2021,and to analyze and evaluate their characteristics and methodological quality.Results 2215 RCTs of Chinese patent medicine(2206 in Chinese/9 in English)were included,which involving 237,379 patients,26 types of diseases,and 750 types of proprietary Chinese medicines(619 types of oral Chinese patent medicine,91 types of Chinese injections,and 40 types of topical Chinese patent medicine).The circulatory system diseases,respiratory system diseases and neurological diseases was highlight research area.The most number of diseases were ischemic Stroke,coronary heart disease,and angina pectoris.The sample size between 30 and 8,000 cases,and the case sources were mainly single-center.Methodologically,the implementation of allocation concealment and blinding remained unappreciated.Conclusion The number of RCTs publication increased in 2021 compared with 2020,more studies pay attention to neurological disease research,and quality control and standardized management during study design and implementation still need to be improved.
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Objective:To search, screen and summarize the best evidence of screening and management of patients with post-stroke fatigue, and to provide basis for early identification of clinical staff.Methods:According to the "6S" pyramid model, the system searches for relevant evidence on post stroke fatigue screening and management from UpToDate, BMJ Best Practice, International Guidelines Collaboration Network, New Zealand Guidelines Collaboration Group, Ontario Registered Nurses Association website, Scottish Interhospital Guidelines Network, Joanna Briggs Institute Evidence Based Health Care Center database, and Yimaitong, National Stroke Foundation, Stroke Association, National Stroke Center, Cochrane Library, PubMed, Embase, CINAHL, CNKI, WanFang Datebase, VIP and CBM from January 2013 to March 2023 regarding screening and management of post stroke fatigue patients. Researchers screen literature, evaluate quality, and summarize evidence.Results:Fifteen articles were selected, including 1 clinical decision, 3 guidelines, 3 expert consensus, 2 evidence summary, 5 systematic review and 1 randomized controlled trial. A total of 22 best evidence items were summarized from seven aspects of screening assessment, risk factors, psychosocial intervention, activity and rest, health education, complementary therapy, and follow-up.Conclusions:The study summarized the best evidence for the screening and management of patients with post-stroke fatigue, so as to provide a more scientific and systematic approach to the management of post-stroke fatigue and provide a reference for improving the long-term quality of life of stroke patients.
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Objective:To retrieve, evaluate and integrate the relevant evidence of prevention of lower limb ischemic complications in venous-arterial extracorporeal membrane oxygenation (VA-ECMO) patients, and provide reference for the development of scientific and complete prevention and management of lower limb ischemic complications.Methods:According to the evidence-based methodology, clinical decisions, guidelines, expert consensus, evidence summary, systematic review, randomized controlled trials and experimental studies related to lower limb ischemia complications in VA-ECMO patients were searched from CNKI, Wanfang, PubMed, Cochrane Library and other domestic and foreign databases as well as relevant professional websites. The literature search period was from the establishment of the database to August 2023. Two researchers independently evaluated the literature quality, and then extracted and summarized the evidence according to the theme.Results:A total of 27 004 articles were obtained in the preliminary search, and 11 articles were finally included after screening, including 1 guide, 2 expert consensus, 2 systematic reviews and 6 original studies. Through literature reading, evidence extraction and classification, and expert group meetings, a total of 24 best evidences were concluded in four dimensions, including team training and management, VA-ECMO pre-computer evaluation, VA-ECMO catheter selection, and the monitoring and management of lower limb ischemia.Conclusions:This study summarized the best evidence for the prevention of lower limb ischemia complications associated with VA-ECMO patients, and can provide reference for healthcare providers in clinical practice. In order to ensure the safety of VA-ECMO treatment and reduce the incidence of related complications, healthcare professionals should carefully select and apply evidence according to the clinical context and patients′ wishes.
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OBJECTIVE:The rabbit model of steroid-induced osteonecrosis of femoral head is the most commonly used animal model of femoral head necrosis.The pathological changes of the femoral head are close to clinical practice,however,the conditions,methods and evaluation standards of animal models reported in and outside China are not uniform,which leads to the low scientific value of animal models and is difficult to popularize.This study aimed to clarify the influence of different mold-making conditions on the establishment of steroid-induced osteonecrosis of femoral head rabbit model and analyze the appropriate conditions for the successful model establishment. METHODS:We searched the CNKI,WanFang,VIP,CBM,WoS,PubMed and EMbsae databases for the literature on the modeling of steroid-induced osteonecrosis of femoral head rabbits up to April 1,2022,completed the screening of the literature according to the inclusion and exclusion criteria and literature quality evaluation,and extracted the outcome index data in the literature.RevMan Stata and ADDIS statistical software were used to conduct a meta-analysis of the included data. RESULTS:(1)A total of 82 articles with 1 366 rabbits were included in the study.The steroid-induced osteonecrosis of femoral head modeling methods were divided into three types:steroid-alone method,steroid combined lipopolysaccharide method and steroid combined serum method.Among these,33 articles used steroid-alone method;20 articles used steroid combined lipopolysaccharide method;29 articles used steroid combined serum method.(2)Meta-analysis results showed that the three modeling methods significantly increased the rate of empty bone lacunae in the femoral head of steroid-induced osteonecrosis of femoral head rabbits(P<0.001),and significantly decreased the ratio of the trabecular bone area in the femoral head of steroid-induced osteonecrosis of femoral head rabbits(P<0.001).The order of empty bone lacunae rate of each modeling method was:steroid combined with lipopolysaccharide method>steroid-alone method>steroid combined with serum method>normal group,and the order of trabecular bone area rate of each modeling method was:normal group>steroid combined with serum method>steroid-alone method>steroid combined with lipopolysaccharide method.(3)The results of subgroup analysis suggested that the rate of empty bone lacunae in the rabbit model induced by steroid alone might be related to the rabbit variety and the type of steroid used for modeling(difference between groups P<0.05),in which the combined effect amount of New Zealand white rabbits was higher than that of Chinese white rabbits(P<0.05)and Japanese white rabbits,and the combined effect amount of dexamethasone was higher than that of other steroids.The rate of empty bone lacunae induced by steroid combined with lipopolysaccharide was related to the administration mode of lipopolysaccharide and the type of steroid(P<0.05),among which the combined effect of methylprednisolone sodium succinate was significantly higher than that of other steroids(P<0.05),and the combined effect of prednisolone was significantly lower than that of other steroids(P<0.05).The combined effect of lipopolysaccharide 100 μg/kg×twice was significantly lower than 10 μg/kg×twice and 50 μg/kg×twice(P<0.05).The rate of empty bone lacunae in the model induced by steroid combined with serum was related to serum dose and steroid type(P<0.05),among which the combined effect amount of dexamethasone sodium phosphate was significantly higher than other steroid types(P<0.05),and the combined effect amount of dexamethasone was significantly lower than other steroid types(P<0.05);the combined effect amount of serum"10 mL/kg+6 mL/kg"combined dose was lower than other serum doses(P<0.05). CONCLUSION:(1)With the rate of empty bone lacunae and the ratio of trabecular bone area as the judgment standard for the successful establishment of the model,the three modeling methods can successfully construct the rabbit steroid-induced osteonecrosis of femoral head model,of which the steroid combined with lipopolysaccharide method is the best.(2)New Zealand white rabbits and dexamethasone are recommended when selecting the steroid-alone method.Methylprednisolone sodium succinate and low-dose lipopolysaccharide are recommended when selecting the steroid combined with lipopolysaccharide method.Dexamethasone sodium phosphate is recommended when selecting the steroid combined with serum modeling method.
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ObjectiveTo systematically evaluate the distribution of traditional Chinese medicine（TCM） syndromes of primary osteoporosis（POP） in China by using evidence-based medicine methods， and to understand the distribution law of the syndromes. MethodChina National Knowledge Infrastructure（CNKI）， VIP Chinese Science and Technology Journal Database（VIP）， WanFang Data Knowledge Service Platform（WanFang） and China Biology Medicine（CBM） were searched to obtain representative literature， and each database was searched from the 1994 World Health Organization defined diagnostic criteria for osteoporosis until May 1， 2023. Two researchers independently screened literature according to the criteria， extracted data， and cross-checked them. Meta analysis was conducted using R4.1.3， and subgroup analysis was performed. ResultA total of 56 Chinese papers were included， involving 14 415 patients. After standardized classification of syndromes， 11 articles were excluded， and Meta analysis results of the ultimately included 45 Chinese articles showed that the distribution frequencies of liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency syndrome and kidney deficiency and blood stasis syndrome in 12 723 patients were 27%［95% confidence interval（CI） 0.24-0.31］， 32%（95% CI 0.29-0.36）， 36%（95% CI 0.30-0.42）. Subgroup analysis showed that there was a statistically significant difference in the distribution of the three TCM syndromes in the north and south（P<0.05）. In addition， the incidence of TCM syndrome fractures in different types of POP was 15%（95% CI 0.09-0.24） for liver-kidney Yin deficiency syndrome， 20%（95% CI 0.12-0.30） for spleen-kidney Yang deficiency syndrome， and 31%（95% CI 0.25-0.39） for kidney deficiency and blood stasis syndrome. ConclusionThe distribution of syndromes in POP patients is mainly kidney deficiency， accompanied by liver and spleen dysfunction. Liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency syndrome and kidney deficiency and blood stasis syndrome are all the main syndromes of POP and osteoporotic fractures， and kidney deficiency and blood stasis syndrome is most closely related to the development of osteoporotic fractures. The reference standards for syndrome determination among the included studies are inconsistent， and in the future， it is necessary to focus on their determination standards to obtain consensus research results， at the same time， conduct large-scale syndrome research to obtain representative research results， providing a basis for clinical practice and research.
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Objective@#To investigate the clinical characteristics, diagnosis, treatment, and prognosis of descending necrotizing mediastinitis (DNM) to provide a reference for the early diagnosis and timely treatment of DNM.@*Methods@#Data on DNM in China was electronically retrieved from the core databases and comprehensively reviewed from June 2012 to June 2023. The infection, pathogenic microorganisms, main symptoms, comorbidities and treatment methods of DNM were analyzed.@*Results@#The data of a total of 781 DNM patients, with an average age of (52.97 ± 5.64) years, were retrieved, including 554 males and 227 females. Odontogenic source, tonsillitis, pharyngeal abscess, sialoadenitis, upper respiratory tract infection, foreign body injury, or iatrogenic traumatic procedures are common causes. Among these, odontogenic infection is the most common source. Streptococcus sp. (n = 217) and Staphylococcus sp. (n = 82) were most isolated, followed by Klebsiella pneumoniae and Pseudomonas aeruginosa (equally n = 59). A total of 69.4% (542/781) of DNM patients recruited in this study were discovered to have various comorbidities, and more than one-third of these patients (n = 185) had diabetes. Of the broad antibiotics, carbapenem was most frequently used as treatment, and vancomycin was the most frequently coadministered. The mediastinal drainage approach varies widely, and the optimal regimen is still unknown. Seventy-two patients were treated with video-assisted thoracoscopic/mediastinoscopic surgical drainage, 22 patients were treated with percutaneous catheter drainage, 30 underwent the transcervical approach, and 40 underwent thoracotomy. A total of 617 patients who were selected underwent the appropriate combined operation for surgical drainage according to the specific location of the infected focus. The overall mortality rate of all 781 DNM patients included was 11.2%.@*Conclusion@#The most effective diagnosis and treatment of DNM is a high degree of clinical vigilance followed by prompt and adequate drainage with intensive care, including hemodynamic monitoring, nutritional support, computer tomographic scanning repeated as necessary, and combined use of systemic antibiotics.
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ObjectiveTo systematically collect， analyze， and evaluate the randomized controlled trials （RCT） of Chinese patent medicine combined with western medicine in the treatment of hypertension， map the evidence， and provide reference for the future clinical research and formulation of guidelines and policies. MethodThe relevant articles were retrieved from China Biology Medicine disc， China National Knowledge Infrastructure （CNKI）， VIP， Wanfang Data， PubMed， Embase， and Cochrane Library with the time interval from inception to December 31， 2022. The RCT of Chinese patent medicines combined with western medicine in the treatment of hypertension were included. The research characteristics and methodological quality were analyzed and evaluated. ResultA total of 330 RCTs of treating hypertension with Chinese patent medicines combined with Western medicine were included in this study， all of which were published in Chinese. These RCTs involved 88 Chinese patent medicines and 37 788 patients， and 46% of RCT had the sample size ≥100 patients. Eighty-seven percent of RCT showed the study period within 3 months. All the interventions in the RCTs were Chinese patent medicine + western medicine vs western medicine. Among the evaluation indicators， blood pressure， response rate， TCM syndrome score， endothelial cell function， and safety were mainly concerned. In terms of methodological quality， most articles did not mention the generation of random sequences， allocation concealment， or blinding method. The blinding evaluation of outcomes showed low risks of bias， and there was insufficient information to judge whether there was selective bias or other bias. ConclusionThere were many Chinese patent medicines used in combination with western medicine in the treatment of hypertension， and they were mainly taken orally. The existing RCT had problems such as small sample size， unclear clinical value positioning， imperfect design failing to reflect the value of Chinese patent medicines， unreasonable measurement indicators， and non-standard measurement methods. Future research should solve the above problems， improve the research quality， value， and authenticity， and enhance the reliability and extension of evidence.
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Objective To introduce a partially nested design based on the characteristics of TCM in treating the same disease with different treatments and syndrome differentiation and treatment.Methods Partially nested design was used for standardized treatment of complex interventions.The TCM group was divided into multiple subsets according to"syndrome type-treatment method-prescription"(with nested structure),while the control group was treated with standardized Western medicine(without nested structure);taking a case study of"different treatments for the same disease"data for ulcerative colitis,this design type was applied and analyzed using a multi-level model.Results The partially nested design was consistent with the feature of TCM of"different treatments for the same disease"and met the methodological requirements for evidence-based evaluation.Multilevel models allowed analyses with this type of data.Conclusion The use of partially nested design enables the evaluation of the comprehensive effectiveness of"different treatments for the same disease",which can provide a methodological reference for the assessment of clinical effectiveness of TCM.
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Myasthenia gravis (MG) is an autoimmune disorder mediated by autoantibodies that target the neuromuscular junction. The detection of pathogenic autoantibodies is crucial for the diagnosis and assessment of the disease. Commercial testing institutions and hospitals commonly use techniques such as radioimmunoprecipitation, enzyme-linked immunosorbent assay, or cell-based assay to test the serum of MG patients. However, these methods have limitations in terms of sensitivity and specificity, and there is a lack of direct comparative studies using high-level evidence-based medicine. The recent release of the SCREAM study using data from Chinese individuals confirms the advantages of cell-based assay, providing level Ⅰ evidence for the preferred recommendation of MG laboratory diagnosis and filling the gap in both domestic and international fields. However, the results obtained from the aforementioned testing methods are difficult to use for longitudinal comparison of patients and may not serve as the best biomarkers for disease monitoring. This article attempts to discuss this question by combining recent advances in understanding the pathogenic autoantibodies of MG and provides an outlook on future developments.
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Introducción: El desarrollo histórico de la medicina basada en la evidencia está interrelacionado con el desarrollo de la investigación científica y su implementación en la práctica médica. Durante este proceso se validó el método científico y se refuerza la necesidad de controles éticos. Objetivo: Recorrer el desarrollo histórico de la medicina basada en la evidencia y enfatizar en las implicaciones bioéticas para una adecuada implementación en aras de contribuir al perfeccionamiento de las ciencias médicas. Métodos: En la implementación clínica de la medicina basada en la evidencia, el nivel de evidencia científica durante la evaluación de la literatura se jerarquiza, y esto ayuda a los profesionales en la toma de decisiones clínicas. Focalizar la implementación de un medio diagnóstico o una medida terapéutica según la gradualidad y calidad de la evidencia sin más, con una visión que deja fuera los valores morales, el contexto social y la participación del propio paciente, y excluir los distintos obstáculos sociales, culturales y económicos constituye una brecha existente durante la implementación de manera aislada de la medicina basada en la evidencia y es aquí donde la bioética es fundamental, debe conceptualizarse no solo para proteger al paciente sino que debe dar respuesta ante la complejidad tecnológica y científica. Conclusiones: La medicina basada en la evidencia trae consigo una mayor calidad de la práctica clínica y, a la vez, plantea la necesidad de asumir una ética de atención al paciente. Debe ser una práctica que integre lo científico con lo axiológico, conceptualizando en salud una bioética basada en la evidencia.
Introduction: The historical development of evidence-based medicine is interrelated with the development of scientific research and its implementation in medical practice. During this process, the scientific method was validated and the need for ethical controls is reinforced. Objective: To review the historical development of evidence-based medicine and to emphasize on the bioethical implications for an adequate implementation in order to contribute to the improvement of medical sciences. Methods: In the clinical implementation of evidence-based medicine, the level of scientific evidence during the assessment of literature is hierarchized, which helps professionals make clinical decisions. Focusing the implementation of a diagnostic means or a therapeutic measure according to the gradualness and quality of evidence with no more, under a vision rulingout moral values, the social context and the participation of patientsthemselves, as well as excluding the various social, cultural and economic obstacles, represents a gap existing during the isolated implementation of evidence-based medicine. At this point, bioethics is paramount; it must be conceptualized not only to protect the patient, but it must respond in the face of technological and scientific complexity. Conclusions: Evidence-based medicine brings about higher quality of clinical practice and, at the same time, raises the need to assume ethics of patient care. It should be a practice that integrates the scientific with the axiological, conceptualizing evidence-based bioethics in health.
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Abstract Background Systematic reviews of Randomized Controlled Trials (RCTs) are considered high-level evidence to support a decision on therapeutic interventions, and their methodological quality is essential to provide reliable and applicable results. Objective This meta-epidemiological study aimed to map and critically appraise systematic reviews assessing treatments for vesiculobullous skin diseases. Methods We conducted a comprehensive search strategy on MEDLINE (via Pubmed) in December 2022 without restrictions to find systematic reviews evaluating pharmacological interventions for vesiculobullous skin diseases. The methodological quality was assessed using the AMSTAR-2 tool, and additional information was extracted. We identified nine systematic reviews published between 2002 and 2021, seven assessing pemphigus. Results According to the AMSTAR-2 tool, 55.6% were classified as critically low quality, 22.2% as moderate quality, 11.1% as low and 11.1% as high quality. No review assessed the certainty of the evidence (GRADE); 86% of pemphigus reviews had at least two overlapping RCTs. There were some limitations regarding methodological flaws and the AMSTAR-2 tool use Conclusions These findings reveal a frail methodological quality of systematic reviews about vesiculobullous diseases treatment that may impact the results. Therefore, methodological rigor is mandatory for future systematic reviews to avoid duplication of effort and increase the certainty of the evidence supporting decision-making.
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Abstract Patient Blood Management (PBM) is a multidimensional approach that seeks to optimize the use of blood and its components in patients. This matter emerged as a response to the need to reduce unnecessary exposure to blood transfusions and their potential risks. In the past, blood transfusion was often overused resulting in complications and high costs. The advent of Patient Blood Management has caused a paradigm shift, highlighting anemia prevention, bleeding control and maximizing the production of blood cells by the organism itself. Patient Blood Management guidelines include the early identification of anemia, strategies to minimize blood loss during surgery, intraoperative blood conservation techniques, preoperative hemoglobin optimization and evidence-based approaches to the rational use of blood transfusions. Aiming to improve clinical outcomes, decrease transfusion-related complications and reduce associated costs, this multidisciplinary approach counts on doctors, nurses, pharmacists and other healthcare professionals. Based on research and clinical evidence, Patient Blood Management continues to evolve thereby promoting safer, more effective patient-centered practices. Its implementation has proven beneficial in various medical contexts thereby contributing to improvements in the quality of care provided to patients. Our goal with this Consensus is to present readers with a broad and diverse view of Patient Blood Management so that they have the building blocks to implement this new technique.
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Abstract The use of strategies to reduce blood loss and transfusions is essential in the treatment of surgical patients, including in complex cardiac surgeries and those that use cardiopulmonary bypass. Antifibrinolytics, such as epsilon-aminocaproic acid (EACA) and tranexamic acid (TXA), are widely used in these procedures, as well as in other types of surgeries. These medicines are included in the World Health Organization (WHO) list of 'essential medicines'. Scientific evidence demonstrates the effectiveness of EACA in reducing bleeding and the need for transfusions in heart surgery. EACA is highly recommended for use in heart surgery by the American Society of Anesthesiology Task Force on Perioperative Blood Management. Regarding the safety of EACA, there is no robust evidence of any significant thrombotic potential. TXA has also been shown to be effective in reducing the use of blood transfusions in cardiac and non-cardiac surgeries and is considered safer than other antifibrinolytic agents. There is no evidence of any increased risk of thromboembolic events with TXA, but doses greater than 2 g per day have been associated with an increased risk of seizures. It is also important to adjust the dose in patients with renal impairment. In conclusion, antifibrinolytics, such as EACA and TXA, are effective in reducing blood loss and transfusion use in cardiac and non-cardiac surgeries, without causing serious adverse effects.
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Abstract Background In 2012, the Neurocritical Care Society launched a compilation of protocols regarding the core issues that should be addressed within the first hours of neurological emergencies - the Emergency neurological life support (ENLS). Objective We aim to evaluate this repercussion through a bibliometric analysis. Methods We searched Scopus on October 2022 for articles mentioning ENLS. The following variables were obtained: number of citations; number of citations per year; number of publications per year; year of publication; research type; research subtype; country of corresponding author and its income category and world region; journal of publication and its 5-year impact factor (IF); and section where ENLS appeared. Results After applying eligibility criteria, we retrieved 421 articles, published from 2012 to 2022. The mean number of citations per article was 17.46 (95% Confidence Interval (CI) = 8.20-26.72), while the mean number of citations per year per article was 4.05 (95% CI = 2.50-5.61). The mean destiny journal 5-year IF was 5.141 (95% CI = 4.189-6.093). The majority of articles were secondary research (57.48%; n= 242/421) of which most were narrative reviews (71.90%; n= 174/242). High-Income countries were the most prominent (80.05%; n= 337/421 articles). There were no papers from low-income countries. There were no trials or systematic reviews from middle-income countries. Conclusion Although still low, the number of publications mentioning ENLS is increasing. Articles were mainly published in journals of intensive care medicine, neurology, neurosurgery, and emergency medicine. Most articles were published by authors from high-income countries. The majority of papers were secondary research, with narrative review as the most frequent subtype.
Resumo Antecedentes Em 2012, a Neurocritical Care Society lançou uma compilação de protocolos sobre as questões centrais que devem ser abordadas nas primeiras horas de emergências neurológicas - Emergency neurological life support (ENLS). Objetivo Avaliar a repercussão do ENLS por meio de uma análise bibliométrica. Métodos A base de dados Scopus foi utilizada em outubro de 2022 para a busca por artigos mencionando o ENLS. As seguintes variáveis foram obtidas: número de citações; número de citações por ano; número de publicações por ano; ano de publicação; tipo de pesquisa; país do autor correspondente e sua categoria de renda; revista de publicação e seu fator de impacto de 5 anos (IF); e seção onde o ENLS apareceu. Resultados Os 421 artigos incluídos foram publicados de 2012 a 2022. A média de citações por artigo foi de 17.46 (intervalo de confiança (IC) 95% = 8.20-26.72), enquanto a de citações por ano por artigo foi de 4.05 (IC95% = 2.50-5.61). O IF médio por revista foi de 5.14 (IC95% = 4.19-6.09). A maioria dos artigos era de pesquisa secundária (57.48%; n= 242/421), dos quais a maioria eram revisões narrativas (71.90%; n= 174/242). Os países de alta renda foram os mais prolíficos (80.05%; n= 337/421 artigos). Não houve publicações de países de baixa ou média renda. Conclusão Embora ainda baixo, o número de publicações mencionando o ENLS vem aumentando recentemente. A maioria dos artigos foram publicados em revistas de medicina intensiva, neurologia, neurocirurgia e medicina de emergência. Artigos de pesquisa secundária foram os mais comuns, com revisões narrativas sendo o subtipo mais frequente.
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Introduction: The Journal Club is an environment for exchanging information within the medical context concerning updated literature and evidence-based medicine. Considering the importance of constantly updating the acquired knowledge and scenarios of social isolation imposed by the COVID-19 pandemic, the Journal Club event was held virtually, aiming to expand the understanding of the scientific methodology among medical students by understanding the differences among each type of evidence pyramid study by reading and discussing scientific articles. Methodology: An analytical, prospective, and cross-sectional study was conducted in October 2021. The Journal Club event took place in nine classes where each type of evidence pyramid study was addressed. The sample included 20 medical students. A questionnaire was used at the beginning and end of the event to assess the participants' knowledge from the classes taught and was divided into two parts: participant identification data and 19 questions regarding the types of studies present on the pyramid of evidence. Results: It was found that after the pre- and post-event analysis of the questionnaire among the 19 questions, correct answers increased in 17, among which 3 obtained a statistically significant value: questions 1 (p = 0.031), 15 (p = 0.039), and 18 (p = 0.016). Discussion: An increase in the number of correct answers was noted between pre- and post-classes, which may indicate an improved understanding of the subject among students. Furthermore, the study demonstrated that the students had little involvement in scientific research (only 25% had ever been involved in a project). Conclu-sion: Based on the analysis of the participants' performance in the pre- and post-event questionnaires, it can be concluded that the medical students were able to expand their knowledge of scientific methodology (AU).
Introdução: O Journal Club é um ambiente para troca de informações dentro do contexto médico, diante de uma literatura atualizada e medicina baseada em evidências. Tendo em vista a importância da atualização constante de conhecimentos adquiridos e o cenário de isolamento social imposto pela pandemia da COVID-19, o evento Journal Club foi realizado virtualmente, com o objetivo de ampliar o entendimento sobre metodologia científica entre estudantes de medicina por meio da compreensão das diferenças de cada tipo de estudo da pirâmide de evidências a partir da leitura e discussão de artigos científicos. Metodologia: Estudo analítico, prospectivo e transversal realizado em outubro de 2021. O evento Journal Club ocorreu em nove aulas onde foram abordados cada tipo de estudo da pirâmide de evidência. A amostra foi composta por 20 estudantes de medicina. Um questionário foi aplicado no início e ao final do evento para avaliar o conhecimento dos participantes a partir das aulas ministradas, e foi dividido em duas partes, a primeira com dados de identificação do participante e a segunda com 19 questões sobre os tipos de estudos presentes na pirâmide de evidência. Resultados: Observou-se que, após a análise do questionário pré e pós-evento, dentre as 19 questões realizadas, houve um aumento de acertos em 17 entre as quais 3 obtiveram um valor estatístico significativo: questões 1 (p= 0,031), 15 (p=0,039) e 18 (p= 0,016). Discussão: Notou-se aumento dos acertos de questões entre o pré e pós-aulas, podendo indicar uma melhora no entendimento por parte dos acadêmicos acerca do assunto. Além disso, o estudo mostrou uma baixa atuação dos acadêmicos em pesquisas científicas (apenas 25% já se envolveram em algum projeto). Conclusão: A partir da análise do desempenho dos participantes nos questionários pré e pós-evento é possível afirmar que os estudantes de medicina conseguiram ampliar seu conhecimento sobre metodologia científica (AU).
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Evidence-Based Medicine , Information Dissemination , Education, Medical, UndergraduateABSTRACT
Introducción: El uso de técnicas de estudio basada en evidencias por parte de los estudiantes constituye un método fundamental para el aprendizaje. Objetivo: Evaluar la frecuencia del uso de técnicas de estudio basadas en evidencia en estudiantes de medicina de una universidad en el Perú. Metodología: Se realizó un estudio observacional transversal con 75 estudiantes de medicina humana de la Universidad Nacional del Centro del Perú a través de una encuesta que recopilo las técnicas de estudio y otras variables, seleccionados mediante un muestreo no probabilístico. Resultados: El (58,73 %) fueron varones, un (58,7 %), no utilizó técnicas de estudio basadas en evidencia, nivel socioeconómico familiar bajo-medio (33,3 %). El material de estudio más utilizado fueron libros (58,14 ), seguido de artículos científicos (24 %); el (45,3 %) dedicaba entre 4-6 horas al estudio y el (40 %) usaba la técnica "Active recall". Por su parte, el (53,3 %) disfrutaban del estudio "algunas veces", (70,7 %) aplazaban el momento de estudiar "algunas veces" y el (62,7 %) tenían dificultad para concentrarse "algunas veces". Además, encontramos que aquellos que estudiaron menos de 2 horas prefirieron videos educativos y los estudiantes que dedicaron 6-8 horas eligieron la lectura de libros, artículos científicos y diapositivas basadas en evidencias. Así mismo los que enfrentaron dificultades 'la mayoría del tiempo' tendieron a utilizar diapositivas en exceso, mientras que los que enfrentaron dificultades 'siempre' prefirieron videos educativos (p<0,05). Discusión: El empleo de técnicas de estudio fundamentadas en evidencias por parte de los estudiantes aún no prevalece de manera mayoritaria. Solo la mitad de los estudiantes mantiene una utilización activa en su desarrollo profesional, mientras que existe desconocimiento y un nivel bajo de implementación. El entendimiento de estas variables brindará la oportunidad de establecer charlas educativas dirigidas a los futuros profesionales.
Introduction: The use of evidence-based techniques by students is a fundamental method for learning. Objective: To evaluate the frequency of the use of evidence-based study techniques in medical students from a university in Peru. Methods: A cross-sectional observational study was carried out with 75 students of human medicine from the National University of Central Peru through a survey that collected study techniques and other variables, selected by non-probabilistic sampling. Results: (58.73%) were male, one (58.7%), did not use evidence-based study techniques, low-medium family socioeconomic level (33.3%). The most used study material was books (58.14%), followed by scientific articles (24%); (45.3%) spent between 4-6 hours studying and (40%) used the "Active recall" technique. For their part, (53.3%) enjoyed studying "sometimes", (70.7%) postponed studying "sometimes" and (62.7%) had difficulty concentrating "sometimes". Furthermore, our findings indicate that those who studied for less than 2 hours preferred educational videos, while students who dedicated 6-8 hours chose to engage with reading books, scientific articles, and evidence-based slides. Similarly, those encountering difficulties 'most of the time' tended to overuse slides, whereas those facing difficulties 'always' favored educational videos (p<0.05). Discussion: The use of evidence-based techniques by human medicine students is still not the majority, only half maintain active use in their professional training, it is unknown or its implementation has a low level. Knowing these variables will make it possible to carry out schemes and educational talks in future professionals.