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ObjectiveThis paper aims to analyze the current status of outcome indicators in randomized controlled trials （RCT） of traditional Chinese medicine （TCM） for treating chronic atrophic gastritis （CAG）， so as to provide references for constructing the core outcome set （COS） of TCM in the treatment of CAG. MethodChina National Knowledge Infrastructure （CNKI）， Wanfang， VIP， SinoMed， PubMed， Embase， and Cochrane Library databases were searched for RCTs of TCM in the treatment of CAG in the last five years. The risk of bias of included studies was evaluated， and the selection status of outcome indicators was statistically analyzed. ResultA total of 150 RCTs were included， with a sample size of 44-398 cases. 164 outcome indicators were reported， with an application frequency of 1 229 times. The outcome indicators were classified into seven indicator domains according to functional attributes， followed by physical and chemical examination （69.41%）， TCM syndrome （12.69%）， symptoms and signs （11.15%）， safety indicators （5.37%）， quality of life （0.65%）， long-term prognosis （0.65%）， and economic evaluation （0.08%）. According to the statistical analysis， there were problems in the selection of outcome indicators in RCTs of TCM for treating CAG， including various indicators， non-standard name reports， unclear primary and secondary indicators， random combination of subjective and objective indicators， neglected patient report outcome indicators， missing long-term prognosis and economic indicators， insufficient reporting of safety indicators， and inconsistent measurement tools and measurement time points. ConclusionIn the past five years， there have been many problems in the selection of outcome indicators in RCTs of TCM for treating CAG. It is necessary to actively promote the construction of the COS of TCM in the treatment of CAG and promote the high-quality development of clinical research of TCM.
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Objective:To analyze the selection status of randomized controlled trial (RCT) outcome indicators of TCM for the treatment of adenomyosis (AM) in the past five years; To provide suggestions for the future studies in this field.Methods:The RCTs of TCM for the treatment of AM were retrieved from the databases of CNKI, Wanfang Data, VIP, CBM, PubMed, Embase, the Cochrane Library, Web of Science, Chinese Clinical Trial Register and ClinicalTrials from the establishment of the database to February 28, 2022. The risk of bias was assessed, and the outcome indicators were classified, described and analyzed, and compared with the international core outcome set (COS) studies.Results:A total of 48 studies were included, of which 47 were from published literature and 1 was from registered clinical trials, involving 4 544 patients and 77 outcome indicators. Among the 47 literatures, the total clinical efficacy rate (63.83%) was the most frequently reported outcome indicator, followed by uterine volume (61.70%). Ultrasound examination was the main outcome index in 1 registered trial. Compared with the international COS study, it was found that the included studies paid attention to the outcome report of pain degree, menstrual status and hematological indicators, the reporting rate of quality of life and economic indicators was low, and the urinary system symptoms and fertility outcome indicators were not reported.Conclusion:In the selection of outcome indicators, RCTs of TCM treatment of AM pay attention to the symptoms and signs outcomes, physical and chemical examination outcomes. However, there were still several problems of the selection of outcome measures: unclear primary and secondary outcome indicator, the use of unreasonable composite outcomes, lack of measurement blindness, insufficient attention to endpoint criteria, and ignoring economic evaluation.
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Objective To standardize the selection of clinical research outcome indicators,which can objectively evaluate the clinical efficacy or effect of traditional Chinese medicine in the treatment of myasthenia gravis.This study aims to standardize the construction of the core outcome set of clinical research of traditional Chinese medicine in the treatment of myasthenia gravis.Methods We followed the core outcome set development specification(COS-STAD)to carry out research,established a research working group,which set up a Delphi-method advisory group.Two graduate students of working group conducted a document research and meetings of patients to establishe an outcome set item pool of myasthenia gravis in clinical trials of Chinese medicine under the instruction of other members.With the questionnaire based on the content of item pool,we then carried out Delphi-method expert consultations and a consensus meeting.Results The core outcome set of clinical research on myasthenia gravis treated with traditional Chinese medicine included five outcome domains:endpoint outcome,myasthenia gravis symptom evaluation,medication evaluation,quality of life evaluation and safety outcome;Nine outcome measures:recurrence rate,incidence of hormone complications,incidence of crisis,QMGS scale(MGFA quantitative myasthenia gravis score),daily activity scale of MG patients(ADL),analysis of immunosuppressant dosage,analysis of glucocorticoid dosage,analysis of cholinesterase inhibitor dosage,and incidence of adverse events.Conclusion The five outcome domains and nine outcome measures included in the core outcome set can be used as outcome options for the efficacy evaluation of myasthenia gravis clinical research.
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Introduction: Numerous health indicators from different domains and comprehensive systems for describing health of community at state or district level are in vogue. Some sub-district information is also available from Health Management Information System but the numbers of indicators are many. Here composite health index of sub-district level is calculated similar to documented procedure. Objective: To develop block wise composite health index in an average district, Yavatmal district using available data. Methods: We grouped health indicators in following four categories; health outcomes, health system, other determinants and utilization of services. From these categories we selected four, three, two and one indicator respectively. Almost all the information is collected from already available data. There are 16 blocks in Yavatmal district. Block wise information of all indicators was first compiled. The block having best value was given 100 marks and remaining blocks were given proportionately less marks. The block wise total marks were calculated. The total score was converted into index by dividing by 1,000. Results: The composite health index ranged from 0.369 to 0.794. The median was 0.425 and interquartile range was 0.126. Out of ten, nine health indicators had normal distribution. We observed positive correlation between urbanization and composite health index. The Yavatmal block obtained highest composite index 0.794 and was an outlier. Principal component analysis extracted four components which contributed 82.06% to total variance. Conclusion: Using only ten indicators and simple method blocks composite health index can be developed which may be used to compare blocks or even districts.
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BACKGROUND: The purpose of this study is comparison of the results between regression and multi-level analysis to find out factors influencing outcome indicators (in-hospital death, length of stay, and medical charges) of stroke patients. METHODS: By using patient sample data of Health Insurance Review & Assessment Service, patients admitted with stroke were selected as survey target and 15,864 patients and 762 hospitals were surveyed. RESULTS: For the results of existing regression analysis and multi-level analysis, models were assessed through model suitability index value and as a result, the value of results of multi-level analysis decreased compared to the results of regression, showing it is a better model. CONCLUSION: Factors influencing in-hospital death of stroke patients were analyzed and as a result, intra-class correlation (ICC) was 13.6%. In factors influencing length of stay, ICC was 11.4%, and medical charges, ICC was 17.7%. It was found that factors influencing the outcome indicators of stroke patients may vary in every hospital. This study could carry out more accurate analysis than existing research findings through analysis of reflecting structure at patient level and hospital level factors and analysis on random effect.
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Humans , Insurance, Health , Length of Stay , Multilevel Analysis , Regression Analysis , StrokeABSTRACT
The World Food Summit in 1996 provided a comprehensive definition for food security which brings into focus the linkage between food, nutrition and health. India has been self sufficient in food production since seventies and low household hunger rates. India compares well with developing countries with similar health profile in terms of infant mortality rate (IMR) and under five mortality rate (U5 MR). India fares poorly when underweight in under five children is used as an indicator for food insecurity with rates comparable to that of Subsaharan Africa. If wasting [low body mass index (BMI) for age in children and low BMI in adults] which is closely related to adequacy of current food intake is used as an indictor for the assessment of household food security, India fares better. The nineties witnessed the emergence of dual nutrition burden with persistent inadequate dietary intake and undernutrition on one side and low physical activity / food intake above requirements and overnutrition on the other side. Body size and physical activity levels are two major determinants of human nutrient requirements. The revised recommended dietary allowances (RDA) for Indians takes cognisance of the current body weight and physical activity while computing the energy and nutrient requirements. As both under- and overnutrition are associated with health hazards, perhaps time has come for use of normal BMI as an indicator for food security.
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PUPPOSE: This study was conducted to develop nursing outcome indicators based on nursing activities done for stroke patients. METHOD: focus group meeting and delphi technique, which consisted of clinical nurse experts, neurologist, and nursing professors. CVI(Index of Content Validity) and user validity test was performed. RESULT: 12 nursing diagnoses, 29 nursing interventions and nursing outcomes were identified. The former were from NIC and the latter were developed according to nursing interventions. They were verified by experts in focus group. 199 nursing activities were identified, 133 nursing outcome indicators were developed. In user validity, usefulness and usability were tested. CONCLUSION: This systemic approach of measuring nursing outcomes verified nurses' positive effects in changing patients health status and nursing contributions in the health care system as a profession.
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Humans , Delivery of Health Care , Delphi Technique , Focus Groups , Nursing Diagnosis , Nursing , StrokeABSTRACT
This paper proposes a system for nursing diagnosis and intervention management that is using nursing outcome indicators to guide the nursing intervention. In Korea, it has been studied on computerization of nursing process, but most of the studies are on the management of nursing records and not on the databases of nursing intervention. So far, the actual nursing processes have been performed by individual nurses' judgement without any supporting programs. Therefore, we provide the system with standardized database for nursing diagnosis and interventions so that nurses can make more accurate diagnoses and perform more adequate interventions. For that purpose, we have developed an algorithm that links nursing outcome indicators to nursing diagnoses and interventions. As a result, we expect the system can be used in many hospitals efficiently in the future after pilot operations.