Evidence-based Medical Information Research Articles

Exploring virtual delivery of academic detailing to general practitioners compared with in-person delivery: a qualitative study

BackgroundInappropriate prescribing may have detrimental consequences for the patient and increase healthcare utilisation and costs. Academic detailing (AD) is an interactive outreach method to deliver non-commercial evidence-based medical information to...

Assessing the ChatGPT aptitude: A competent and effective Dermatology doctor?

BackgroundThe efficacy and adeptness of ChatGPT 3.5 and ChatGPT 4.0 in the precise diagnosis and management of conditions like atopic dermatitis and Autoimmune blistering skin diseases (AIBD) remain to be elucidated. So this study examined the accuracy and effectiveness of the ChatGPT responses related to understanding, therapies, and specific cases of these two conditions. MethodFirstly, the responses provided by ChatGPTs to a set of 50 questionnaires underwent evaluation by five distinct dermatologists, with complete adjudication of the third-party reviewer. The comparative analysis included the evaluative efficacy of both ChatGPT3.5 and ChatGPT4.0 against the diagnostic abilities exhibited by three distinct cohorts of qualified clinical professionals. And then, an examination was conducted to assess the diagnostic proficiency of ChatGPT3.5 and ChatGPT4.0 in the context of diagnosing specific instances of skin blistering autoimmune diseases. ResultsIn assessing the proficiency of ChatGPTs in generating responses related to fundamental knowledge about AD it is noteworthy that both versions of ChatGPTs, despite their lack of specialized training on medical databases, exhibited a commendable capacity to yield solutions that exhibited a substantial degree of concurrence with evidence-based medical information. Accordingly we observed that the performance of ChatGPT-4.0 beyond that of the ChatGPT-3.5. However, it it crucial to emphasize that ChatGPT-4.0 did not show the ability to offer answers surpassing those provided by associate senior, and senior medical professionals. In the assessment designed to determine the proficiency of ChatGPTs in recognizing particular type of AIBD, it is evident that both ChatGPT-4 and ChatGPT-3.5 demonstrated inadequacy in providing responses that are both precise and accurate for each individual occurrence of this skin condition. ConclusionBoth ChatGPT-3.5 and ChatGPT-4.0 satisfactory for addressing fundamental inquiries related to atopic dermatitis, however they prove insufficient for diagnosing AIBD. The progress of ChatGPT in achieving utility within the professional medical domain remains a considerable journey ahead.

Efficacy and Safety of Shi Cervical Rotational Manipulation in Patients With Atlantoaxial Joint Subluxation: Protocol for a Randomized Controlled Trial.

The clinical diagnosis of atlantoaxial joint subluxation (AJS) in traditional Chinese medicine (TCM) is characterized by an unequal distance between the lateral mass of the atlas and the odontoid process on imaging, resulting in neck pain accompanied by symptoms such as dizziness, headache, and limited cervical mobility. In Shanghai, Shi cervical rotational manipulation (SCRM) is a commonly employed TCM manual therapy for treating this condition. Nevertheless, there is a lack of evidence-based medical information regarding the clinical efficacy and safety of this technique. The principal aim of this study is to evaluate the efficacy and safety of SCRM in patients diagnosed with AJS. This study is a prospective randomized controlled clinical trial that will be conducted at a single center and that has a follow-up period of 24 weeks. A total of 96 patients diagnosed with AJS will be recruited from outpatient and inpatient clinics at Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine. These patients will be randomly assigned to either the experimental group (SCRM) or the comparison group (basic cervical manipulation [BCM]). Treatment sessions consisting of SCRM or BCM will be administered twice a week for a duration of 4 weeks. Clinical monitoring indicators include the presence or absence of clinical symptoms as recorded on a symptom recording form, cervical imaging examination findings using cervical computed tomography, degree of neck pain measured by a visual analog scale (VAS), cervical range of motion assessed through cervical mobility measurement, degree of vertigo evaluated using the Vertigo Symptoms Scale-Chinese Version (VSS-C), and adverse events that may occur during the follow-up period. The time points for data collection and follow-up are baseline and postintervention (weeks 4, 8, 12, 16, 20, and 24). This paper presents an overview of the reasoning and structure of a prospective randomized controlled trial with the objective of investigating the clinical efficacy and safety of SCRM in patients with AJS by assessing improvements in clinical symptoms, neck pain severity, and vertigo severity and evaluating changes in cervical imaging findings. Recruitment was started in March 2023. By the end of May 2024, 76 patients were included in this project. The last follow-up data are predicted to be collected by the end of February 2025. This investigation will yield dependable evidence regarding the efficacy and safety of SCRM in patients with AJS. Chinese Clinical Trial Registry ChiCTR2300068510; https://www.chictr.org.cn/showprojEN.html?proj=186883. DERR1-10.2196/57865.

Assessment of the quality, content, and reliability of YouTube® videos on diabetes mellitus and polycystic ovary syndrome: a systematic review with cross-sectional analysis comparing peer-reviewed videos.

YouTube® is one of the leading platforms for health information. However, the lack of regulation of content and quality raises concerns about accuracy and reliability. CoMICs (Concise Medical Information Cines) are evidence-based short videos created by medical students and junior doctors and reviewed by experts to ensure clinical accuracy. We performed a systematic review to understand the impact of videos on knowledge and awareness about diabetes and PCOS. We then evaluated the quality of YouTube® videos about diabetes and PCOS using various validated quality assessment tools and compared these with CoMICs videos on the same topics. Quality assessment tools like DISCERN, JAMA benchmark criteria, and global quality scale (GQS) score were employed. Some of the authors of this study also co-authored the creation of some of the CoMICs evaluated. Our study revealed that while videos effectively improve understanding of diabetes and PCOS, there are notable differences in quality and reliability of the videos on YouTube®. For diabetes, CoMICs videos had higher DISCERN scores (CoMICs vs YouTube®: 2.4 vs 1.6), superior reliability (P < 0.01), and treatment quality (P < 0.01) and met JAMA criteria for authorship (100% vs 30.6%) and currency (100% vs 53.1%). For PCOS, CoMICs had higher DISCERN scores (2.9 vs 1.9), reliability (P < 0.01), and treatment quality (P < 0.01); met JAMA criteria for authorship (100% vs 34.0%) and currency (100% vs 54.0%); and had higher GQS scores (4.0 vs 3.0). In conclusion, CoMICs outperformed other similar sources on YouTube® in providing reliable evidence-based medical information which may be used for patient education.

Evaluation and significance of a digital assistant for patient history-taking and physical examination in telemedicine

Introduction Assisted history-taking systems can be used in provider-to-provider teleconsultations to task-shift the collection of evidence-based medical history and physical exam information to a frontline health worker. We developed such a task-shifting digital assistant, called ‘Ayu’, for nurses in rural India to collect clinical information from a patient and share it with a remote doctor to arrive at an accurate diagnosis and triage decision. Materials &amp; Methods We evaluated the ability of the task-shifting digital assistant to collect a comprehensive patient history by using 190 standardized patient case studies and evaluating the information recall of the assistant by a skilled clinician. Following this, we tested the ability of nurses to use the system by training and evaluating the system’s accuracy when used by 19 nurses in rural Gujarat, India. We also measured the diagnostic and triage accuracy based on the generated history note. Finally, we evaluated the system’s acceptability by using the Technology Acceptance Model framework. Results Ayu could capture 65% of patient history information and 42% of physical exam information from patient case studies. When used by nurses, the mean accuracy of the generated clinical note was 7.71 ± 2.42. Using the information collected by a nurse using Ayu, a primary care physician could arrive at the correct diagnosis in 74% of cases, and correct triage decision in 88% of cases. Overall, we saw a high acceptability from nurses to use the system. Conclusions Ayu can capture an acceptable proportion of clinical information and can aid in collecting an evidence-based medical history by task-shifting some of the early investigational steps. Further development of Ayu to increase its information retrieval ability and ease of use by health workers is needed.

Judicious use of the YouTube platform as a complementary source of reliable medical information for physiotherapy students — a paradigm shift in educational methodology during the COVID-19 pandemic.

: Background. The COVID-19 pandemic has imposed a paradigm shift in the pedagogical methodology for a resilient medical educational university system. The epidemiological context has imposed a large-scale closure of universities and disturbed traditional methods of teaching and learning (the direct face-to-face patient-student clinical interactions). Social networks such as the YouTube platform seemed to be a complementary source for medical information, providing a modern, viable e-health strategy for physiotherapy students. Only nine studies addressed rehabilitation in various pathologies, but none of them analyzed the quality of videos focusing on neuraxial rehabilitation. Methods. During the 2021–2022 academic year, six undergraduate license theses focused on the frequently encountered pathology in the Neuromuscular Rehabilitation Clinic of TEHBA: rehabilitation after spinal cord injury, stroke, Parkinson`s disease, and disk hernia. The studies started with the hypothesis that the materials posted on the YouTube platform might have variable-quality content depending on the provider who posted the film. The students were given guidance to search for and select the videos and instructions to use the DISCERN and global quality (GQS) scales and to classify the technical and scientific features of each item using descriptive analysis. These qualitative Likert scales assess several video parameters, including the audio-visual flow, the content's medical knowledge value, and its applicability to physiotherapy students. Given the use of public-domain videos available to the general public and posted in the mass media on the YouTube platform, the approval of the Ethical Council was not necessary. Results. Each movie's scientific content was assessed according to its significance, relevance, and clarity. Videos posted to the YouTube platform by healthcare professionals (including experienced physiotherapists), healthcare institutions, and academic health organizations achieved the highest DISCERN and GQS scores compared to other video sources. Videos posted by vloggers (independent authors or patients) received the lowest reliability and quality scores. Discussion. The article presents a timely and relevant study on integrating digital tools in medical education. Although many YouTube videos with kinesiotherapy and rehabilitation content have offered valuable information, students and younger residents should be aware that the social platform sometimes fails to provide high-quality content. YouTube administrators, vloggers, and publishers should use validity scales (such as DISCERN and GQS) as standard guides for quality self-control and promote reliable, evidence-based medical information. Conclusions. A judicious use of e-health education and social media platforms during the COVID-19 pandemic represented complementary sources of reliable medical information for physiotherapy students.

The health of working dogs in conservation in Africa.

Dogs are increasingly being employed for conservation purposes worldwide. In Africa, they work in challenging environments with unique health risks which have not been investigated until now. To understand the health challenges faced by the dogs, semi-structured interviews were conducted with participants from 14 organisations that used working dogs in their conservation programmes. The data was qualitatively analysed by thematic analysis. Five themes were generated. Three affective themes influenced how participants responded to the challenges associated with having a successful conservation dog programme. A strong handler-dog attachment, proficient handler training, and the acknowledgement of the challenging environment were pivotal to maintaining dog health. Two themes related to the difficulties in managing these programmes and how veterinary support interacts with the management choices being made. To have healthy conservation dogs, current and future programmes should focus on fostering the handler-dog relationship and provide continuous handler training. The management of conservation dogs' health should adopt an evidence-based approach. Future research should focus on areas where the evidence base is lacking, particularly in the areas of prevention and treatment of African canine trypanosomiasis. Programmes should develop a good working relationship with a veterinarian that has access to evidence-based veterinary medical information.

Evidence-based guidelines for diagnosis and treatment of age-related macular degeneration in China (2023)

Age-related macular degeneration (AMD) is the main cause of low vision and even blindness in the elderly. With the aging of our population, the number of AMD patients will continue to rise. In the past decade, the rapid development of ocular fundus imaging technology has provided a new perspective and approach for the classification, diagnosis and follow-up of AMD. The advent of new drugs has provided more diverse intervention and treatment methods for AMD, especially for neovascular AMD, and the emphasis on accurate and individualized treatment has put forward higher requirements for retinal specialists. Therefore, based on the latest evidence-based medical information, combined with the international guidelines and the current situation of China's social and economic development, experts from the Chinese Vitreo-Retinal Society of Chinese Medical Association, the Fundus Disease Group of Chinese Ophthalmologist Association, and the National Clinical Research Center for Eye Diseases gave recommendations around eight clinical problems and formed China's guidelines for the clinical diagnosis and treatment of AMD. With the implementation of these guidelines, we can standardize the diagnosis, treatment, prevention and follow-up of AMD in China.

Clinical outcomes associated with complementary and alternative medicine-related "immunity-boosting" practices in patients with cirrhosis during the COVID-19 pandemic - an observational study.

During the coronavirus disease 2019 pandemic, Ayurvedic herbal supplements and homeopathic immune boosters (IBs) were promoted as disease-preventive agents. The present study examined the clinical outcomes among patients with chronic liver disease who presented with complications of portal hypertension or liver dysfunction temporally associated with the use of IBs in the absence of other competing causes. This single-center retrospective observational cohort study included patients with chronic liver disease admitted for the evaluation and management of jaundice, ascites, or hepatic encephalopathy temporally associated with the consumption of IBs and followed up for 180 days. Chemical analysis was performed on the retrieved IBs. From April 2020 to May 2021, 1022 patients with cirrhosis were screened, and 178 (19.8%) were found to have consumed complementary and alternative medicines. Nineteen patients with cirrhosis (10.7%), jaundice, ascites, hepatic encephalopathy, or their combination related to IBs use were included. The patients were predominantly male (89.5%). At admission, 14 (73.75%) patients had jaundice, 9 (47.4%) had ascites, 2 (10.5%) presented with acute kidney injury, and 1 (5.3%) had overt encephalopathy. Eight patients (42.1%) died at the end of the follow up period. Hepatic necrosis and portal-based neutrophilic inflammation were the predominant features of liver biopsies. IB analysis revealed detectable levels of (heavy metals) As (40%), Pb (60%), Hg (60%), and various hepatotoxic phytochemicals. Ayurvedic and Homeopathic supplements sold as IBs potentially cause the worsening of preexisting liver disease. Responsible dissemination of scientifically validated, evidence-based medical health information from regulatory bodies and media may help ameliorate this modifiable liver health burden.

Satellite Symposia Deliver Education and Value to ANESTHESIOLOGY® 2022

Article| September 2022 Satellite Symposia Deliver Education and Value to ANESTHESIOLOGY® 2022 Santhanam Suresh, MD, MBA, FASA Santhanam Suresh, MD, MBA, FASA Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor September 2022, Vol. 86, 20. https://doi.org/10.1097/01.ASM.0000874236.09281.b0 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Search Site Citation Santhanam Suresh; Satellite Symposia Deliver Education and Value to ANESTHESIOLOGY® 2022. ASA Monitor 2022; 86:20 doi: https://doi.org/10.1097/01.ASM.0000874236.09281.b0 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: knowledge acquisition, community, evidence-based practice, partnerships Benjamin Franklin once said, “An investment in knowledge pays the best interest.” ANESTHESIOLOGY 2022, from October 21-25 in New Orleans, Louisiana, presents just such an opportunity to invest in learning about the specialty. The anesthesiology community will come together to network and absorb information from thought leaders, industry innovators, and peers. Practice guidelines, pioneering research, and the latest in evidence-based science will enrich minds and inspire hearts. And this year's Satellite Symposia will be an essential part of the educational mix. Delivered by corporate partners, Satellite Symposia augment and enhance learning opportunities. You won't want to miss these non-CME educational sessions, which are held Saturday, Sunday, and Monday and include complimentary breakfast, lunch, and dinner. This year's Satellite Symposia will cover topics ranging from pain management and situational awareness to brain monitoring and best practices for addressing everyday imperfections. These industry presentations cover evidence-based medical and scientific information on current... You do not currently have access to this content.

RELEASING TERMINOLOGY INHIBITIONS IN MEDICAL ENGLISH UNDER A POSTMODERNIST INFLUENCE

There is a universally acknowledged truth that the medical lexis is largely composed of Greco-Latin vocabulary. There is also a general assumption that health professionals supposedly possess no other relevant linguistic means but the Greco-Latin terms to communicate clinically specific information. In a postmodernist approach, however, there is an ‘assault’ on this dogmatic view. To the postmodern eye, the truth is pluralistic; diverting opinions are embraced when constructing this truth. And if postmodernist approach welcomes pluralism and open-mindedness in composing this information, then health professionals may well construct the evidence-based information through various linguistic devices, rather than relying exclusively on fixed terminology and concepts of Latin and Greek origin. This means that the evidence-based medical and clinical information may be communicated, inter alia, by such constructs as metaphors and metaphoric expressions.

The use of erythropoietins in oncology

The editorial article presents information about the problem of the use of erythropoietins in anemia in cancer patients in conjunction with the results of Cochrane systematic reviews the gold standard of the quality of evidence-based medical information.

Fishing nets and video creation: diabetic nephropathy education on screen

Abstract: Introduction: Noncommunicable Chronic Diseases (NCDs), such as Diabetes and Hypertension are responsible for 2/3 of deaths in the world, with Diabetic Nephropathy (DN) representing the most important cause of chronic kidney disease. Health Literacy (HL) is one of the social determinants of health. To guide and expand the knowledge of patients and teams involved in the care of people with NCDs, and for a better approach to chronic complications of Diabetes and Hypertension, the development of learning objects (LO) was proposed. Experience Report: this study involved the construction of an educational video by a group of five students during the academic program of undergraduate Medical School in 2019. They proposed a guiding question in relation to DN from a theoretical material. The chosen question was: “What is the level of understanding of patients with diabetic nephropathy in relation to their own disease?”. They developed a questionnaire on diabetes and hypertension and their complications, which was answered by patients with diabetes who were treated at the specialized outpatient clinic, aiming to answer the proposed problem. They drew a synthesis from the analysis of the responses, of the possible gaps in relation to the understanding of the diseases. Then, a script was created with the description of these gaps with the medical explanation and an analogy was made with fishing nets for the video production, containing narratives, texts, audios and images. Finally, the video was presented to teachers and students in the classroom. Discussion: The characterization of the video as an LO implies constructing it as an educational component, self-sufficient, reusable and with the possibility of combining it with other LOs as new educational tools. Conclusion: The educational material was characterized as an LO. It allows pointing out aspects of the progression of DN and recommended medical orientations for the disease. It establishes a tool for group discussions and isolated actions based on succinct and evidence-based medical information. The video validation is undergoing validation for use in health services.

Fishing nets and video creation: diabetic nephropathy education on screen

Abstract: Introduction: Noncommunicable Chronic Diseases (NCDs), such as Diabetes and Hypertension are responsible for 2/3 of deaths in the world, with Diabetic Nephropathy (DN) representing the most important cause of chronic kidney disease. Health Literacy (HL) is one of the social determinants of health. To guide and expand the knowledge of patients and teams involved in the care of people with NCDs, and for a better approach to chronic complications of Diabetes and Hypertension, the development of learning objects (LO) was proposed. Experience Report: this study involved the construction of an educational video by a group of five students during the academic program of undergraduate Medical School in 2019. They proposed a guiding question in relation to DN from a theoretical material. The chosen question was: “What is the level of understanding of patients with diabetic nephropathy in relation to their own disease?”. They developed a questionnaire on diabetes and hypertension and their complications, which was answered by patients with diabetes who were treated at the specialized outpatient clinic, aiming to answer the proposed problem. They drew a synthesis from the analysis of the responses, of the possible gaps in relation to the understanding of the diseases. Then, a script was created with the description of these gaps with the medical explanation and an analogy was made with fishing nets for the video production, containing narratives, texts, audios and images. Finally, the video was presented to teachers and students in the classroom. Discussion: The characterization of the video as an LO implies constructing it as an educational component, self-sufficient, reusable and with the possibility of combining it with other LOs as new educational tools. Conclusion: The educational material was characterized as an LO. It allows pointing out aspects of the progression of DN and recommended medical orientations for the disease. It establishes a tool for group discussions and isolated actions based on succinct and evidence-based medical information. The video validation is undergoing validation for use in health services.

A fuzzy mobile decision support system for diagnosing of the angiographic status of heart disease

In estimating the risk of heart disease due to non-deterministic risk factors, often diagnosis of angiographic disease is difficult for physicians. For modeling and application of this uncertain and imprecise modality, decision support systems based on fuzzy logic are appropriate and an effective approach. Smartphone-based applications can facilitate the efficient use of these systems in form of evidence-based medicine. The aim of this applied study was developing and evaluating an application to diagnose angiographic disease conditions and the severity of heart attacks through a smartphone-based clinical decision support system. Android application development environment was utilized after extraction of linguistic rules and definition of membership functions needed for decisions. A smartphone-based application was designed using these guidelines and utilizing fuzzy modeling. Then, the app was evaluated in terms of accuracy using the popular Cleveland dataset. According to the results, 10 fuzzy rules for modeling, seven input variables and one decision variable were extracted. Programming was done in Eclipse. The evaluation results indicate that the accuracy of the program was 94%. Decision support systems within the context of mobile health have become some of the most efficient and influential information technology tools in recent years. They can improve patient-care management, provide easier access to the information needed for healthcare decisions and ultimately reduce healthcare costs while improving its quality.

The challenges of COVID-19 for community pharmacists and opportunities for the future.

Pharmacists, like psychiatrists, have modified their practices amidst COVID-19 in order to guarantee care and support to their patients. Designated an essential frontline service, community pharmacists are facing a spectrum of challenges to surmount to ensure patient care continues. These include assisting in the prevention of infection, managing supply chains, preventing stockpiling and provision of evidence-based medical information. However, disasters like COVID-19 disproportionately affect poor and vulnerable populations, and patients with mental health conditions may be among the hardest hit. Pharmacist-level, system-level and regulatory responses have sought to minimise this impact, although there is likely to be a lasting impression on the profession, both good and bad. This article reviews the pandemic-related challenges and responses by pharmacists, as well as forming recommendation for areas of professional support and role expansion, particularly in the case of mental health.

Attitudes of Nurses Towards Searching Online for Medical Information for Personal Health Needs: Cross-Sectional Questionnaire Study.

BackgroundUse of online clinical health care information has become part of the skill set required by medical teams. Nurses believe that information quality and availability affect nursing care and methods. However, nurses tend not to exploit professional medical databases for evidence-based medical information for their personal needs. This phenomenon has received little research attention.ObjectiveThis study aimed to address the knowledge gap around nurses' attitudes towards searching online for medical information for their personal needs (ie, for themselves and their families) by (1) evaluating the level of exposure to medical information and the effect on attitudes towards the use of online search options, (2) assessing the effect of the choice of a primary means of searching for medical information on the attitudes towards the use of online search options, and (3) gauging the influence of sociodemographic data and health status on nurses’ attitudes towards searching online for medical information.MethodsNurses employed in general departments in a general hospital (34/210, 16.2%), nursing home (42/200, 21.0%), and geriatric medical center (45/180, 25.0%) in Israel were invited to complete the eHealth Impact Questionnaire (alpha=.95). Questionnaires were distributed by nurses in charge of the general hospitalization wards. The data collection period was February to March 2018. The response rate was 40.3% (121/300).ResultsNurses tended to search for medical information for personal needs on social media (24/121, 19.8%) and TV (eg, health programs, health news; 23/121, 19.0%). Nurses who chose social media as their primary means of receiving general information had a positive attitude about using the online environment as a source for medical information compared to nurses who found information through other means (t119=4.44, P<.001). Nurses exposed to medical information via social media had a positive attitude towards the use of the internet to find medical information compared to nurses who were not exposed to social media (t119=3.04, P=.003). The attitudes of nurses towards the utility of online medical information for personal needs increased with better participant health status (F2,118=3.63, P=.03). However, the attitudes of participants with a chronic disease did not differ from those of healthy participants.ConclusionsNurses in Israel are less likely to use their professional skills and knowledge to search in professional databases for evidence-based medical information for their personal needs. Instead, they prefer medical information that is easy to access and not evidence-based, such as that on social media and TV. However, these search patterns for personal use may affect their clinical role, impair quality of care, and lead to incorrect medical decisions for their patients in the health care system. Therefore, during nursing education, training for searching skills, retrieval skills, and online search techniques for evidence-based medical information is vital for evidence-based practice.

Efficacy and safety of basic fibroblast growth factor in the treatment of burns: Protocol for a systematic review and meta-analysis of randomized controlled trials.

Background:To systematically evaluate the efficacy and safety of basic fibroblast growth factor (bFGF) in the treatment of burns and to provide evidence-based medical information for clinicians to choose the appropriate treatment measures for burns.Methods:Seven databases, including PubMed, the Cochrane Library, Embase, the Chinese Biomedical Literature Database, the Wanfang Database, the China National Knowledge Infrastructure Internet, and the Chongqing Chongqing Weipu Chinese Science and Technology Journal Full-text Database (VIP), were searched by computer. Randomized controlled trials on bFGF in the treatment of burns were collected, and the search was conducted by using a combination of subject terms (MeSH) and free words. The search time limit was from the establishment of each database until January 2019. Two researchers independently screened the literature and extracted the data. According to the evaluation criteria recommended in the Cochrane Handbook for Systematic Reviews of Interventions version 5.3.0, they conducted a rigorous bias risk assessment for the included studies, and Stata 12.0 software was used for meta-analysis.Results:System evaluation and meta-analysis were carried out strictly in accordance with the requirements of the Cochrane Handbook for Systematic Reviews of Interventions version 5.3.0 on meta-analysis and provided a high-quality evaluation of the efficacy and safety of bFGF in the treatment of burns.Conclusion:This study provided conclusions from evidence-based medicine and a scientific basis for the efficacy and safety of bFGF in the clinical treatment of burns.Ethics and dissemination:This study was not a clinical trial and therefore did not require ethical approval. The results of this study will be published in an SCI academic journal related to this study in the form of a public publication.PROSPERO registration number:CRD42019124778.

Written Health Education Materials for Women with Gestational Diabetes Mellitus – Evaluation of Usefulness and Patients’ Satisfaction

Written health educational materials are an integral part of the treatment process. Because of the constantly increasing gestational diabetes mellitus (GDM) global rate, pregnant women require accessible, easy-to-understand and evidence-based medical information about this pregnancy complication. To adapt and elaborate printed educational materials on GDM and to evaluate the usefulness of the produced training materials and pregnant women's satisfaction. The present study implemented a methodological approach covering three phases: (1) systematic literature review; (2) compilation of printed educational materials for pregnant women with GDM; (3) evaluation of the usefulness and satisfaction with the produced educational materials through a focus group consisting of pregnant women. A seven-item self-administered feedback questionnaire was adopted for evaluation of patient satisfaction after the use of educational materials. An educational manual was developed in compliance with the main requirements for effectiveness of educational materials referring to content, structure, language, layout and illustrations. The usefulness of the educational manual and patient satisfaction were evaluated by a sample group of 20 women with GDM. Approximately 95% agreed or strongly agreed that the information in the educational manual was useful. The patients' assessment of the understanding and readability of the written materials showed a satisfaction rate of 85%. The overall assessment for the educational materials was very high - excellent (65%), very good (30%) and good (5%). The provision of educational materials on GDM can enhance pregnant women's health literacy as well as their responsibility, motivation and attitude to their personal health.

Antibiotics for Groin Hernia Repair According to Evidence-Based Guidelines: Time for Action in Ghana

BackgroudGroin hernia repairs (GHR), though classified as clean surgeries, are associated with varying rates of surgical site infections. We assessed the practices of surgeons in Ghana regarding antibiotic use for GHR in comparison to evidence-based international guidelines (EBIG). MethodsWe interviewed surgeons trained by the Ghana College of Physicians and Surgeons (GCPS), from inception (2003) through 2016, about their use of antibiotics for GHR. We defined the outcome variable of consistently following EBIG in antibiotics use for GHR. Logistic regression was used to examine how a priori selected covariates contributed to the outcome. ResultsEighty-two of 117 surgeons reported performing/supervising at least one GHR per week. They performed/supervised a mean of five GHR per week. Thirty-two (40%) reported using mesh for at least 50% of GHR. For primary GHR, 75% of surgeons administered antibiotics according to EBIG, whereas for GHR with mesh only, 45% did so. Predictors of consistently following EBIG were increasing number of GHR performed per week (adjusted odds ratio 1.44, 95% CI 1.07-1.96) and increasing time spent for clinical work (adjusted odds ratio 0.95, 95% CI 0.91-0.99). Years of practice since GCPS graduation, total operations performed per week, and hospital level of practice were not predictive of the outcome variable. ConclusionsTwo-thirds of Ghanaian surgeons interviewed do not consistently administer antibiotics for GHR per EBIG, raising the need to improve access to evidence-based medical information overall to guide practice. Determining local surgical site infections rates to guide antibiotic use in GHR will be useful in Ghana and other LMICs.