Evidence-based medicine vital for health and medical progress in China

Abstract

medicine--using the best available evidence to make decisions about individual patients' care -- holds vast untapped potential for improving health in China. Youping Li talks to Ursula Zhao. [ILLUSTRATION OMITTED] Professor Youping Li, an organ transplant immunology specialist, has devoted the last 18 years to establishing evidence-based medicine in China. Initially, as vice dean in charge of research at the West China Hospital, Sichuan University in Chengdu (1996 to 2001). In 1997 she established with the Ministry of Health the Chinese Medicine Centre, which became the 14th Cochrane Centre in 1999. Since 2002, she has helped launch 18 sub-centres for evidence-based medicine across China with the Ministry of Education. Since 2003, Li has been a member of the World Health Organization (WHO) Expert Committee on Selection and Use of Essential Medicines. In 2007, she set up the Chinese Clinical Trial Registry as part of the WHO International Clinical Trials Registry Platform. She is the editor of the Chinese Journal of Evidence-Based Medicine (in Chinese) and co-editor-in-chief of the Journal of Evidence-Based Medicine (in English). She is the director of the Evidence-Based Medicine Research Centre at the West China Hospital, where she also heads the Key Lab of Transplant Engineering and Immunology, accredited by the health ministry, and the director of the Evidence-Based Medicine Online Cooperative Research Centre, accredited by the education ministry. Q: How did you become interested in this field? A: A month after I finished four years as a research fellow in organ transplantation immunology at the University of Pittsburgh in the United States [of America] (USA) in May 1996,1 returned to the West China Hospital, where I had worked before. One day, an associate professor named Ming Liu, who had been working with the Cochrane Stroke Group in Edinburgh [Scotland], came to my office, asking whether I would help her launch a Cochrane Centre in China. I felt strongly that this field--i.e. evidence-based medicine--was essential and, after a brief discussion with the dean and others at the hospital, we approved the proposal and raised 100 000 yuan (about US$ 12 000 in 1996) within a week. What happened after that was beyond my expectations. Two months later, Liu was unexpectedly sent abroad, leaving me to carry out this important project all on my own. Q: Where did the idea come from to set up such a centre? A: Early in 1996, officials from the health ministry, joined by Ming Liu as their translator, visited the United Kingdom Cochrane Centre in Oxford, where Iain Chalmers told them about the Cochrane Collaboration and asked them if they would like to establish a Cochrane centre in China. Q: How did you go about this? A: In October 1996, I received an encouraging message from a deputy health minister and, in November, [the late] Chris Silagy, who was director of the Australasian Cochrane Centre at the time, sent me a two-page explanation of how to set up a Cochrane Centre. First, in February 1997, we submitted an official request to set up the first evidence-based medicine centre in China--this was the first step before applying for Cochrane status. Two weeks later we got the go-ahead with a very positive comment from a senior official in the health ministry: Evidence-based medicine is essential for Chinas future. And so, with support from the Sichuan provincial government, our university and our hospital, we launched the centre in the city of Chengdu. In 1997, we received a grant of 40 000 yuan (about US$ 5000) from the National Natural Science Foundation of China, which helped us to organize our first training seminar in evidenced-based medicine. By 1998, several organizations, including the China Medical Board, the Sino-Australian joint programme and WHO were backing our work and so a little spark of 40 000 yuan finally lit great fires. …