PICO

PICO
  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    草原对于为畜牧业提供重要资源和提供宝贵的生态系统服务至关重要,例如生物多样性和土壤碳(C)封存。尽管它们至关重要,这些生态系统面临着人类干扰不断升级的威胁,人类退化,和气候变化,C.恢复退化的草地成为应对气候变化的务实和具有成本效益的方法。然而,为了实现这一目标,成功实施了草地管理,面临重大挑战。系统的制图方法将有助于编制全面的全球研究清单,调查不同的草地管理措施对土壤碳的影响。此外,与其他温室气体排放权衡的可能性进一步强调了系统评估的价值。这种方法旨在识别知识集群(即,具有良好代表性的子主题,可以进行全面综合)进行潜在的系统审查,并查明需要进一步进行初步研究工作的知识差距,所有这些都有助于更好地理解围绕这个主题的证据。
    遵循系统证据综合标准,我们使用PICO框架开发了要在系统地图协议中解决的问题。我们通过组合人口(草原)的搜索词建立了一个初步的搜索字符串,干预(管理)和结果(土壤碳)类别,以及另外一组(研究类型-专注于农场和田间试验)。我们将使用WebofScience对相关的同行评审和灰色文献进行全面的文献检索,Scopus,CABI平台,谷歌学者,和专业网站(例如,Agrotrop)。搜索将以英语进行,西班牙语,葡萄牙语,法语,德语,蒙古语,根据研究团队的语言能力。将通过将收集的文献与40篇相关文章的测试列表进行比较来评估搜索的全面性。文献筛选过程的可重复性将通过一系列纳入/排除标准和审阅者间一致性统计检验来确保。数据提取将组织成四个互补的部分(文章信息,PICO类别,研究特点,可测量参数),我们将在其上执行查询以生成表,构成系统地图的数字和证据地图。结果将确定和描述知识差距和集群。
    在线版本包含10.1186/s13750-024-00345-2提供的补充材料。
    UNASSIGNED: Grasslands are essential for providing vital resources in the livestock sector and delivering invaluable ecosystem services such as biodiversity and soil carbon (C) sequestration. Despite their critical importance, these ecosystems face escalating threats from human disturbances, human degradation, and climate change, compromising their ability to effectively stock C. Restoring degraded grasslands emerges as a pragmatic and cost-effective approach to tackling climate change. However, the successful implementation of grassland management toward this goal, faces significant challenges. A systematic mapping approach will help to compile a comprehensive global inventory of studies investigating the impact of differing grassland management practices on soil carbon. In addition, the potential for trade-offs with other greenhouse gas emissions further underlines the value of a systematic assessment. This approach aims to identify knowledge clusters (i.e., well-represented subtopics that are amenable to full synthesis) for potential systematic reviews and pinpoint knowledge gaps requiring further primary research efforts, all contributing to a better understanding of the evidence surrounding this topic.
    UNASSIGNED: Following systematic evidence synthesis standards, we developed the question to address in the systematic map protocol using the PICO framework. We established a preliminary search string by combining search terms for the Population (Grasslands), Intervention (management) and Outcome (soil carbon) categories, as well as with one additional group (Study types-to focus on farm and field experiments). We will conduct a comprehensive literature search of relevant peer-reviewed and grey literature using Web of Science, Scopus, CABI platforms, Google Scholar, and specialised websites (e.g., Agrotrop). Searches will be conducted in the English, Spanish, Portuguese, French, German, and Mongolian languages, as per the linguistic capabilities of the research team. The comprehensiveness of the search will be assessed by comparing the literature collected to a test-list of forty relevant articles. The repeatability of the literature screening process will be ensured by a list of inclusion/exclusion criteria and inter-reviewer consistency statistical tests. Data extraction will be organised into four complementary sections (article information, PICO categories, study characteristics, measurable parameters), on which we will perform queries to produce the tables, figures and evidence maps that will compose the systematic map. The results will identify and describe knowledge gaps and clusters.
    UNASSIGNED: The online version contains supplementary material available at 10.1186/s13750-024-00345-2.
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  • 文章类型: Journal Article
    从1879年首次印刷到2004年停止出版,IndexMedicus对希望进行医疗保健相关研究的人来说是无价的。随着这种资源的流失和替代品的迅速扩张,在线来源,人们必须了解如何适当地搜索和使用这些信息。这次审查的目的是概述现有的信息来源,讨论如何使用当前的搜索技术来最好地获取相关信息,同时最大限度地减少非生产性参考,并给出了作者对各种信息来源的可靠性的意见。要讨论的主题将包括医学主题词和PICO搜索以及从国家医学图书馆和Cochrane评论到维基百科和其他网站的来源,如协会和商业利益网站。
    From its first printing in 1879 to when publication ceased in 2004, the Index Medicus had proved invaluable for persons wishing to conduct healthcare-related research. With the loss of this resource and the rapid expansion of alternative, online sources, it is vital that persons understand how to appropriately search for and use this information. The purpose of this review is to outline the information sources available, discuss how to use current search technology to best obtain relevant information while minimizing nonproductive references, and give the author\'s opinion on the reliability of the various informational sources available. Topics to be discussed will include Medical Subject Headings and PICO searches and sources ranging from the National Library of Medicine and Cochrane Reviews to Wikipedia and other sites, such as associations and commercial interest sites.
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  • 文章类型: Journal Article
    背景:随机对照试验(RCT)的系统评价是循证医学范式的重要组成部分。然而,由临床专家创建这样的系统评价既昂贵又耗时,结果在出版后很快就会过时。大多数RCT都是基于患者的结构,干预,比较,结果(PICO)框架,并且存在许多旨在自动提取PICO元素的方法。从RCT中自动提取PICO信息有可能显着加快系统评价的创建过程,这种方式也有利于循证医学领域。
    结果:以前的工作已经解决了提取PICO元素作为识别相关文本跨度或句子的任务,但没有填充试验的结构化表示。相比之下,在这项工作中,我们将PICO元素视为带有插槽的结构化模板,以公正地处理它们所代表的信息的复杂性质。我们提出了两种不同的方法来从RCT摘要中提取这些结构化信息。第一种方法是基于我们以前的工作的提取方法,该方法扩展为捕获完整的文档表示,并通过聚类步骤来推断每种模板类型的实例数量。第二种方法是基于seq2seq模型的生成方法,该模型对描述RCT的摘要进行编码,并使用解码器来推断包括其臂在内的试验的结构化表示,治疗,终点和结果。两种方法在手动注释的数据集上用不同的基础模型进行评估,该数据集由现有数据集上的RCT摘要组成,该现有数据集包括211个注释的2型糖尿病和青光眼的临床试验摘要。对于这两种疾病,提取方法(用flan-t5-base)达到了最好的F1评分,即2型糖尿病为0.547(±0.006),青光眼为0.636(±0.006)。一般来说,青光眼的F1评分高于2型糖尿病,而生成性方法的标准差更高.
    结论:在我们的实验中,这两种方法都显示出从RCT中提取结构化PICO信息的良好性能,特别是考虑到大多数相关的工作都集中在预测结构较少的对象这个容易得多的任务上。在我们的实验结果中,提取方法在这两种情况下都表现最好,尽管青光眼的铅含量高于2型糖尿病。为了将来的工作,基础模型大小如何影响两种方法的性能还有待研究。尽管采掘方法目前为直接改进留下了更多空间,生成方法可能会受益于更大的模型。
    BACKGROUND: Systematic reviews of Randomized Controlled Trials (RCTs) are an important part of the evidence-based medicine paradigm. However, the creation of such systematic reviews by clinical experts is costly as well as time-consuming, and results can get quickly outdated after publication. Most RCTs are structured based on the Patient, Intervention, Comparison, Outcomes (PICO) framework and there exist many approaches which aim to extract PICO elements automatically. The automatic extraction of PICO information from RCTs has the potential to significantly speed up the creation process of systematic reviews and this way also benefit the field of evidence-based medicine.
    RESULTS: Previous work has addressed the extraction of PICO elements as the task of identifying relevant text spans or sentences, but without populating a structured representation of a trial. In contrast, in this work, we treat PICO elements as structured templates with slots to do justice to the complex nature of the information they represent. We present two different approaches to extract this structured information from the abstracts of RCTs. The first approach is an extractive approach based on our previous work that is extended to capture full document representations as well as by a clustering step to infer the number of instances of each template type. The second approach is a generative approach based on a seq2seq model that encodes the abstract describing the RCT and uses a decoder to infer a structured representation of a trial including its arms, treatments, endpoints and outcomes. Both approaches are evaluated with different base models on a manually annotated dataset consisting of RCT abstracts on an existing dataset comprising 211 annotated clinical trial abstracts for Type 2 Diabetes and Glaucoma. For both diseases, the extractive approach (with flan-t5-base) reached the best F 1 score, i.e. 0.547 ( ± 0.006 ) for type 2 diabetes and 0.636 ( ± 0.006 ) for glaucoma. Generally, the F 1 scores were higher for glaucoma than for type 2 diabetes and the standard deviation was higher for the generative approach.
    CONCLUSIONS: In our experiments, both approaches show promising performance extracting structured PICO information from RCTs, especially considering that most related work focuses on the far easier task of predicting less structured objects. In our experimental results, the extractive approach performs best in both cases, although the lead is greater for glaucoma than for type 2 diabetes. For future work, it remains to be investigated how the base model size affects the performance of both approaches in comparison. Although the extractive approach currently leaves more room for direct improvements, the generative approach might benefit from larger models.
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  • 文章类型: Journal Article
    一氧化碳(CO),由于不完全燃烧,如吸烟,作为尼古丁成瘾的指标。这项研究的目的是比较电子烟(电子烟)和吸烟者之间的呼出CO水平,并确定电子烟和吸烟者中尼古丁依赖与呼出CO水平之间的关联。进行了一项横断面研究,对活跃吸烟者进行有目的的抽样,每组有70名吸烟者。尼古丁依赖是使用宾夕法尼亚州立大学尼古丁依赖指数(PSNDI)问卷对电子烟组和Fagerstrom问卷对吸烟组进行测量的。使用烟熏器piCO测量CO水平。为了比较电子烟和烟草吸烟者组的平均呼出CO水平,使用了Mann-Whitney测试.Mann-Whitney检验和Kruskal-Wallis检验用于评估电子烟吸烟者组和烟草吸烟者组中尼古丁依赖性与平均呼出CO水平之间的关联。分别。大多数电子烟吸烟者是17岁(65.7%)和男性(75.7%)。在吸烟者中,大多数也是17岁(44.3%),主要是男性(91.4%)。烟草吸烟者组的平均呼出CO水平显著高于电子烟吸烟者组,6.86ppm对1.61ppm,p<0.001。吸烟者中尼古丁依赖与呼出的CO水平之间存在显著关联(p<0.001)。尼古丁依赖与电子烟吸烟者的呼出CO水平无关。这项研究强调,吸烟者piCO设计可用于筛查吸烟者的尼古丁成瘾。
    Carbon monoxide (CO), resulting from incomplete combustion such as tobacco smoking, serves as an indicator of nicotine addiction. The aim of this study was to compare the levels of exhaled CO levels between electronic cigarette (e-cigarette) and tobacco smokers and to determine the association between nicotine dependence and exhaled CO levels in e-cigarette and tobacco smokers. A cross-sectional study was conducted using purposive sampling on active smokers, with 70 smokers in each group. The nicotine dependence was measured using the Penn State Nicotine Dependence Index (PSNDI) questionnaire for the e-cigarette group and the Fagerstrom questionnaire for the tobacco smoking group. The CO level was measured using the smokerlyzer piCO. To compare the mean exhaled CO levels between e-cigarettes and tobacco smoker groups, the Mann-Whitney test was used. The Mann-Whitney test and Kruskal-Wallis test were used to assess the associations between nicotine dependence and mean exhaled CO levels in the e-cigarette smoker group and in the tobacco smoker group, respectively. The majority of e-cigarette smokers were 17 years old (65.7%) and male (75.7%). Among tobacco smokers, the majority were also 17 years old (44.3%), and mostly male (91.4%). The mean exhaled CO levels in the tobacco smoker group were significantly higher than the e-cigarette smoker group, 6.86 ppm vs 1.61 ppm with p<0.001. There was a significant association between nicotine dependence and exhaled CO levels among tobacco smokers (p<0.001). Nicotine dependence was not associated with exhaled CO levels among e-cigarette smokers. This study highlights that the smokerlyzer piCO devise could be used to screen nicotine addiction in tobacco smokers.
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  • 文章类型: Journal Article
    椎间盘扩散仍然是临床微生物学实验室中评估抗生素活性的主要技术。然而,FDA认可的检测方案,DIN,谁是无效的。尽管在这一领域进行了几十年的研究和实践,制造光盘的定量质量在很大程度上是未知的,可能导致不良临床结局。在质量控制方面,新医疗器械的通常标准预期,QA,基于证据的结果评估几乎完全缺乏。最近的数据表明,很大一部分光盘不符合规格,椎间盘扩散对临床结局的预测效果较差。此外,EUCAST和CLSI之间缺乏协调,尽管经过多年的努力,强烈表明这些系统存在严重缺陷。这个领域缺乏科学严谨,这也可能导致不良临床结局和抗菌素耐药性的出现.
    Disc diffusion remains the main technique for evaluating antibiotic activity in clinical microbiology laboratories. However, the assay protocol endorsed by the FDA, DIN, and WHO is invalid. Despite decades of research and practice in this field, the quantitative quality of manufactured discs is largely unknown, potentially leading to adverse clinical outcomes. The usual standards expected for new medical devices in terms of quality control, QA, and evidence-based assessment of outcomes are almost completely lacking. Recent data indicate that a large proportion of discs do not meet the specifications, and that disc diffusion is a poor predictor of clinical outcomes. In addition, lack of harmonisation between EUCAST and CLSI, despite many years of effort, strongly suggests that there are serious flaws in these systems. This area lacks scientific rigour, which may have also contributed to adverse clinical outcomes and the emergence of antimicrobial resistance.
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  • 文章类型: Journal Article
    目标:核心结果集(COS)是一套商定的标准化结果集,应进行衡量和报告,至少,在特定的健康或保健领域。COS是通过共识过程制定的,以确保要衡量的医疗保健结果与决策者相关,包括患者和医疗保健专业人员。在准则制定中使用COS可能会增加准则与这些决策者的相关性。以前的工作已经研究了COS在试验中的吸收,系统评价,健康技术评估和监管指导,但迄今为止,尚未对COS在实践指南开发中的使用进行评估。这项研究的目的是调查一套国际惯例指南中核心结果的代表性。
    方法:我们搜索了与十种高质量COS相关的临床指南(重点是英国,德国,中国,印度,加拿大,丹麦,美国和世界卫生组织)。我们在条件方面匹配了COS和指南之间的范围,人口和结果。我们特别计算了提及或引用COS的指南的比例以及COS域的比例,或者一般来说,与每个指南PICO声明中指定的结果匹配。
    结果:我们发现了38条指南,其中包含170条PICO语句,与10条COS的范围相匹配,并且质量足够,可以进行数据提取。审查的指南均未明确提及或引用相关COS。PICO指南具体或总体涵盖的核心结果比例的中位数(范围)为30%(0%至100%)。
    结论:没有证据表明COS被常规用于指导指南制定过程,并且已发布指南中的结果与COS中的结果之间的一致性有限。在制定临床指南时,需要进一步的工作来探索使用COS的障碍和促进因素。
    OBJECTIVE: A core outcome set (COS) is an agreed standardized set of outcomes that should be measured and reported, as a minimum, in specific areas of health or health care. A COS is developed through a consensus process to ensure health care outcomes to be measured are relevant to decision-makers, including patients and health-care professionals. Use of COS in guideline development is likely to increase the relevance of the guideline to those decision-makers. Previous work has looked at the uptake of COS in trials, systematic reviews, health technology assessments and regulatory guidance but to date there has been no evaluation of the use of COS in practice guideline development. The objective of this study was to investigate the representation of core outcomes in a set of international practice guidelines.
    METHODS: We searched for clinical guidelines relevant to ten high-quality COS (with focus on the United Kingdom, Germany, China, India, Canada, Denmark, United States and World Health Organisation). We matched scope between COS and guideline in terms of condition, population and outcome. We calculated the proportion of guidelines mentioning or referencing COS and the proportion of COS domains specifically, or generally, matching to outcomes specified in each guideline populations, interventions, comparators and outcome (PICO) statement.
    RESULTS: We found 38 guidelines that contained 170 PICO statements matching the scope of the ten COS and of sufficient quality to allow data extraction. None of the guidelines reviewed explicitly mentioned or referenced the relevant COS. The median (range) of the proportion of core outcomes covered either specifically or generally by the guideline PICO was 30% (0%-100%).
    CONCLUSIONS: There is no evidence that COS are being used routinely to inform the guideline development process, and concordance between outcomes in published guidelines and those in COS is limited. Further work is warranted to explore barriers and facilitators in the use of COS when developing clinical guidelines.
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  • 文章类型: Practice Guideline
    全球,肝细胞癌(HCC)是癌症相关死亡的第三大常见原因。近年来在治疗HCC方面取得的显着进步增加了HCC管理的复杂性。根据需要更新HCC多学科治疗管理指南,参与这种癌症管理的意大利科学协会推动起草了一份新的专门文件。本文件是根据根据证据制定指南所需的GRADE方法起草的。以下是指南的第一部分,专注于多学科肿瘤专家委员会和肝癌的外科治疗。
    Worldwide, hepatocellular carcinoma (HCC) is the third most common cause of cancer-related death. The remarkable improvements in treating HCC achieved in the last years have increased the complexity of HCC management. Following the need to have updated guidelines on the multidisciplinary treatment management of HCC, the Italian Scientific Societies involved in the management of this cancer have promoted the drafting of a new dedicated document. This document was drawn up according to the GRADE methodology needed to produce guidelines based on evidence. Here is presented the first part of guidelines, focused on the multidisciplinary tumor board of experts and surgical treatments of HCC.
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  • 文章类型: Journal Article
    期刊俱乐部广泛用于大多数医疗机构的研究生课程;但是,在本科医学课程中使用期刊俱乐部几乎没有或非常罕见。
    这项工作的目的是记录期刊俱乐部的插入,作为本科生学习的一种方法,从内分泌学/内分泌外科模块开始,将在FMBU的MBBS的所有模块中全面实施。此外,该研究旨在通过遵循特定程序以及通过期刊俱乐部的5年实施来确定学生和教师满意度来概述设计期刊俱乐部的步骤。
    共有453名学生参加了这项研究,这些学生代表了2019年至2023年连续五批研究内分泌/内分泌外科模块的医学生。遵循质量和认证委员会通过的期刊俱乐部实施准则,教师从学生选择的文章中选择论文类型。讨论的论文是案例报告,原创研究,并审查文章。要求学生制定批判性评估主题,PICO,每一张纸。对所有参与者进行了20个问题的测试。学生的出勤,分数,并估计了学生/教师的满意度。
    5年期刊俱乐部共讨论了50篇论文15例病例报告(30%),26项原始研究(52%),和9篇评论文章(18%)。学生的出勤率范围为72.53±3.74至98.07±3.15。学生和教师的满意度分别为3.52和3.82。在为期5年的期刊俱乐部的20个问题的测试中,学生的平均分数为76.93±9.78,最低分数为第二批(在线批)。
    在本科医学课程中插入结构良好的期刊俱乐部对于提高包括学生知识在内的知识是必要的。此外,期刊俱乐部激励学生成为终身学习者。
    UNASSIGNED: The journal club is widely used in most postgraduate programs of medical institutes; however, the use of journal clubs in undergraduate medical programs is nearly absent or very rare.
    UNASSIGNED: The aim of this work is to document the insertion of the journal club as a method for learning in the undergraduate starting with the endocrinology/endocrine surgery module to be fully implemented in all modules of the MBBS of FMBU. In addition, the study aimed to outline the steps of designing a journal club by following specific procedures and Identification of students\' and faculty satisfaction through 5-years implementation of the journal club.
    UNASSIGNED: A total of 453 students representing the five consecutive batches of medical students from 2019 to 2023 who studied the endocrinology/endocrine surgery module were entered into the study. Following guidelines for implementation of the journal clubs that were adopted by the quality and accreditation committee, the faculty select the types of papers from the articles chosen by students. The papers discussed were case reports, original research, and review articles. The students were asked to formulate critical appraisal topics, PICO, for each paper. A 20-question test was applied to all participants. The students\' attendance, scores, and students/faculty satisfaction were estimated.
    UNASSIGNED: A total of 50 papers were discussed in the 5-year journal club 15 case reports (30%), 26 original research (52%), and 9 review articles (18%). The student\'s attendance ranged from 72.53±3.74 to 98.07±3.15. The students and faculty\'s satisfaction were 3.52 and 3.82 respectively. The mean Students\' score in A 20-question test in a 5-year journal club was 76.93 ± 9.78 and the lowest score was in the 2nd batch (online batch).
    UNASSIGNED: The insertion of a well-structured journal club in the undergraduate medical program is necessary to improve the knowledge including knowledge among students. In addition, journal clubs inspire students to be lifelong learners.
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