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evidence-based medicine and precision medicine:complementary approaches to clinical decision-making

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Precision Clinical medicine 2018年第2期1卷 60-64页

作者： Ngai Chow Lucas Gallo Jason W.Busse Department of Health Research Methods Evidence and ImpactMcMaster UniversityHSC-2C1280 Main St.WestHamiltonOntarioL8S 4K1Canada The Michael G.DeGroote Institute for Pain Research and Care McMaster UniversityMDCL-21011280 Main St.WestHamiltonOntarioL8S 4K1Canada Department of medicine McMaster University4V331280 Main St.WestHamiltonOntarioL8N 3Z5Canada Department of Anesthesia McMaster UniversityHSC-2V91280 Main St.WestHamiltonOntarioL8S 4K1Canada The Michael G.DeGroote Centre for Medicinal Cannabis Research McMaster University1280 Main St.WestHamiltonOntarioL8S 4K1Canada

evidence-based medicine is widely promoted for decision-making in health care and is associated with improved patient *** have suggested that evidence-based medicine focuses primarily on groups of patients rather than individuals,but often fail to consider subgroup analyses,N-of-1 trials,and the incorporation of patient values and *** medicine has been promoted as an approach to individualize diagnosis and treatment of diseases through genetic,biomarker,phenotypic,and psychosocial ***,there are often high costs associated with personalized medicine,and high-quality evidence is lacking for effectiveness in many *** the potential of personalized medicine to be realized,it must adhere to the principles of evidencebased medicine:(1)evidence in isolation is not sufficient to make clinical decisions—patient’s values and preferences as well as resource implications must be considered,and(2)there is a hierarchy of evidence to guide clinical decision-making and studies at lower risk of bias are likely to provide more trustworthy findings.

关键词： evidence-based medicine precision medicine decision-making

The artificial intelligence evidence-based medicine pyramid

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World Journal of Critical Care medicine 2023年第2期12卷 89-91页

作者： Valentina Bellini Federico Coccolini Francesco Forfori Elena Bignami Department of medicine and Surgery University of ParmaAnesthesiologyCritical Care and Pain Medicine DivisionParma 43126Italy Department of General Emergency and Trauma SurgeryPisa University HospitalPisa 56124Italy Department of Anesthesia and Intensive Care University of PisaPisa 53126Italy

Several studies exist in the literature regarding the exploitation of artificial intelligence in intensive ***,an important gap between clinical research and daily clinical practice still exists that can only be bridg... 详细信息

关键词： Artificial intelligence Intensive care Intensive care unit evidence-based medicine Clinical research

The Downsides of evidence-based medicine

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Open Journal of Medical Psychology 2022年第3期11卷 125-128页

作者： Nicholas Pediaditakis Brody School of medicine East Carolina University Greenville USA

There exist problems in the actual evidence-based in the practice of medicine relating to the time available and the stringent algorithms employed by the attending physicians. The mistakes are often serious. Illustrating clinical examples are given as to how things can go wrong under the pressure baring on clinicians by the factors given.

关键词： evidence-based medicine Misdiagnoses Comorbidities

Empirical study on the evidence-based medicine in court of China

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History & Philosophy of medicine 2022年第1期4卷 11-15页

作者： Xin Xing Si-Da Shen Zhengzhou University School of law ZhengzhouHenanChina Arizona State University Sandra Day O'Connor College of Law Arizonathe USA

evidence-based medicine(EBM)is recognized as one of the highest-quality scientific approaches in the medical community around the *** calls for doctors to use the best available scientific evidence in clinical *** paper used an empirical study on 44 EBM related judicial cases in China,the result shows the EBM is commonly used as a supplement to the expert opinion in actual judicial review,it is deemed to illuminate the causation in the case fact rather than as the standards of care,which has the similar characteristics as"documentary evidence",and over the years the Chinese judicial practice formed a"three-stage"judicial review rule on EBM:(1)the first stage is whether the evidence itself can meet the standards of EBM;(2)the second stage is when determining the evidence presented by parties is sufficient to meet the legal standards of EBM,and whether it can be applied in a court case would depend upon comprehensive consideration of adaptability and maturity of EBM;(3)the third stage is whether to treat EBM as the only basis in causation analysis.

关键词： evidence-based medicine judicial review court decision Chinese Law

Thinking and practice of accelerating transformation of traditional Chinese medicine from experience medicine to evidence-based medicine

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Frontiers of medicine 2011年第2期5卷 163-170页

作者： Baoyan Liu Yanhong Zhang Jingqing Hu Liyun He Xuezhong Zhou China Academy of Chinese Medical Sciences Beijing 100700China Institute of Basic Research in Clinical medicine China Academy of Chinese Medical SciencesBeijing 100700China Guang'anmen Hospital China Academy of Chinese Medical SciencesBeijing 100053China School of Computer and Information Technology Beijing Jiaotong UniversityBeijing 100044China

The gradual development of Chinese medicine is based on constant accumulation and summary of experience in clinical practice,but without the benefit of undergoing the experimental medicine *** Chinese medicine has formed a systematic and unique theory system through thousands of years,with the development of evidence-based medicine,the bondage of the research methods of experience medicine to Chinese medicine is *** rapid transition and transformation from experience medicine to evidence-based medicine have become important content in the development of Chinese *** to the features of Chinese medicine,we propose the research idea of“taking two ways simultaneously,”which is the study both in the ideal condition and in the real *** and constructing the theoretical basis and methodology of clinical research in the real world,and building the stage for research technique is key to the effective clinical research of Chinese *** by gradually maturing and completing the clinical research methods of the real world could we realize“taking two ways simultaneously”and complementing each other,continuously produce scientific and reliable evidence of Chinese medicine,as well as transform and develop Chinese medicine from experience medicine to evidence-based medicine.

关键词： Chinese medicine experience medicine evidence-based medicine real world

Clinical effects of antidiabetic drugs on psoriasis:The perspective of evidence-based medicine

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World Journal of Diabetes 2021年第8期12卷 1141-1145页

作者： Mei-Xian Zhang Bo-Yuan Zheng Hai-Xiao Chen Ching-Wen Chien evidence-based medicine Center Taizhou Hospital of Zhejiang ProvinceWenzhou Medical UniversityLinhai 317000Zhejiang ProvinceChina Public Laboratory Taizhou Hospital of Zhejiang ProvinceWenzhou Medical UniversityLinhai 317000Zhejiang ProvinceChina Institute for Hospital Management Tsing Hua UniversityShenzhen CampusShenzhen 518055Guangdong ProvinceChina Department of Orthopedics Taizhou Hospital of Zhejiang ProvinceWenzhou Medical UniversityLinhai 317000Zhejiang ProvinceChina

Psoriasis and diabetes shared common underlying pathophysiological *** data suggested that antidiabetic medications may improve the psoriasis severity in patients with diabetes *** hypoglycemic agents including thiazolidinediones,glucagon-like peptide-1 receptor agonists,dipeptidyl peptidase-4 inhibitors,and biguanides have been reported to make a remarkable reduction in the Psoriasis Area and Severity Index score from *** antipsoriatic effect could be mediated not only by the glucoselowering action of these agents but also via inhibition of keratinocyte over proliferation,increase expression of differentiation markers,suppression the immune inflammatory pathway,and blocking the calcium channels and mitogen-activated protein kinase signaling *** the other hand,there was no significant increase in adverse reactions associated with the treatment of pioglitazone or ***,previous studies often had the relatively short duration of the trials,and did not have enough power to assess recurrence of *** bias in the study and missing data could undermine the reliability of the ***,the appropriately randomized controlled studies with large sample sizes and long-term durations in various psoriasis patients are warranted for further support.

关键词： Psoriasis Hypoglycemic agents Thiazolidinediones Glucagon-like peptide-1 receptor agonists Dipeptidyl peptidase-4 inhibitors Biguanides Antipsoriatic effect evidence-based medicine

evidence-based medicine Research on Shanghan Zabing Lun Prescriptions in the Treatment of Endometriosis

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Open Journal of Obstetrics and Gynecology 2016年第12期6卷 769-784页

作者： Junsheng Song Hongyu Liu Mengmeng Han Tianjin University of Traditional Chinese medicine Tianjin China Graduate School Tianjin University of Traditional Chinese Medicine Tianjin China

Objective: Adopting the methods of evidence-based medicine research to acquire the dominant prescriptions of Shanghan Zabing Lun in the treatment of Endometriosis, meanwhile to fully dig the value of classical prescriptions. Method: Firstly, we searched and collected the literatures from last three decades in CNKI, Wanfang and VIP databases, which are about classical prescriptions treating endometriosis. Then, by screening all the literatures, we obtained the clinical research literatures and individual case reports. Finally, we went through the internal quality of the two categories of literatures to get the dominant prescriptions. Results: 22 Shanghan Zabing Lun prescriptions have been used in the treatment of endometriosis. According to the clinical research and case literatures, Guizhi Fuling Wan is the prime prescription to treat endometriosis with high quality and high frequency. Conclusions: Through evidence-based medical research and evaluation of evidence, it can be seen that treatment of endometriosis presents a certain tendency that Guizhi Fuling Wan, Wenjing Decoction and Dahuang Zhechong Wan have good clinical effect treating endometriosis and their syndromes are well matched with the symptoms of endometriosis in the present clinical environment.

关键词： Shanghan Zabing Lun Endometriosis evidence-based medicine Guizhi Fuling Wan

Management of upper gastrointestinal bleeding emergencies： evidence-based medicine and practical considerations

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World Journal of Emergency medicine 2011年第1期2卷 5-12页

作者： Zongyu John Chen Martin L Freeman Minnesota Gastroenterology PA Minneapolis MN 55414 Department of Gastroenterology Hepatology andNutrition University of Minnesota Medical School Minneapolis MN 55455 (Freeman ML) USA

Acute upper gastrointestinal (GI) bleeding remains one of the most common encounters in emergency medicine. The increased use of non-steroid anti-inflammatory drugs by the general population and the increased prescription of anti-platelet agents and anti-coagulants after cardiovascular interventions and for prevention of cerebral vascular accidents may have aggravated the situation. Significant progress has been made in the past decade or so in the non-surgical management of acute upper GI bleeding emergencies. This article will review the current standard treatment of the most common upper GI bleeding emergencies in adults as supported by evidence-based medicine with practical considerations from the authors' own practice experience.

关键词： Emergency medicine evidence-based medicine Upper gastrointestinal bleeding

Developing evidence-based medicine in Persian medicine: obstacles, challenges, and solutions andsolutions

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TMR Integrative medicine 2022年第27期6卷 1-7页

作者： Fataneh Hashem-Dabaghian Aida Asghari Marzieh Qaraaty Department of Traditional medicine Institute for Studies in Medical HistoryPersian and Complementary MedicineSchool of Persian MedicineIran University of Medical SciencesTehran ***Iran. Student in Health Services Management School of HealthTehran University of Medical SciencesTehranIran. Education Development Center Golestan University of Medical SciencesGorganIran. Department of Persian medicine Golestan University of Medical SciencesGorganIran.

Introduction:Considering the importance of evidence-based medicine(EBM)and the emphasis of Persian medicine(PM)experts on its use,this study was designed;to investigate the practice of PM specialists,the obstacles,challenges,and solutions of developing and using EBM in PM were also the aims of the present ***:In the present study,98 PM specialists,who work in Iran completed the electronic Persian version of the evidence-based *** effective factors in the practice of specialists were assessed by Spearman correlation and Mann-Whitney U ***:The mean±standard deviation of age,graduation time,and clinical experience were 44.52±6.45,3.26±2.28,and 6.76±5.27 years,*** the data showed,that 52 participants(53.1%)had not passed any EBM training *** media,general and medical databases,textbooks,colleagues,and journal articles were used frequently in clinical practices,but the specific EBM-specific resources were ***:More attention must be paid to produce scientific evidence,improving the infrastructures and health policies,and empowering PM specialists to apply EBM in their clinical practices.

关键词： evidence-based medicine clinical practice Persian medicine obstacles and solutions Iran