In 2018,the 11^(th) Edition of the International Classification of Diseases(ICD-11)defined a diagnostic code list for standard traditional medicine(TM)conditions.The codes improve patient safety by providing more comp...In 2018,the 11^(th) Edition of the International Classification of Diseases(ICD-11)defined a diagnostic code list for standard traditional medicine(TM)conditions.The codes improve patient safety by providing more comprehensive and accurate medical records for hospitals in the Western Pacific Region.In these facilities,TM is often a standard of care for those populations.In several mainstream media sources,writers are circumventing evidence-based peer-reviewed medical literature by unduly influencing public opinion and,in this case,against the new ICD-11 codes.The dangers imposed by the transgression of popular writing onto the discipline of peer-reviewed works are present since best practices in medical record-keeping will fail without the inclusion of TM in the ICD-11 codes.Such failures directly affect the health of the patients and policymakers in regions where TM and conventional medicine are combined.This article investigates the boundaries between substantial evidence and popular opinion.In this era where media is used to manipulate evidence,the reader’s use of sound judgment and critical thought are thwarted.This article also challenges three controversial themes in pop literature,including the threat to endangered species,increased patient risk,and contaminants in the TM.These themes are made without evidence and are,in fact,of flawed logic.There is no reason to assume that improved medical record-keeping and knowledge of patient cases increase risks.展开更多
Background:The 11th revision of the International Classification of Diseases and Related Health Problems(ICD-11)was released on June 18,2018,by the World Health Organization and will come into effect on January 1,2022...Background:The 11th revision of the International Classification of Diseases and Related Health Problems(ICD-11)was released on June 18,2018,by the World Health Organization and will come into effect on January 1,2022.Apart from the chapters on the classification of diseases in the conventional medicine(CM),a new chapter,traditional medicine(TM)conditions–Module 1,was added.Low back pain(LBP)is one of the common reasons for the physician visits.The classification codes for LBP in the ICD-11 are vital to documenting accurate clinical diagnoses.Methods:The qualitative case study method was adopted.The secondary use data for 100 patients were randomly selected using the ICD-11 online interface to find the classification codes for both the CM section and the TM Conditions–Module 1(TM1)section for LBP diagnosis.Results:Of the 27 codes obtained from the CM section,six codes were not relevant to LBP,whereas the other 21 codes represented diagnoses of LBP and its related diseases or syndromes.In the TM1 section,six codes for different patterns and disorders represented the diagnoses for LBP from the TM perspective.Conclusion:This study indicates that specific diagnoses of LBP can be represented by the combination of CM classification codes and TM1 classification codes in the ICD-11;the CM codes represent specific and accurate clinical diagnoses for LBP,whereas the TM1 codes add more accuracy to the diagnoses of different patterns from the TM perspective.展开更多
Objective： To determine whether patterns of enterovirus 71（EV71）-associated hand, foot, and mouth disease（HFMD） were classified based on symptoms and signs, and explore whether individual characteristics were cor...Objective： To determine whether patterns of enterovirus 71（EV71）-associated hand, foot, and mouth disease（HFMD） were classified based on symptoms and signs, and explore whether individual characteristics were correlated with membership in particular pattern. Methods： Symptom-based latent class analysis（LCA） was used to determine whether patterns of EV71-HFMD existed in a sample of 433 cases from a clinical data warehouse system. Logistic regression was then performed to explore whether demographic, and laboratory data were associated with pattern membership. Results： LCA demonstrated a two-subgroup solution with an optimal fit, deduced according to the Bayesian Information Criterion minima. Hot pattern（59.1% of all patients） was characterized by a very high fever and high endorsement rates for classical HFMD symptoms（i.e., rash on the extremities, blisters, and oral mucosa lesions）. Non-hot pattern（40.9% of all patients） was characterized by classical HFMD symptoms. The multiple logistic regression results suggest that white blood cell counts and aspartate transaminase were positively correlated with the hot pattern（adjust odds ratio=1.07, 95% confidence interval： 1.006–1.115; adjust odds ratio=1.051, 95% confidence interval： 1.019–1.084; respectively）. Conclusions： LCA on reported symptoms and signs in a retrospective study allowed different subgroups with meaningful clinical correlates to be defined. These findings provide evidence for targeted prevention and treatment interventions.展开更多
In the 11th revision of the International Classification of Diseases(ICD),the World Health Organization included traditional medicine disorders and patterns originated from ancient Chinese medicine that are commonly u...In the 11th revision of the International Classification of Diseases(ICD),the World Health Organization included traditional medicine disorders and patterns originated from ancient Chinese medicine that are commonly used in China,Japan,Korea and elsewhere around the world.For the first time,a chapter on traditional medicine was incorporated,which has completely changed the status quo on the lack of information on traditional medicine and health statistics in the ICD.In this study,we systematically analyzed the background,structure,content and characteristics of the Traditional Medicine chapter,with focus on its positive effects on promoting the development and utilization of Traditional Chinese Medicine worldwide.展开更多
Amyotrophic lateral sclerosis is a fatal neurodegenerative disease characterized by progressive muscle wasting,breathing and swallowing difficulties resulting in patient’s death in two to five years after disease ons...Amyotrophic lateral sclerosis is a fatal neurodegenerative disease characterized by progressive muscle wasting,breathing and swallowing difficulties resulting in patient’s death in two to five years after disease onset.In amyotrophic lateral sclerosis,both upper and lower motor neurons of the corticospinal tracts are involved in the process of neurodegeneration,accounting for great clinical heterogeneity of the disease.Clinical phenotype has great impact on the pattern and rate of amyotrophic lateral sclerosis progression and overall survival prognosis.Creating more homogenous patient groups in order to study the effects of drug agents on specific manifestations of the disease is a challenging issue in amyotrophic lateral sclerosis clinical trials.Since amyotrophic lateral sclerosis has low incidence rates,conduction of multicenter trials requires certain standardized approaches to disease diagnosis and staging.This review focuses on the current approaches in amyotrophic lateral sclerosis classification and staging system based on clinical examination and additional instrumental methods,highlighting the role of upper and lower motor neuron involvement in different phenotypes of the disease.We demonstrate that both clinical and instrumental findings can be useful in evaluating severity of upper motor neuron and lower motor neuron involvement and predicting the following course of the disease.Addressing disease heterogeneity in amyotrophic lateral sclerosis clinical trials could lead to study designs that will assess drug efficacy in specific patient groups,based on the disease pathophysiology and spatiotemporal pattern.Although clinical evaluation can be a sufficient screening method for dividing amyotrophic lateral sclerosis patients into clinical subgroups,we provide proof that instrumental studies could provide valuable insights in the disease pathology.展开更多
基金financed by grants from the National Major Science and Technology Projects of China (No. YB2019023)Independent Project of China Academy of Chinese Medical Sciences (No. ZZ12-002)
文摘In 2018,the 11^(th) Edition of the International Classification of Diseases(ICD-11)defined a diagnostic code list for standard traditional medicine(TM)conditions.The codes improve patient safety by providing more comprehensive and accurate medical records for hospitals in the Western Pacific Region.In these facilities,TM is often a standard of care for those populations.In several mainstream media sources,writers are circumventing evidence-based peer-reviewed medical literature by unduly influencing public opinion and,in this case,against the new ICD-11 codes.The dangers imposed by the transgression of popular writing onto the discipline of peer-reviewed works are present since best practices in medical record-keeping will fail without the inclusion of TM in the ICD-11 codes.Such failures directly affect the health of the patients and policymakers in regions where TM and conventional medicine are combined.This article investigates the boundaries between substantial evidence and popular opinion.In this era where media is used to manipulate evidence,the reader’s use of sound judgment and critical thought are thwarted.This article also challenges three controversial themes in pop literature,including the threat to endangered species,increased patient risk,and contaminants in the TM.These themes are made without evidence and are,in fact,of flawed logic.There is no reason to assume that improved medical record-keeping and knowledge of patient cases increase risks.
文摘Background:The 11th revision of the International Classification of Diseases and Related Health Problems(ICD-11)was released on June 18,2018,by the World Health Organization and will come into effect on January 1,2022.Apart from the chapters on the classification of diseases in the conventional medicine(CM),a new chapter,traditional medicine(TM)conditions–Module 1,was added.Low back pain(LBP)is one of the common reasons for the physician visits.The classification codes for LBP in the ICD-11 are vital to documenting accurate clinical diagnoses.Methods:The qualitative case study method was adopted.The secondary use data for 100 patients were randomly selected using the ICD-11 online interface to find the classification codes for both the CM section and the TM Conditions–Module 1(TM1)section for LBP diagnosis.Results:Of the 27 codes obtained from the CM section,six codes were not relevant to LBP,whereas the other 21 codes represented diagnoses of LBP and its related diseases or syndromes.In the TM1 section,six codes for different patterns and disorders represented the diagnoses for LBP from the TM perspective.Conclusion:This study indicates that specific diagnoses of LBP can be represented by the combination of CM classification codes and TM1 classification codes in the ICD-11;the CM codes represent specific and accurate clinical diagnoses for LBP,whereas the TM1 codes add more accuracy to the diagnoses of different patterns from the TM perspective.
基金Supported by the Nation Health and Family Planning Commission of China(No.2012ZX10005009)Fundamental Research Funds for the Central Public Welfare Research Institutes(No.Z0474)National Natural Science Foundation of China(No.81503679)
文摘Objective： To determine whether patterns of enterovirus 71（EV71）-associated hand, foot, and mouth disease（HFMD） were classified based on symptoms and signs, and explore whether individual characteristics were correlated with membership in particular pattern. Methods： Symptom-based latent class analysis（LCA） was used to determine whether patterns of EV71-HFMD existed in a sample of 433 cases from a clinical data warehouse system. Logistic regression was then performed to explore whether demographic, and laboratory data were associated with pattern membership. Results： LCA demonstrated a two-subgroup solution with an optimal fit, deduced according to the Bayesian Information Criterion minima. Hot pattern（59.1% of all patients） was characterized by a very high fever and high endorsement rates for classical HFMD symptoms（i.e., rash on the extremities, blisters, and oral mucosa lesions）. Non-hot pattern（40.9% of all patients） was characterized by classical HFMD symptoms. The multiple logistic regression results suggest that white blood cell counts and aspartate transaminase were positively correlated with the hot pattern（adjust odds ratio=1.07, 95% confidence interval： 1.006–1.115; adjust odds ratio=1.051, 95% confidence interval： 1.019–1.084; respectively）. Conclusions： LCA on reported symptoms and signs in a retrospective study allowed different subgroups with meaningful clinical correlates to be defined. These findings provide evidence for targeted prevention and treatment interventions.
文摘In the 11th revision of the International Classification of Diseases(ICD),the World Health Organization included traditional medicine disorders and patterns originated from ancient Chinese medicine that are commonly used in China,Japan,Korea and elsewhere around the world.For the first time,a chapter on traditional medicine was incorporated,which has completely changed the status quo on the lack of information on traditional medicine and health statistics in the ICD.In this study,we systematically analyzed the background,structure,content and characteristics of the Traditional Medicine chapter,with focus on its positive effects on promoting the development and utilization of Traditional Chinese Medicine worldwide.
文摘Amyotrophic lateral sclerosis is a fatal neurodegenerative disease characterized by progressive muscle wasting,breathing and swallowing difficulties resulting in patient’s death in two to five years after disease onset.In amyotrophic lateral sclerosis,both upper and lower motor neurons of the corticospinal tracts are involved in the process of neurodegeneration,accounting for great clinical heterogeneity of the disease.Clinical phenotype has great impact on the pattern and rate of amyotrophic lateral sclerosis progression and overall survival prognosis.Creating more homogenous patient groups in order to study the effects of drug agents on specific manifestations of the disease is a challenging issue in amyotrophic lateral sclerosis clinical trials.Since amyotrophic lateral sclerosis has low incidence rates,conduction of multicenter trials requires certain standardized approaches to disease diagnosis and staging.This review focuses on the current approaches in amyotrophic lateral sclerosis classification and staging system based on clinical examination and additional instrumental methods,highlighting the role of upper and lower motor neuron involvement in different phenotypes of the disease.We demonstrate that both clinical and instrumental findings can be useful in evaluating severity of upper motor neuron and lower motor neuron involvement and predicting the following course of the disease.Addressing disease heterogeneity in amyotrophic lateral sclerosis clinical trials could lead to study designs that will assess drug efficacy in specific patient groups,based on the disease pathophysiology and spatiotemporal pattern.Although clinical evaluation can be a sufficient screening method for dividing amyotrophic lateral sclerosis patients into clinical subgroups,we provide proof that instrumental studies could provide valuable insights in the disease pathology.
