Optimization of evidence-based research in the prevention and treatment of coronary heart disease with traditional Chinese medicine:A comprehensive review

Coronary heart disease(CHD) has severely impacted the lives and health of patients for ages. Although the modern methods used for the prevention and treatment of CHD have been increasingly perfected,clinical problems remain that require solutions. In the prevention and treatment of CHD with traditional Chinese medicine(TCM), great therapeutic advantages have been demonstrated. However, the expression of its advantages relies on scientific evidence-based research and evaluation, which require further optimization and improvement. Therefore, this review aims to comprehensively emphasize our understanding of the current deficiencies in TCM evidence-based studies and the necessity of adopting scientific evidence-based optimization methods for use in research. In this process, evidence should be produced in a standard manner, and the advantages of TCM patterns should be accurately stated because these factors contribute to efficient transformation and proper verification of the obtained evidence.Additionally, focusing on patient-oriented medicine and doctor-patient relationships is also essential.These methods are of great significance to prove the clinical efficacy of TCM and promote its development.

Use of Evidence-Based Research Approach in RCTs of Acupuncture-Related Therapies for Primary Dysmenorrhea: A Meta-Research

Objective To assess the use of evidence-based research(EBR)approach in randomized controlled trials(RCTs)of acupuncture-related therapies for primary dysmenorrhea(PD).Methods PubMed,EMBASE,Cochrane Library,China National Knowledge Infrastructure,Wanfang Database,Chinese Biomedical Database,and China Science and Technology Journal Database were searched from January 2013 to December 2022 for RCTs of acupuncture on PD.The full text and references of each RCT were read to assess whether systematic reviews(SRs)or other types of studies with similar research questions and end-users’perspectives were cited to justify and design the trial.In addition,the discussion section were analyzed to evaluate whether trials placed the new result in the existing SRs to draw a conclusion.Multivariable logistic regression was used to find variables that associated with 3 aspects of EBR approach:(1)citing clinical studies for justification,(2)citing relevant studies that obtain the perspectives of end users,and(3)citing clinical studies for results discussion.Results Of 473 RCTs included,45.67%(216)of the trials cited relevant similar studies,21.56%(102)referenced to the studies that collected end-users’perspectives,and 10.99%(52)placed result in the context of the previous research.Few RCTs appropriately applied EBR approach.Among all the included studies,3.17%(15)of the trials used SRs to inform study questions but none of them used updated SRs with acceptable quality;1.05%(5)of the trials cited SRs of end-user’s perspectives in the justification and design of the study,and only 1 trial added results in existing SR to draw a conclusion.Year of publication,language,funding,registration,ethical approval and number of sites were significantly associated with 1 of the 3 aspects of EBR approach.Conclusions Few RCTs in acupuncture-related therapies for PD used the EBR approach to minimize research redundancy.Researchers,research institutes,funding agencies,ethics committees,journals and peer reviewers in acupuncture should make efforts to use and promote the EBR approach to ensure the value of new trials.

Research on the Application of Evidence-Based Quality Control Circle to Improve the Implementation Rate of Airway Management Measures in Adult Critically Ill Patients

Objective: To explore the effect of evidence-based quality control circle (QCC) in improving the implementation rate of airway management measures in adult critically ill patients. Methods: Based on the Joanna Briggs Institute (JBI) evidence-based health care model, the best evidence of airway management in adult critically ill patients was obtained and applied to the clinic. Results: The total implementation rate of airway management measures in adult critically ill patients increased from 23.62% before the implementation of quality control circle to 88.82%, and the pulmonary infection rate in critically ill patients decreased from 42.31% to 21.74%, with statistical significance between the two groups (P 0.05). Conclusion: Evidence-based quality control circle activities can standardize the practice standards of airway management in critically ill patients, reduce the occurrence of patients’ airway related complications, and improve clinical outcomes.

Effect of cetuximab plus FOLFOX4 regimen on clinical outcomes in advanced gastric carcinoma patients receiving evidence-based care

BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.AIM To determine the efficacy and safety of cetuximab(CET)combined with the FOLFOX4 regimen(infusional fluorouracil,folinic acid,and oxaliplatin)as firstline therapy for patients with aGC,who received evidence-based care(EBC).METHODS A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled.Of these,60 in the research group(RG)received CET+FOLFOX4 as first-line therapy,whereas 57 in the control group(CG)received FOLFOX4.The efficacy[clinical response rate(RR)and disease control rate(DCR)],safety(liver and kidney dysfunction,leukopenia,thrombocytopenia,rash,and diarrhea),serum tumor marker expression[STMs;carbohydrate antigen(CA)19-9,CA72-4,and carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin(IL)-2 and IL-10],and quality of life(QOL)of the two groups were compared.RESULTS A markedly higher RR and DCR were observed in the RG compared with the CG,with an equivalent safety profile between the two groups.RG exhibited notably reduced CA19-9,CA72-4,CEA,and IL-2 levels following treatment,which were lower than the pre-treatment levels and those in the CG.Post-treatment IL-10 was statistically increased in RG,higher than the pre-treatment level and the CG.Moreover,a significantly improved QOL was evident in the RG.CONCLUSION The CET+FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC.It facilitates the suppression of STMs,ameliorates the serum inflammatory microenvironment,and enhances QOL,without increased adverse drug effects.

Clinical Practice of Evidence-Based PDCA Cycle Management Model in Accelerated Recovery of Lung Cancer Patients

Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent thoracoscopic lung cancer radical surgery in our hospital from June 2022 to February 2023 were randomly divided into control group and intervention group, with 52 cases in each group. The control group implemented evidence-based ERAS clinical pathway management, while the intervention group implemented evidence-based PDCA cycle quality management. The postoperative recovery of the two groups of patients was compared. Results: The postoperative recovery of the intervention group was significantly better than that of the control group. The first time to get out of bed, the first time to eat, the duration of chest drainage tube placement, and the length of hospital stay were significantly shorter than those of the control group. The incidence of postoperative chest complications and hospitalization costs were significantly lower than those of the control group, and patient satisfaction was significantly higher than that of the control group (P Conclusion: Evidence-based PDCA cycle quality management mode can effectively improve the implementation quality of accelerated rehabilitation nursing for patients undergoing thoracoscopic lung cancer radical surgery, and it is worthy of clinical promotion.

A Study on the Application of Evidence-Based Nursing in The Care of Patients with Severe Acute Pancreatitis

Objective: To explore the application research of evidence-based nursing in the care of patients with severe acute pancreatitis. Methods: This study focuses on evidence-based nursing care of severe acute pancreatitis. Patients with severe acute pancreatitis who received treatment in our hospital were selected, from which 80 cases were chosen for detailed analysis. The patients were randomly grouped into a control group (conventional nursing care) and a study group (evidence-based nursing care), with 40 patients each. Relevant research data were recorded during the nursing process, analyzed, and used as research indicators. Results: The hospitalization time and morbidity and mortality rate of the research group were shorter than those of the control group, and the recovery rate was higher than that of the control group (P < 0.05). Patient satisfaction with nursing care in the observation group was higher than in the control group (P < 0.05). Conclusion: For patients with severe acute pancreatitis, the use of evidence-based nursing methods effectively reduced the patient’s mortality rate, improved its curative effect, and also shortened the patient’s hospitalization time.

Evidence-Based Nursing Practice of Reducing Immune-Related Skin Toxicity of Tumor Patients Guided by Sensitive Indicators

Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.

Nurses’ and midwives’ participation and utilization of health-related research in Kenya: Implications for evidence-based practice

Objective To assess the level of participation of nurses and midwives in health-related research,determine the status of utilization of research to inform nursing and midwifery practice in Kenya,and explore perspectives of nurses and midwives about strategies to empower nurses/midwives to engage in health research in Kenya.Methods Data were extracted from online survey responses of 156 nurse and midwife educators,practitioners,and managers/administrators.SPSS version 26 was used to analyze quantitative data;qualitative data were analyzed using Excel to organize data into categories.Results Over one-third of participants reported ever publishing research(37.2%,58/156).Participants reported using knowledge gained in nursing school to guide practice most frequently(n=148).Utilization of research findings to guide practice was reported by 80.3%(110/137)of participants.Strategies to enhance participation in the research included research training,research forums,policy reforms,and emphasis on research in curricula.Conclusions There is need to intensify and prioritize proposed strategies to empower nurses/midwives to engage in health research.

Evidence-Based Design Application of Water Landscaping for Rehabilitation Gardens for Patients with Mental Disorders

The aim of the article is to explore the influence of the water landscape design of a rehabilitation garden for patients with mental disorders on the recovery effect of patients,intending to provide a better rehabilitation environment for patients with mental disorders.Based on literature research,this article reviews three aspects of evidence-based design theory,the concept of water landscape in rehabilitation gardens,and the types of water features in rehabilitation gardens.The results show that well-designed water features can significantly improve patients’psychological state and reduce anxiety and stress,and that water landscape design in rehabilitation gardens is an effective rehabilitation tool that can facilitate the recovery process of patients with mental disorders.Future designs should take into full consideration patients’needs and preferences,as well as best practices in waterscape design,to maximize its positive impact on patients’recovery.

Improving the Selection Model of Essential Medicines in China by Evidence-based Thinking

Objective To sort out the problems in the selection model of essential medicines in China,and to put forward some suggestions to optimize the selection model to ensure the rationality of the medicines in the essential medicines list.Methods The domestic and foreign literature on the selection of essential medicines was reviewed.Then,the opinions on the selection methods and results of essential medicines from foreign literature were investigated to make a comparison with the selection of essential medicines in China.Finally,the general and special laws of the selection process of the essential medicines were explored.Results and Conclusion It is recommended that the selection model of essential medicines in China should be further optimized,and the evidence-based thinking and methods should be utilized to enhance the scientific nature of the selection process.

Application of evidence-based medicine methods in integrative oncology research

To present the advances of evidence-based medicine and clinical research methodology in integrative oncology,we conducted a literature review of real-world studies of traditional Chinese medicine(TCM)in cancer care and summarized the available evidence.Pragmatic randomized controlled trials(pRCTs)and clinical registry studies are becoming more popular as they could compensate for the limitations of RCTs.Many RCTs of TCM for cancer treatment as well as systematic reviews have been published.The most investigated therapies are based on acupuncture,Chinese herbal compounds,and Chinese patent medicines.Acupuncture has a significant advantage in relieving cancer-related symptoms.Published studies focus more on improving clinical symptoms and laboratory indicators.However,the patient's quality of life deserves more attention.

Improving Statistical Literacy through Evidence-Based Strategies Among First-Year Education Students in a State University

Statistical literacy is crucial for cultivating well-rounded thinkers.The integration of evidence-based strategies in teaching and learning is pivotal for enhancing students’statistical literacy.This research specifically focuses on the utilization of Share and Model Concepts and Nurturing Metacognition as evidence-based strategies aimed at improving the statistical literacy of learners.The study employed a quasi-experimental design,specifically the nonequivalent control group,wherein students answered pre-test and post-test instruments and researcher-made questionnaires.The study included 50 first-year Bachelor in Secondary Education majors in Mathematics and Science for the academic year 2023-2024.The results of the study revealed a significant difference in the scores of student respondents,indicating that the use of evidence-based strategies helped students enhance their statistical literacy.This signifies a noteworthy increase in their performance,ranging from very low to very high proficiency in understanding statistical concepts,insights into the application of statistical concepts,numeracy,graph skills,interpretation capabilities,and visualization and communication skills.Furthermore,the study showed a significant difference in the post-test scores’performance of the two groups in understanding statistical concepts and visualization and communication skills.However,no significant difference was found in the post-test scores of the two groups concerning insights into the application of statistical concepts,numeracy and graph skills,and interpretation capabilities.Additionally,students acknowledged that the implementation of evidence-based strategies significantly contributed to the improvement of their statistical literacy.

Necessary prerequisites for evidence-based practice:results of investigating nurses'informatics competency and information literacy skills

This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

Clinical application of multidisciplinary team-and evidence-based practice project in gynecological patients with perioperative hypothermia

BACKGROUND Perioperative hypothermia(PH)negatively affects the physical and mental health of patients to varying degrees.Currently,there is no effective multidisciplinary team(MDT)intervention for gynecological patients with PH.AIM To apply the best evidence on the prevention and management of PH in gynecological patients,improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT-and evidence-based practice(EBP)projects on the psychological status and cognitive function of gynecological patients with PH.METHODS Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts,the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice setting.Based on the evidence,the practice plan was developed,and the MDT intervention was carried out in the preoperative ward,the preoperative preparation room,the intraoperative operating room,the postanesthesia care unit,and the 24-hour postoperative gynecological ward through the EBP program.The incidence of hypothermia,the nurses’awareness,the implementation rate of examination indicators,and the thermal comfort level,psychological status and cognitive function of patients were compared before and after the implementation of the program.RESULTS The incidence of PH in gynecological patients decreased from 43.33%to 13.33%after the implementation of the scheme.The implementation rate of examination indicators 6-10,12,14,16-18,21,and 22 reached 100%,and that of other indicators was above 90%,except for examination indicators 5 and 13,which was 66.67%;the indices were significantly improved compared with the baseline(before evidence application)(P<0.05).The score of nurses'awareness of PH prevention and management in gynecological patients increased from 60.96±9.70 to 88.08±8.96,and the difference was statistically significant(P<0.001).The total score of the perioperative thermal comfort level of patients undergoing gynecological surgery was 27.97±2.04,which was significantly increased compared with the score of 21.27±1.57 observed by researchers at baseline(P<0.001).The perioperative Hamilton Depression Scale and Hamilton Anxiety Scale scores of patients undergoing gynecological surgery decreased from 15.03±3.16 and 13.93±2.64 to 4.30±1.15 and 3.53±0.78,respectively,with statistically significant differences(P<0.001).The perioperative Montreal Cognitive Assessment Scale score of the gynecological surgery patients increased from 23.17±1.68 to 26.93±1.11,also with statistical significance(P<0.001).CONCLUSION MDT-based EBP for PH prevention and management in gynecological patients during the perioperative period can standardize nursing operations,improve nurses'awareness and behavioral compliance with gynecological hypothermia management,and reduce the occurrence of PH in gynecological patients while playing a positive role in reducing patients’negative emotions and enhancing their cognitive function.

The artificial intelligence evidence-based medicine pyramid

Several studies exist in the literature regarding the exploitation of artificial intelligence in intensive care.However,an important gap between clinical research and daily clinical practice still exists that can only be bridged by robust validation studies carried out by multidisciplinary teams.

Validation of short version of evidence-based practice instruments among nurses in clinical practice:Evidence-based practice beliefs,implementation,and organizational culture

Objective:The objective of the study is to validate the short version of evidence-based practice(EBP)instruments among nurses in clinical practice.Methods:An institutional-based cross-sectional research design was used and a stratified sampling technique to select 285 nurse clinicians.The study utilized a structured questionnaire comprising of demographic data from the participants and three validated scales:the shortened versions of the EBP Beliefs Scale,the EBP Implementation Scale,and the Organizational Culture and Readiness for System-Wide Integration of Evidence-Based Practice(OCRSIEP)survey.With the use of descriptive statistics,the data were analyzed and presented in frequencies and percentages,while inter-item correlation coefficient(ICC)and the Kaiser-Meyer-Olkin measure of sampling adequacy were used to confirm the validity of using factor analysis.Results:Findings revealed the mean scores of the EBP Beliefs Scale ranged from 1.50 to 1.61,EBP Implementation Scale ranged from 1.84 to 1.94,and the OCRSIEP Scale ranged from 1.93 to 2.19.All the three shortened scales accordingly had good internal reliability,29.30±9.93 out of 80 for the EBP Beliefs Scale,19.56±7.37 out of 72 for the EBP Implementation Scale,and 66.32±20.35 out of 125 for the OCRSIEP Scale.Conclusion:This study has generated a valid Short Version of EBP reliable instrument that is psychometrically robust that can be used by nurses and clinicians to evaluate EBP in clinical settings since the results presented as a whole confirmed the high reliability and factorial validity.

New evidence-based practice:Artificial intelligence as a barrier breaker

The concept of evidence-based practice has persisted over several years and remains a cornerstone in clinical practice,representing the gold standard for optimal patient care.However,despite widespread recognition of its significance,practical application faces various challenges and barriers,including a lack of skills in interpreting studies,limited resources,time constraints,linguistic competencies,and more.Recently,we have witnessed the emergence of a groundbreaking technological revolution known as artificial intelligence.Although artificial intelligence has become increasingly integrated into our daily lives,some reluctance persists among certain segments of the public.This article explores the potential of artificial intelligence as a solution to some of the main barriers encountered in the application of evidence-based practice.It highlights how artificial intelligence can assist in staying updated with the latest evidence,enhancing clinical decision-making,addressing patient misinformation,and mitigating time constraints in clinical practice.The integration of artificial intelligence into evidence-based practice has the potential to revolutionize healthcare,leading to more precise diagnoses,personalized treatment plans,and improved doctor-patient interactions.This proposed synergy between evidencebased practice and artificial intelligence may necessitate adjustments to its core concept,heralding a new era in healthcare.

Evidence-Based Medicine Research on Prescriptions in Synopsis of the Golden Chamber in the Treatment of Pelvic Inflammatory Disease

Purpose: Based on the National Natural Science Foundation of China, we collect and sort out the literature published in approximately the last 30 years, which use prescriptions in Synopsis of the Golden Chamber to treat pelvic inflammatory disease (PID). This study provides theoretical basis for the treatment of PID;we recommend this achievement to colleagues. Method: Firstly, we searched and collected the literatures from last three decades in CNKI, Wanfang and VIP databases, which are about classical prescriptions treating endometriosis. Then, by screening all the literatures, we obtained the clinical research literatures and individual case reports. Finally, we went through the internal quality of the two categories of literatures to get the dominant prescriptions. Using a retrospective study of evidence-based medicine research, we comprehensively collect literature, standardize the disease spectrum, classify the evidence, and then evaluate the internal quality. Results: We refine 4 prescriptions which commonly are used in the treatment of PID;in other words, they are also the clinical symptoms of PID: Gui Zhi Fu Ling Wan symptom, which manifests blood stasis and cold-damp stagnancy;Dang Gui Shao Yao San symptom, which manifests disharmony of liver and spleen, qi-blood stasis and damp obstruction;Da Huang Mu Dan Tang symptom, which manifests the gathering toxic heat and qi-blood stasis;Yi Yi Fu Zi Bai Jiang San symptom, which manifests the internal toxic heat and qi-blood injury. Conclusion: This study is gospel for the patients with recurrent episodes of PID who can’t often use antibiotics. At the same time, it is also a green therapeutics which Chinese ancients dedicated to human medicine.

Evidence-based Nomenclature and Taxonomy of Research Impact Indicators

Purpose: This study aims to classify research impact indicators based on their characteristics and scope. A concept of evidence-based nomenclature of research impact(RI) indicator has been introduced for generalization and transformation of scope. Design/methodology/approch: Literature was collected related to the research impact assessment. It was categorized in conceptual and applied case studies. One hundred and nineteen indicators were selected to prepare classification and nomenclature. The nomenclature was developed based on the principle—"every indicator is a contextual-function to explain the impact". Every indicator was disintegrated into three parts, i.e. Function, Domain, and Target Areas.Findings: The main functions of research impact indicators express improvement(63%), recognition(23%), and creation/development(14%). The focus of research impact indicators in literature is more towards the academic domain(59%) whereas the environment/sustainability domain is least considered(4%). As a result, research impact related to the research aspects is felt the most(29%). Other target areas include system and services, methods and procedures, networking, planning, policy development, economic aspects and commercialisation, etc. Research limitations: This research applied to 119 research impact indicators. However, the inclusion of additional indicators may change the result. Practical implications: The plausible effect of nomenclature is a better organization of indicators with appropriate tags of functions, domains, and target areas. This approach also provides a framework of indicator generalization and transformation. Therefore, similar indicators can be applied in other fields and target areas with modifications. Originality/value: The development of nomenclature for research impact indicators is a novel approach in scientometrics. It is developed on the same line as presented in other scientific disciplines, where fundamental objects need to classify on common standards such as biology and chemistry.

Can ChatGPT evaluate research quality?

Purpose:Assess whether ChatGPT 4.0 is accurate enough to perform research evaluations on journal articles to automate this time-consuming task.Design/methodology/approach:Test the extent to which ChatGPT-4 can assess the quality of journal articles using a case study of the published scoring guidelines of the UK Research Excellence Framework(REF)2021 to create a research evaluation ChatGPT.This was applied to 51 of my own articles and compared against my own quality judgements.Findings:ChatGPT-4 can produce plausible document summaries and quality evaluation rationales that match the REF criteria.Its overall scores have weak correlations with my self-evaluation scores of the same documents(averaging r=0.281 over 15 iterations,with 8 being statistically significantly different from 0).In contrast,the average scores from the 15 iterations produced a statistically significant positive correlation of 0.509.Thus,averaging scores from multiple ChatGPT-4 rounds seems more effective than individual scores.The positive correlation may be due to ChatGPT being able to extract the author’s significance,rigour,and originality claims from inside each paper.If my weakest articles are removed,then the correlation with average scores(r=0.200)falls below statistical significance,suggesting that ChatGPT struggles to make fine-grained evaluations.Research limitations:The data is self-evaluations of a convenience sample of articles from one academic in one field.Practical implications:Overall,ChatGPT does not yet seem to be accurate enough to be trusted for any formal or informal research quality evaluation tasks.Research evaluators,including journal editors,should therefore take steps to control its use.Originality/value:This is the first published attempt at post-publication expert review accuracy testing for ChatGPT.