Background: Promotion of Evidence-Based Practice (EBP) in nursing appears to be developing slowly. Research indicates that nurses’ beliefs in EBP may play an even more significant role than knowledge and resources in...Background: Promotion of Evidence-Based Practice (EBP) in nursing appears to be developing slowly. Research indicates that nurses’ beliefs in EBP may play an even more significant role than knowledge and resources in making implementation feasible. To address this issue, measurement of nurses’ beliefs regarding EBP is paramount. Aims and objectives: This study explores the internal consistency reliability and the construct factor structure of the Norwegian version of the original Evidence-Based Practice Beliefs Scale (EBP-BS). Methods: The study has a Non-experimental exploratory survey design. A Norwegian translation of the EBP-BS was tested in a convenience sample of 118 healthcare professionals (95% nurses) attending a continuing education program at a University College in Norway. The response rate was 95% (n = 112). The internal consistency of the scale was measured by Cronbach’s alpha, and an explorative Principal Component Analysis (PCA) was used to explore the construct structure. Results: The overall internal consistency of the EBP-BS was acceptable. The PCA indicated a four-factor structure. The psychometric properties of two of the factors were too weak for expanding to a four-factor model. Based on our investigation of the EBP-BS, we suggest a two-factor structure model. The factors were named 1) General knowledge and confidence concerning EBP and 2) Task specific beliefs in EBP. This finding differs from previous results that indicated a unidimensional structure. Conclusion: As a starting point, reliable and valid measurement of nurses’ beliefs about EBP is required in order to identify possible obstacles and to optimize implementation in the individual clinical setting. Our results indicate that the EBP-BS has a two-factor structure. Further exploration of the factor structure is needed. Further empirical research may contribute to the resolving of controversies concerning basic understandings of the concept of EBP.展开更多
To address the issue of rule premise combination explosion in the construction of the traditional complete conjunctive belief rule base(BRB),this paper introduces an orthogonal design method to reduce the conjunctive ...To address the issue of rule premise combination explosion in the construction of the traditional complete conjunctive belief rule base(BRB),this paper introduces an orthogonal design method to reduce the conjunctive BRB.The reasoning method based on reduced conjunctive BRB is designed with the help of the conversion technology from conjunctive BRB to disjunctive BRB.Finally,the operational mission effectiveness evaluation is taken as an example to verify the proposed method.The results show that the method proposed in this paper is feasible and effective.展开更多
Individualized treatment is a basic feature of Traditional Chinese Medicine(TCM), and individualized efficacy evaluation is also emphasized in TCM clinical practice. Individualized evaluation is in favor of improving ...Individualized treatment is a basic feature of Traditional Chinese Medicine(TCM), and individualized efficacy evaluation is also emphasized in TCM clinical practice. Individualized evaluation is in favor of improving intervention continuously, and optimizing the TCM evidenceusing pattern gradually. Traditional case reports can better demonstrate the efficacy of individual, but lack of standardized design, making such evidence show a lower quality. Meanings, objectives and design elements of TCM individualized evaluation were discussed in this paper.Then based on the original work, design ideas and framework of TCM evidence-based case reporting system were established preliminarily.This work will improve the methodology of TCM individualized evaluation to realize the goal of optimizing TCM clinical evidence-using pattern.展开更多
The first decade since the completion of the Human Genome Project has been marked with rapid development of genomic technologies and their immediate clinical applications. Genomic analysis using oligonucleotide array ...The first decade since the completion of the Human Genome Project has been marked with rapid development of genomic technologies and their immediate clinical applications. Genomic analysis using oligonucleotide array comparative genomic hybridization (aCGH) or single nucleotide polymorphism (SNP) chips has been applied to pediatric patients with developmental and intellectual disabilities (DD/ ID), multiple congenital anomalies (MCA) and autistic spectrum disorders (ASD). Evaluation of analytical and clinical validities of aCGH showed 〉 99% sensitivity and specificity and increased analytical resolution by higher density probe coverage. Reviews of case series, multi-center comparison and large patient-control studies demonstrated a diagnostic yield of 12%--20%; approximately 60% of these abnormalities were recurrent genomic disorders. This pediatric experience has been extended toward prenatal diagnosis. A series of reports indicated approximately 10% of pregnancies with ultrasound-detected structural anomalies and normal cytogenetic findings had genomic abnormalities, and 30% of these abnormalities were syndromic genomic disorders. Evidence-based practice guidelines and standards for implementing genomic analysis and web-delivered knowledge resources for interpreting genomic findings have been established. The progress from this technology-driven and evidence-based genomic analysis provides not only opportunities to dissect disease-causing mechanisms and develop rational therapeutic interventions but also important lessons for integrating genomic sequencing into pediatric and prenatal genetic evaluation.展开更多
Purpose: To develop and test a mission-oriented and multi-dimensional benchmarking method for a small scale university aiming for internationally first-class basic research.Design/methodology/approach: An individualiz...Purpose: To develop and test a mission-oriented and multi-dimensional benchmarking method for a small scale university aiming for internationally first-class basic research.Design/methodology/approach: An individualized evidence-based assessment scheme was employed to benchmark ShanghaiTech University against selected top research institutions,focusing on research impact and competitiveness at the institutional and disciplinary levels.Topic maps opposing ShanghaiTech and corresponding top institutions were produced for the main research disciplines of ShanghaiTech. This provides opportunities for further exploration of strengths and weakness. Findings: This study establishes a preliminary framework for assessing the mission of the university. It further provides assessment principles, assessment questions, and indicators.Analytical methods and data sources were tested and proved to be applicable and efficient.Research limitations: To better fit the selective research focuses of this university, its schema of research disciplines needs to be re-organized and benchmarking targets should include disciplinary top institutions and not necessarily those universities leading overall rankings.Current reliance on research articles and certain databases may neglect important research output types.Practical implications: This study provides a working framework and practical methods for mission-oriented, individual, and multi-dimensional benchmarking that ShanghaiTech decided to use for periodical assessments. It also offers a working reference for other institutions to adapt. Further needs are identified so that ShanghaiTech can tackle them for future benchmarking.Originality/value: This is an effort to develop a mission-oriented, individually designed,systematically structured, and multi-dimensional assessment methodology which differs from often used composite indices.展开更多
Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system.A literature search on the practice of evidence...Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system.A literature search on the practice of evidence-based evaluation was conducted in key biomedical databases,i.e.PubMed,Excerpt Medica Database,China Biology Medicine disc and China National Knowledge Infrastructure.However,no relevant study on the subjects of interest was identified.Therefore,drawing on the principles of narrative medicine and expert opinion from systems of Chinese medicine and Western medicine,we propose to develop and pilot-test a novel evidence-based medical record format that captures the perspectives of both patients and doctors in a clinical trial.Further,we seek to evaluate a strategic therapeutic approach that integrates the wisdom of Chinese medicine with the scientific basis of Western medicine in the treatment of digestive system disorders.Evaluation of therapeutic efficacy of remedies under the system of Chinese medicine is an imperative ongoing research.The present study intends to identify a novel approach to assess the synergistic benefits achievable from an integrated therapeutic approach combining Chinese and Western system of medicine to treat digestive system disorders.展开更多
目的对国内外住院患者跌倒预防相关临床实践指南进行质量评价和推荐意见总结。方法系统检索国内外指南网、医学文献数据库以及专业学术网站,应用相应评价工具对纳入指南和专家共识进行质量评价,并汇总相关推荐内容。检索时限为建库至202...目的对国内外住院患者跌倒预防相关临床实践指南进行质量评价和推荐意见总结。方法系统检索国内外指南网、医学文献数据库以及专业学术网站,应用相应评价工具对纳入指南和专家共识进行质量评价,并汇总相关推荐内容。检索时限为建库至2022年12月13日。结果共纳入9篇指南和5篇专家共识,9篇指南在AGREE II 6个领域得分为范围和目的94.03%、清晰性73.86%、参与人员76.07%、严谨性80.19%、应用性69.34%、独立性63.88%,其中5篇为A级推荐、4篇为B级推荐;3篇专家共识中的质量评价结果中条目1~6均为“是”,其余2篇条目1~4均为“是”,条目5~6分别为“否”和“不清楚”,5篇专家共识质量评价结果均为“纳入”。经内容整理,住院患者跌倒预防相关内容包括环境改善、跌倒风险评估、跌倒干预及跌倒后处理、药物审查、物理训练、保护器具的使用、营养支持、健康宣教8个方面,28项内容。结论本研究纳入的住院患者跌倒预防指南整体质量较好但仍有待提高,对临床护理人员预防患者跌倒、提高护理质量有一定的指导意义。展开更多
目的检索并再评价声音对NICU早产儿生长发育影响的系统评价,为临床医务人员临床决策及早产儿健康干预策略的持续改进提供参考。方法计算机检索The Cochrane Library、Embase、PubMed、Web of Science、万方、中国知网、维普和中国生物...目的检索并再评价声音对NICU早产儿生长发育影响的系统评价,为临床医务人员临床决策及早产儿健康干预策略的持续改进提供参考。方法计算机检索The Cochrane Library、Embase、PubMed、Web of Science、万方、中国知网、维普和中国生物医学文献数据库,检索关于声音对NICU早产儿影响的系统评价/Meta分析/荟萃分析,检索时间为建库至2023年5月。2名研究人员应用AMSTAR对文献进行方法学质量评价后,通过GRADE进行证据整理与分级。结果初检文献405篇,最终纳入文献20篇,AMSTAR质量评价结果表明,高等质量文献有5篇,其余15篇均为中等质量,纳入文献的总体方法学质量较低。采用GRADE系统对20篇系统评价的79条结局指标的证据质量评价结果显示,12条证据为中等质量,34条证据为低等质量,33条证据为极低质量。结论声音干预有利于改善NICU早产儿的相关生理指标、睡眠效率、行为状态、神经行为及大脑发育,可促进早产儿健康恢复,但系统评价的方法学质量和证据的质量均较低,临床实践需谨慎采纳有关证据,并逐步进行更加规范、严谨的研究。展开更多
目的:系统评价脑卒中后认知障碍的风险预测模型。方法:检索中国知网、万方数据库、维普网、中国生物医学文献服务系统、PubMed、EMbase、the Cochrane Library、Web of Science和EBSCO数据库中的脑卒中后认知障碍风险预测模型相关研究,...目的:系统评价脑卒中后认知障碍的风险预测模型。方法:检索中国知网、万方数据库、维普网、中国生物医学文献服务系统、PubMed、EMbase、the Cochrane Library、Web of Science和EBSCO数据库中的脑卒中后认知障碍风险预测模型相关研究,检索时限为建库至2023年1月30日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险和适用性。结果:共纳入16项研究,包括19个脑卒中后认知障碍风险预测模型,其中,16个模型采用了Logistic回归分析方法,2个模型采用了随机森林的方法,1个模型采用了LASSO回归的方法。建模时受试者工作特征曲线下面积(AUC)为0.773~0.940。4个模型进行了Hosmer-Lemeshow(H-L)检验,其中2个模型报告了P值且P≥0.05。11个模型进行了内部验证,5个模型进行了外部验证,4个模型同时进行了内部验证和外部验证。16项研究适用性较好,但存在较高的偏倚风险,主要问题集中在分析领域。结论:脑卒中后认知障碍风险预测模型整体性能良好,但模型质量有待提高,在未来的研究中需优化研究设计、扩大样本量、根据临床需要选择合适的预测因子、改进统计分析方法,并注重模型的外部验证,以验证模型的泛化能力。展开更多
文摘Background: Promotion of Evidence-Based Practice (EBP) in nursing appears to be developing slowly. Research indicates that nurses’ beliefs in EBP may play an even more significant role than knowledge and resources in making implementation feasible. To address this issue, measurement of nurses’ beliefs regarding EBP is paramount. Aims and objectives: This study explores the internal consistency reliability and the construct factor structure of the Norwegian version of the original Evidence-Based Practice Beliefs Scale (EBP-BS). Methods: The study has a Non-experimental exploratory survey design. A Norwegian translation of the EBP-BS was tested in a convenience sample of 118 healthcare professionals (95% nurses) attending a continuing education program at a University College in Norway. The response rate was 95% (n = 112). The internal consistency of the scale was measured by Cronbach’s alpha, and an explorative Principal Component Analysis (PCA) was used to explore the construct structure. Results: The overall internal consistency of the EBP-BS was acceptable. The PCA indicated a four-factor structure. The psychometric properties of two of the factors were too weak for expanding to a four-factor model. Based on our investigation of the EBP-BS, we suggest a two-factor structure model. The factors were named 1) General knowledge and confidence concerning EBP and 2) Task specific beliefs in EBP. This finding differs from previous results that indicated a unidimensional structure. Conclusion: As a starting point, reliable and valid measurement of nurses’ beliefs about EBP is required in order to identify possible obstacles and to optimize implementation in the individual clinical setting. Our results indicate that the EBP-BS has a two-factor structure. Further exploration of the factor structure is needed. Further empirical research may contribute to the resolving of controversies concerning basic understandings of the concept of EBP.
基金supported by the Military Scientific Research Program(41401020301).
文摘To address the issue of rule premise combination explosion in the construction of the traditional complete conjunctive belief rule base(BRB),this paper introduces an orthogonal design method to reduce the conjunctive BRB.The reasoning method based on reduced conjunctive BRB is designed with the help of the conversion technology from conjunctive BRB to disjunctive BRB.Finally,the operational mission effectiveness evaluation is taken as an example to verify the proposed method.The results show that the method proposed in this paper is feasible and effective.
基金supported by Special Fund for Traditional Chinese Medicine Research in the Public Interest[201507006-01]
文摘Individualized treatment is a basic feature of Traditional Chinese Medicine(TCM), and individualized efficacy evaluation is also emphasized in TCM clinical practice. Individualized evaluation is in favor of improving intervention continuously, and optimizing the TCM evidenceusing pattern gradually. Traditional case reports can better demonstrate the efficacy of individual, but lack of standardized design, making such evidence show a lower quality. Meanings, objectives and design elements of TCM individualized evaluation were discussed in this paper.Then based on the original work, design ideas and framework of TCM evidence-based case reporting system were established preliminarily.This work will improve the methodology of TCM individualized evaluation to realize the goal of optimizing TCM clinical evidence-using pattern.
基金supported in part by fellowship award from the China Scholarship Council to Yuan Wei
文摘The first decade since the completion of the Human Genome Project has been marked with rapid development of genomic technologies and their immediate clinical applications. Genomic analysis using oligonucleotide array comparative genomic hybridization (aCGH) or single nucleotide polymorphism (SNP) chips has been applied to pediatric patients with developmental and intellectual disabilities (DD/ ID), multiple congenital anomalies (MCA) and autistic spectrum disorders (ASD). Evaluation of analytical and clinical validities of aCGH showed 〉 99% sensitivity and specificity and increased analytical resolution by higher density probe coverage. Reviews of case series, multi-center comparison and large patient-control studies demonstrated a diagnostic yield of 12%--20%; approximately 60% of these abnormalities were recurrent genomic disorders. This pediatric experience has been extended toward prenatal diagnosis. A series of reports indicated approximately 10% of pregnancies with ultrasound-detected structural anomalies and normal cytogenetic findings had genomic abnormalities, and 30% of these abnormalities were syndromic genomic disorders. Evidence-based practice guidelines and standards for implementing genomic analysis and web-delivered knowledge resources for interpreting genomic findings have been established. The progress from this technology-driven and evidence-based genomic analysis provides not only opportunities to dissect disease-causing mechanisms and develop rational therapeutic interventions but also important lessons for integrating genomic sequencing into pediatric and prenatal genetic evaluation.
文摘Purpose: To develop and test a mission-oriented and multi-dimensional benchmarking method for a small scale university aiming for internationally first-class basic research.Design/methodology/approach: An individualized evidence-based assessment scheme was employed to benchmark ShanghaiTech University against selected top research institutions,focusing on research impact and competitiveness at the institutional and disciplinary levels.Topic maps opposing ShanghaiTech and corresponding top institutions were produced for the main research disciplines of ShanghaiTech. This provides opportunities for further exploration of strengths and weakness. Findings: This study establishes a preliminary framework for assessing the mission of the university. It further provides assessment principles, assessment questions, and indicators.Analytical methods and data sources were tested and proved to be applicable and efficient.Research limitations: To better fit the selective research focuses of this university, its schema of research disciplines needs to be re-organized and benchmarking targets should include disciplinary top institutions and not necessarily those universities leading overall rankings.Current reliance on research articles and certain databases may neglect important research output types.Practical implications: This study provides a working framework and practical methods for mission-oriented, individual, and multi-dimensional benchmarking that ShanghaiTech decided to use for periodical assessments. It also offers a working reference for other institutions to adapt. Further needs are identified so that ShanghaiTech can tackle them for future benchmarking.Originality/value: This is an effort to develop a mission-oriented, individually designed,systematically structured, and multi-dimensional assessment methodology which differs from often used composite indices.
基金Supported by the National Natural Science Foundation of China(No.81303151)Beijing Nova Program(No.xxjh2015A093and No.Z1511000003150125)National Major Scientific and Technological Special Project for"Significant New Drugs Development"(No.2012ZX09303-010-002)
文摘Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system.A literature search on the practice of evidence-based evaluation was conducted in key biomedical databases,i.e.PubMed,Excerpt Medica Database,China Biology Medicine disc and China National Knowledge Infrastructure.However,no relevant study on the subjects of interest was identified.Therefore,drawing on the principles of narrative medicine and expert opinion from systems of Chinese medicine and Western medicine,we propose to develop and pilot-test a novel evidence-based medical record format that captures the perspectives of both patients and doctors in a clinical trial.Further,we seek to evaluate a strategic therapeutic approach that integrates the wisdom of Chinese medicine with the scientific basis of Western medicine in the treatment of digestive system disorders.Evaluation of therapeutic efficacy of remedies under the system of Chinese medicine is an imperative ongoing research.The present study intends to identify a novel approach to assess the synergistic benefits achievable from an integrated therapeutic approach combining Chinese and Western system of medicine to treat digestive system disorders.
文摘目的对国内外住院患者跌倒预防相关临床实践指南进行质量评价和推荐意见总结。方法系统检索国内外指南网、医学文献数据库以及专业学术网站,应用相应评价工具对纳入指南和专家共识进行质量评价,并汇总相关推荐内容。检索时限为建库至2022年12月13日。结果共纳入9篇指南和5篇专家共识,9篇指南在AGREE II 6个领域得分为范围和目的94.03%、清晰性73.86%、参与人员76.07%、严谨性80.19%、应用性69.34%、独立性63.88%,其中5篇为A级推荐、4篇为B级推荐;3篇专家共识中的质量评价结果中条目1~6均为“是”,其余2篇条目1~4均为“是”,条目5~6分别为“否”和“不清楚”,5篇专家共识质量评价结果均为“纳入”。经内容整理,住院患者跌倒预防相关内容包括环境改善、跌倒风险评估、跌倒干预及跌倒后处理、药物审查、物理训练、保护器具的使用、营养支持、健康宣教8个方面,28项内容。结论本研究纳入的住院患者跌倒预防指南整体质量较好但仍有待提高,对临床护理人员预防患者跌倒、提高护理质量有一定的指导意义。
文摘目的检索并再评价声音对NICU早产儿生长发育影响的系统评价,为临床医务人员临床决策及早产儿健康干预策略的持续改进提供参考。方法计算机检索The Cochrane Library、Embase、PubMed、Web of Science、万方、中国知网、维普和中国生物医学文献数据库,检索关于声音对NICU早产儿影响的系统评价/Meta分析/荟萃分析,检索时间为建库至2023年5月。2名研究人员应用AMSTAR对文献进行方法学质量评价后,通过GRADE进行证据整理与分级。结果初检文献405篇,最终纳入文献20篇,AMSTAR质量评价结果表明,高等质量文献有5篇,其余15篇均为中等质量,纳入文献的总体方法学质量较低。采用GRADE系统对20篇系统评价的79条结局指标的证据质量评价结果显示,12条证据为中等质量,34条证据为低等质量,33条证据为极低质量。结论声音干预有利于改善NICU早产儿的相关生理指标、睡眠效率、行为状态、神经行为及大脑发育,可促进早产儿健康恢复,但系统评价的方法学质量和证据的质量均较低,临床实践需谨慎采纳有关证据,并逐步进行更加规范、严谨的研究。
文摘目的:系统评价脑卒中后认知障碍的风险预测模型。方法:检索中国知网、万方数据库、维普网、中国生物医学文献服务系统、PubMed、EMbase、the Cochrane Library、Web of Science和EBSCO数据库中的脑卒中后认知障碍风险预测模型相关研究,检索时限为建库至2023年1月30日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险和适用性。结果:共纳入16项研究,包括19个脑卒中后认知障碍风险预测模型,其中,16个模型采用了Logistic回归分析方法,2个模型采用了随机森林的方法,1个模型采用了LASSO回归的方法。建模时受试者工作特征曲线下面积(AUC)为0.773~0.940。4个模型进行了Hosmer-Lemeshow(H-L)检验,其中2个模型报告了P值且P≥0.05。11个模型进行了内部验证,5个模型进行了外部验证,4个模型同时进行了内部验证和外部验证。16项研究适用性较好,但存在较高的偏倚风险,主要问题集中在分析领域。结论:脑卒中后认知障碍风险预测模型整体性能良好,但模型质量有待提高,在未来的研究中需优化研究设计、扩大样本量、根据临床需要选择合适的预测因子、改进统计分析方法,并注重模型的外部验证,以验证模型的泛化能力。