1.Best evidence summary of non-pharmacological management of venous thromboembolism in patients with haemorrhagic stroke during perioperative period
Li WU ; Jiumei CAI ; Yangyulin LI ; Darong LU ; Jiexin SHENG ; Wei CHEN
Modern Clinical Nursing 2024;23(11):62-72
Objective To retrieve,evaluate and summarise the relevant evidence in non-pharmacological management of venous thromboembolism in patients with haemorrhagic stroke during perioperative period so as to provide references for clinical practice. Methods According to the "6S" evidence pyramid mode,evidence was retrieved from top to bottom across databases such as BMJ Best Practice,UpToDate,JBI Evidence-Based Healthcare Centre,the National Guideline Clearinghouse (NGC),the National Institute for Health and Care Excellence (NICE),the Scottish Intercollegiate Guidelines Network (SIGN),the Registered Nurses' Association of Ontario (RNAO) guidelines network,the Canadian Heart and Stroke Foundation (HSF),the American Heart Association/American Stroke Association (AHA/ASA),the Neuro-Critical Care Society (NCS),the European Stroke Organization (ESO),Cochrane Library,PubMed,Medline,CNKI,Web of Science,Embase,the China Biomedical Literature Database,Wanfang Data,Medlive,VIP,and the Chinese Medical Journal Full-Text Database. The search focused on non-pharmacological management of perioperative venous thromboembolism in haemorrhagic stroke patients,including guidelines for clinical practice,expert consensus,systematic reviews and evidence summaries. The searched literatrue was from the inception of the databases to April 11th,2024. Two researchers independently evaluated the quality of the literature,extracted,integrated and summarised the best evidences. Results A total of 23 articles were included,comprising 12 guidelines,5 systematic reviews,4 expert consensuses and 2 evidence summaries. Thirty-one pieces of the best evidence were summarised and integrated into 5 topics,including multidisciplinary teamwork,risk assessment and screening,basic prevention,mechanical prophylaxis and health education. Conclusion This study has summarised the best evidence for non-pharmacological management of venous thromboembolism in patients with haemorrhagic stroke during the perioperative period. It provides evidence-based references for clinical medical staff to prevent and manage venous thromboembolism in patients with hemorrhagic stroke during perioperative period.
2.Best evidence summary of non-pharmacological management of venous thromboembolism in patients with haemorrhagic stroke during perioperative period
Li WU ; Jiumei CAI ; Yangyulin LI ; Darong LU ; Jiexin SHENG ; Wei CHEN
Modern Clinical Nursing 2024;23(11):62-72
Objective To retrieve,evaluate and summarise the relevant evidence in non-pharmacological management of venous thromboembolism in patients with haemorrhagic stroke during perioperative period so as to provide references for clinical practice. Methods According to the "6S" evidence pyramid mode,evidence was retrieved from top to bottom across databases such as BMJ Best Practice,UpToDate,JBI Evidence-Based Healthcare Centre,the National Guideline Clearinghouse (NGC),the National Institute for Health and Care Excellence (NICE),the Scottish Intercollegiate Guidelines Network (SIGN),the Registered Nurses' Association of Ontario (RNAO) guidelines network,the Canadian Heart and Stroke Foundation (HSF),the American Heart Association/American Stroke Association (AHA/ASA),the Neuro-Critical Care Society (NCS),the European Stroke Organization (ESO),Cochrane Library,PubMed,Medline,CNKI,Web of Science,Embase,the China Biomedical Literature Database,Wanfang Data,Medlive,VIP,and the Chinese Medical Journal Full-Text Database. The search focused on non-pharmacological management of perioperative venous thromboembolism in haemorrhagic stroke patients,including guidelines for clinical practice,expert consensus,systematic reviews and evidence summaries. The searched literatrue was from the inception of the databases to April 11th,2024. Two researchers independently evaluated the quality of the literature,extracted,integrated and summarised the best evidences. Results A total of 23 articles were included,comprising 12 guidelines,5 systematic reviews,4 expert consensuses and 2 evidence summaries. Thirty-one pieces of the best evidence were summarised and integrated into 5 topics,including multidisciplinary teamwork,risk assessment and screening,basic prevention,mechanical prophylaxis and health education. Conclusion This study has summarised the best evidence for non-pharmacological management of venous thromboembolism in patients with haemorrhagic stroke during the perioperative period. It provides evidence-based references for clinical medical staff to prevent and manage venous thromboembolism in patients with hemorrhagic stroke during perioperative period.
3.Exploration on the Development of Evidence-based Grading System for Chinese Medicine Interventional Clinical Evidence
Shaonan LIU ; Xinfeng GUO ; Darong WU ; Anthony Lin ZHANG ; Charlie Changli XUE ; Zehuai WEN
Journal of Traditional Chinese Medicine 2023;64(18):1885-1889
The grading of evidence is an important factor in clinical decision-making. The current evidence grading system based on western medicine is limited in the clinical practice of traditional Chinese medicine (TCM), therefore we propose the solutions to the development of grading system for TCM interventional evidence, following the international evidence grading standards, taking into considerations of the unique characteristics of TCM practice, based on the Grades of recommendation, assessment, development and evaluation (GARDE) evaluation system, and integrating with grading system regarding TCM classical literature and empirical evidence from modern famous doctors. The evidence from classical literature is suggested to be evaluated from three aspects including source of ancient medical records, comprehensive of treatment details, and the inheritance. The qualification of famous doctors, content integrity, and inheritance of experiences will be used to evaluate the evidence from famous doctors' experience. The multi-sourced evidence such as TCM classical literature, experience of modern famous doctors, and modern researches is mainly integrated in a qualitative way, and the overall level of evidence of TCM interventions will be graded consistently with the GRADE system based on modern research. The evidence from classical literature and modern famous doctors' experience will be assessed and considered as supplementary evidence, which will make the evaluation of clinical evidence more objectively and comprehensively, thereby guiding clinical practice further.
4.Experience in Treating Intractable Rheumatism by Yang-palm Therapy
Jinzhong WANG ; Ran LV ; Darong WU ; Peng HU ; Xieyao INSTRUCTORSTAN ; Huantian ZHANG
Chinese Journal of Information on Traditional Chinese Medicine 2017;24(2):104-105
Yang-palm, through early systematic Zhan-zhuang training to raise qi, pats the affected area to extract pathological product outer surface using the distal of 2-5 fingers in palm dorsal. This therapy emphasizes infusing qi and extract silt. The treatment continues when pathological product scatters and disappears, so the short-term and long-term efficacy is significant, and especially suitable for the treatment of TCM arthralgia. This article introduced the clinical therapy in treating two rheumatism patients by Yang-palm, explained process and study method of Yang-palm therapy, and shared treatment experience and explored the basic principles of treatment, with a purpose to provide a new treatment for rheumatism.
5.Analysis on reliability and validity of the Pittsburgh sleep quality index
Taoying LU ; Yan LI ; Ping XIA ; Guangqing ZHANG ; Darong WU
Chongqing Medicine 2014;(3):260-263
Objective To assess the reliability and validity of the Pittsburgh sleep quality index (PSQI) .Methods The cross-sectional survey was conducted in the outpatient department of this hospital .544 insomnia and non-insomnia voluntary participants (18-65 years old) from July to October 2011 were assessed with PSQI and the insomnia severity index (ISI) ,which were randomly delivered to them .Results The test-retest reliability of PSQI was 0 .994 .The split-half reliability coefficient of PSQI was 0 .824 . The overall Cronbach′s alpha coefficient was 0 .845 .The confirmatory factor analysis showed that the fitting indicators for the χ2/df ,root mean square error of approximation(RMSEA) ,non-normed fit index(NNFI) ,comparative fit index(CFI) and goodness-of-fit index(GFI) were 4 .83 ,0 .09 ,0 .96 ,0 .98 and 0 .97 respectively .The correlation coefficient between the PSQI and ISI was 0 .842 . The correlations coefficients between PSQI with the questionnaire type ,interview date and interview department were -0 .046 , 0 .276 and -0 .331 .Grouping by individuals with or without insomnia ,the area under the receiver operator characteristic curve (ROC) for PSQI was 0 .944(95% CI:0 .925-0 .963) .Conclusion PSQI has good reliability and validity ,and could be used for the sleep quality comprehensive evaluation in the patients with insomnia .
6.Modern testing theory and its application in the field of health measurement.
Journal of Integrative Medicine 2012;10(3):271-8
This paper briefly introduces item response theory (IRT) as a typical representation of modern testing theory (MTT), and systematically reviews the processes and contents of the application of IRT in the area of health measurement, including, for example, item bank development, scale revision and computerized adaptive testing. The author presents the potential benefits and the notable problems during health measuring by IRT. Then, the author asserts the need for thorough assessment of feasibility when using the IRT in patient-reported outcome research. Further research based on IRT and computerized adaptive testing in health measurement will be carried out in the field of medical care including traditional Chinese medicine and integrative medicine.
7.Delphi research on the evaluation indicators system for clinical pathway management
Ping XIA ; Darong WU ; Xueying HUANG ; Lan CHENG ; Zhenwei LIN ; Weixuan ZHANG ; Jianxiong CAI
Chinese Journal of Hospital Administration 2012;(11):811-817
Objective To build the indicators system for clinical pathway management as required by clinical pathway control.Methods An indicators system was proposed by means of evidence-based review,focus group discussions,and ratings of the indicators' importance by doctors and nurses.A multidisciplinary panel of 60 experts from across the country were selected.A 3-round Delphi survey was made on the proposed indicators.The weights of the indicators were established by analytical hierarchy process (AHP).The response rate,Cronbach's α,and the authority coefficient of experts were used as a measure of reliability.Results The response rates of the 3 rounds were 85%,70%,and 94%; the experts authority coefficient was 0.80.The ccoefficient of variation falls with the rising number of consultations.The Kendall's W ranged from 0.40 to 0.83.Following the 3 rounds,consensus was achieved among experts as such a system comprising three first-level,9 second-level,and 36 third-level indicators.Conclusion The expert consultation has achieved reliable results.The established indicators system can serve as a useful instrument for standardized development of clinical pathways management and constant improvement.
8.Investigation on response of the patient-reported outcome scale of the main-symptoms of chronic obstructive pulmonary disease complicated with pulmonary heart disease.
Luming CHEN ; Hui YU ; Darong WU ; Xun HU ; Lan ZHENG
Journal of Integrative Medicine 2012;10(9):970-4
To select appropriate descriptors for response of the patient-reported outcome (PRO) scale for the main symptoms of patients with chronic obstructive pulmonary disease (COPD) complicated with pulmonary heart disease.
9.A study of scale response for Health Scale of Traditional Chinese Medicine.
Darong WU ; Shilong LAI ; Weixiong LIANG ; Xinfeng GUO ; Aihua OU ; Zehuai WEN
Journal of Integrative Medicine 2009;7(8):717-23
To select appropriate descriptors for responses of the Health Scale of Traditional Chinese Medicine (HSTCM).
10.Reliability and validity of Health Scale of Traditional Chinese Medicine
Darong WU ; Shilong LAI ; Xinfeng GUO ; Zehuai WEN ; Weixiong LIANG
Journal of Integrative Medicine 2008;6(7):682-9
OBJECTIVE: To test the reliability and validity of Health Scale of Traditional Chinese Medicine (HSTCM) by means of questionnaires. METHODS: A cross-sectional survey was conducted at Liwan Community of Guangzhou, Old People's Home in Guangzhou and Outpatient Department of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine. A total of 652 Chinese individuals (over 18 years old) were assessed with the 88-item version of HSTCM and World Health Organization Quality of Life Measure-Abbreviated Version (WHOQOL-BREF), which were randomly delivered to them. Some socioeconomic characteristics were registered. RESULTS: A test-retest reliability (15-day interval) was found among the 76 persons who completed the questionnaires by themselves. Intra-class correlation coefficient (ICC) was 0.93. Associated 95% confidence interval (CI) was 0.89-0.96. Split-half reliability was 0.79. Inter-investigator reliability (0.93) was also good, and the ICC of HSTCM was 0.90 (95%CI 0.67-0.97). The correlation between HSTCM and WHOQOL-BREF was -0.66. The correlations of HSTCM and questionnaire deliver order, investigator, interview date and interview time were 0.06, -0.12, -0.17 and 0.20 respectively. The correlation between HSTCM and self-rated health (0.46) was greater than that between HSTCM and chronic illness (0.28). Divided by individuals with or without chronic illness, area under the ROC (receiver operator characteristic) curve for HSTCM was 0.67 (95%CI 0.63-0.71). CONCLUSION: It indicates that the HSTCM is conceptually valid with satisfactory psychometric properties and forms a basis for further applications in clinical research of traditional or integrative medicine.

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