Patient-centric periodontal research:A pioneering application of patient-reported outcome measures

Conventional dentistry or periodontal research often ignores the human component in favor of clinical outcomes and biological causes.Clinical research is driven by the statistical significance of outcome parameters rather than the satisfaction level of the patient.In this context,patient-centric periodontal research(PCPR)is an approach that considers the patient´s feedback concerning their functional status,experience,clinical outcomes,and accessibility to their treatments.It is argued that data self-reported by the patient might have low reliability owing to the confounding effect of their personal belief,cultural background,and social and economic factors.However,literature has shown that the incorporation of“patient-centric outcome”components considerably enhances the validity and applicability of research findings.Variations in the results of different studies might be due to the use of different and non-standardized assessment tools.To overcome this problem,this editorial enlists various reliable tools available in the literature.In conclusion,we advocate that the focus of researchers should shift from mere periodontal research to PCPR so that the results can be effectively applied in clinical settings and the therapeutic strategy can also change from mere periodontal therapy to patient-centric periodontal therapy.

Exploring the Implications of Patient Advocacy Outcomes among Practicing Nurses within the Hospital Context: A Qualitative Research

Background: Nurses are expected by their international code of ethics to advocate for patients to enhance safety and quality care. However, there is a limited understanding regarding the implications of specific patient advocacy outcomes experienced by nurses who advocate for patients in the hospital context. Purpose: This study explored the implications of patient advocacy outcomes experienced among practicing nurses in the hospital context. Methods: A qualitative, descriptive study design was utilized. Data was collected through purposive sampling and an in-depth semi-structured interview of 25 Registered Nurses in an acute care hospital. An inductive qualitative content analysis method was used, and the SRQR guidelines for reporting qualitative studies were followed. Results: This study revealed that nurses who succeeded in advocating for patients experienced feelings of happiness, increased confidence levels, increased work output, and job satisfaction. However, nurses who failed to succeed in advocating for patients experienced physical, emotional, and psychological consequences, which contributed negatively to the quality of patient care. Therapeutic communication and nurses’ commitment to intervene for patients emerged as vital qualities and skills required to succeed in the patient advocacy process. Conclusions: This study showed that patient advocacy has advantages. However, when nurses fail to succeed in their attempt to advocate for patients in clinical practice, the outcomes can negatively affect their own well-being and the quality of patient care delivery. These study results could promote awareness and help nurses to develop strategies for improving patient advocacy activities based on their experiences. Additionally, nurses can seek help, including psychological counseling, when necessary to enhance their optimal well-being as they care for their patients. Nursing educational institutions and hospital managers can support, train, and equip nurses with the required skills for enhancing positive advocacy outcomes. .

Outcomes research in gastroenterology and endoscopy

Although the field of outcomes research has received increased attention in recent years,there is still considerable uncertainty and confusion about what is 'outcomes research'.The following editorial is designed to provide an overview on this topic,illustrate specific examples of outcomes research in clinical gastroenterology and endoscopy,and discuss its importance as a whole.In this article,we review the definition and specific goals of outcomes research.We outline the difference between traditional clinical research and outcomes research and discuss the benefits and limitations of outcomes research.We summarize the types of outcomes studies and methods utilized for outcomes assessment,and give specific examples of the impact of outcomes studies in the field of gastroenterology and endoscopy.

Understanding celiac disease monitoring patterns and outcomes after diagnosis:A multinational,retrospective chart review study

BACKGROUND Long-term outcomes and monitoring patterns in real-world practice are largely unknown among patients with celiac disease.AIM To understand patterns of follow-up and management of patients with celiac disease,and to characterize symptoms and villous atrophy after diagnosis.METHODS A retrospective chart review study was performed using medical chart data of patients diagnosed with celiac disease.Three gastroenterology referral centers,with substantial expertise in celiac disease,participated in the United Kingdom,United States,and Norway.Demographic and clinical data were collected from medical charts.Descriptive analyses were conducted on patients with biopsyconfirmed celiac disease,diagnosed between 2008 and 2012,with at least one follow-up visit before December 31,2017.Patient demographic and clinical characteristics,biopsy/serology tests and results,symptoms,and comorbidities were captured at diagnosis and for each clinic visit occurring within the study period(i.e.,before the study end date of December 31,2017).RESULTS A total of 300 patients were included in this study[72%female;mean age at diagnosis:38.9 years,standard deviation(SD)17.2].Patients were followed-up for a mean of 29.9 mo(SD 22.1)and there were,on average,three follow-up visits per patient during the study period.Over two-thirds(68.4%)of patients were recorded as having ongoing gastrointestinal symptoms and 11.0%had ongoing symptoms and enteropathy during follow-up.Approximately 80%of patients were referred to a dietician at least once during the follow-up period.Half(50.0%)of the patients underwent at least one follow-up duodenal biopsy and 36.6%had continued villous atrophy.Patterns of monitoring varied between sites.Biopsies were conducted more frequently in Norway and patients in the United States had a longer follow-up duration.CONCLUSION This real-world study demonstrates variable follow-up of patients with celiac disease despite most patients continuing to have abnormal histology and symptoms after diagnosis.

Interim Outcomes and Adverse Events among Drug-Resistant Tuberculosis Patients Treated with Bedaquiline in the Philippines

Objectives: This study aimed to assess the interim outcomes for drug-resistant tuberculosis (DR-TB) patients treated with bedaquiline regimen under the operational research conditions compared to DR-TB patients treated without bedaquiline in their regimen, and to describe the adverse events that occurred among patients treated with bedaquiline in the Philippines. Design: Patients who were treated with a bedaquiline-containing regimen from June 2016 to May 2017 were included in this study as the intervention group, while patients who were treated without bedaquiline regimen from January 2013 to May 2016 were included as the comparison group. The interim treatment outcomes were compared using Chi-square test. The analysis of time to culture conversion within 6 months of treatment was conducted. A Cox proportional hazard model was constructed to identify the variables associated with a favorable interim treatment outcome. The R program was used for statistical analysis. Results: On the 6th month of treatment, the culture conversion for patients treated with a bedaquiline-containing regimen was significantly higher than with the comparison group [63/75 (84.0%) vs 84/117 (71.8%), p = 0.012)]. Nearly 15% of the patients treated with bedaquiline were lost to follow-up. Frequent adverse events included vomiting, dizziness, nausea, joint pain, and abdominal pain. Conclusion: The patients who were treated with bedaquiline-containing regimen have better interim treatment outcomes than those treated without bedaquiline, but the proportion of patients who were lost to follow-up remains substantial.

External validation of the Moroccan Arabic version of the European Organization for Research and Treatment of Cancer colorectal(CR29)module:Monocentric study

BACKGROUND Quality of life(QoL)outcomes are a focal endpoint of cancer treatment strategies.AIM To externally validate the Moroccan Arabic version of the European Organization for Research and Treatment of Cancer(EORTC)QoL Questionnaire(QLQ)for colorectal cancer(CRC)patients(CR29).METHODS Both Moroccan Arabic modules of QLQ-CR29 and QLQ-C30 were administered to Moroccan CRC.Psychometric properties were retested by measuring Cronbach’s alpha coefficient for reliability and Intraclass correlation coefficient(ICC)to examine test-retest reproducibility.The multitrait-scaling analysis was performed to demonstrate the validity of the instrument and known-groups comparison was used to test the score’s ability to discriminate between different groups of patients.RESULTS In total,221 patients were included in our study and 34 patients completed the questionnaire twice.The Urinary Frequency scale and Stool Frequency scale had good internal consistency with alpha Cronbach coefficients of 0.79 and 0.83 respectively,while the same coefficients were moderately lower for the Blood and Mucus in Stool scale(0.61)and the Body Image scale(0.67).The ICCs ranged from 0.88 to 1 indicating good to excellent reproducibility.In multitrait scaling analyses,the criterion for item convergent and divergent validity was satisfactory.The known-group comparison showed statistically significant differences between patients according to age,gender,stoma status,tumor location,and radiotherapy.CONCLUSION The Moroccan Arabic version of the EORTC QLQ-CR29 is a valid and reliable tool that can be used safely for research and clinical purposes in Moroccan CRC patients.

OBE理念联合PBL教学法在肿瘤学研究生培养中的效果分析

目的:比较OBE理念联合PBL教学法与传统教学法在肿瘤学研究生培养中的效果。方法:随机选取昆明医科大学在读肿瘤学专业研究生60人,将其分两组,每组30人,分别是OBE理念联合PBL教学法的联合组和传统组。比较两组在考试成绩、自主学习能力、自我效能感方面的差异。结果:传统组的理论考试平均成绩(80.63±6.44)分低于联合组(86.87±5.78)分,差异有统计学意义(P<0.05);联合组自主学习能力、自我效能感明显优于传统组(P<0.05)。结论:与传统教学法相比,OBE理念联合PBL教学法模式能够提高肿瘤学研究生的学习成绩,提高学习的主动性。

葛斛调脂方干预代谢综合征患者的随机对照研究

背景 全球约有1/4的人患有代谢综合征(Met S)。近年来我国Met S患病率也呈逐年上升趋势,对生命健康造成严重威胁。中医药治疗Met S有着多靶点、多环节的优势,但目前临床上缺乏高质量的随机对照研究和真实世界研究。目的 观察葛斛调脂方对Met S患者腰围(WC)、体质量、体脂率(BFP)及糖脂代谢的影响。方法2021年6月—2022年11月前瞻性选取上海中医药大学附属龙华医院门诊就诊及住院的84例Met S患者为研究对象。应用SPSS 25.0统计软件给定随机种子数,将受试者随机分为葛斛组(42例)和对照组(42例)。葛斛组应用葛斛调脂方颗粒治疗(葛根6 g,铁皮石斛6 g),患者空腹早晚各1次,1包/次,冲服,连续服用8周。对照组应用安慰剂颗粒干预,患者空腹早晚各1次,1包/次,冲服,连续服用8周。干预期间对两组患者进行相同的健康宣教(包括膳食方案和运动处方的指导)。干预8周后对比分析两组患者的WC、体质量、BMI、BFP、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)。结果 最终葛斛组41例、对照组41例完成8周的干预研究。治疗前两组患者WC、体质量、BMI、BFP比较,差异均无统计学意义(P>0.05)。两组治疗前后WC、体质量、BMI、BFP差值比较,差异均有统计学意义(P<0.05)。治疗前两组患者的TG、TC、HDL-C、LDL-C、FBG比较,差异均无统计学意义(P>0.05)。两组治疗前后TG、TC、FBG差值比较,差异均有统计学意义(P<0.05)。在治疗期间和随访结束后两组均未发生严重不良反应事件。结论 葛斛调脂方能较好地改善MetS患者的WC、体质量、BMI、BFP、TG、TC及FBG,且安全性较好。

远程采集数字健康技术赋能临床研究的伦理探讨

近年来,随着可实现远程采集的数字健康技术逐步成熟,越来越多的临床研究应用这一技术提高了数据收集的质量并减轻研究参与者负担。但是,其脱离诊疗环境以及实时传输敏感信息的技术特点,也对受试者权益保障以及数据规范管理造成相应的风险,其中个人信息保护和数据控制权限是较为突出的问题。在风险分析和法规梳理的基础上,探讨申办方、研究者、临床试验机构及伦理委员会多方职责,并提出五项伦理审查特殊关注要素,以期为推动临床研究中数字健康技术部分的规范开展提供参考。

基于OBE的混合式教学在麻醉科住院医师规范化培训中的应用

目的探讨基于成果导向教育(outcome-based education,OBE)理念的混合式教学在麻醉科住院医师规范化培训教学中的应用效果。方法选取2022年6月—2023年6月在武汉大学人民医院麻醉科进行住院医师规范化培训的50名住院医师,采用随机数字表法分为对照组和研究组,每组25名。对照组开展传统的教学方法,研究组开展以OBE理念为基础,运用微课、腾讯视频会议、钉钉、微信平台等“互联网+”进行混合式教学。经过分组培训后,比较2组学员的麻醉理论知识考核成绩、实践技能成绩和教学质量理想率;评估2组学员对麻醉学的学习兴趣、学习积极性、临床思维以及教学满意度。结果研究组学员的理论考核成绩[(91.67±5.74)分]和实践操作成绩[(90.86±5.12)分]均高于对照组的成绩[(73.56±3.81)分,(75.23±4.50)分],差异有统计学意义(P<0.05)。研究组学员对麻醉学的学习兴趣[(90.59±5.27)分]、学习积极性[(91.50±4.86)分],和临床思维评分[(92.15±5.45)分],均高于对照组[(74.23±4.56)分,(72.78±3.98)分,(76.25±5.10)分],差异有统计学意义(P<0.05)。此外,研究组的教学质量理想率(96.00%)和满意度(92.00%)均高于对照组(60.00%,52.00%),差异有统计学意义(P<0.05)。结论基于OBE理念的混合式教学,可有效提高麻醉科住院医师的临床理论知识和技能操作水平,有利于提升学员的综合能力、增强其对麻醉学的兴趣、学习积极性和临床麻醉思维,进一步提高了麻醉科住院医师规范化培训的教学质量和满意度。

艺术与科技融合背景下艺术类高校科研成果管理挑战与应对策略研究

科技的飞速进步使得艺术与科技的交融成为当下艺术领域的一大风潮。在新技术浪潮的助推下,艺术创作与科学探索逐渐交融,呈现出前所未有的风貌与形态。这种跨学科领域的科研成果管理,仍面临评价标准难以统一、知识产权保障乏力、成果转化机制不畅等诸多难题。通过探讨这些问题,深入剖析艺术与科技融合的现状,针对艺术类高校在科研成果管理中所遇到的种种挑战,提出切实可行的应对方案,为艺术类高校优化科研管理流程、促进艺术创新与技术革新提供有益的参考。

新疆维吾尔自治区南疆地区结核病防治工作实施现状的定性评价——基于扎根理论的质性访谈

目的:通过深度访谈,调查和分析新疆维吾尔自治区(简称“新疆”)南疆地区结核病防治工作的实施现状、存在的问题及合理化建议,为促进新疆结核病防治工作的完善和可持续发展提供决策依据。方法:采用系统随机抽样的方式,在南疆四地州(阿克苏地区、和田地区、喀什地区、克孜勒苏柯尔克孜自治州)对从事结核病防治工作的相关工作人员27名进行半结构式访谈,基于扎根理论框架凝练资料信息,对访谈文本进行梳理、编码与提炼。结果:对访谈文本提取南疆地区结核病防治工作的成效、问题及建议三个主题,深度了解与定性分析南疆地区结核病防控工作的实施的成效、不足与问题,以及提出的合理性建议。结论:南疆地区实施新型肺结核防治工作后,患者发现的方式、数量和患者治疗管理情况均有大幅改观,目前仍存在一些不足,还需不断完善和充实南疆地区结核病防治工作,为新疆结核病防治提出科学有效的策略和路径,切实控制结核病的发生与传播,在新疆早日实现“终止结核病流行策略”的目标。

中医患者报告结局量表研究现状文献计量学分析

目的分析目前中医患者报告结局(PRO)量表的研究现状及存在的问题,为中医PRO量表研制提供参考。方法在中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中国生物医学文献数据库(CBM)、PubMed、Embase及Web of Science中检索中医PRO量表研究文献,收集量表相关信息,抽取量表相关的12个数据元素进行统计,分析中医PRO量表的开发情况及测评情况等。结果共纳入88篇文献,涉及50个量表。研究集中在2008-2022年,涉及疾病种类以消化系统最多;中医PRO量表设置以3~4个维度最多,其中有9个量表设置了中医特色维度;条目池的构建多采用专家咨询法、文献研究法及访谈法相结合;条目筛选方面,运用客观方法的较多,其次为主观德尔菲法及主客观方法结合;量表测评方面,27个量表进行了信度测评,24个量表进行了效度测评,9个量表进行了反应度测评,16个量表进行了可行性测评。结论中医PRO量表的研究整体处于起步阶段,其研制的规范度及完整度仍存在不足,信效度等指标测评需引起重视,维度和条目设置方面需注重结合中医自身治疗特色,后续学者需更加完善中医PRO量表研制过程,丰富中医临床诊疗评价体系。

基于ILOs的“电气传动课程设计”建设与实践

双一流建设背景下,课程是人才培养的核心要素。该文以“两性一度”为标准,对标《北京理工大学研究型课程认证标准》,对综合性实验课程“电气传动课程设计”进行研究型课程建设,构建了具有高阶性的知识、能力、素质相融合的预期学习成果(ILOs),并针对每条ILOs设计了具有创新性、挑战度的教学内容,明确了相应的教学策略,制定了评价标准及评价反馈机制,持续改进,不断提高教学质量及课程水平。实践证明,基于ILOs的研究型课程的实施,培养了学生解决复杂工程问题的能力及创新实践能力,实现了“价值塑造、知识养成、实践能力”三位一体的培养目标。

基于OBE理念的中医康复学多种教学法融合应用探讨

文章阐述了成果导向型教育(OBE)理念的基本概念及主要特点,以及当下中医康复学已实施多种有效教学法并引入OBE理念,传递以学生为中心、以成果为导向的理念;并设计了实施框架与方案,以期作为导向性课程设计的选择之一,旨在提升教学质量和效率,培养实践型、应用型中医康复学人才,更好地满足社会需求,促使行业进步。

中医药临床疗效评价的研究进展与思考

中医药临床疗效评价创新方法与技术在中医药发展中具有至关重要的作用。然而,当前中医药临床疗效评价难以体现中医特色和优势,在一定程度上阻碍了中医药高质量发展。通过梳理中医药常用临床疗效评价指标的相关分类,总结中医临床疗效评价方面相关的新理念,提出构建中医临床评价体系时,应关注证的动态变化、个体化差异、临床疾病与干预机制的复杂性、指标选择的合理性,以期为中医药临床评价研究者提供参考。

中医药治疗多囊卵巢综合征临床研究结局指标与测量工具现状分析

目的 评估中医药治疗多囊卵巢综合征(PCOS)临床研究报告的结局指标,为建立PCOS的临床核心指标集提供理论基础。方法 检索中国知识资源总库(CNKI)、万方数据知识服务平台(万方数据)、维普资讯中文期刊服务平台(维普网)、中国生物医学文献数据库(CBM)、Embase、PubMed、Web of Science、Cochrane Library 2019年1月1日-2023年11月15日收录的中医药治疗PCOS相关临床研究。根据纳入和排除标准,筛选出符合条件的研究文献,并对提取的资料进行综合分析。结果 共纳入临床研究951篇(包括中文文献915篇、英文文献36篇),涉及患者86 369例,确定结局指标221个,总频次为8 991。分析显示,常用结局指标包括激素水平(如促黄体生成素、卵泡刺激素、睾酮)、临床总有效率、排卵率、妊娠率、中医证候积分、卵巢体积、胰岛素抵抗指数等,但指标选择在不同研究中差异较大,部分指标与临床需求脱节,缺乏对远期预后和安全性的关注。结论 中医药治疗PCOS临床研究报告的结局指标存在指标差异大、主次指标不明确、指标描述混乱、测量工具选择多样、缺少针对特定人群的指标等问题,导致同类研究组合困难、无法合并分析,不能为临床提供高级别的循证证据,亟需构建中医药治疗PCOS临床研究核心指标集。

药物治疗相关的患者报告结局量表研究进展

药物治疗是治愈疾病和缓解症状的常用方法,患者报告结局在评价药物治疗效果中的价值逐渐得到重视。患者报告结局量表是一种标准化的问卷,能从患者的角度出发科学评估药物治疗的体验及其主观效果,有助于患者和临床医师做出更合理的用药决策。通过查阅并整理国内外相关文献,发现药物治疗相关的患者报告结局量表在内容上集中于“用药满意度”“用药依从性”“药物治疗负担”“用药相关生活质量”以及“药品不良反应”5个领域。本研究从上述内容中分别阐述近年来常用量表的基本信息、测量学特性和应用情况,总结该领域量表研制存在的问题与启示,旨在为量表的选择、应用与开发提供参考。

补肾助孕方对复发性流产患者子宫内膜容受性及妊娠结局影响的临床研究

目的观察补肾助孕方对复发性流产(recurrent spontaneous abortion,RSA)患者子宫内膜容受性及妊娠结局的影响。方法纳入2019年10月—2021年3月就诊于广安门医院妇科的符合复发性流产诊断的患者共100例,按照随机数字表法分成对照组50例和治疗组50例。观测指标包括治疗前后中医证候评分、月经情况评分、子宫内膜容受性相关指标和妊娠结局等。结果对照组有3例患者失访,治疗组有2例患者治疗期间未按规定试验方案服药剔除,最终95例患者完成本次研究,其中对照组47例,治疗组48例。治疗3个月经周期后,治疗组总有效率、月经情况改善、临床妊娠率均优于对照组,中医证候评分降低,差异具有统计学意义(P<0.05)。治疗后治疗组的子宫内膜厚度、血流分布和Salle评分均得到明显优化,血流阻力指数(resistance index,RI)显著降低,差异具有统计学意义(P<0.05),在血流灌注指数(perfusion index,PI)方面差异无统计学意义(P>0.05)。随访后发现治疗组临床妊娠率显著升高,妊娠失败例数低于对照组,具差异有统计学意义(P<0.05)。两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论研究表明补肾助孕方可改善肾虚中医证候,提高RSA患者临床妊娠率。补肾助孕方具有明显促进子宫内膜生长、增加子宫内膜血流灌注、降低RI和PI的作用,验证了补肾助孕方孕前干预可提高子宫内膜容受性治疗RSA。

Clinical and socioeconomic determinants of survival in biliary tract adenocarcinomas

BACKGROUND Despite advances in detection and treatments,biliary tract cancers continue to have poor survival outcomes.Currently,there is limited data investigating the significance of socioeconomic status,race/ethnicity,and environmental factors in biliary tract cancer survival.Data from the Surveillance,Epidemiology,and End Results database for biliary and gallbladder adenocarcinomas were extracted from 1975 to 2016.Socioe-conomic data included smoking,poverty level,education,adjusted household income,and percentage of foreign-born persons and urban population.Survival was calculated with Cox proportional hazards models for death in the 5-year period following diagnosis.RESULTS Our study included 15883 gallbladder,11466 intrahepatic biliary,12869 extrahepatic biliary and 7268 ampulla of Vater adenocarcinoma cases.When analyzing county-specific demographics,patients from counties with higher incomes were associated with higher survival rates[hazard ratio(HR)=0.97,P<0.05].Similarly,counties with a higher percentage of patients with a college level education and counties with a higher urban population had higher 5-year survival rates(HR=0.96,P=0.002 and HR=0.97,P=0.004,respectively).CONCLUSION Worse survival outcomes were observed in lower income counties while higher income and education level were associated with higher 5-year overall survival among gallbladder and biliary malignancies.