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Objective To establish the argatroban drug use evaluation(DUE)criteria and provide reference for the rational use of argatroban in clinical practice.Methods Based on the domestic and foreign drug instructions of argatroban,referring to relevant guidelines and literature,the DUE standard rules were established by expert consultation.Using the established standard rules,the medical records of argatroban in the Fuzhou First Hospital Affiliated with Fujian Medical University from August 2020 to August 2022 were evaluated for the rationality of medication.Results A total of 368 medical records were included,the rational rate of drug use was 48.64％,and the irrational drug use was mainly without indications(46.19％)and inappropriate combination of drugs(4.35％).Conclusion The rational rate of argatroban clinical use in the hospital is not high,and the problems mainly include off-indication drug use and unreasonable combination drug use.Through the establishment and clinical application of DUE standard rules,the clinical use of argatroban can be further standardized and the ability of rational drug use can be improved.
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Objective To establish the drug use evaluation(DUE)standard of fibrinogenase for injection and provide a reference for the rational clinical application of fibrinogenase for injection.Methods Based on the specification of fibrinogenase for injection,the DUE standard was established from three aspects:drug indication,drug process and drug results,with reference to relevant guidelines and literature,and through discussion with clinical experts.A retrospective survey was conducted to evaluate the inpatients using fibrinogenase for injection from January 2021 to December 2021 in Ningde Hospital of Traditional Chinese Medicine,Fujian Province.Results A total of 256 patients were included,with a medication reasonable rate of 61.72％.The irrational use of drugs was mainly including the inappropriate usage and dosage(3.91％),off-label medication(1.95％),no skin test(8.98％),too long or inadequate course of medication(25.00％).Conclusion The DUE standard established of fibrinogenase for injection is scientific,practical and feasible.The use of fibrinogenase for injection in contraindications and high blood coagulation state,and off-label medication can be further optimized.
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Objective:To clarify the elements of post competency of public health professionals and technical personnel, and construct a post competency index system of public health professionals and technical personnel.Methods:Referring to the Hay Group Competency Dictionary and literature review method, the post competency information elements of public health professional and technical personnel were constructed, and were revised through the expert consultation method. Unit-level stratified sampling was used, and 120 public health professionals were invited to evaluate the importance of the elements. SPSS 26.0 was used for data analysis, the continuous data were expressed in ( x ± s) mode, and Pearson was used to study the degree of correlation of each dimension. Finally, the post competency index system for public health positions was constructed by using the factor analysis method to extract the common factor as the first-level index. Results:The index system contained 7 first-level indicators (43 items), including public health practice skills, clinical practice skills, professional basic subject knowledge, personal professional accomplishment, public health authority and management ability, public health leadership, and public health methodology knowledge. Its weight coefficients (%) were 20.03, 17.48, 15.89, 15.68, 13.98, 12.82 and 4.11, respectively. The elements with the highest materiality scores were personal protection, responsibility and professionalism.Conclusion:Personal protection and other public health practical skills and personal professional qualities such as sense of responsibility and professionalism are the core elements of public health positions, and it is recommended to strengthen the training of public health professionals' public health practical skills in actual work, and pay attention to the cultivation of personal professional qualities, so as to establish a better team of public health talents.
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Objective To develop two multi-dimensional value evaluation index systems for intraocular lens(IOL)to assist decision makers in selecting appropriate IOLs.Methods IOL value assessment indexes were determined preliminarily through literature research and expert consultation,and the weights of the indexes were calculated through hierarchical analysis method and then ranked to form two evaluation index systems.Results Two multi-dimensional value evaluation index systems were constructed for monofocal and refractive IOLs respectively,which both contained 3 first-level indicators and 13 second-level indicators;the evaluation index system for monofocal IOL involved in 26 third-level indicators,and the other for refractive IOL had 33 third-level indicators.The three first-level indicators of the two systems were ranked by weight as clinical dimension,economic dimension and institutional dimension.The monofocal IOL evaluation index system had product performance being the second-level indicator with the highest weight,and the top three third-level indicators with the highest weights being lens capsule biocompatibility,risk of intraocular lens damage during implantation and range of applicable populations;the refractive IOL evaluation index system had clinical efficacy(vision)being the second-level indicator with the highest weight,and the top three third-level indicators with the highest weights being distant vision,(astigmatism)rotational stability/postoperative axial rotation and near vision.Conclusion The multi-dimensional value evaluation index systems developed provide references for comprehensive value evaluation of IOLs.[Chinese Medical Equipment Journal,2023,44(11):83-89]
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Objective To construct an evaluation index system for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept, so as to provide insights into the control and elimination of mountain-type zoonotic visceral leishmaniasis using the One Health approach. Methods A preliminary evaluation index system was constructed based on literature review, panel discussions and field surveys. Thirty-three experts were selected from 7 provincial disease control and prevention centers in Beijing Municipality, Hebei Province, Shanxi Province, Henan Province, Sichuan Province, Shaanxi Province and Gansu Province where mountain-type zoonotic visceral leishmaniasis was endemic, and two rounds of expert consultations were conducted to screen the indicators. The positive coefficient, degree of concentration, degree of coordination, and authority of the experts were calculated, and the normalized weights of each index were calculated with the analytic hierarchy process. Results The response rates of questionnaires during two rounds of expert consultation were both 100.00% (33/33), and the authority coefficients of the experts were 0.86 and 0.88, respectively. The coefficients of coordination among experts on the rationality, importance, and operability of the indicators were 0.392, 0.437, 0.258, and 0.364, 0.335, 0.263, respectively (all P values < 0.05). Following screening, the final evaluation index system included 3 primary indicators, 17 secondary indicators, and 50 tertiary indicators. The normalized weights of primary indicators “external environment”, “internal support” and “comprehensive control” were 16.98%, 38.73% and 44.29%, respectively. Among the secondary indicators of the primary indicator “external environment”, the highest weight was seen for natural environment (66.67%), and among the secondary indicators of the primary indicator “internal support”, the lowest weight was seen for the scientific research for visceral leishmaniasis control (8.26%), while other indicators had weights of 12.42% to 13.38%. Among the secondary indicators of the primary indicator “comprehensive control”, the weight was 16.67% for each indicator. Conclusions An evaluation index system has been constructed for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept. In addition to assessment of the effect of conventional mountain-type zoonotic visceral leishmaniasis control measures, this index system integrates the importance of top-level design, organizational management, and implementation of control measures, and includes indicators related to multi-sectoral cooperation.
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Objective:To construct a risk prediction and assessment system for incisional infection after spinal surgery.Methods:Based on the failure mode and effect analysis (FMEA), risk factors and assessment indicators of postoperative incisional infection in spinal surgery were sorted out through literature search followed by expert consultation using the Delphi expert consultation method. After three-level assessment indicators were selected according to their importance and expert opinions and assigned by different scores, a risk prediction and evaluation system was constructed for postoperative incisional infection after spinal surgery.Results:The 2 rounds of expert consultation questionnaire resulted in an effective response rate of 100%. The degree of expert consultation authority was 0.85, showing high reliability; the Kendall coordination coefficients of expert consultation ranged from 0.525 to 0.686, showing good coordination ( P<0.05). The three-level assessment indicators consisted of 3 primary, 18 secondary and 54 tertiary ones. After statistical analyses of the important risk indicators selected which consisted of 6 preoperative evaluation ones and 18 postoperative evaluation ones, 6 preoperative and 12 postoperative predictive indicators were obtained. The values of risk priority number (RPN) were calculated for high, medium and low risks for postoperative incisional infection using a semi-quantitative method. Conclusion:A self-designed system has been constructed for risk prediction and assessment of incisional infection after spinal surgery based on expert consultation and FMEA method.
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Objective:To build a performance appraisal index system for medical specialty alliances, as a reference for promoting the development of the alliances in a connotation-based, high quality and sustainable manner.Methods:An index system was initialized by means of policy literature review and brainstorming, which was followed by two rounds of expert consultations to finalize the index system. Each index in the system was weighted through the analytic hierarchy process.Results:A performance appraisal index system of specialist alliances so developed comprised the six level-1 indexes of organization and implementation, hierarchical healthcare, influence capacity, talent cultivation, clinical research and academic research, as well as 31 level-2 indexes. The average scoring of importance and operability of all the indexes was>3.50, while the weights of organization and implementation(0.205 3), talent cultivation(0.178 8)and clinical research indexes(0.165 1)were higher than the rest.Conclusions:The performance appraisal index system of specialty alliances proves highly reliable and scientific, serving a desirable vehicle for the leaders of the alliance to develop cross-regional development of medical specialties.
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Objective:To construct an index system for evaluating the development of research-oriented disciplines in medical institutions, and to provide a basis for guiding the superior disciplines towards international high-level disciplines.Methods:Through literature research and expert discussions, the basic framework of the research-oriented disciplines development evaluation system was established. The final version of the index system was determined using the Delphi method and expert interviews, and the weights of each index were established using the hierarchical analysis method.Results:After consultation, the framework of 5 first-class indexes, 16 second-class indexes, and 51 third-class indexes was finally constructed for the evaluation system of research-oriented discipline development, and the weights of indexes at different classes were calculated. The high-frequency terms " research mechanism construction" , " research team construction" and " representative research results" extracted from the expert interviews echoed the results of the weighting calculation.Conclusions:The evaluation system for research-oriented disciplines constructed in this study is relatively reasonable, scientific, reliable, and operable. The construction of the index system adapts to the characteristics of the development of research-oriented disciplines, with guiding significance for enhancing the development of research-oriented disciplines.
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ABSTRACT With the gradual improvement of people's quality of life, the average life expectancy of our country has been extended. It is estimated that the total number of the elderly population in China will exceed 250 million by the end of 2020. Therefore, promoting healthy aging is a necessary measure to cope with the coming aging society in China, and physical exercise is an important method to keep the physical and mental health of the elderly. In order to promote the development of healthy aging in China, this study focused on the current level of public sports services for the elderly. This study uses the expert consultation method to test the rationality of the evaluation index, and uses the method of questionnaire survey to score each evaluation index, and uses the analytic hierarchy process (AHP) to calculate the weight of the index. Finally, the paper takes the public sports service of the elderly in a city as an example to verify. The results show that the level of sports public service for the elderly in this city is only 77,928. Especially the two aspects of allocation of sports venues and the use of funds are the most unsatisfactory ones. It can be targeted to improve these two aspects, so as to improve the level of public sports services for the elderly. It is hoped that, through this study, we can provide some reference for improving the level of sports public service for the elderly from the perspective of healthy aging.
RESUMO Com a melhoria gradual da qualidade de vida das pessoas, a expectativa média de vida do nosso país foi ampliada. Estima-se que o número total de pessoas idosas na China excederá 250 milhões até o final de 2020. Por isso, promover um envelhecimento saudável é uma medida necessária para lidar com a futura população idosa na China, e o exercício físico é um método importante para manter a saúde física e mental dos idosos. A fim de promover o desenvolvimento de um envelhecimento saudável na China, este estudo centrou-se no nível atual de serviços desportivos públicos para os idosos. Este trabalho utiliza o método de consulta de especialistas para testar a racionalidade do índice de avaliação, e utiliza o método de levantamento por questionário para marcar cada índice de avaliação, e utiliza o processo hierárquico analítico (AHP) para calcular o peso do índice. Finalmente, a pesquisa toma como exemplo o serviço público de desportos dos idosos numa cidade. Os resultados mostram que o nível de serviço público desportivo para os idosos nesta cidade é apenas 77.928. Em especial, os aspectos da atribuição de espaços desportivos e a utilização de recursos financeiros são os mais insatisfatórios. Pode visar-se melhorar esses dois aspectos, de modo a melhorar o nível dos serviços desportivos públicos para os idosos. Espera-se que, através deste estudo, possamos oferecer uma referência para melhorar o nível de serviço público desportivo para os idosos sob a perspectiva do envelhecimento saudável.
RESUMEN Con la mejora paulatina de la calidad de vida de las personas se ha ampliado la esperanza de vida media de nuestro país. Se estima que el número total de personas añosas en China superará los 250 millones a finales de 2020. Por lo tanto, promover un envejecimiento saludable es una medida necesaria para hacer frente al aumento de la edad de la sociedad en China. El ejercicio físico es un método importante para mantener la salud física y mental de las personas mayores. Con el fin de promover el desarrollo del envejecimiento saludable en China, este estudio se centró en el nivel actual de los servicios deportivos públicos para las personas añosas. Este estudio utiliza la consulta de expertos para probar la racionalidad del índice de evaluación, la encuesta de cuestionario para calificar cada índice de evaluación, y el proceso de jerarquía analítica (PJA) para calcular el peso del índice. Finalmente, el trabajo toma como ejemplo a ser verificado, el servicio público deportivo de la tercera edad en una ciudad determinada. Los resultados muestran que el nivel de servicio público deportivo para personas añosas en esa ciudad es de solo 77.928. Especialmente los aspectos de la asignación de instalaciones deportivas y del uso de fondos son los más insatisfactorios. Se debe apuntar a mejorar estos dos aspectos, a fin de conseguir un mejor nivel de servicios deportivos públicos para las personas añosas. Esperamos que, a través de este estudio, podamos proporcionar una referencia para mejorar el nivel de servicio público deportivo para las personas añosas desde la perspectiva del envejecimiento saludable.
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Humans , Aged , Healthy Aging , Public Health Services , Sports , ChinaABSTRACT
Objective This article takes a cosmetics factory in Yichang City as an example, uses a variety of methodologies to explore methods of health impact assessment and provides methodological references for future health evaluation of related public policies. Methods By analyzing the environmental assessment report of the cosmetic renovation project, an indicator system was established and expert consultation meetings were conducted to score the impact of the corresponding indicators on health. The impact of the renovation project of the factory on the factory workers, surrounding residents and the sustainable development of the environment was analyzed by means of the Kaiser model with the risk matrix and the Borda value. Results The risk values of the five influencing factors of industrial wastewater, domestic wastewater, industrial waste gas, industrial waste and noise were 5.11%, 5.43%, 10.6%, 6.71% and 7.02% respectively. All the influencing factors were in the green zone of the risk matrix. The Borda values of the five influencing factors of industrial waste water, domestic waste water, industrial waste gas, industrial waste residue and noise were 4, 5, 10, 7 and 5 respectively. Conclusion The multiple methodologies adopted in the factory renovation project are feasible, and can provide new ideas for the health impact assessment of public policies in the future.
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Objective:To construct competency index of nurses in public health emergencies based on iceberg mode.Methods:Based on the analysis of the work of public emergencies in the past five years, the deficiencies were summarized, and the competence index of nursing staff in public health emergencies was preliminarily formulated with the Iceberg Model as the theoretical framework and the literature review. The Delphi expert consultation method was used to select 15 experts from 7 Class Ⅲ Grade A general hospitals and Class Ⅲ Grade A specialized hospitals in Jiangsu Province who met the standards of admission and discharge from January to June 2020 for two rounds of consultation, and the competency index was finally formed.Results:The competency index of nursing staff in public health emergencies included 5 first-level indicators and 27 second-level indicators. The authority coefficient of experts on the first-level index and second-level index were 0.84 and 0.81. The coordination coefficients were 0.68 and 0.72, respectively. The differences were statistically significant( χ2 values were 73.22, 95.30, P<0.01). Conclusions:The competency index of nurses in public health emergencies in this study is highly reliable and scientific, and can provide reference for the reserve, training and assessment of nurses in public health emergencies.
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OBJECTIVE：To establish sustainable development ability evaluation index system for ethnomedicine enterprises in Guizhou province ，and to promote the sustainable development of the ethnomedicine industry. METHODS ：The draft of evaluation index system had been made by documents collection and a meeting of focus group discussion ，the final indexes and weight had been determined by Delphi method for conducting 2 rounds expert questionnaire survey ；the index system was used to measure and compare the results with the evaluation results of the drug regulatory department and the authoritative experts of the industry. RESULTS：The draft of evaluation index system included 6 indexes in the first level indicators and 49 indexes in the second. The expert’s positive coefficients was 100％ after 2 rounds of consultation ；the authoritative coefficients on the opinions of experts for the levels of indicators were 0.86，the coordination coefficient of experts was 0.22 in the first round and 0.48 in the second. After 2 rounds of expert consultation ，the final established evaluation index system contained 6 indexes in the first level indicators and 33 indexes in the second. Fifteen ethnomedicine enterprises in Guizhou province were selected for on-site testing. The evaluation results were not much different from those of the drug regulatory department and the authoritative experts of the industry. CONCLUSIONS：Established sustainable development ability evaluation index system for ethnomedicine enterprises is scientific ， reasonable and feasible ，and can provide standardized reference for regular monitoring and evaluation.
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Objective @#To construct a visual literacy evaluation system for pupils by Delphi expert consultation method（Delphi method）. @*Methods @#The visual literacy evaluation indices for pupils were preliminarily constructed through literature review. Twenty experts in relevant fields were invited and the visual literacy evaluation system for pupils was established by two rounds of expert consultation based on Delphi method. @*Results @# The average age of 20 experts was（48.35±5.79）years old,of which 19 experts had senior titles,and 17 experts had master's degree or above. The enthusiasm of the experts in two rounds of consulting was both 100.00%. The average authoritative coefficient（W）of the experts was 0.88. For the first consulting round,the W of importance scores from experts was 0.91（P<0.01）;the W of operability scores from experts was 0.89（P<0.01）,which indicated satisfactory consistency. For the second consulting round,the W of importance scores from experts was 0.79（P<0.01）;the W of operability scores from experts was 0.77（P<0.01）,which also indicated satisfactory consistency. The finalized visual literacy evaluation system for pupils after two rounds of expert consultation included three primary indices（eye care knowledge literacy,eye care attitude literacy and eye care behavior literacy）,six secondary indices（basic knowledge,eye care behavior,eye care attitude,eye care willingness,bad eye care behavior and eye protection）and 40 tertiary indices（≥5.0 of eyesight among normal people,always wearing glasses due to poor eyesight and so on）. @*Conclusion @#The experts who participated in the construction of visual literacy evaluation system for pupils had strong professional representativeness,high enthusiasm,high authority and good coordination,and the evaluation system can be used for evaluating pupils visual literacy.
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OBJECTIVE： To provide reference for improving the level of pharmaceutical care in medical institution， and realizing the precision of pharmaceutical care. METHODS： A sampling survey of third grade class A hospitals in Guangxi was conducted on the basis of Guangxi Hospital Pharmaceutical Administration Quality Control Center. Based on the results of literature analysis and international standard， by using Delphi method， the expert consultation form was issued by E-mail and field investigation； the results of four rounds of expert consultation were analyzed and summarized. Pharmaceutical care quality control index system was established in medical institutions. RESULTS & CONCLUSIONS： All experts （100％） agreed that pharmaceutical care in medical institutions was very important and required a quality control index system. Finally， 5 first-level indicators （including the construction of pharmaceutical care management organizational framework， rational drug use management， pharmaceutical care professional capacity management， pharmaceutical care monitoring management and characteristic pharmaceutical care management） and 26 second-level indicators were fitted according to results of expert consultation. Among first-level indicators， the indicators of “the construction of pharmaceutical care management organizational framework”， “rational drug use management” and “pharmaceutical care professional competence management” were generally considered as important quality control indicators by experts； the proportion of “very important” and “important” were 96.65％， 100％ and 100％. Among second- level indicators， the indicators of “organization construction”“system construction”“prescription drug use management”“hospitalization medical order review”“adverse drug reaction monitoring”“medicine knowledge”“clinical knowledge” were generally considered as important quality control indicators by experts； the proportion of “very important” and “important” were 95.65％， 95.65％， 100％， 95.66％， 96.65％， 100％ and 91.30％. The quality control index system of pharmaceutical care in medical institutions fitted by this research institute is authoritative. Now， 15 medical institutions in Guangxi Zhuang Autonomous Region have been pilot implemented after audited and finalised by Guangxi Hospital Pharmaceutical Administration Quality Control Center.
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The clinical research articles relevant with 's subcutaneous needling therapy (FSN) were retrieved from CNKI, WANFANG, CBM and PubMed databases till January 2018 since the establishment of database. According to the general international criteria of disease classification, the diseases involved in the articles were classified and summarized. In terms of the clinical application and research of FSN, the questions were extracted and commented through expert's consultation. As a result, 412 articles were included. The statistical results of disease spectrum indicated that FSN was adopted in 65 kinds of diseases in 11 systems. Of these diseases, the relevant somatic pain disorders in the musculoskeletal system were the most appropriate. Professor explained that the clinical physicians of FSN should select the muscle-related disorders as the clinical research subject and treat them with normalized manipulation of FSN. The research on FSN is still at the preliminary stage. It needs more high-quality clinical and basic researches to provide the evidences for the therapeutic effects of FSN.
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Humans , Acupuncture Analgesia , Acupuncture Points , Acupuncture Therapy , Nociceptive Pain , TherapeuticsABSTRACT
Objective To establish a scientific and comprehensive evaluation index for new technology access in tertiary public hospital, so as to provide a tool for new technology access management system and scientific basis for decision-making. Methods This study collected data from eight provinces nationwide including 30 tertiary public hospital based new technology access application, catalogued dimensions of application. It also referred to the European Union, Denmark, Canada and other countries in forming the hospital health technology assessment form, along with two rounds of Delphi expert consultation. Results The new medical technology access index system of China′s tertiary public hospitals was preliminarily formed, including 5 first-level indexes and 24 level-2 indexes. Conclusions The two rounds of expert advice have a high degree of consistency, indicating that the indicators are in line with the actual situation of hospital management in China, yet with rooms of constant improvement in practice.
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Objective To study the evaluation index system for home treatment quality of negative pressure therapy. Methods Two-round Delphi expert consultation method was used to consult 20 experts, so as to initially establishthe quality evaluation index system. Results An evaluation index system for home treatment quality of negative pressure therapy was formed, including 4 items of primary indexes, 13 items of secondary indexes and 30 items of tertiary indexes. Conclusions The evaluation index system for home treatment quality of negative pressure therapy in patients with chronic wounds has a clear hierarchy, the reliability of the research results is high, which provides a standardized reference for the objective evaluation of the work and the continuous improvement of nursing quality.
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Objective To develop an indicator system for evaluating midwifery quality. Methods Guided by the latest evidence-based framework of midwifery quality,based on indicator selection principle,the indicator system for evaluating midwifery quality was preliminarily developed by literature review,expert meeting,theoretical analysis and expert consultation,for further validation through large-scale Delphi method. Results The indicator pool for mid-wifery quality evaluation was identified by literature review,including indicator name and definition of special indi-cator. The indicator system was finalized through comprehensive analysis and selection,and consisted of 45 indica-tors. The expert consultation questionnaire response rate was 100%,the rate of experts who provided written sug-gestions was 81.3%,the authority coefficient was 0.92,the coefficients of variation of indicators ranged from 0 to 0.29. Conclusion The preliminarily developed indicator system for midwifery quality evaluation guided by the lat-est evidence-based framework of midwifery quality was scientific,oriented and accessible,which could be further ex-amined through large-scale Delphi method.