Journal of Evidence‐Based Medicine最新文献

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A Randomized, Double-Blinded, Placebo-Controlled Study of the Use of Traditional Chinese Medicine for Treating Patients With Mild/Moderate Chronic Obstructive Pulmonary Disease 中医药治疗轻/中度慢性阻塞性肺疾病的随机、双盲、安慰剂对照研究
IF 3.6 2区 医学
Journal of Evidence‐Based Medicine Pub Date : 2025-04-10 DOI: 10.1111/jebm.70023
Jiansheng Li, Minghang Wang, Yang Xie, Suyun Li, Xueqing Yu, Fengsen Li, Hanrong Xue, Zegeng Li, Nianzhi Zhang, Guiying Liu, Wei Zhang, Qing Miao, ZiKai Sun, Zhenghang Ge, Zhanping Ma, Hongyan Cai, Zhijia Sun, Hailong Zhang, Yanfang Wang
{"title":"A Randomized, Double-Blinded, Placebo-Controlled Study of the Use of Traditional Chinese Medicine for Treating Patients With Mild/Moderate Chronic Obstructive Pulmonary Disease","authors":"Jiansheng Li,&nbsp;Minghang Wang,&nbsp;Yang Xie,&nbsp;Suyun Li,&nbsp;Xueqing Yu,&nbsp;Fengsen Li,&nbsp;Hanrong Xue,&nbsp;Zegeng Li,&nbsp;Nianzhi Zhang,&nbsp;Guiying Liu,&nbsp;Wei Zhang,&nbsp;Qing Miao,&nbsp;ZiKai Sun,&nbsp;Zhenghang Ge,&nbsp;Zhanping Ma,&nbsp;Hongyan Cai,&nbsp;Zhijia Sun,&nbsp;Hailong Zhang,&nbsp;Yanfang Wang","doi":"10.1111/jebm.70023","DOIUrl":"https://doi.org/10.1111/jebm.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Chronic obstructive pulmonary disease (COPD) is a critical disease, with lung function closely linked to disease severity. This study aimed to evaluate the clinical efficacy of treatments for stable COPD in patients with pulmonary function Grades I and II.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We conducted a multicenter, randomized, double-blind, placebo-controlled trial (registration number: NCT01486186). A total of 502 patients were randomly assigned to an experimental group (<i>n </i>= 251, treated with Bufei, Bufei Jianpi, and Bufei Yishen granules based on traditional Chinese medicine [TCM] syndromes) and a control group (<i>n </i>= 251, treated with a Chinese medicine-based placebo). Acute exacerbations (AEs), lung function, clinical symptoms, 6-min walking distance (6MWD), and dyspnea were assessed over 12 months of treatment and 12 months of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 432 patients, including 214 and 218 patients in the experimental and control groups, respectively, completed the trial. The early treatment group had fewer AEs (<i>p </i>&lt; 0.05), better clinical symptom scores (<i>p </i>&lt; 0.05), longer 6MWD (<i>p</i> &lt; 0.05), and better Modified Medical Research Council (mMRC) scores than the control group (<i>p </i>&lt; 0.05). No significant differences were found in forced vital capacity (FVC) and forced expiratory volume in first second (FEV1%) between the two groups, but there was a significant difference in FEV1 and the annual rate of FEV1 decline between the groups over 2 years (<i>p </i>&lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Treatment with TCM for stable COPD significantly reduced AEs, increased the 6MWD, and alleviated dyspnea in patients with pulmonary function Grades I and II. FEV1 was improved, and the slower FEV1 decline indicates a potential benefit in mitigating disease progression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Using Integrative Therapies to Improve Patient-Reported Outcomes in Breast Cancer Survivors: A Living Evidence-Based Clinical Practice Guideline 使用综合疗法改善乳腺癌幸存者患者报告的结果:一个活生生的循证临床实践指南
IF 3.6 2区 医学
Journal of Evidence‐Based Medicine Pub Date : 2025-04-10 DOI: 10.1111/jebm.70029
Tingting Lu, Honghao Lai, Hongsheng Lin, Fei Ma, Li Hou, Lili Tang, Yi Zhu, Huijuan Mao, Anthony Lin Zhang, Myeong Soo Lee, Akihiko Ozaki, Mariana Cabral Schveitzer, Hui Zhao, Lidan Zhong, Baohui Jia, Lei Fan, Jiajie Huang, Baojin Han, Weilong Zhao, Long Ge, Jie Liu, Luqi Huang
{"title":"Using Integrative Therapies to Improve Patient-Reported Outcomes in Breast Cancer Survivors: A Living Evidence-Based Clinical Practice Guideline","authors":"Tingting Lu,&nbsp;Honghao Lai,&nbsp;Hongsheng Lin,&nbsp;Fei Ma,&nbsp;Li Hou,&nbsp;Lili Tang,&nbsp;Yi Zhu,&nbsp;Huijuan Mao,&nbsp;Anthony Lin Zhang,&nbsp;Myeong Soo Lee,&nbsp;Akihiko Ozaki,&nbsp;Mariana Cabral Schveitzer,&nbsp;Hui Zhao,&nbsp;Lidan Zhong,&nbsp;Baohui Jia,&nbsp;Lei Fan,&nbsp;Jiajie Huang,&nbsp;Baojin Han,&nbsp;Weilong Zhao,&nbsp;Long Ge,&nbsp;Jie Liu,&nbsp;Luqi Huang","doi":"10.1111/jebm.70029","DOIUrl":"https://doi.org/10.1111/jebm.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Breast cancer imposes a serious disease and economic burden on patients. This guideline aims to develop a living evidence-based clinical practice recommendations to guide the use of integrative therapies for the improvement of patient-reported outcomes (PROs) in breast cancer survivors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched systematic reviews and meta-analyses or conducted de nova systematic reviews and meta-analyses to support the recommendations. The grading of recommendations, assessment, development, and evaluation approach was used to rate the certainty of evidence and the strength of recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The guideline panel issued 17 recommendations: for alleviating anxiety, strong recommendations in favor of muscle relaxation training, yoga, acceptance and commitment therapy, cognitive behavioral therapy, psychological education, and Tai Chi in general breast cancer survivors; for alleviating depression, strong recommendations in favor of mindfulness therapy, cognitive behavioral therapy, group psychotherapy, muscle relaxation training, acceptanceand commitment therapy in general breast cancer survivors, and exercise intervention for patients received radiotherapy; for sleep quality, conditional recommendations for all therapies; for pain, strong recommendations in favor of exercise intervention for postoperative breast cancer survivors; for alleviating fatigue, strong recommendations in favor of mindfulness therapy and group psychotherapy in general breast cancer survivors; for improving the quality of life, strong recommendations in favor of mindfulness therapy in general breast cancer survivors, Baduanjin and exercise intervention for patients undergoing anticancer treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This proposed guideline provides recommendations for improving the PROs of breast cancer survivors. We hope these recommendations can help support practicing physicians and other healthcare providers for breast cancer survivors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Chinese Expert Consensus on Home Nutrition Administration for Older Patients (2024) 老年患者家庭营养管理专家共识(2024)
IF 3.6 2区 医学
Journal of Evidence‐Based Medicine Pub Date : 2025-04-07 DOI: 10.1111/jebm.70025
Jie Gong, Xuemei Li, Lei Shi, Xiaofan Jing, Xinyi Liao, Ya Ma, Wen Hu
{"title":"Chinese Expert Consensus on Home Nutrition Administration for Older Patients (2024)","authors":"Jie Gong,&nbsp;Xuemei Li,&nbsp;Lei Shi,&nbsp;Xiaofan Jing,&nbsp;Xinyi Liao,&nbsp;Ya Ma,&nbsp;Wen Hu","doi":"10.1111/jebm.70025","DOIUrl":"https://doi.org/10.1111/jebm.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Families constitute important settings for the nutritional management of older adults, and there is a growing demand for continuous nutritional management services extending from hospital care to home-based care. Since the publication of the <i>Chinese Expert Consensus on Home Nutrition Administration for the Elderly (2017 Edition)</i> 7 years ago, accumulating research evidence and practical experience in home-based nutritional management has highlighted an urgent need for updating this consensus. In this revised edition, a total of 35 recommendations and expert consensus statements have been proposed to guide community-based health professionals in delivering scientifically sound, rational, and standardized home nutritional management services to elderly populations residing at home or within community settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bayesian Proactive Dynamic Borrowing Utilizing Propensity Score Overlap for a Hybrid Control Arm and the Impacts of Various Biases: A Simulation Study 利用倾向得分重叠的混合控制臂贝叶斯主动动态借贷及各种偏差影响的仿真研究
IF 3.6 2区 医学
Journal of Evidence‐Based Medicine Pub Date : 2025-04-07 DOI: 10.1111/jebm.70022
Kai Wang, Han Cao, Chen Yao
{"title":"Bayesian Proactive Dynamic Borrowing Utilizing Propensity Score Overlap for a Hybrid Control Arm and the Impacts of Various Biases: A Simulation Study","authors":"Kai Wang,&nbsp;Han Cao,&nbsp;Chen Yao","doi":"10.1111/jebm.70022","DOIUrl":"https://doi.org/10.1111/jebm.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The use of external controls in clinical trials can reduce sample size and increase efficiency. Propensity score (PS)-integrated Bayesian borrowing methods discount external controls based solely on prior-data conflict or covariate similarity. We aim to propose a PS-integrated Bayesian proactive dynamic borrowing method that simultaneously considers the similarity of covariates and outcomes and to evaluate its performance under various biases through simulations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a two-stage strategy, covariates were balanced via the PS during the design phase, independent of outcomes. In the analysis phase, Power Prior, Elastic Prior, and Mixture Prior with the random discounting parameter were adopted. We proposed a weakly informative initial prior, using the PS overlap between concurrent and external controls as its mean. It was compared to competitors under selection bias, unmeasured confounders, measurement errors (in covariates and outcomes), and effect drift.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Under selection bias, our approach outperformed using Bayesian dynamic borrowing alone. Compared with the discounting parameter fixed at the PS overlap, it exhibited better control of bias and the Type I error rate. Compared with the noninformative uniform prior, it yielded higher power and a narrower 95% credible interval. However, under other biases, it and other PS-integrated Bayesian borrowing methods exhibited undesirable control of bias and the Type I error rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our approach has an advantage in borrowing external controls with selection bias. However, biases that severely affect PS estimation and outcomes can undermine the performance of PS-integrated Bayesian borrowing methods, particularly those that rely solely on covariate similarity for discounting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of 11 Formulas and Breastfeeding for Atopic Dermatitis and Growth in Pediatric Cow's Milk Protein Allergy: A Systematic Review and Network Meta-Analysis of 23 Randomized Controlled Trials 11种配方奶粉和母乳喂养治疗特应性皮炎和儿童牛奶蛋白过敏生长的比较:23项随机对照试验的系统评价和网络荟萃分析
IF 3.6 2区 医学
Journal of Evidence‐Based Medicine Pub Date : 2025-04-03 DOI: 10.1111/jebm.70026
Tengfei Li, Qingyong Zheng, Jianguo Xu, Yiyi Li, Mingyue Zhang, Bowa Zhang, Li Zhou, Jinhui Tian
{"title":"Comparison of 11 Formulas and Breastfeeding for Atopic Dermatitis and Growth in Pediatric Cow's Milk Protein Allergy: A Systematic Review and Network Meta-Analysis of 23 Randomized Controlled Trials","authors":"Tengfei Li,&nbsp;Qingyong Zheng,&nbsp;Jianguo Xu,&nbsp;Yiyi Li,&nbsp;Mingyue Zhang,&nbsp;Bowa Zhang,&nbsp;Li Zhou,&nbsp;Jinhui Tian","doi":"10.1111/jebm.70026","DOIUrl":"https://doi.org/10.1111/jebm.70026","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study aimed to evaluate the effectiveness of various formulas and the ability of breastfeeding with the exclusion of cow milk protein to reduce the Scoring Atopic Dermatitis (SCORAD) index and promote growth in infants with cow milk protein allergy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted a systematic search of PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, China National Knowledge Infrastructure, WanFang Data, Weipu, and the China Biomedical Literature Database. The search period ranged from the inception of each database to December 2023 (with an update until January 15, 2025). We included randomized controlled trials (RCTs) comparing formulas and breastfeeding for cow's milk protein allergy in infants. Two independent reviewers extracted data via standardized methods and assessed the risk of bias via the revised Cochrane risk-of-bias 2.0 tool. We performed a network meta-analysis (NMA) via a Bayesian fixed-effects model in RStudio and assessed the certainty of the evidence via the Confidence in Network Meta-Analysis (CINeMA) online application. The protocol for this NMA was preregistered in PROSPERO (No. CRD42024504707).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This analysis included 23 RCTs involving 1997 children and assessed 12 interventions. Compared with the regular formula, the pectin-thickened amino acid formula (TAAF) might reduce the SCORAD index (−12.49, 95% confidence interval [CI] −20.38 to −4.48, low certainty). At ≤6 months of follow-up, compared with rice-hydrolyzed formula (RHF), breastfeeding might improve the length-for-age &lt;i&gt;Z&lt;/i&gt; score (LAZ) (0.47, 95% CI 0.13–0.81, moderate certainty), and breastfeeding (0.39, 95% CI 0.02–0.77, low certainty) and extensively hydrolyzed formula (EHF) with probiotics (0.38, 95% CI 0.00–0.77, low certainty) might respectively improve the weight-for-age &lt;i&gt;Z&lt;/i&gt; score (WAZ) and weight-for-length &lt;i&gt;Z&lt;/i&gt; score (WLZ). At the 12-month follow-up, EHF might improve the LAZ (0.41, 95% CI 0.11–0.71, low certainty) and WLZ (0.37, 95% CI 0.18–0.56, low certainty) compared with RHF, whereas the amino acid formula (AAF) may improve the WAZ (0.33, 95% CI 0.02–0.63, low certainty).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Low-certainty evidence suggested that TAAF might reduce the SCORAD index. Moderate or low certainty evidence indicated that, at ≤6 months of follow-up, breastfeeding might improve the LAZ and WAZ, whereas EHF with probiotics might improve the WLZ. At the 12-month follow-up, EHF might improve the LAZ and WLZ, whereas AAF might imp","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development and Performance of a Large Language Model for the Quality Evaluation of Multi-Language Medical Imaging Guidelines and Consensus 多语言医学影像指南和共识质量评估的大型语言模型的开发和性能
IF 3.6 2区 医学
Journal of Evidence‐Based Medicine Pub Date : 2025-04-03 DOI: 10.1111/jebm.70020
Zhixiang Wang, Jing Sun, Hui Liu, Xufei Luo, Jia Li, Wenjun He, Zhenhua Yang, Han Lv, Yaolong Chen, Zhenchang Wang
{"title":"Development and Performance of a Large Language Model for the Quality Evaluation of Multi-Language Medical Imaging Guidelines and Consensus","authors":"Zhixiang Wang,&nbsp;Jing Sun,&nbsp;Hui Liu,&nbsp;Xufei Luo,&nbsp;Jia Li,&nbsp;Wenjun He,&nbsp;Zhenhua Yang,&nbsp;Han Lv,&nbsp;Yaolong Chen,&nbsp;Zhenchang Wang","doi":"10.1111/jebm.70020","DOIUrl":"https://doi.org/10.1111/jebm.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to develop and evaluate an automated large language model (LLM)-based system for assessing the quality of medical imaging guidelines and consensus (GACS) in different languages, focusing on enhancing evaluation efficiency, consistency, and reducing manual workload.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We developed the QPC-HASE-GuidelineEval algorithm, which integrates a Four-Quadrant Questions Classification Strategy and Hybrid Search Enhancement. The model was validated on 45 medical imaging guidelines (36 in Chinese and 9 in English) published in 2021 and 2022. Key evaluation metrics included consistency with expert assessments, hybrid search paragraph matching accuracy, information completeness, comparisons of different paragraph matching approaches, and cost-time efficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The algorithm demonstrated an average accuracy of 77%, excelling in simpler tasks but showing lower accuracy (29%–40%) in complex evaluations, such as explanations and visual aids. The average accuracy rates of the English and Chinese versions of the GACS were 74% and 76%, respectively (<i>p</i> = 0.37). Hybrid search demonstrated superior performance with paragraph matching accuracy (4.42) and information completeness (4.42), significantly outperforming keyword-based search (1.05/1.05) and sparse-dense retrieval (4.26/3.63). The algorithm significantly reduced evaluation time to 8 min and 30 s per guideline and reduced costs to approximately 0.5 USD per guideline, offering a considerable advantage over traditional manual methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The QPC-HASE-GuidelineEval algorithm, powered by LLMs, showed strong potential for improving the efficiency, scalability, and multi-language capability of guideline evaluations, though further enhancements are needed to handle more complex tasks that require deeper interpretation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing the Artificial Intelligence Method and System for “Multiple Diseases Holistic Differentiation” in Traditional Chinese Medicine and Its Interpretability to Clinical Decision 中医“多病整体辨证”人工智能方法和系统的开发及其对临床决策的可解释性
IF 3.6 2区 医学
Journal of Evidence‐Based Medicine Pub Date : 2025-04-02 DOI: 10.1111/jebm.70016
Zhe Chen, Dong Zhang, Pengfei Nie, Guanhao Fan, Zhiyuan He, Hui Wang, Chenyue Zhang, Fengwen Yang, Chunxiang Liu, Junhua Zhang
{"title":"Developing the Artificial Intelligence Method and System for “Multiple Diseases Holistic Differentiation” in Traditional Chinese Medicine and Its Interpretability to Clinical Decision","authors":"Zhe Chen,&nbsp;Dong Zhang,&nbsp;Pengfei Nie,&nbsp;Guanhao Fan,&nbsp;Zhiyuan He,&nbsp;Hui Wang,&nbsp;Chenyue Zhang,&nbsp;Fengwen Yang,&nbsp;Chunxiang Liu,&nbsp;Junhua Zhang","doi":"10.1111/jebm.70016","DOIUrl":"https://doi.org/10.1111/jebm.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The development of artificial intelligence (AI) for traditional Chinese medicine (TCM) has played an important role in clinical decision-making, mainly reflected in the intersectionality and variability of symptoms, syndromes, and patterns for TCM multiple diseases holistic differentiation (MDHD). This study aimed to develop a TCM AI method and system for clinical decisions more transparent with explainable structural framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study developed the TCM syndrome elements integration with priori rule and deep learning (TCM-SEI-RD) method and TCM-MDHD system by high-quality expert knowledge datasets, to predict various TCM syndromes and patterns in hierarchical modules. TCM-BERT-CNN model fused the BERT with CNN model capture feature-related sequence, as the benchmark model in the TCM-SEI-RD method, to improve the performance of predicting TCM syndrome elements. The framework of the TCM-MDHD system involved the TCM-SEI-RD method and TCM “diseases—syndromes—patterns” benchmark sequences, to provide distributed results with credibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For predicting results to the overall TCM syndrome elements, the TCM-SEI-RD achieves 95.4%, 94.43%, and 94.89% in precision, recall, and <i>F</i>1 score, respectively, and 3.33%, 2.28%, and 2.81% improvement over the benchmark model. TCM-MDHD system demonstrates credibility grading at each stage in various diseases and uses the practical example to illustrate the process of distributed decision-making results and transparency with credibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our method and system, as the general AI technologies for TCM syndromes and patterns diagnosis in multiple diseases, can provide the clinical diagnostic basis with the best performance for the TCM preparations rational use, and distribute interpretability to the clinical decision-making process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Expert Consensus on Perioperative Physician–Pharmacist Airway Co-Management 围手术期医师-药师气道协同管理的专家共识
IF 3.6 2区 医学
Journal of Evidence‐Based Medicine Pub Date : 2025-03-31 DOI: 10.1111/jebm.70008
Dongmei Meng, Yuan Qiu, Shiyue Li, Jun Liu, Lunxu Liu, Qiang Pu, Zhen You, Lan Lan, Dehui Chen, Guoying Wang, Ping Wang, Xiaowen Zhang, Hui Xie, Yuwen He, Suzhen He, Zhihua Zheng, Li Wei, Jun Zhao, Jianguo Zhu, Hui Tian, Anchang Liu, Chuangqi Chen, Kejing Tang, Gening Jiang, Yuping Li, Gang Jin, Zheng Jiao, Jian Hu, Sheng Yan, Haibin Dai, Qiang Zhang, Yong Cui, Xingang Li, Zhigang Zhao, Daqiang Sun, Libing Ma, Yingtong Zeng, Dan Guo, Lei Zhang, Li Wei, Jianxing He
{"title":"Expert Consensus on Perioperative Physician–Pharmacist Airway Co-Management","authors":"Dongmei Meng,&nbsp;Yuan Qiu,&nbsp;Shiyue Li,&nbsp;Jun Liu,&nbsp;Lunxu Liu,&nbsp;Qiang Pu,&nbsp;Zhen You,&nbsp;Lan Lan,&nbsp;Dehui Chen,&nbsp;Guoying Wang,&nbsp;Ping Wang,&nbsp;Xiaowen Zhang,&nbsp;Hui Xie,&nbsp;Yuwen He,&nbsp;Suzhen He,&nbsp;Zhihua Zheng,&nbsp;Li Wei,&nbsp;Jun Zhao,&nbsp;Jianguo Zhu,&nbsp;Hui Tian,&nbsp;Anchang Liu,&nbsp;Chuangqi Chen,&nbsp;Kejing Tang,&nbsp;Gening Jiang,&nbsp;Yuping Li,&nbsp;Gang Jin,&nbsp;Zheng Jiao,&nbsp;Jian Hu,&nbsp;Sheng Yan,&nbsp;Haibin Dai,&nbsp;Qiang Zhang,&nbsp;Yong Cui,&nbsp;Xingang Li,&nbsp;Zhigang Zhao,&nbsp;Daqiang Sun,&nbsp;Libing Ma,&nbsp;Yingtong Zeng,&nbsp;Dan Guo,&nbsp;Lei Zhang,&nbsp;Li Wei,&nbsp;Jianxing He","doi":"10.1111/jebm.70008","DOIUrl":"https://doi.org/10.1111/jebm.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Airway management during the perioperative period is a vital component of perioperative care. However, there is a lack of consensus on the selection of medications, timing of administration, and the management of airway complications. This consensus aimed to promote a more rational and standardized application of airway management medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical medical and pharmaceutical experts were invited to participate in this study using the modified Delphi method. Participants completed two rounds of online surveys, with the second round based on the responses from the first round.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 42) reached a consensus on 11 clinical issues and formed 11 recommendations for clinical practice, each with a consensus degree of more than 80%. The recommendations covered aspects of preoperative, intraoperative, and postoperative risk factors evaluation, along with crucial points of medication monitoring in preventing and treating perioperative pulmonary complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The modified Delphi method resulted in consensus recommendations for the perioperative physician–pharmacist airway co-management. We hope this consensus will prevent pulmonary complications and improve patient outcomes through collaborative discussions between physicians and pharmacists.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New Icebergs in Evidence-Based Medicine 循证医学中的新冰山
IF 3.6 2区 医学
Journal of Evidence‐Based Medicine Pub Date : 2025-03-28 DOI: 10.1111/jebm.70028
José Nunes de Alencar
{"title":"New Icebergs in Evidence-Based Medicine","authors":"José Nunes de Alencar","doi":"10.1111/jebm.70028","DOIUrl":"https://doi.org/10.1111/jebm.70028","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Synthesizing Public Health Preparedness Mechanisms for High-Impact Infectious Disease Threats: A Jurisdictional Scan 高影响传染病威胁的综合公共卫生准备机制:司法管辖区扫描
IF 3.6 2区 医学
Journal of Evidence‐Based Medicine Pub Date : 2025-03-28 DOI: 10.1111/jebm.70019
KM Saif-Ur-Rahman, Nikita N. Burke, Lena Murphy, Randal Parlour, Máirín Boland, Petek Eylul Taneri, Bearach Reynolds, Mary Horgan, John N. Lavis, Declan Devane
{"title":"Synthesizing Public Health Preparedness Mechanisms for High-Impact Infectious Disease Threats: A Jurisdictional Scan","authors":"KM Saif-Ur-Rahman,&nbsp;Nikita N. Burke,&nbsp;Lena Murphy,&nbsp;Randal Parlour,&nbsp;Máirín Boland,&nbsp;Petek Eylul Taneri,&nbsp;Bearach Reynolds,&nbsp;Mary Horgan,&nbsp;John N. Lavis,&nbsp;Declan Devane","doi":"10.1111/jebm.70019","DOIUrl":"https://doi.org/10.1111/jebm.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>High-impact infectious diseases pose major global health challenges, underscoring the urgent need for robust public health preparedness. Despite efforts to improve global health security, recent pandemics have revealed significant weaknesses in health systems’ preparedness and response capabilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed and synthesized key strategies and lessons from existing public health preparedness plans for high-impact infectious diseases. This included examining national and global plans, focusing on strategic approaches, evidence integration, and real-world implementation lessons. A narrative synthesis, based on the Public Health Emergency Preparedness (PHEP) model, identified effective practices and areas needing improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We screened 1987 documents, selecting 38 for detailed analysis. Findings highlighted strategies for long-term health emergency preparedness, workforce development, enhancing global health frameworks, and investing in infrastructure. Challenges included maintaining laboratory detection, managing sentinel surveillance, and logistical issues. Effective approaches emphasized early threat detection, rapid response, healthcare capacity, medical supply management, and strategic communication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Effective public health preparedness for high-impact infectious diseases requires a coordinated approach, including early threat detection, rapid response, robust healthcare systems, and strategic communication. Past outbreaks show the need for continuous investment, evidence-based policies, and adaptable health systems. Future research should assess ongoing preparedness efforts and implementation challenges.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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