可持续发展专题

Topics on sustainable development
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Data Analytics to Support Policy Making for Noncommunicable Diseases: Scoping Review.
Background: There is an emerging need for evidence-based approaches harnessing large amounts of health care data and novel technologies (such as artificial intelligence) to optimize public health policy making. Objective: The aim of this review was to explore the data analytics tools designed specifically for policy making in noncommunicable diseases (NCDs) and their implementation. Methods: A scoping review was conducted after searching the PubMed and IEEE databases for articles published in the last 10 years. Results: Nine articles that presented 7 data analytics tools designed to inform policy making for NCDs were reviewed. The tools incorporated descriptive and predictive analytics. Some tools were designed to include recommendations for decision support, but no pilot studies applying prescriptive analytics have been published. The tools were piloted with various conditions, with cancer being the least studied condition. Implementation of the tools included use cases, pilots, or evaluation workshops that involved policy makers. However, our findings demonstrate very limited real-world use of analytics by policy makers, which is in line with previous studies. Conclusions: Despite the availability of tools designed for different purposes and conditions, data analytics is not widely used to support policy making for NCDs. However, the review demonstrates the value and potential use of data analytics to support policy making. Based on the findings, we make suggestions for researchers developing digital tools to support public health policy making. The findings will also serve as input for the European Union-funded research project ONCODIR developing a policy analytics dashboard for the prevention of colorectal cancer as part of an integrated platform.
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A compendium of evidence-based practice instruments for nursing education, practice and research.
Background: Evidence-based practice (EBP) is a cornerstone for safe, high-quality care. Implementation science recognizes that many factors influence the successful use of EBP, from attitudes and beliefs, self-efficacy, and knowledge and skills to contextual factors related to unit and organizational culture. This integrative review aimed to identify valid and reliable instruments measuring critical EBP domains with nursing professionals. Methods: A systematic search of the literature was conducted. CINAHL, PubMed, EMBASE, Cochrane, and Joanna Briggs were searched to identify original research publications testing the reliability and validity of EBP nursing instruments. Results: Of 347 records, 48 studies representing 50 instruments were identified as having undergone psychometric testing, thus meeting the inclusion criteria. Most instruments were validated in English-speaking countries. Content validity, construct validity, and internal consistency standards were met for 70%, 62%, and 94% of instruments, respectively. Limited testing was found for other types of validity, test-retest reliability, acceptability, feasibility, or responsivity and sensitivity, thus representing gaps in psychometric validation. Less than 20% of instruments have been translated to other languages limiting their use to advance EBP worldwide. Linking evidence to action: Eighty-two percent of instruments met minimal psychometric standards and are sound for education, practice, and research. Expanding psychometric testing and utilizing validated EBP instruments will further the EBP movement to improve global population health.
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Augmentative and alternative communication tools for mechanically ventilated patients in intensive care units: A scoping review.
Objectives: The aim of this scoping review was to understand the extent and type of evidence on augmentative and alternative communication tools used with mechanically ventilated patients in the intensive care unit. Review method used: This scoping review was conducted using Arksey and O'Malley's methodological framework, followed by PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) framework to provide a structured approach to analysis of reviews. Data sources: In December 2021, six electronic databases-CENTRAL, CINAHL, Embase, Medline (Ebscohost), PyscINFO, and Web of Science-were searched. Searches were supplemented with hand searching of reference lists of included studies. Review methods: Studies were selected according to inclusion and exclusion criteria. Full-text review was completed by two independent authors, with any disagreement resolved by consensus or with consultation with a third reviewer. A table was developed to extract key information from the eligible studies. The Mixed Methods Appraisal Tool and Supporting the Use of Research Evidence checklist were used to quality appraise the selected primary research and reviews, respectively. Results: Twenty-three studies (19 primary studies and four reviews) were included in the review. Findings highlighted five main patterns: (i) Co-designing of the augmentative and alternative communication tools; (ii) Patients' and healthcare professionals' training needs on augmentative and alternative communication tools; (iii) Implementation of validated communication assessment algorithms; (iv) Amalgamate several communication methods/approaches; (v) Technical competency required for high-technology augmentative and alternative communication tools. Conclusion: Both low- and high-technology augmentative and alternative communication tools are widely used for mechanically ventilated patients in intensive care units, but there is a need for systematically assessing the communication needs and implementing communication interventions to promote meaningful patient-centred clinical outcomes.
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Decision Support Tools for Low-Dose CT Lung Cancer Screening: A Scoping Review of Information Content, Format, and Presentation Methods.
Several countries mandate informed or shared decision-making for low-dose CT (LDCT) lung cancer screening, but knowledge is limited about the type of information and presentation techniques used to support decision-making in practice. This review aimed to characterize the content, format, mode, and presentation methods of decision support tools (DSTs) for LDCT lung cancer screening. DSTs reported within peer-reviewed articles (January 2000-April 2021) were identified systematically from PubMed, PsycInfo, EMBASE, and CINAHL Plus. Inclusion criteria revolved around the development or evaluation of a resource or tool intended to support individual or shared decision-making for LDCT lung cancer screening. The data-charting and extraction framework was based on the International Patient Decision Aids Standards instrument and Template for Intervention Description and Reporting. Extracted data were organized within two categories: (1) study characteristics and context, format, and mode of DST use and (2) DST content and presentation methods. This review identified 22 DSTs in paper, video, or electronic formats across 26 articles. Most DSTs (n = 13) focused on knowledge exchange, whereas seven used interactive techniques to support values clarification (eg, Likert scales) and nine DSTs guided deliberation (eg, suggested discussion topics). The DSTs addressed similar topics, but the detail, quantification of probability, and presentation methods varied considerably. None described all the potential screening harms and results. The heterogeneity in DST design may affect the quality of decision-making, particularly for participants with lower literacy and numeracy. Evidence-based consensus guidelines for DST content and presentation methods should be developed collaboratively with screening-eligible adults.
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The RIGHT Extension Statement for Traditional Chinese Medicine: Development, Recommendations, and Explanation
Nowadays, the number of traditional Chinese medicine (TCM) guidelines is constantly increasing, but its reporting quality remains unsatisfactory. One of the main reasons is that there is a lack of suitable reporting standard to guide it. In response to this long-standing problem, the Reporting Items for practice Guidelines in HealThcare (RIGHT) Working Group has invited a group of TCM clinical experts, methodologists and epidemiology, and developed the RIGHT Extension Statement for TCM (RIGHT-TCM) through a multi-staged development process, including systematic review, reporting quality evaluation and online Delphi expert consensus. The RIGHT-TCM extends two sections of the RIGHT Statement, includes basic information and recommendations section. Seven strong recommendation sub-items were added to RIGHT Statement and formed the final RIGHTTCM. The group hopes that the RIGHT-TCM may assist TCM guideline developers in reporting guidelines, support journal editors and peer reviewers when considering TCM guideline reports, and help health care practitioners understand and implement a TCM guideline. This article will introduce its background, development, recommendations and explanation.
期刊论文
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Development of Rapid Advice Guidelines for the Treatment of Coronavirus Disease 2019 with Traditional Chinese Medicine
The worldwide spread of the 2019 novel coronavirus has become a profound threat to human health. As the use of medication without established effectiveness may result in adverse health consequences, the development of evidence-based guidelines is of critical importance for the clinical management of coronavirus disease (COVID-19). This research presents methods used to develop rapid advice guidelines on treating COVID-19 with traditional Chinese medicine (TCM). We have followed the basic approach for developing WHO rapid guidelines, including preparing, developing, disseminating and updating each process. Compared with general guidelines, this rapid advice guideline is unique in formulating the body of evidence, as the available evidence for the treatment of COVID-19 with TCM is from either indirect or observational studies, clinical first-hand data together with expert experience in patients with COVID-19. Therefore, our search of evidence not only focuses on clinical studies of treating COVID-19 with TCM but also of similar diseases, such as pneumonia and influenza. Grading of recommendations assessment, development and evaluation (GRADE) methodology was adopted to rate the quality of evidence and distinguish the strength of recommendations. The overall certainty of the evidence is graded as either high, moderate, low or very low, and to give either "strong" or "weak" recommendations of each TCM therapy. The output of this paper will produce the guideline on TCM for COVID-19 and will also provide some ideas for evidence collection and synthesis in the future development of rapid guidelines for COVID-19 in TCM as well as other areas.
期刊论文
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A systematic review of instruments for the analysis of national-level physical activity and sedentary behaviour policies.
Background: This systematic review aimed to identify and critically assess available instruments for the analysis of national-level physical activity (PA) and sedentary behaviour (SB) policies and provide recommendations for their future use. Methods: We conducted a systematic search of academic and grey literature through six bibliographic databases, Google and the websites of three international organisations for PA promotion to identify instruments that are used or that may be used for national-level PA/SB policy analysis. In order to describe and categorise the identified instruments, we used the Comprehensive Analysis of Policy on Physical Activity framework. This framework specifies the elements of a comprehensive analysis of PA/SB policies through the following categories: purpose, level, policy sector, type of policy, stages of policy cycle and scope of analysis. Results: Out of 22,071 screened items, 26 publications describing 16 instruments met the selection criteria. All the instruments can be used for analysing PA policy, whilst only two include questions about SB policy. None of the instruments allow for the analysis of all the relevant components of national PA/SB policy. Some important elements of PA policy analysis, such as the tourism and research sectors, the agenda-setting and endorsement/legitimisation stages, and the effects of policy, are addressed by only a few instruments. Moreover, none of the instruments address unwritten formal statements, informal policies, and the termination and succession stages of the policy cycle. Conclusion: Designing new instruments or adapting existing ones is needed to allow for a more thorough analysis of national PA and SB policies. Given that policy analysis covering all important components of PA/SB policy may be extremely time-consuming, a way forward might be to develop a set of complementary instruments, with each tool collecting detailed information about a specific component.
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