背景运动为防治绝经后骨质疏松症经济有效的干预措施之一,但目前其相关证据内容广泛且分散,临床尚无规范、全面的运动指导方案。目的检索、评价并总结绝经后骨质疏松症患者运动干预的最佳证据。方法系统检索BMJ Best Practice、Up To D...背景运动为防治绝经后骨质疏松症经济有效的干预措施之一,但目前其相关证据内容广泛且分散,临床尚无规范、全面的运动指导方案。目的检索、评价并总结绝经后骨质疏松症患者运动干预的最佳证据。方法系统检索BMJ Best Practice、Up To Date临床顾问、Dyna Med,英国国家临床医学研究所指南网、国际指南网、苏格兰学院间指南网、美国指南网,加拿大安大略注册护士协会、国际骨质疏松症基金会、英国皇家骨质疏松协会、美国骨质疏松症基金会、澳大利亚皇家全科医师学院、美国妇产科医师学会、加拿大妇产科医师协会、医脉通、澳大利亚乔安娜循证研究所网站,Cochrane Library、CINAHL、Web of Science、PubMed、Embase、中国知网、中国生物医学文献服务系统中关于绝经后骨质疏松症运动干预的临床实践指南、临床决策、证据总结、专家共识、系统评价。检索时限为建库至2022年1月。采用临床指南研究与评价系统(AGREEⅡ)对指南进行质量评价,采用证据总结评价工作表(CASE)对临床决策进行质量评价,采用澳大利亚JBI循证卫生保健中心专家共识的真实性评价工具(2016版)对专家共识进行质量评价,采用澳大利亚JBI循证卫生保健中心系统评价方法学质量评价工具(2016版)对系统评价进行质量评价。结果共纳入18篇文献,其中指南7篇、临床决策2篇、专家共识4篇、系统评价5篇,从运动前评估、运动类型、运动强度和时间、健康教育及注意事项5个方面提取了22条证据。结论本文从运动前评估、运动类型、运动强度和时间、健康教育及注意事项5个方面提取了绝经后骨质疏松症患者运动干预的最佳证据,医护人员可参考最佳证据为绝经后骨质疏松症患者提供合理的运动指导方案,减少其跌倒和骨折发生率以提高生活质量。展开更多
Evidence-based medicine is widely promoted for decision-making in health care and is associated with improved patient outcomes.Critics have suggested that evidence-based medicine focuses primarily on groups of patient...Evidence-based medicine is widely promoted for decision-making in health care and is associated with improved patient outcomes.Critics have suggested that evidence-based medicine focuses primarily on groups of patients rather than individuals,but often fail to consider subgroup analyses,N-of-1 trials,and the incorporation of patient values and preferences.Precision medicine has been promoted as an approach to individualize diagnosis and treatment of diseases through genetic,biomarker,phenotypic,and psychosocial characteristics.However,there are often high costs associated with personalized medicine,and high-quality evidence is lacking for effectiveness in many applications.For the potential of personalized medicine to be realized,it must adhere to the principles of evidencebased medicine:(1)evidence in isolation is not sufficient to make clinical decisions—patient’s values and preferences as well as resource implications must be considered,and(2)there is a hierarchy of evidence to guide clinical decision-making and studies at lower risk of bias are likely to provide more trustworthy findings.展开更多
文摘背景运动为防治绝经后骨质疏松症经济有效的干预措施之一,但目前其相关证据内容广泛且分散,临床尚无规范、全面的运动指导方案。目的检索、评价并总结绝经后骨质疏松症患者运动干预的最佳证据。方法系统检索BMJ Best Practice、Up To Date临床顾问、Dyna Med,英国国家临床医学研究所指南网、国际指南网、苏格兰学院间指南网、美国指南网,加拿大安大略注册护士协会、国际骨质疏松症基金会、英国皇家骨质疏松协会、美国骨质疏松症基金会、澳大利亚皇家全科医师学院、美国妇产科医师学会、加拿大妇产科医师协会、医脉通、澳大利亚乔安娜循证研究所网站,Cochrane Library、CINAHL、Web of Science、PubMed、Embase、中国知网、中国生物医学文献服务系统中关于绝经后骨质疏松症运动干预的临床实践指南、临床决策、证据总结、专家共识、系统评价。检索时限为建库至2022年1月。采用临床指南研究与评价系统(AGREEⅡ)对指南进行质量评价,采用证据总结评价工作表(CASE)对临床决策进行质量评价,采用澳大利亚JBI循证卫生保健中心专家共识的真实性评价工具(2016版)对专家共识进行质量评价,采用澳大利亚JBI循证卫生保健中心系统评价方法学质量评价工具(2016版)对系统评价进行质量评价。结果共纳入18篇文献,其中指南7篇、临床决策2篇、专家共识4篇、系统评价5篇,从运动前评估、运动类型、运动强度和时间、健康教育及注意事项5个方面提取了22条证据。结论本文从运动前评估、运动类型、运动强度和时间、健康教育及注意事项5个方面提取了绝经后骨质疏松症患者运动干预的最佳证据,医护人员可参考最佳证据为绝经后骨质疏松症患者提供合理的运动指导方案,减少其跌倒和骨折发生率以提高生活质量。
文摘Evidence-based medicine is widely promoted for decision-making in health care and is associated with improved patient outcomes.Critics have suggested that evidence-based medicine focuses primarily on groups of patients rather than individuals,but often fail to consider subgroup analyses,N-of-1 trials,and the incorporation of patient values and preferences.Precision medicine has been promoted as an approach to individualize diagnosis and treatment of diseases through genetic,biomarker,phenotypic,and psychosocial characteristics.However,there are often high costs associated with personalized medicine,and high-quality evidence is lacking for effectiveness in many applications.For the potential of personalized medicine to be realized,it must adhere to the principles of evidencebased medicine:(1)evidence in isolation is not sufficient to make clinical decisions—patient’s values and preferences as well as resource implications must be considered,and(2)there is a hierarchy of evidence to guide clinical decision-making and studies at lower risk of bias are likely to provide more trustworthy findings.
