目的基于多组学数据,采用机器学习的分类算法,构建高性能的特异性致病菌感染败血症的早期诊断模型,并比较基于单组学和多组学数据模型的预测效果。方法利用败血症患者早期血浆中测得的蛋白质组学数据、代谢组学数据以及多组学融合数据,...目的基于多组学数据,采用机器学习的分类算法,构建高性能的特异性致病菌感染败血症的早期诊断模型,并比较基于单组学和多组学数据模型的预测效果。方法利用败血症患者早期血浆中测得的蛋白质组学数据、代谢组学数据以及多组学融合数据,使用支持向量机(support vector machine,SVM)算法分别构建三个诊断模型,对比三个模型的性能。结果相较于单组学模型,利用多组学数据构建的模型效果最优,金黄色葡萄球菌感染组受试者工作特征曲线下的面积(area under the receiver operating characteristic curve,AUC)=0.97,非金黄色葡萄菌感染组AUC=0.94,非感染组AUC=0.94。结论在特异性败血症早期诊断时,基于多组学相较于单组学构建的模型有较好的预测效果。展开更多
Background Evidence-based medicine has come into its second decade. How prepared clinicians are in practicing it in particular in developing countries remains unclear. Thus we conducted this survey of physicians in ur...Background Evidence-based medicine has come into its second decade. How prepared clinicians are in practicing it in particular in developing countries remains unclear. Thus we conducted this survey of physicians in urban hospitals in China to determine the size of the gap between research evidence and physicians＇ knowledge and practice regarding antihypertensive drugs for primary prevention of cardiovascular diseases in China.Methods A cross sectional survey by a face-to-face interview was conducted in 20 tertiary general hospitals in China in 2005. A total of 444 physicians （mostly cardiologists） in internal medicine who had treated at least one hypertensive patient in the past 12 months were invited for the interview on their perception of the cardiovascular risk of hypertension,the magnitude of the benefit of antihypertensive drugs, knowledge on the overall risk approach, first-line drugs used, the risk above which drug treatment is recommended, and knowledge on evidence-based medicine.Results A total of 444 of the 468 eligible physicians were successfully interviewed with a response rate of 94.9%. They estimated that a hypertensive man with an actual 5-year cardiovascular risk of 8.4% would have a 5-year cardiovascular risk of 40% （95% CI： 38% to 42%） if not treated, and have an absolute risk reduction and relative risk reduction from drug treatment by 20% （95% CI. 18% to 22%） and 39% （95% CI： 37% to 42%） respectively, as compared to 3.3% and 33%respectively shown in research evidence. On average, the physicians would recommend drug treatment at a number needed to treat （NNT） of 368 or smaller, as compared to the actual NNT of 50 for drug treatment in an average hypertensive Chinese. Fifty-five percent （95% CI： 50% to 59%） of them had never intently used the national hypertension guidelines. The majority still prescribed drugs primarily based on blood pressure alone by ignoring other risk factors or the overall risk and 78% （95 % C/. 76% to 83%） used new expensive drugs such as calcium channel blockers and angiotensin converting enzyme （ACE） inhibitors as first-line treatment. Only 13% （95% CI：9% to 18%） could correctly interpret the NNT. Forty-three percent （95% CI： 39% to 48%） did not know the randomized controlled trial was scientifically the most rigorous among other study designs for evaluating the effectiveness of anti-hypertensive drugs.Ninety-two percent （95% CI： 90% to 94%） did not know they could start by searching systematic reviews when looking for evidence on the effectiveness of anti-hypertensive drugs as opposed to trials. Ninety-six percent （95% CI： 94% to 98%）did not know the Cochrane Library was an important source of systematic reviews.Conclusions The surveyed physicians significantly over-estimated the cardiovascular risk of hypertension and the benefit of drug treatment, and had insufficient knowledge on the overall risk approach. They recommended drug treatment at a cardiovascular risk which was even much lower than the cutoff suggested for western populations, which would make many more people eligible for drug treatment. They also tended to prescribe new expensive drugs although the older cheaper ones may be more appropriate in many patients. They showed inappropriate knowledge on the basics of evidence-based medicine.展开更多
WHAT IS MEDICAL SCREENING？Worldwide chronic diseases have become a major cause of suffering, disability and mortality. When patients are diagnosed as a result of the appearance of symptoms, it is often too late and t...WHAT IS MEDICAL SCREENING？Worldwide chronic diseases have become a major cause of suffering, disability and mortality. When patients are diagnosed as a result of the appearance of symptoms, it is often too late and treatment options are limited. Hoping that early diagnosis and early treatment can retard or stop disease progression, medical screening is proposed as a secondary prevention method in which people without specific medical complaints are invited to undergo interventions to identify and modify risk factors, or to find disease early in its course so that early treatment prevents further severe complications.展开更多
文摘目的基于多组学数据,采用机器学习的分类算法,构建高性能的特异性致病菌感染败血症的早期诊断模型,并比较基于单组学和多组学数据模型的预测效果。方法利用败血症患者早期血浆中测得的蛋白质组学数据、代谢组学数据以及多组学融合数据,使用支持向量机(support vector machine,SVM)算法分别构建三个诊断模型,对比三个模型的性能。结果相较于单组学模型,利用多组学数据构建的模型效果最优,金黄色葡萄球菌感染组受试者工作特征曲线下的面积(area under the receiver operating characteristic curve,AUC)=0.97,非金黄色葡萄菌感染组AUC=0.94,非感染组AUC=0.94。结论在特异性败血症早期诊断时,基于多组学相较于单组学构建的模型有较好的预测效果。
文摘Background Evidence-based medicine has come into its second decade. How prepared clinicians are in practicing it in particular in developing countries remains unclear. Thus we conducted this survey of physicians in urban hospitals in China to determine the size of the gap between research evidence and physicians＇ knowledge and practice regarding antihypertensive drugs for primary prevention of cardiovascular diseases in China.Methods A cross sectional survey by a face-to-face interview was conducted in 20 tertiary general hospitals in China in 2005. A total of 444 physicians （mostly cardiologists） in internal medicine who had treated at least one hypertensive patient in the past 12 months were invited for the interview on their perception of the cardiovascular risk of hypertension,the magnitude of the benefit of antihypertensive drugs, knowledge on the overall risk approach, first-line drugs used, the risk above which drug treatment is recommended, and knowledge on evidence-based medicine.Results A total of 444 of the 468 eligible physicians were successfully interviewed with a response rate of 94.9%. They estimated that a hypertensive man with an actual 5-year cardiovascular risk of 8.4% would have a 5-year cardiovascular risk of 40% （95% CI： 38% to 42%） if not treated, and have an absolute risk reduction and relative risk reduction from drug treatment by 20% （95% CI. 18% to 22%） and 39% （95% CI： 37% to 42%） respectively, as compared to 3.3% and 33%respectively shown in research evidence. On average, the physicians would recommend drug treatment at a number needed to treat （NNT） of 368 or smaller, as compared to the actual NNT of 50 for drug treatment in an average hypertensive Chinese. Fifty-five percent （95% CI： 50% to 59%） of them had never intently used the national hypertension guidelines. The majority still prescribed drugs primarily based on blood pressure alone by ignoring other risk factors or the overall risk and 78% （95 % C/. 76% to 83%） used new expensive drugs such as calcium channel blockers and angiotensin converting enzyme （ACE） inhibitors as first-line treatment. Only 13% （95% CI：9% to 18%） could correctly interpret the NNT. Forty-three percent （95% CI： 39% to 48%） did not know the randomized controlled trial was scientifically the most rigorous among other study designs for evaluating the effectiveness of anti-hypertensive drugs.Ninety-two percent （95% CI： 90% to 94%） did not know they could start by searching systematic reviews when looking for evidence on the effectiveness of anti-hypertensive drugs as opposed to trials. Ninety-six percent （95% CI： 94% to 98%）did not know the Cochrane Library was an important source of systematic reviews.Conclusions The surveyed physicians significantly over-estimated the cardiovascular risk of hypertension and the benefit of drug treatment, and had insufficient knowledge on the overall risk approach. They recommended drug treatment at a cardiovascular risk which was even much lower than the cutoff suggested for western populations, which would make many more people eligible for drug treatment. They also tended to prescribe new expensive drugs although the older cheaper ones may be more appropriate in many patients. They showed inappropriate knowledge on the basics of evidence-based medicine.
文摘WHAT IS MEDICAL SCREENING？Worldwide chronic diseases have become a major cause of suffering, disability and mortality. When patients are diagnosed as a result of the appearance of symptoms, it is often too late and treatment options are limited. Hoping that early diagnosis and early treatment can retard or stop disease progression, medical screening is proposed as a secondary prevention method in which people without specific medical complaints are invited to undergo interventions to identify and modify risk factors, or to find disease early in its course so that early treatment prevents further severe complications.
