目的对目前已有药物经济学文献质量评价工具的内容、特点进行比较分析,对如何选择最优的质量评价工具给出建议。方法计算机检索PubMed、EMbase、ScienceDirect、Web of Science、CNKI、WanFang Data和VIP数据库,搜集有关药物经济学质量...目的对目前已有药物经济学文献质量评价工具的内容、特点进行比较分析,对如何选择最优的质量评价工具给出建议。方法计算机检索PubMed、EMbase、ScienceDirect、Web of Science、CNKI、WanFang Data和VIP数据库,搜集有关药物经济学质量评价工具的研究,检索时限均为建库至2017年12月。由2名研究者独立筛选文献、提取资料并从条目内容、设计方法、适用范围和各自特点等方面进行详细分析。结果共纳入信度、效度较好的原创评估量表12个,其中最早的质量评估量表设计于1987年,最新的发表于2013年,条目数量从11个到61个不等。结论药物经济学研究的质量评价迄今尚无统一方法。评价者可根据评价目的、评价类型及可操作性等,选择适宜的评价工具。展开更多
Background Insulin resistance （IR） plays an important pathophysiological role in the development of diabetes,dyslipidemia,hypertension,and cardiovascular disease.Moreover,IR can occur even in non-obese people withou...Background Insulin resistance （IR） plays an important pathophysiological role in the development of diabetes,dyslipidemia,hypertension,and cardiovascular disease.Moreover,IR can occur even in non-obese people without diabetes.However,direct detection of IR is complicated.In order to find a simple surrogate marker of IR early in nonobese people,we investigate the association of commonly-used biochemical markers （liver enzymes and lipid profiles） with IR in urban middle-aged and older non-obese Chinese without diabetes.Methods This cross-sectional study included 1 987 subjects （1 473 women）.Fasting blood samples were collected for measurement of glucose,insulin,liver enzymes,lipid profiles and creatinine.Subjects whose homeostasis model of assessment-IR （HOMA-IR） index values exceeded the 75th percentile （2.67 for women and 2.48 for men） of the population were considered to have IR.The area under the receiver operating characteristic curve （ROC） was used to compare the power of potential markers in identifying IR.Results Triglycerides （TG） and ratio of TG to high-density lipoprotein cholesterol （TG/HDL-C） discriminated IR better than other indexes for both sexes; areas under the receiver operating characteristic （ROC） curves （AUC） values were 0.770 （95％ confidence interval 0.733-0.807） and 0.772 （0.736-0.809）,respectively,for women and 0.754 （0.664-0.844）and 0.756 （0.672-0.840）,respectively,for men.To identify IR,the optimal cut-offs for TG and TG/HDL-C ratio were 1.315 mmol/L （sensitivity 74.3％,specificity 71.0％） and 0.873 （sensitivity 70.1％,specificity 73.4％）,respectively,for women,and 1.275 mmol/L （sensitivity 66.7％,specificity 74.4％） and 0.812 （sensitivity 75.8％,specificity 69.2％）,respectively,for men.Conclusion TG and TG/HDL-C ratio could be used to identify IR in urban middle-aged and older non-obese Chinese without diabetes.展开更多
文摘目的对目前已有药物经济学文献质量评价工具的内容、特点进行比较分析,对如何选择最优的质量评价工具给出建议。方法计算机检索PubMed、EMbase、ScienceDirect、Web of Science、CNKI、WanFang Data和VIP数据库,搜集有关药物经济学质量评价工具的研究,检索时限均为建库至2017年12月。由2名研究者独立筛选文献、提取资料并从条目内容、设计方法、适用范围和各自特点等方面进行详细分析。结果共纳入信度、效度较好的原创评估量表12个,其中最早的质量评估量表设计于1987年,最新的发表于2013年,条目数量从11个到61个不等。结论药物经济学研究的质量评价迄今尚无统一方法。评价者可根据评价目的、评价类型及可操作性等,选择适宜的评价工具。
文摘Background Insulin resistance （IR） plays an important pathophysiological role in the development of diabetes,dyslipidemia,hypertension,and cardiovascular disease.Moreover,IR can occur even in non-obese people without diabetes.However,direct detection of IR is complicated.In order to find a simple surrogate marker of IR early in nonobese people,we investigate the association of commonly-used biochemical markers （liver enzymes and lipid profiles） with IR in urban middle-aged and older non-obese Chinese without diabetes.Methods This cross-sectional study included 1 987 subjects （1 473 women）.Fasting blood samples were collected for measurement of glucose,insulin,liver enzymes,lipid profiles and creatinine.Subjects whose homeostasis model of assessment-IR （HOMA-IR） index values exceeded the 75th percentile （2.67 for women and 2.48 for men） of the population were considered to have IR.The area under the receiver operating characteristic curve （ROC） was used to compare the power of potential markers in identifying IR.Results Triglycerides （TG） and ratio of TG to high-density lipoprotein cholesterol （TG/HDL-C） discriminated IR better than other indexes for both sexes; areas under the receiver operating characteristic （ROC） curves （AUC） values were 0.770 （95％ confidence interval 0.733-0.807） and 0.772 （0.736-0.809）,respectively,for women and 0.754 （0.664-0.844）and 0.756 （0.672-0.840）,respectively,for men.To identify IR,the optimal cut-offs for TG and TG/HDL-C ratio were 1.315 mmol/L （sensitivity 74.3％,specificity 71.0％） and 0.873 （sensitivity 70.1％,specificity 73.4％）,respectively,for women,and 1.275 mmol/L （sensitivity 66.7％,specificity 74.4％） and 0.812 （sensitivity 75.8％,specificity 69.2％）,respectively,for men.Conclusion TG and TG/HDL-C ratio could be used to identify IR in urban middle-aged and older non-obese Chinese without diabetes.
