OBJECTIVES: To evaluate and integrate evidence on the management of sleep disorders in children with attention deficit hyperactivity disorder (ADHD). METHODS: Literature was retrieved based on the 6S model, and evidence related to sleep disorder management in children with ADHD was extracted from the included references. RESULTS: A total of 17 studies were included, from which 16 pieces of evidence were extracted. Of these, 6 were classified as Level 1 evidence and 10 as Level 5. The evidence covered screening, assessment, non-pharmacological interventions, pharmacological interventions, follow-up, and multidisciplinary collaboration. CONCLUSIONS This study integrated evidence on the management of sleep disorders in children with ADHD using an evidence-based approach, providing an evidence-based foundation for managing sleep disorders in this population.
Humans ; Attention Deficit Disorder with Hyperactivity/complications* ; Sleep Wake Disorders/etiology* ; Child ; Evidence-Based Medicine

To enhance medication safety and rational use, a multidisciplinary expert panel from the Yangtze River Delta region-comprising specialists in pharmacy, clinical medicine, healthcare administration, and evidence-based medicine-was convened to develop this consensus through multiple rounds of Delphi consultation. A management system for the off-label use of novel antineoplastic agents was established, incorporating a tiered management process and a regional information sharing platform. Standardized procedures were implemented to regulate the applications, review, documentation, and dynamic adjustment of off-label use. The regional platform centralizes the collection and evaluation of evidence for off-label usage, facilitating consistent and homogeneous manage-ment across healthcare institutions. The tiered management process and information sharing platform established herein are intended to serve as a practical reference for standardizing the management of off-label use of novel antineoplastic agents in medical institutions.
Antineoplastic Agents/therapeutic use* ; Humans ; Off-Label Use/standards* ; Consensus ; Evidence-Based Medicine

OBJECTIVE: To systematically search and integrate the best evidence for early rehabilitation of ICU-acquired swallowing dysfunction (ICU-ASD) using evidence-based medicine methods, providing high-quality evidence-based support for intensive care unit (ICU) healthcare professionals in implementing early rehabilitation assessment and intervention strategies for ICU-ASD. METHODS: The systematic search was conducted according to the "6S" pyramid evidence model. Multiple authoritative databases and resources were comprehensively searched, including: National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Canadian Medical Association Clinical Practice Guidelines Library (CMACPGL), New Zealand Guidelines Group (NZGG), Guidelines International Network (GIN), Registered Nurses' Association of Ontario (RNAO), Scottish Intercollegiate Guidelines Network (SIGN), PubMed/Medline, Cochrane Library, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, JBI Evidence-Based Health Care Database, Physiotherapy Evidence Database (PEDro), Chinese Medical Pulse Guidelines Website, SinoMed, CNKI, Wanfang Data, UpToDate, BMJ Best Practice, and professional association websites. The search encompassed guidelines, expert consensus statements, original studies [including cohort studies, quasi-experimental studies, and randomized controlled trials (RCT)], systematic reviews, and evidence summaries related to the prevention and management of ICU-ASD. The search period was limited from the inception of each database to November 30, 2024. The best evidence for early rehabilitation of ICU-ASD was summarized. The quality assessment of the literature and the extraction and synthesis of evidence were independently performed by two researchers with expertise in evidence-based medicine methodology. RESULTS: A total of 16 articles were included, consisting of 1 clinical decision-making study, 1 cohort study, 2 guidelines, 2 RCTs, 6 systematic reviews, 1 evidence summary, 2 expert consensuses, and 1 expert opinion. Following quality assessment, all 16 articles were incorporated into the analysis. For the early rehabilitation of ICU-ASD, five major themes were ultimately identified and 25 best evidence items were summarized, focusing on: multidisciplinary collaboration, swallowing screening and assessment, rehabilitation interventions, dietary and nutritional management, and oral hygiene. CONCLUSIONS The evidence summary provides individualized rehabilitation strategies for ICU-ASD patients, but their implementation still needs to be adapted to China's clinical practice context and patient preferences.
Humans ; Deglutition Disorders/etiology* ; Intensive Care Units ; Evidence-Based Medicine

Allergic asthma, a major phenotype of bronchial asthma, shares similarities and differences with non-allergic asthma in its pathogenesis, clinical manifestations, diagnostic approach and criteria, and intervention strategies. The "Chinese guidelines for the diagnosis and treatment of allergic asthma (2019, the first edition)" established a framework for standardizing clinical practice relating to this condition in China. Based on the first edition, this guideline combines recent research progress and novel clinical evidence to supplement and revise the epidemiology, pathogenesis, common allergens, clinical manifestations, diagnostic techniques and standards, treatment and prevention principles of allergic asthma. Key amendments were made to the definition and underlying mechanisms, allergen detection techniques, and endotype assessment. Based on the current landscape of allergic asthma management in China, the updated guidelines provide tailored diagnostic and therapeutic recommendations, especially for allergen-specific immunotherapy, biologic-targeted therapies, and tertiary prevention strategies. A total of 14 evidence-based recommendations are proposed, serving as a clinical reference (guiding document) for optimizing the diagnosis, treatment, and long-term management of allergic asthma in China.
Humans ; Asthma/therapy* ; China ; Allergens ; Practice Guidelines as Topic ; Evidence-Based Medicine

Hemoptysis is a serious medical emergency associated with high mortality rates. Notably, it poses significant therapeutic challenges owing to the complexities in rapidly identifying the bleeding site and underlying cause. In severe cases, it can lead to death by asphyxia, thus necessitating prompt intervention. Bronchoscopy-guided endobronchial balloon occlusion (EBBO) is a vital procedure for blocking the bleeding bronchus, allowing time for subsequent embolization of the responsible vessel and definitive treatment. While traditional techniques for EBBO are intricate and demanding, recent advancements in balloon technology, along with procedural refinements, have simplified the process, reduced operation times, and enhanced medical staff proficiency. Nevertheless, a lack of standardized protocols and technical guidelines has hindered the widespread adoption of this technique in China. Accordingly, the Internal Medicine of Chinese Medical Association convened a group of experts to develop the "Expert consensus on endobronchial balloon occlusion in the treatment of hemoptysis (2025 edition)" to standardize this procedure. This consensus, grounded in evidence-based medicine and clinical practice both domestically and internationally, covers seven essential elements: treatment strategies, equipment, indications and contraindications, preoperative preparation, technical procedures and specifications, integration with other therapeutic techniques, efficacy assessment, and follow-up. By offering comprehensive guidance, the consensus aims to standardize and promote the use of EBBO for hemoptysis management in China.
Humans ; Hemoptysis/therapy* ; Balloon Occlusion/methods* ; Bronchoscopy ; Consensus ; Evidence-Based Medicine

OBJECTIVES

This study aimed to develop and to pilot-test a tailored introductory Evidence-Based Practice (EBP) training program for registered nurses. Despite the recognized importance of EBP in nursing, many practicing nurses lacked formal training and confidence in its application. This study addressed the gap in accessible and entry-level EBP education designed specifically for EBP competency among nurses.

A quasi-experimental one-group pretest-post test design was employed in this study. A convenient sample of 23 registered nurses from a tertiary educational institution in Angeles City, Pampanga, Philippines had participated in the pilot testing. The introductory EBP Training Program was developed based on core EBP competencies and structured into a modular format. The program was delivered in a computer laboratory setting and conducted for eight to ten hours. The training included lectures, guided case-based discussions, and hands-on exercises covering each step of the EBP process.

Data were collected using the Academic Center for Evidence-Based Practice Readiness Inventory (ACE-ERI) before and after the intervention. Statistical analysis was performed using paired sample t-tests to assess differences in pre- and post-intervention scores. All analyses were conducted using SPSS version 26. Ethical approval was obtained from the Holy Angel University Institutional Review Board (HAU-IRB).

The EBP training program resulted in a statistically significant improvement in both knowledge and confidence in using evidence-based practice. Participants' knowledge scores increased from a pre-test mean of 7.04 (SD = 1.72) to a post-test mean of 8.30 (SD = 1.87), while confidence scores rose from 64.61 (SD = 17.32) to 88.43 (SD = 16.80). Wilcoxon signed-rank tests confirmed the significance of these improvements in both EBP knowledge (Z = -4.16, p < .001) and confidence (Z = -3.56, p < .001).

The study demonstrated that the evidence-based practice (EBP) training program led to a significant improvement in nurses' knowledge and skills, as evidenced by the marked difference in pre- and post-test scores. EBP training programs can effectively enhance healthcare professionals' capacity to integrate evidence into clinical practice. Based on these findings, healthcare organizations should consider incorporating EBP training into regular professional development programs for nurses. EBP training programs should focus on fostering practical application skills and include more case-based learning to further reinforce the integration of EBP in clinical decision-making. Lastly, future researches may explore focusing on long-term outcomes of EBP training, including its impact on patient care and organizational practices, to assess the sustainability of the knowledge gained through such interventions. Overall, by enhancing EBP training and supporting its widespread adoption, healthcare systems can further improve the quality of patient care and promote a culture of continuous learning and evidence-based decision-making.

Databases, Bibliographic ; Evidence-based Practice ; Health Services Needs And Demand

Humans ; Pre-Eclampsia/diagnosis* ; Pregnancy ; Female ; China ; Evidence-Based Medicine ; Risk Factors

Humans ; Heart Defects, Congenital/therapy* ; Child ; Evidence-Based Medicine ; Cardiac Surgical Procedures/methods* ; Cardiac Catheterization/methods*

The effective implementation of clinical practice guideline(CPG), as a crucial vehicle of evidence-based medicine, plays a vital role in improving healthcare quality and patient safety. Currently, there remains a significant gap between the actual implementation outcomes of traditional Chinese medicine(TCM) guidelines and their intended objectives, which necessitates a systematic investigation into their influencing factors to optimize implementation strategies. This study aims to comprehensively identify the factors influencing CPG implementation in China, adapt the theoretical domains framework(TDF) to the local context, and integrate TCM-specific characteristics to provide recommendations for optimizing the development and implementation processes of TCM guidelines. Systematic search was conducted across multiple databases, including CNKI, Wanfang, VIP, SinoMed, PubMed, and EMbase, covering the period from each database's inception to March 2024. Qualitative and mixed-methods studies were included to examine factors affecting the implementation of clinical practice guidelines. The methodological quality of the included studies was assessed using the critical appraisal skills programme(CASP) tool. RESULTS:: were synthesized through framework analysis and thematic synthesis, and expert consensus was achieved via a structured consensus meeting. A total of 16 studies involving 2 388 participants were included with overall good methodological quality. Based on the TDF, 43 influencing factors across 14 domains were identified. The most critical factors included the quality of guideline evidence, training and academic conferences organized by hospitals and academic institutions to promote guideline adoption among medical staff, support from professional leaders for guideline implementation, the applicability and clarity of guideline recommendations, and material resources(supplies, funding, and facilities) required for implementation. Additionally, influencing factors of TCM guideline implementation were identified, including the distinctive advantages of TCM therapies, the applicability of syndrome differentiation, and the feasibility of TCM treatments. Based on these findings, it is recommended that TCM guideline development should incorporate these unique influencing factors to formulate high-quality, clear, and actionable recommendations. Following guideline publication, healthcare and academic institutions should strengthen training and dissemination efforts and ensure the availability of necessary implementation resources to facilitate the successful adoption of guidelines in clinical practice.
China ; Humans ; Practice Guidelines as Topic ; Medicine, Chinese Traditional/standards* ; Evidence-Based Medicine