The National Institute for Health and Care Excellence ( NICE) is taken for the typical success in u-sing health technology assessment to control cost increase. For other countries in a budget constrained context, this health technology assessment process and knowledge translation mechanism might be of significant implications. The objective of this paper is to provide some hints of knowledge translation to evidence-based decision making by sharing the experience from the NICE health technology assessment.

The paper presented a reform program jointly launched by China National Health Development Research Center(CNHDRC) and the UK National Institutes of Health and Care Excellence (NICE) for integrated care pathway and payment reform in China,and its theory basis and framework as well.Intervention measures of the program in Shanxi,Chongqing,Shandong and Henan proved the program theory design as reasonable and implementation outcomes as successful.These two measures,though proven,fall far short of a total solution to overcome roadblocks in the ongoing healthcare reform,and further reforms are expected in the future.

A description of the intervention measures of the reform program for integrated care and payment in pilot areas,covering such diseases as chronic obstructive pulmonary disease and cerbral stroke.The reform aims at exploring impacts on both medical behaviors and medical costs.Authors of the paper hold that the practice of packaged ceiling payment for a single disease is a two-edged sword for clinical pathway management,and joint efforts by the government,medical insurers,medical workers and patients at large are required to regulate medical behaviors over time.They also see the total growth of medical costs as an objective rule,and the correct way out for optimal use of medical insurance funds is to focus on makeup of such costs.

Objective To investigate the influence of the post stroke depression (PSD) on cognitive function in patients with stroke and their correlation, and to evaluate the diagnosis value of P300 cognitive function in patients with PSD. Methods One hundred and seventeen cases of inpatient with acute stroke in neurology medicine were continuously observed and scored using HAMD rating scale at the onset of 2 weeks. And 53 cases of PSD and 64 cases of non-post-stroke depression (NPSD) were scored using MMSE score and P300 determination respectively,and the results were compared. Results The incidence of PSD was 45.29%(53/117) at the 2 weeks after stroke,including 35 cases (29.91%) of mild depression,11 cases (9.40%) of medium degree depression and 7 cases (5.98%) of major depression. Compared with NPSD group, the P300 latency period of PSD group was significantly prolonged ( < 0.01), and the amplitude significantly reduced ( < 0.01) . The MMSE score difference was statistically significant ( <0.05) in the two groups. Conclusion The PSD is given priority to with mild-to-moderate depression, and the cognitive function damage in patients with PSD is more obvious than that in NPSD group. P300 determination can be used as the evaluation indicator of diagnosis cognitive function in patients with PSD.