1.Family physicians'concept of 'neurotic'as a medical terminology.
San Duk YOON ; Byung Chan AHN ; Yoo Seock CHENGE ; Sun Mi YOO ; Eal Whan PARK
Journal of the Korean Academy of Family Medicine 1999;20(10):1232-1238
BACKGROUND: A good doctor-patient relationship should be based on mutual understanding and reliance. Proper conversation and same understanding of the use of this terminology is needed. This study was designed to make a comerstone to establish appropriate medical terminology by means of investigation of the meaning of 'neurotic' among family' physicians. METHOD: A questionnaire was sent to 971 family doctors registered as regular members in the Korean Academy of Family Medicine. We analysed 184 returned questionnaires. We calculated the percent for each item. Chi-square test used to analyse demographic characteristics and compare whether the word 'neurotic' has been used or not, and whether it was a proper medical terminology or not. RESULT: 82.6% of responders(152/184) were used to 'neurotic' as a medical terminology. Doctors in their thirties were the least using group(78.7%) and doctors working in university hospitals rarely used them being statistically significant (p<0.000). 82.5% of the doctors in using 'neurotic' responded it is not an appropriate terminology. The most frequent situation in using it was 'patient appealed organic symptom without abnormal lab result'(51.1%). The target diseases were not organic disorders such as functional dyspepsia(64.1%), tension headache(58.5%), psychosomatic or somatoform disorder(54.9%). 59% of the patients diagnosed as 'neurotic' gave unsatisfying responses. Family doctors recommended substituting to terminology such as 'functional'(33%), 'psychogenic'(31.8%), and 'stress-induced'(25.0%). CONCLUSION: Most family doctors were used to the word 'neurotic' but they did not think it was an appropriate terminology. There fore, other substitute words should be faken into consideration.
Hospitals, University
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Humans
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Surveys and Questionnaires
2.GRADE Clinical Study Evidence Evaluation and Expert Consensus on Antihypertensive Chinese Patent Medicines Combined with Western Medicines for Treatment of Hypertension
Liangyu CUI ; Yukun LI ; Tianyue JING ; Yu WANG ; Cong REN ; Tong YIN ; Zhiwei ZHAO ; Jiaheng WANG ; Chenge SUN ; Dasheng LIU ; Zhizheng XING ; Xuejie HAN ; Liying WANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):106-115
ObjectiveTo evaluate the quality of research and evidence related to antihypertensive Chinese patent medicines combined with western medicines for the treatment of hypertension, synthesize and update the evidence, form expert consensus, and provide evidence for clinical decision-making. MethodThe databases of China National Knowledge Infrastructure (CNKI), WanFang Data Knowledge Service Platform (WanFang), Vip Chinese Science and Technology Journal Database (VIP), Chinese Biomedical Literature Service System (Sinomed), National Library of Medicine (PubMed), Cochrane Library, Web of Science, and US Clinical Trials Registry were searched for randomized controlled trials of antihypertensive Chinese medicine combined with western medicine for the treatment of hypertension from database construction to July 31, 2022. The quality of the literature was evaluated using the bias risk assessment tool in Cochrane Handbook 6.3. Evidence synthesis of main outcome indicators was performed using R software. The Grading of Recommendations Assessment, Development, and Evaluation profiler (GRADEprofiler) 3.6 was employed to evaluate the quality of evidence. Expert consensus was formed based on the Delphi method after two rounds of voting. Result64 pieces of literature were included, and the results of literature quality evaluation and risk of bias showed that 70.31% (45/64) of the studies indicated some risks, and 29.69% (19/64) indicated high risks. Compared with conventional western medicines, the combination of Chinese patent medicines with western medicines can significantly lower systolic pressure (SBP) and diastolic pressure (DBP), increase the effective rate of antihypertensive, reduce the incidence of adverse reactions, endothelin-1, and traditional Chinese medicine syndrome scores. Egger's test showed that Songling Xuemaikang capsules reduced SBP and DBP. Tianma Gouteng granules reduced SBP and DBP and increased the effective rate of antihypertensive, and Xinmaitong capsules reduced SBP and increased the effective rate of antihypertensive, without significant publication bias. Songling Xuemaikang capsules increased the effective rate of antihypertensive, and Xinmaitong capsules decreased DBP, with significant publication bias. The results of the GRADE evidence quality evaluation showed that most evidence was at grades B and C. Finally, four strong recommendations and 14 weak recommendations were formed. ConclusionCompared with conventional western medicines for the treatment of hypertension, antihypertensive Chinese patent medicines combined with western medicines have advantages in reducing blood pressure and improving drug use safety, but they are mostly weak recommendations in terms of efficacy, and more high-quality evidence is needed.