1.Research on the focus of ethical governance in the field of artificial intelligence in medicine
Zhuojun YE ; Yanli SHEN ; Xiao JIANG ; Huiyun YUAN
Chinese Medical Ethics 2024;37(1):39-44
Objective:To explore the focus of ethical governance in the field of artificial intelligence(Al)in medicine.Methods:By comprehensively reviewing relevant literature to compare the relevant laws and regulations of the field of AI in medicine between China and foreign countries,analyze the governance focus of potential ethical issues,and propose the corresponding governance strategies.Results:At present,the laws,regulations,and regulatory systems related to the field of AI in medicine in China need to be improved.The emphasis of ethical governance should focus on core issues such as protecting privacy rights,ensuring the transparency and fairness of algorithms,clarifying the demarcation and allocation of responsibilities,and clarifying public perceptions and attitudes.Conclusion:The government and all sectors of society should actively learn from international legislative experience,and build an omnidirectional and multi-level ethical governance system from the aspects of policy formulation,legal framework,scientific research,and technological research and development by strengthening top-level design,improving policies and regulations,attaching importance to public feedback,and strengthening interdisciplinary cooperation.
2.The Practical Basis and Scientific Connotation of the Great Anti-epidemic Spirit: Taking Dr. Zha’s Diary of Fighting the COVID-19 as an Example
Shulei FAN ; Yanli SHEN ; Xiao JIANG ; Zhuojun YE ; Huiyun YUAN
Chinese Medical Ethics 2023;36(7):815-818
The great anti-epidemic spirit is a magic weapon for the Chinese people to fight against the COVID-19. Taking the Dr. Zha’s Diary of Fighting the COVID-19 as an example to explore the practical basis and scientific connotation of the great anti-epidemic spirit is of great significance for telling Chinese stories and transmitting Chinese spirit. The anti-epidemic experience described in the book reflects the professional qualities of medical staff who are people-oriented and life first in the fight against the epidemic, the overall view of respecting science and precise prevention and control by various forces in society, and the overall pattern of national unity and shared destiny in China, vividly interprets the precious connotation of the new era medical and health professional spirit.
3.Research on Ethical Hotspots of Assisted Reproductive Technology in China: A Review of Quantitative Research in the Past Two Decades
Xiao JIANG ; Shulei FAN ; Yanli SHEN ; Huiyun YUAN
Chinese Medical Ethics 2023;36(4):413-418
【Objective:】 The data of the literature of the research progress on the assisted reproductive technology (ART) ethical issues in China in the past two decades were summarized to explore the research hotspots and frontiers of ethical issues in this field. 【Methods:】 The relevant literature records of China National Knowledge Infrastructure (CNKI) were retrieved from January 1, 2002 to October 30, 2022. CiteSpace 6.1.R2 software was used to visually analyze the authors, institutions, keywords, etc. 【Results:】 A total of 1274 papers were included, and the number of papers was on the rise. The hot topics covered three dimensions: surrogacy, ethics issues and laws of ART, and measures of ART. 【Conclusion:】 The combination of theory and practice on the ethical issues of ART is not close enough, the cooperation network of researchers need to be further strengthened. The relevant research on surrogacy, reproductive rights, gene editing, and embryo ownership has become a major hotspot and difficulty in recent years, which should be given full attention.
4.Application effect of a sequential clinical skill curriculum system in standardized residency training
Xiao JIANG ; Li SHAO ; Yan CHEN ; Yu SI ; Huiming HU ; Aiping SU ; Yi LI ; Huiyun YUAN
Chinese Journal of Medical Education Research 2023;22(12):1796-1801
Objective:To investigate the application effect of a sequential clinical skill curriculum system in standardized residency training.Methods:A total of 300 residents who participated in the residency training of a clinical medical school from 2020 to 2022 were selected as the research subjects, among whom 46 residents in the experimental group had received the clinical skill training course of the clinical medical school in the undergraduate stage, and 254 in the control group had not received such training in the undergraduate stage. The teaching effect of the two groups was observed from the first year to the third year after they entered the residency training base and were trained together based on the curriculum system. SPSS 24.0 statistical software was used for data analysis, and the main statistical methods included descriptive analysis, the Kolmogorov-Smirnov test, the Mann-Whitney U test, and the chi-square test. Results:Before the residents entered the residency base, class 2020 [60.0(52.0,60.0) vs. 51.0(48.0,53.0)], class 2021 [54.0(52.0,56.0) vs. 51.0(48.0,53.0)] and class 2022 [53.0(51.0,55.0) vs. 50.0(47.0,51.0)] The difference between the entry base grades of the residents in the experimental group compared to the control group was statistically significant ( P<0.05). After 36 months of residency training, the difference between the residents in the trial group and the control group in the 2020 class was not statistically significant when it came to the passing rate of the final exam ( χ2=1.20, P=0.273). At the end of 12 months of residency training, there was a statistically significant difference ( P<0.05) between the scores of residents in the experimental group compared with the control group in the theoretical examination [124.0 (123.8,125.0) vs. 115.0 (101.0,125.0)] and medical history taking [92.0 (91.0,95.0) vs. 85.1 (79.3,94.5)]. The differences were not statistically significant ( P>0.05) at the end of 6, 18, and 24 months of residency training. At the end of 6 months [93.0(90.0,97.0) vs. 89.0(86.3,95.0)], 12 months [94.0(92.0,95.0) vs. 89.0(87.0,92.0)] and 18 months [90.0(86.5,93.5) vs. 81.0(69.0,91.0)] of residency training, residents in the experimental group Physical examination scores were statistically significant compared to the control group ( P<0.05). At the end of 24 months of residency training, there was no statistically significant difference ( P>0.05) between the physical examination scores of residents in the experimental group compared with the control group in the classes of 2020 [92.0(87.5,95.3) vs. 85.0(79.0,92.0)] and 2021 [94.0(87.0,96.0) vs. 90.0(84.0,95.0)]. Conclusions:The clinical skill curriculum system can help to improve the comprehensive clinical ability of residents, and the teaching contents and methods of physical examination should be further optimized, with a focus on the training of doctor-patient communication skills and humanistic literacy among residents in the future.
5.Exploration and practice of patient satisfaction evaluation management in multi-campus public hospitals
Weiqi ZHANG ; Rong ZHAO ; Haoning WANG ; Songxuan YU ; Jiayu MO ; Xiaorong WU ; Yang WEN ; Shulei FAN ; Yanli SHEN ; Huiyun YUAN
Chinese Journal of Hospital Administration 2022;38(4):280-284
Patient satisfaction is one of the core indicators to measure the service quality of medical institutions. To this end, a multi-campus public hospital in Shanghai constructed a management system of patient satisfaction evaluation. Since 2021, its call center has conducted a full coverage satisfaction assessment for discharged patients from its three campuses and collected dissatisfaction information feedback. The hospital organized relevant clinical departments and functional departments to fully communicate with the dissatisfied patients according to the feedback information, followed by a joint rectification. The hospital regularly conducts in-depth analysis of all complaints for timely discovery of common problems in different campuses for continuous improvement. This practice can provide reference for multi-campus hospitals to promote homogeneous management, to improve management efficiency, service quality and patient satisfaction.
6.Current Status and Time Trends of Cancer Incidence and Mortality Worldwide
Huiyun YUAN ; Yufei JIANG ; Yuting TAN ; Yongbing XIANG
Cancer Research on Prevention and Treatment 2021;48(6):642-646
As the second most common cause of death in the world, cancer has become a persistent public health challenge. The incidence and mortality in different countries and regions or of multiple cancer types are significantly different, which is closely related to economic development level, lifestyle and environmental factors. A large number of epidemiological studies have focused on cancer burden, epidemic pattern, etiology and prevention, which is very important for the government to formulate cancer prevention policies based on medical evidence and protect population health. Therefore, based on the latest epidemiological publications, this paper reviews the incidence and mortality of cancer as well as the time trend in major countries and areas.
7.Research on Characteristics and Problems of Ethical Review of Living Organ Transplantation
Chinese Medical Ethics 2018;31(1):73-76
Objective:To systematically and comprehensively expound the features and problems of ethics com-mittee for human organ transplantation in the ethical review work of living organ transplantation. Methods:We took interviews with insiders,literature research as the main research methods,supplemented by group discussion and other methods. Results:The ethical review of living organ transplantation has the characteristics of high require-ments of promptness,the need of protection for the rights of life and health for both parties,the complicated prepara-tion work,the need of weighing the risk and benefit of both parties at the same time and the lack of final judgment. In terms of the problems existing in the ethical review of living organ transplantation,it mainly had that the ethical review of living organ transplantation lacked supervision and guidance,the feasibility and scientificity of ethical re-view mode need to be improved,and the self - construction of ethics committee for human organ transplantation was insufficient. Conclusion:The ethics review of human organ transplant ethics committee should follow the principle of prudence,and improve the standardization and normalization of ethical review of human organ transplantation. Re-gional human organ transplant ethical review center should better conduct the ethical review work of living organ transplantation.
8.Possible Risk Analysis of Surrogacy and Legislative Proposals
Chinese Medical Ethics 2018;31(7):883-885,893
Objective: To better understand surrogate technology,so as to enable surrogacy to be used more or-derly,rationally and legitimately in Chinese society as one of human assisted reproductive technologies.Methods:Through literature retrieval and other methods,this paper analyzed the possible risks of surrogate behavior at various stages.Results: China explicitly prohibited surrogacy,but surrogacy existed objectively.The risk of surrogacy ex-isted in the entire process of surrogacy,and the risks varied in different stages.There lacked perfect legal protec-tion for the rights and interests of all parties.Conclusion: It is not effective to ban surrogacy negatively in order to avoid ethical and legal disputes,and surrogacy is often illegal for many times.It should only formulate the authori-tative laws actively to respond to surrogacy issues,standardize the ethical principles of surrogacy,access condi-tions,and illegal punishment,and fundamentally deal with possible risks so as to effectively protect the rights and interests of all parties of surrogacy.Therefore,the introduction of the legislative regulation on surrogacy should not be delayed.
9.Research on Ethical Issues of Living Organ Donation in China
Chinese Medical Ethics 2017;30(5):589-593
Objective:To discuss the ethical issues of living organ donation in China systematically and comprehensively,from the perspective of society,institution,family,individual and other level.Methods:Literature research and expert interviews were used as main research methods,supplemented by group discussion,in-depth interviews and other methods.Results:In the development of living organ donation in China,from the social level,the relevant laws and regulations,civic education and supporting measures had problems.From the institutional level,hospital human organ transplant ethics committee also had some deficiencies in staff composition,review capacity and supervision.On the individual level,donors and receptors of living organ donation and related medical personnel also had their own ethical dilemma.Conclusion:It is beneficial to fully promote living organ donation and fully realize the purpose of living organ transplantation for the benefit of mankind through solving the ethical issues from social,institutional and individual levels.
10.Investigation and Ethical Analysis on Surrogacy
Chinese Medical Ethics 2017;30(5):535-538
Objective:To investigate the current situation of surrogate in China,analyze the reasons,and then provide effective suggestions and countermeasures.Methods:A questionnaire survey was conducted among medical staff and patients in an institution with assisted reproductive technology (ART),combining literature review and sociological research methods such as data maps,to explore and analyze the surrogacy.Results:The number of institutions with ART increased rapidly and its regulation became difficult.More surrogate network was observed in first-tier cities as well as the eastern and southeastern coastal provinces.That respondents agreeing with surrogacy was quite serious in some provinces.The reasons of surrogate were patients' needs,social concepts,weak government supervision,and so on.Conclusions:It should improve the laws of ART,explore long-term supervision mechanism,strengthen the management of internet,shield the information about surrogate,enhance medical ethics education for ART staff,and guide the infertility patients to establish the correct ethical concepts.

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