目的构建重症创伤伤员体外膜肺氧合(ECMO)转运方案,为重症创伤伤员ECMO转运提供参考。方法基于循证原则检索建库至2024年9月16日ProVation MD、BMJ Best Practice、UpToDate、英国国家卫生与临床优化研究所、国际指南协作网、美国国立...目的构建重症创伤伤员体外膜肺氧合(ECMO)转运方案,为重症创伤伤员ECMO转运提供参考。方法基于循证原则检索建库至2024年9月16日ProVation MD、BMJ Best Practice、UpToDate、英国国家卫生与临床优化研究所、国际指南协作网、美国国立指南库、WHO、Embase、Cochrane Library、PubMed、Web of Science、CKNI、中国生物医学数据库、维普数据库、万方数据库、医脉通等网站或数据库形成范围综述并构建重症创伤伤员ECMO转运方案初稿。通过2轮Delphi专家咨询法对18名专家函询,小组讨论后形成重症创伤伤员ECMO转运方案终稿。结果共纳入16篇文献,形成了包含人力分工、注意事项等在内的7项一级条目、20项二级条目、67项三级条目的重症创伤伤员ECMO转运方案。2轮函询的有效回收率均为94.4%,专家的权威系数均为0.94,专家意见的Kendall协调系数分别为0.310和0.489(P均<0.01)。结论本研究基于范围综述和Delphi法构建重症创伤伤员ECMO转运方案,形成了以重症创伤ECMO转运的常用模式、工具载体、人力分工、准备工作、监测、注意事项、交接核查为主题的转运方案,对重症创伤伤员具有较强的针对性与临床应用价值,可以为重症创伤伤员ECMO转运提供参考。展开更多
Background:Physicalfitness in childhood and adolescence is associated with a variety of health outcomes and is a powerful marker of current and future health.However,inconsistencies in tests and protocols limit interna...Background:Physicalfitness in childhood and adolescence is associated with a variety of health outcomes and is a powerful marker of current and future health.However,inconsistencies in tests and protocols limit international monitoring and surveillance.The objective of the study was to seek international consensus on a proposed,evidence-informed,Youth Fitness International Test(YFIT)battery and protocols for health monitoring and surveillance in children and adolescents aged 618 years.Methods:We conducted an international modified Delphi study to evaluate the level of agreement with a proposed,evidence-based,YFIT of core health-relatedfitness tests and protocols to be used worldwide in 6-to 18-year-olds.This proposal was based on previous European and North American projects that systematically reviewed the existing evidence to identify the most valid,reliable,health-related,safe,and feasiblefitness tests to be used in children and adolescents aged 618 years.We designed a single-panel modified Delphi study and invited 216 experts from all around the world to answer this Delphi survey,of whom one-third are from low-to-middle income countries and one-third are women.Four experts were involved in the piloting of the survey and did not participate in the main Delphi study to avoid bias.We pre-defined an agreement of 80%among the expert participants to achieve consensus.Results:We obtained a high response rate(78%)with a total of 169fitness experts from 50 countries and territories,including 63 women and 61 experts from low-or middle-income countries/territories.Consensus(>85%agreement)was achieved for all proposed tests and protocols,supporting the YFIT battery,which includes weight and height(to compute body mass index as a proxy of body size/composition),the 20-m shuttle run(cardiorespiratoryfitness),handgrip strength,and standing long jump(muscularfitness).Conclusion:This study contributes to standardizingfitness tests and protocols used for research,monitoring,and surveillance across the world,which will allow for future data pooling and the development of international and regional sex-and age-specific reference values,health-related cut-points,and a global picture offitness among children and adolescents.展开更多
Objective To develop a quality appraisal tool for case reports in traditional Chinese medicine(TCM)based on their characteristics.Methods An extensive literature search was conducted in Chinese Biomedical Literature D...Objective To develop a quality appraisal tool for case reports in traditional Chinese medicine(TCM)based on their characteristics.Methods An extensive literature search was conducted in Chinese Biomedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),and China Science and Technology Journal Database(CSTJ),focusing on expert consensus statements and check-lists for TCM case reports.Relevant items were extracted,and a Delphi method involving 34 experts was used in two rounds to rate each item on a 5-point Likert scale.Items were screened based on measures of central tendency and coordination(including total score,mean score,percentage of items rated as unimportant,and coefficient of variation).The weighted average method was used to determine item weights and construct the appraisal tool.Internal consistency was assessed using Cronbach’sαcoefficient.The finalized tool was pilot-tested by two reviewers independently appraising 20 case reports,with an additional four reviewers evaluating 5 of these cases to compare inter-rater consistency.Results A total of 9513 articles were retrieved,and 96 items from 25 articles were extracted.After two rounds of the Delphi method,27 items across 10 domains were retained.The Cron-bach’sαcoefficient was 0.72 in the first round(acceptable range),and 0.96 in the second round,indicating strong internal consistency.The tool was piloted by six reviewers,achieving a kappa value of 0.663 and a Kendall’s coefficient of concordance of 0.845,demonstrating high consistency among reviewers.Conclusion The developed TCM case report quality appraisal tool,consisting of 27 items in 10 domains,offers a scientific and reliable means of assessing the quality of TCM case reports.The tool showed high consistency and practical utility,and its application is expected to en-hance the standardization,scientific rigor,and evidence quality of TCM case reports,facilitat-ing the integration of traditional medical knowledge with modern evidence-based standards.展开更多
文摘目的构建重症创伤伤员体外膜肺氧合(ECMO)转运方案,为重症创伤伤员ECMO转运提供参考。方法基于循证原则检索建库至2024年9月16日ProVation MD、BMJ Best Practice、UpToDate、英国国家卫生与临床优化研究所、国际指南协作网、美国国立指南库、WHO、Embase、Cochrane Library、PubMed、Web of Science、CKNI、中国生物医学数据库、维普数据库、万方数据库、医脉通等网站或数据库形成范围综述并构建重症创伤伤员ECMO转运方案初稿。通过2轮Delphi专家咨询法对18名专家函询,小组讨论后形成重症创伤伤员ECMO转运方案终稿。结果共纳入16篇文献,形成了包含人力分工、注意事项等在内的7项一级条目、20项二级条目、67项三级条目的重症创伤伤员ECMO转运方案。2轮函询的有效回收率均为94.4%,专家的权威系数均为0.94,专家意见的Kendall协调系数分别为0.310和0.489(P均<0.01)。结论本研究基于范围综述和Delphi法构建重症创伤伤员ECMO转运方案,形成了以重症创伤ECMO转运的常用模式、工具载体、人力分工、准备工作、监测、注意事项、交接核查为主题的转运方案,对重症创伤伤员具有较强的针对性与临床应用价值,可以为重症创伤伤员ECMO转运提供参考。
基金supported by the Grant PID2020-120249RB-I00PID2023-148404OB-100funded by MCIN/AEI/10.13039/501100011033+4 种基金by the Andalusian Government(Junta de Andalucía,Plan Andaluz de Investigación,ref.P20_00124)by the Erasmus+Sport Programme of the European Union within the project FitBack4Literacy(No.101089829)Additional support is provided by the University of Granada,Plan Propio de Inves-tigación,Units of ExcellenceUnit of Excellence on Exercise,Nutrition and Health(UCEENS)by theCIBERobn Physiopa-thology of Obesity and Nutrition,and by the Spanish Network in Exercise and Health,EXERNET Network(RED2022-134800-Tand EXP_99828).
文摘Background:Physicalfitness in childhood and adolescence is associated with a variety of health outcomes and is a powerful marker of current and future health.However,inconsistencies in tests and protocols limit international monitoring and surveillance.The objective of the study was to seek international consensus on a proposed,evidence-informed,Youth Fitness International Test(YFIT)battery and protocols for health monitoring and surveillance in children and adolescents aged 618 years.Methods:We conducted an international modified Delphi study to evaluate the level of agreement with a proposed,evidence-based,YFIT of core health-relatedfitness tests and protocols to be used worldwide in 6-to 18-year-olds.This proposal was based on previous European and North American projects that systematically reviewed the existing evidence to identify the most valid,reliable,health-related,safe,and feasiblefitness tests to be used in children and adolescents aged 618 years.We designed a single-panel modified Delphi study and invited 216 experts from all around the world to answer this Delphi survey,of whom one-third are from low-to-middle income countries and one-third are women.Four experts were involved in the piloting of the survey and did not participate in the main Delphi study to avoid bias.We pre-defined an agreement of 80%among the expert participants to achieve consensus.Results:We obtained a high response rate(78%)with a total of 169fitness experts from 50 countries and territories,including 63 women and 61 experts from low-or middle-income countries/territories.Consensus(>85%agreement)was achieved for all proposed tests and protocols,supporting the YFIT battery,which includes weight and height(to compute body mass index as a proxy of body size/composition),the 20-m shuttle run(cardiorespiratoryfitness),handgrip strength,and standing long jump(muscularfitness).Conclusion:This study contributes to standardizingfitness tests and protocols used for research,monitoring,and surveillance across the world,which will allow for future data pooling and the development of international and regional sex-and age-specific reference values,health-related cut-points,and a global picture offitness among children and adolescents.
基金General Program of National Natural Science Foundation of China (82274412)Natural Science Foundation of Hunan Province (2020JJ4062)Science and Technology Innovation Program of Hunan Province (2020RC2061)。
文摘Objective To develop a quality appraisal tool for case reports in traditional Chinese medicine(TCM)based on their characteristics.Methods An extensive literature search was conducted in Chinese Biomedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),and China Science and Technology Journal Database(CSTJ),focusing on expert consensus statements and check-lists for TCM case reports.Relevant items were extracted,and a Delphi method involving 34 experts was used in two rounds to rate each item on a 5-point Likert scale.Items were screened based on measures of central tendency and coordination(including total score,mean score,percentage of items rated as unimportant,and coefficient of variation).The weighted average method was used to determine item weights and construct the appraisal tool.Internal consistency was assessed using Cronbach’sαcoefficient.The finalized tool was pilot-tested by two reviewers independently appraising 20 case reports,with an additional four reviewers evaluating 5 of these cases to compare inter-rater consistency.Results A total of 9513 articles were retrieved,and 96 items from 25 articles were extracted.After two rounds of the Delphi method,27 items across 10 domains were retained.The Cron-bach’sαcoefficient was 0.72 in the first round(acceptable range),and 0.96 in the second round,indicating strong internal consistency.The tool was piloted by six reviewers,achieving a kappa value of 0.663 and a Kendall’s coefficient of concordance of 0.845,demonstrating high consistency among reviewers.Conclusion The developed TCM case report quality appraisal tool,consisting of 27 items in 10 domains,offers a scientific and reliable means of assessing the quality of TCM case reports.The tool showed high consistency and practical utility,and its application is expected to en-hance the standardization,scientific rigor,and evidence quality of TCM case reports,facilitat-ing the integration of traditional medical knowledge with modern evidence-based standards.
