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Objective To compare and analyze the characteristics of the teaching evaluation tools for evidence-based medicine(EBM) in recent 5 years, so as to provide suggestions for further design and optimization of curriculum evaluation methods. Methods PubMed, Web of Science, Chinese biomedical literature database, CNKI, Wanfang database were searched from January 1, 2018 to September 16, 2022. Two researchers screened the literature, extracted the objects, focused topics, psychometric indicators, item contents, etc. of the tools, and made a comprehensive analysis of the existing tools. Results 16 articles (involving 14 tools) were finally included, all of which were reliable. Among them, 11 tools focus on the mastery level of the respondents' knowledge and (or) skills related to evidence-based medicine (the number of items ranges from 6 to 24), mostly involving the comprehensive cognition of evidence-based medicine, the understanding of common terms, the judgment of key concepts, the sharing and application of evidence-based practice, etc., and the evaluation criteria are mostly the judgment of right and wrong, self-evaluation, and the objective evaluation of feedback content; 7 tools focus on the true attitude of the respondents to the evidence-based practice (the number of items ranges from 3 to 21), and the evaluation criteria are mostly subjective intention options; 4 tools are used to understand the implementation frequency, time allocation and sharing of key links of evidence-based practice by the respondents (the number of items ranges from 6 to 18). The evaluation criteria are mostly subjective choices of frequency. Conclusion The questionnaire of knowledge/skills and their attitudes and behaviors can be used as an auxiliary tool in the evaluation of EBM courses. However, it is still necessary to further optimize the content and proportion of items according to the teaching characteristics and goals of the teaching objects, and develop monitoring and evaluation tools for the teaching process of evidence-based medicine curriculum.

With the popularization and promotion of information technology, healthcare big data is growing exponentially, and clinical real-world research based on healthcare big data is receiving increasing attention. The hospital electronic medical record (EMR) records the whole process of diagnosis and treatment of patients in the "real-world", and is one of the most supportive data sources for clinical decision-making. However, the existence of a large number of unstructured text data in EMR data increases the difficulty of data processing and restricts the development of research based on EMR data. Advanced methods such as information technology and artificial intelligence need to be applied to the processing of unstructured EMR data to accelerate the transformation of data value. This paper summarizes the current common methods of unstructured medical data processing, including methods based on dictionaries and rules, methods based on traditional machine learning and deep learning, and methods based on cognitive models represented by ontology, and also discusses the problems of standardization and transparent reporting when processing unstructured EMR data and looks forward to the relevant development.

Objective To systematically review the effectiveness and safety of cathe-ter-directed thrombolytic therapy (CDT) using alteplase and urokinase in the treatment of deep vein thrombosis (DVT) in the lower extremities.Method PubMed, The Cochrane Library, Web of Science, Embase, WanFang Data, CNKI and SinoMed databases were searched electronically to collect randomized clinical trials and cohort sudies on CDT using alteplase and urokinase in the treatment of DVT in the lower extremities from inception of the databases to December 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias in included studies, a Meta-analysis was performed using RevMan 5.4 software.Result A total of 7 cohort studies involving 598 patients were included. The results of the Meta-analysis showed that there was no sta-tistically significant difference between alteplase and urokinase in the clinical effectiveness rate [RR=1.07, 95%CI(0.91, 1.25), P=0.43] and thrombolysis rate [RR=1.08, 95%CI(0.99, 1.16), P=0.07]; the thrombolytic time of alteplase was shorter than that of urokinase [MD=-1.12, 95%CI(-1.93, -0.31), P=0.007]; there were no statistically sig-nificant differences between alteplase and urokinase in the incidence of minor bleed-ing[RR=1.19，95%CI(0.70, 2.00), P=0.52] and major bleeding[RR=0.73, 95%CI(0.27, 1.98), P=0.54]. Conclusion The effectiveness and safety of CDT of alteplase and urokinase in the treatment of DVT in the lower extremities and the risk of bleeding are comparable, but alteplase achieved thrombolysis in a shorter time than urokinase. The above conclusions are limited by the quantity and quality of included studies and need to be verified by more high-quality research.

The real-world data comes from the real medical environment, which can reflect the med-ical process and the patient's health status under real clinical conditions, and can be used as an important source of evidence and knowledge. As a semantic network, knowledge map can be used to organize, pre-sent and reason medical knowledge. The combination of real-world data and knowledge map can better supplement, display and use medical knowledge. At present, using real-world data to build a medical knowledge map or using real-world data to complete the medical knowledge map are the main ways of combining the two applications. When carrying out the application research on the combination of re-al-world data and medical knowledge map, attention should be paid to the issues about the multidiscipli-nary team collaboration, patient privacy protection and data standardization.

There are many shortcomings in the readability and applicability of current clinical practice guidelines used both in the computer-aided clinical decision making process and in clinical practice. We have explored the framework of the universality of guidelines by standardizing the representation of their structure and knowledge; and the relationship between this and the guideline knowledge. Promoting the standardization and standardized expression of guideline knowledge and constructing a standardized easily shareable guideline knowledge base that is transplantable through modeling and demonstration, is conducive to meeting the needs for the development of a clinical decision support system promoting the implementation of clinical practice guidelines and the improvement of clinical diagnosis and treatment service quality. The introduction of knowledge graphs provides a solid foundation for digital intelligentization of guidelines. However, there is little methodological content available for guideline knowledge graph construction. This study used the construction of a knowledge graph for Evidence-based clinical practice guidelines for the treatment and monitoring of non-muscular invasive bladder cancer in China (2018 Standard Edition) as an example. We identified the guideline module, analyzed its basic information, background and the scope of its methodological content, then set out the hierarchical relationship between concepts in combination with expert opinions, designed the concept structure table according to multi-level concept layers and concept examples, adjusted the relationship structure between concepts, and improved the relationship between the different entities. This article discusses and summarizes the modeling and representation methods of the basic information, background and methods of the guidelines, thus providing a reference for the construction of knowledge maps for other clinical practice guidelines in the future.

Abstract Background Obesity (waist circumference, body mass index (BMI)) and lifestyle factors (dietary habits, smoking, alcohol drinking, Sedentary behavior) have been associated with risk of benign prostatic hyperplasia (BPH) in observational studies, but whether these associations are causal is unclear. Methods We performed a univariable and multivariable Mendelian randomization study to evaluate these associations. Genetic instruments associated with exposures at the genome-wide significance level (P

Objective To systematically evaluate the prognostic value of circulating tumor cells (CTCs) in patients with non-small cell lung cancer (NSCLC).Methods We electronically searched CNIK, WanFang Data, CBM, VIP, PubMed, Web of Science, The Cochrane Library, and Embase database for literature regarding detection of baseline levels of CTCs and survival in NSCLC patients from inception to 28 September 2021. After screening for inclusion criteria, data extraction and quality assessment were performed followed by Meta-analysis using the RevMan 5.3 and Stata 15.0 software.Results 19 studies were included in this Meta-analysis with a total of 1,853 NSCLC patients. Meta-analysis revealed that NSCLC patients with high levels of CTCs had poorer progression-free survival (PFS) than those with low levels of CTCs [HR=2.49, 95% CI(1.50, 4.13), P=0.0004], but levels of CTCs had no significant predictive effect on overall survival (OS) [HR=1.18, 95%CI(0.70, 1.99), P=0.54].Conclusions Baseline CTCs levels have a significant predictive effect on PFS in NSCLC patients, but have no significant predictive ability on OS. This is an area which requires further study in the future.

Benign prostatic hyperplasia is the most common benign disease that causes urination dysfunction in middle-aged and elderly men, and is also the main cause of lower urinary tract symptoms. Transurethral plasmakinetic resection of prostate has been widely used in clinical practice for its good efficacy and safety. In order to further standardize the clinical application of this surgery, the National Health Commission published the initial Clinical Pathway Interpretation of Transurethral Plasmakinetic Resection of Prostate for Benign Prostatic Hyperplasia in 2019. In view of the limited content of this clinical pathway, using it as a blueprint, we have interpreted it and applied the ideas and methods of evidence-based medicine, aiming to provide a more detailed evidence supplement to help medical staff and managers better understand, grasp and correctly use this clinical pathway.

Bladder cancer is the tenth most frequently diagnosed cancer in the world, and is more common among men. Transurethral resection of bladder tumor is not only an important diagnostic method for bladder tumors, but also a major treatment for non-muscle invasive bladder cancer. Com-pared with traditional unipolar electrotomy, plasma bipolar electrotomy has the advantages of good surgical results and fewer complications, and its clinical application is becoming more and more exten-sive. In order to standardize the diagnosis and treatment of common diseases, the National Health Commission continues to issue relevant clinical pathways; however, the content of a clinical pathway is limited, and its interpretation can help it be better disseminated and used. This interpretation is based on the latest "clinical pathway for transurethral plasma resection of bladder tumor (2019 edition)". It uses the method of evidence-based medicine to make a detailed and necessary supplementary descrip-tion of the pathway, and gives a detailed interpretation of the drug delivery scheme involved, so as to provide reference for medical staff and managers to better understand, grasp and correctly use it.

In this study, based on the characteristics of Traditional Chinese Medicine (TCM) diagnosis and treatment and TCM clinical guidelines, knowledge extraction and knowledge storage were carried out to construct a knowledge graph depicting Traditional Chinese Medicine/Integrated Traditional Chi-nese and Western Medicine (IM) clinical guidelines using the "Guidelines of the Traditonal Chinese Medicine management of stable angina pectoris in coronary artery disease" as an example. This enabled us to further test the operability and rationality of the application of knowledge graph technology to the field of TCM/IM guidelines. The graph was constructed using the design of the concept layer and the da-ta layer, extracting entities and relationships from the guidelines, sorting them into the entity database and triple relationship databases for knowledge importation, using neo4j for knowledge storage, re-trieving and verifying the correctness of the knowledge graph, and completing the visual display. The methods used in constructing the knowledge graph for this clinical guideline also provides a template for the construction of knowledge graphs for TCM/IM clinical guidelines for other diseases.

The transformation and application of the guidelines is a crucial link in the transformation of medical science achievements and technology. However, there are still many problems with the op-erability of the current guidelines in clinical decision-making and practice. The knowledge graph has provided a solid foundation for the intelligentization of the guidelines and a good method for solving the problems of the implementation of the guidelines. Non-muscle invasive bladder cancer (NMIBC) is a common malignant tumor of the urinary system, and new diagnosis and treatment methods for NMIBC are emerging. In view of the time-consuming and frequent update of clinical guidelines for NMIBC, as well as the urgent need for clinicians to learn, use, and sort out the updated content of the guidelines, this study is based on the disease characteristics of NMIBC and the clinical guidelines to propose and construct a knowledge graph framework for clinical guidelines of NMIBC, which mainly starts from ana-lyzing the scope of the guideline, combing the guideline content modules, summarizing the guideline knowledge structure. Then, we referred to the OMAHA Schema, and designed the concept structure ta-ble according to the secondary concept layer and concept instances. Thereafter, we designed and ad-justed the relationship structure between concepts, improved the relationship between entities, and finally reviewed and evaluated the scientific and method validity of the knowledge graph through ex-perts. The design of the knowledge graph construction framework based on the guideline for NMIBC proposed in this paper provides a basis for the digitization and intelligence of the guideline, which is conducive to the implementation and dissemination of the guideline.

The implementation of clinical practice guidelines is an important form of evidence transformation and a main way to narrow the gap between research results and clinical practice. Af-fected by factors such as low operability, single form of dissemination and application, not timely update, and lack of implementation tools and implementation evaluation tools, the implementation of clinical practice guidelines is still insufficient. Combining the evidence ecosystem framework, constructing guideline implementation evaluation tools, and using knowledge graph and other artificial intelligence technologies to provide theoretical support, effect evaluation tools, and technical paths for the imple-mentation of the guidelines are effective methods to promote the implementation of clinical practice guidelines.

Objective To comprehensively evaluate the quality of the non-randomized studies on the effects of published interventions into the Chemoprophylaxis, diagnosis, treatments, and dis-charge management of COVID-19: an evidence-based clinical practice guideline (updated version).Methods The well-established guideline search strategy was used in this study. An electronic litera-ture search was conducted using PubMed, Embase, the Cochrane Library, CNKI, Wanfang Database and major medical journals which included the topics of infection or respiration, preprint platforms and clinical trial registries from December 1, 2019, to July 8, 2020. The language was limited to Chi-nese and English. Non-randomized intervention studies of pharmacotherapies for the prevention and treatment of COVID-19 were sought and included, and methodological quality assessment was con-ducted using the f ROBINS-I tool.Results A total of 40 non-randomized intervention studies were retrieved, including 20 antiviral drug intervention studies, 16 immunotherapy intervention studies and 4 traditional Chinese medicine intervention studies. Our evaluation showed that the overall risk of bias in all 40 studies was moderate to serious, and 15 of them had a "serious" overall risk of bias. Two domains (bias due to confounding and bias due to deviations from intended interventions) had a high risk of bias, mainly because of the poor control of baseline confounding factors, time-varying confounding factors and important intergroup variations of intervention measures.Conclusions The overall quality of existing non-randomized intervention studies on pharmacotherapy for the preven-tion and treatment of COVID-19 is poor, and some recommendations are inconclusive. Large, pro-spective studies and randomized controlled trials with a rigorous design are needed to improve the quality of evidence.

Objective To evaluate complications related to transurethral plasmakinetic prostatectomy (TUPKP) in the treatment of benign prostatic hyperplasia (BPH).Methods CNKI, Wanfang database, VIP Chinese journal service platform, CBM, PubMed, Embase, Web of Science and The Cochrane Library were searched for cross-sectional studies on the incidence of complications of TUPKP in the treatment of BPH from January 1st, 2018 till to September 15th, 2020. Two researchers independently screened the literature, extracted data and evaluated the risk of bias in the included studies, the R software meta package was used for meta-analysis.Results Twenty-seven studies were finally included, reporting on 5,247 patients with 31 complications described. Meta-analysis showed that the incidence of 6-month abnormal ejaculation rate is 75.15% [95%CI (68.25%, 81.47%)]; the incidence of retrograde ejaculation is 24.77% [95%CI (0.00%, 73.81%)]; the incidence of irritating symptoms was 17.15% [95%CI (9.61%, 26.22%)]. The incidence of other complications was less than 10%, and 21 of them had an incidence of less than 3%. The incidence of transurethral resection syndrome in 15 studies was 0.Conclusion There are many types of complications after TUPKP treatment for BPH, and the incidence rate varies greatly.

Objective To systematically evaluate the efficacy and safety of transurethral plasmakinetic prostatectomy (TUPKP) and trans urethral resection of prostate (TURP) in the treatment of benign prostatic hyperplasia (BPH).Methods We searched the databases of PubMed, Embase, Web of Science, the Cochrane Library, CNKI, Weipu, China Biomedical Literature Database and Wanfang Database, and collected relevant randomized controlled trials (RCTs) from their inception to September 15, 2020. Data extraction and assessment of risk of bias were performed by two reviewers independently. Meta-analysis was performed using Stata 16.0 software.Results A total of 45 RCTs involving 6 490 subjects were included. The results of Meta-analysis showed that, in patients with normal volume of prostate (

Objective To evaluate the efficacy and safety of transurethral plasmakinetic prostatectomy (TUPKP) versus transurethral plasmakinetic enucleation of prostate (TUPEP) in treating benign prostate hyperplasia (BPH).Methods PubMed, EMBASE, the Cochrane Library, CNKI, VIP, CBM database and Wanfang database were searched for relevant randomized controlled trials from January 1st, 2018until September 15, 2021, and references were manually searched. Two researchers independently conducted literature screening, data extraction and quality evaluation. Stata13.0 software was used for Meta-analysis.Results A total of 30 studies were included, reporting on 3,218 BPH patients, of whom 1,626 received TUPKP and 1,592 received TUPEP. Meta-analysis of results show that: for effectiveness, when treating a normal volume (

Objective To formulate the 2019 novel coronavirus (2019-nCoV) nosocomial infection research and analysis tools.Methods Based on the questionnaire for infection process and prevention of 2019-nCoV infection in medical staffs, we developed the new questionnaire by means of three procedures including refining the purpose of the questionnaire, establishing the item pool, and evaluating the content validity of the questionnaire.Results We formulated three questionnaires for 2019-nCoV releated nosocomial infection including questionnaires for staff in administrative and logistics departments, the non-infected health care staff, and non-infected staff in administrative and logistics departments. The content of the questionnaires were consistent with the research objectives. The questionnaire for COVID-19 among staff in administrative and logistics departments included two aspects of investigation before and after diagnosis, "before diagnosis" involved infection cause, plan of prevention and control, knowledge of prevention and control, and psychological symptoms, there were 16 items in total; "after diagnosis" included 5 parts, including symptoms after diagnosis, treatment after diagnosis, impact on the surrounding environment and people after infection, psychology symptoms, awareness of protection, there were 21 items in total. The questionnaire for COVID-19 among non-infected health care staff included analysis of causes of infection in work and life, relevant prevention and control behaviors, infection prevention and control knowledge and psychological response to the epidemic, there were 29 items in total; the questionnaire for COVID-19 among non-infected staff in administrative and logistics departments included same aspects as questionnaire for COVID-19 among non-infected health care staff, and also 20 items.Conclusions We developed questionnaires for 2019-nCoV releated nosocomial infection including a study on infection processes and prevention measures for COVID-19 among staff in administrative and logistics departments, a study on infection processes and prevention measures for COVID-19 among non-infected healthcare staff, and a study on infection processes and prevention measures for COVID-19 among non-infected staff in administrative and logistics departments. The reliability, validity, and practicability of these questionnaires are all acceptable.

The objective of this study was to compare the efficacy and safety of 10 different surgical treatments for benign prostatic hyperplasia (BPH) with volume >60 mL. A systematic literature review and network meta-analysis of randomized controlled trials (RCTs) within a Bayesian framework was performed. A total of 52 parallel-group RCTs included, reporting on 6,947 participants, comparing open prostatectomy (OP), monopolar/bipolar transurethral resection of prostate (monopolar/ bipolar TURP), thulium, holmium and diode laser enucleation of prostate (LEP), bipolar enucleation of prostate, potassium titanyl phosphate laser vaporization of prostate (KTP LVP), bipolar vaporization of prostate (bipolar VP), and laparoscopic simple prostatectomy (laparoscope SP). Compared with OP, laparoscope SP identified better maximal flow rate (Qmax; mean differences [MDs] = 2.89 mL/s) at the 24th month, but bipolar VP demonstrated worse Qmax (MD = −3.20 mL/s) and International Prostate Symptom Score (IPSS; MD = 2.60) at the 12th month. Holmium LEP (MD = 1.37) demonstrated better International Index of Erectile Function–5 at the 12th month compared with OP. However, compared with OP, KTP LVP demonstrated worse postvoid residual volume (PVR) at the sixth (MD = 10.42 mL) and 12th month (MD = 5.89 mL) and monopolar TURP (MD = 6.9 mL) demonstrated worse PVR at the 12th month. Eight new surgical methods for BPH with volume >60 mL appeared to be superior in safety compared with OP and monopolar TURP due to fewer complications. Bipolar VP and KTP LVP maybe not suitable for prostates more than 60 mL due to short- and middle-term worse Qmax, IPSS, and PVR than OP.