加护病房患者的变动成本：多中心前瞻性研究【外文翻译】

外文翻译

原文

Variable cost of ICU patients:a multicenter prospective study

Material Source:Intensive Care Med(2006) 32:545-552 Author:Carlotta Rossi Abstract Objective

To analyze thecosts of treating critically ill patients. Design and setting: Multicenter, observational, prospective, cohort,bottom-up study on variable costsin 51 ICUs. Patients and participants: A total of 1,034 patients aged over 14 years who either spent less than 48 h in the ICU or had multiple trauma, major abdominal surgery, ischemic stroke, chronic obstructive pulmonary disease, cardiac failure, isolated head injury, acute lung injury/adult respiratory distress syndrome (ALI/ARDS), nontraumatic Conclusions: Cost of treatment in an ICU varies widely for different types of patients. Strategies are needed to contain the major determinants of high costs and low cost-efficiency.

Costing strategy

The monetary cost of each item considered was recorded. Drug costs were one-half retail prices (which is what hospitals are charged in Italy). The 2000 national price list provided by theMinistry of Health was used to cost laboratory and imaging tests. For all the other 235 items ICUs were asked to provide the prices actually paid in 2000. Since only 32 ICUs (63%) were able to provide these, we calculated the mean price for each item from the available data and applied this to all ICUs. In some cases (21.9%) such as pulmonary artery catheters we found outliers (ICUs paying disproportionately high prices compared to others). When this happened and the data were not corrected after the proper query, we computed trimmed means.

We then subdivided the cost structure for each single patient into seven headings: drugs, where the cost was related to the quantity consumed; nutrition, excluding nutritional devices; infusions, including blood and blood products; consumables, including nutritional devices, catheters, and all kinds of kits (e.g., for ventilation, dialysis); imaging; laboratory tests; and consultations from other intra-

or extrahospital departments.

Statistical analyses

Patients enrolled in each diagnostic group were fully representative of the population belonging to that group, but the data collection design meant that the relative sizes of the groups were not representative of the overall population admitted to the ICUs. For example, our protocol yielded the same number of patients with nontraumatic intracranial hemorrhage and with major abdominal surgery, while the former are much rarer than the latter in a general ICU population. Therefore for estimates referring to the overall population we could not simply add what we had obtained in the patients collected because this would have overweighted the contribution of rarer diagnostic groups. To remove this bias data were directly standardized to the diagnostic group structure of the overall population admitted[13].

By this fundamental epidemiological approach we expected the standardized description of the present population to be similar to an independent sample of patients admitted to Italian ICUs [12]. This was actually true (data not shown), giving evidence of the validity of the process. All estimates that refer to the overall population were thus standardized, while estimates that refer to individual diagnostic groups were left as crude parameters. Since patients undergoing major abdominal surgery can differ widely depending upon the type of intervention, we split this group into scheduled and unscheduled abdominal surgery.

To better describe the financial burden of the various diagnostic groups of patients we developed two further measures: cost per surviving patient, i.e., money spent for all patients divided by the number of patients who survived, and money loss per patient, i.e., money spent for patients who died divided by the total number of patients. These two measures were plotted together yielding a graph of the efficiency of resource consumption.

Categorical and ordinal variables are presented as percentages and continuous variables as mean and standard deviation. Multiple regression analysis using a step-bystep backward approach was used to identify independent predictors of the cost per patient. All available patient characteristics were entered into the model. The backward approach compared different models by the likelihood ratio test, using 0.05 as the threshold of statistical significance. Collinearity, i.e., interrelationship between independent variables, was assessed using variance inflation factors (VIF) and condition number (CN) [14]. A VIF greater than 10 or a

CN greater than 30 was considered suggestive of moderate to severe collinearity, a problem that could affect the accuracy of regression calculations. Normality and homoscedasticity of the dependent variable distribution were assessed by the normal probability plot and Spearman’s correlation coefficient between predicted and absolute values of residuals, using data transformation, where appropriate. Data were analyzed by the SAS system 8.02.

Results

As expected, we found wide variability in variable costs, both within and between diagnostic groups (Fig. 1). The mean cost of treating a multiple trauma patient was e4717 and that for a coronary bypass surgery was e576. Much of the variability was due to the difference in the length of stay (LOS), and therefore daily costs vary much less (Fig. 2). Table 1 shows different variable costs for each diagnostic group, ICU mortality and LOS.

Fig. 3 plots the two measures: cost per surviving patient and money loss per patient. Cost per surviving patient was higher in ALI/ARDS, nontraumatic intracranial hemorrhage, multiple trauma, and unscheduled major abdominal surgery, but these conditions differed widely in terms of money loss per patient, which was higher for ALI/ARDS and lower for multiple trauma. Coronary bypass, scheduled major abdominal surgery, and short-stay patients were treated most cost-efficiently.

Log-transformation of the cost was adopted to fulfill the normality and homoscedasticity assumptions for the linear regression model (Table 2). Eight variables proved to be significantly correlated with variable costs: diagnostic group, Simplified Acute Physiology Score II (SAPS-II), coma on admission, sepsis classification, length of ICU stay, respiratory failure on admission, cardiac failure on admission, and vital status at ICU discharge. The latter was important only for patients staying less than 48 h. VIF and CN ruled out collinearity. The correlation coefficient was 0.71 (p < 0.0001). Having adopted the log-transformation, the expo nential of β for dichotomous variables corresponds to the relative increment in costs. For example, patients with respiratory failure on admission cost about 19% more than patients without failure, other covariates in the model being the same.

Discussion

This multicenter study took the bottom-up approach for estimating costs. No bottom-up study, to our knowledge, has collected data on a sample as large as ours. To make this feasible we restricted the analysis to the costs related to resources consumed at bedside. This means that we took into account only direct variable

costs. Direct costs are those fully attributable to a single patient and not shared by more than one, while variable costs are those affected by the level of activity during the period considered [6]. Thus personnel costs were considered fixed since they are not affected by the level of activity required by patients during the study period. This can be seen as a limitation, particularly considering that personnel costs account for up to 60% of ICU costs [15]. However, we were interested mainly in studying the cost drivers that are under direct and exclusive control of intensive care staff itself. Staff size and salaries were therefore not considered.

Our results show how widely costs can differ across ICU patient groups. Much of this variability is due to differences in length of ICU stay, but many other cost drivers play a role, even after adjusting for LOS. The two new measures of costs, cost per surviving patient and money loss per patient, especially when considered together, gave a better picture of the financial burden of each disease entity.

These kinds of measures are not to be confused with the outputs of classical economic evaluation studies (i.e., cost-minimization, cost-effectiveness, cost-benefit, or cost-utility analysis) where the focus is on comparison of alternative courses of treatment [16]. Here we limited the analysis to the efficiency of treatments. Thus, as shown in Fig. 3, diseases in row A are the most expensive (per surviving patient) while those in row C involve lower costs. Similarly, diseases in column 1 are those most efficiently treated and those in column 3 the most inefficiently treated. The challenge is therefore to shift diseases from the top to the bottom of the graph, and from right to left.

Obviously much of this challenge depends on research, which should strive to provide more effective treatments, if possible inexpensive ones. However, clinicians have a key role as well. To move a disease from top to bottom, waste of resources should be minimized by more cost-conscious use of expensive ones. This seems especially important for patients with ALI/ARDS, nontraumatic intracranial hemorrhage, multiple trauma, and unscheduled major abdominal surgery. These results are in agreement with reports in the literature [17]. Analysis of the cost structure (Table 1) helps to indicate the best strategy for this task. Thus when treating ALI/ARDS close attention should be paid to laboratory tests and drugs; for nontraumatic intracranial hemorrhage patients laboratory tests and imaging are the most important items, while in multiple trauma and unscheduled major abdominal surgery patients laboratory tests and infusions (including blood and blood products) call for highest priority.

To move a disease from right to left, apart from improving the general effectiveness of treatment (especially for ALI/ARDS, nontraumatic intracranial hemorrhage, and unscheduled major abdominal surgery) better awareness of a poor prognosis needs to be stressed. This implies avoiding the admission of patients who are too ill and all forms of treatment obstinacy. The short LOS of patients who died compared with surviving ones for nontraumatic intracranial hemorrhage and isolated head trauma suggests that selection can be improved. The longer LOS for COPD and ALI/ARDS patients may indicate the need for continuous assessment of the patient’s prognosis to prevent useless obstinacy. Nevertheless, although the idea that early identification of terminally ill patients who can be transferred to less expensive settings is intuitively appealing, many authors argue that it would not reduce costs

[18].

A potential limitation of our study derives from the application of the same average cost per item to all ICUs. If, for example, a drug is cheap in an ICU but expensive otherwise, the use of this drug in the ICU may be improperly viewed as technically inefficient .Coma deserves a final comment: why do patients admitted with coma cost less than those admitted without coma? Other studies with an approach different from that taken here have also found this [17]. In all groups considered coma is a strong negative prognostic factor. One possible explanation is that it is easier to withhold treatment for comatose patients. Again, this calls for

a better prognostic evaluation of all patients to avoid obstinacy and wastes.

According to the design, each of the nine types of conditions considered was enrolled by at least ten ICUs, and short-stay patients were collected by all ICUs. This further enhances the general applicability of the results. However, since comparable studies are lacking in the literature, it is difficult to say how far our findings apply to other countries. Nevertheless, the key messages could easily be validated and possibly refined by single ICUs. This would be an important contribution to more efficient management of ICUs and, possibly, of ICU patients too.

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唑吡坦治疗老年原发性失眠的开放性前瞻性多中心自身对照研究 发表时间：2016-08-01T15:25:30.630Z 来源：《中国医学人文》(学术版)2016年7月第8期作者：石雪丽 [导读] 探讨选择唑吡坦对老年原发性失眠患者于临床实施开放性前瞻性多中心自身对照研究结果。 呼伦贝尔市精神卫生中心精神五科 022150 【摘要】目的：探讨选择唑吡坦对老年原发性失眠患者于临床实施开放性前瞻性多中心自身对照研究结果。方法：选择我院2014年06月～2016年06月收治的老年原发性失眠患者100例作为本次研究对象；对于所有患者于临床展开开放性前瞻性多中心自身对照研究。最终对PSQI（匹兹堡睡眠质量指数）评分同基线的差值等实施对比。结果：对所有老年原发性失眠患者完成1周的治疗后，同基线进行比较，患者的PSQI量表总分表现出一定程度的下降（P<0.05）。结论：对于老年原发性失眠患者，临床选择唑吡坦（5毫克）进行治疗过程中，控制用药频率为1次/天，最终可以获得显著效果，表现出的原发性失眠治疗安全性显著。 【关键词】唑吡坦；老年原发性失眠；PSQI评分 针对老年原发性失眠患者，临床选择唑吡坦进行治疗，可以将患者的总睡眠时间有效增加，将患者的睡眠质量显著提高，将患者日间表现出的困倦症状显著缓解，患者表现出较好的治疗耐受性【1】。为了进一步探讨采用唑吡坦对老年原发性失眠患者进行治疗后获得的临床效果，本文主要将我院收治的老年原发性失眠患者作为研究对象，临床通过开展开放性前瞻性多中心自身对照研究，以确定最佳的用药频率，具体分析如下。 1、资料与方法 1.1一般资料 选择我院2014年06月～2016年06月收治的老年原发性失眠患者100例作为本次研究对象；其中男51例，女49例；患者的平均年龄为（71.7±5.5）岁；患者平均基线PSQI总分为（12.59±2.01）分；患者平均疾病病程为（12.49±2.39）年；合并患有相关疾病的患者89例，未合并患有相关疾病的患者11例。 1.2 选择标准【2】 所有患者全部满足老年原发性失眠患者疾病的相关诊断标准，患者的年龄不小于65岁，患者表现出失眠症状的时间不小于3个月。患者睡眠潜伏期不小于30分钟，患者的夜间觉醒次数不小于3次。 1.3 排除标准【3】 将研究前选择镇静催眠药物进行干预的患者进行排除；将实验研究过程中需要选择其他失眠药物进行干预的患者进行排除；将针对唑吡坦表现出过敏症状的患者进行排除；将表现出严重呼吸功能不全的患者进行排除；将具有药物依赖史的患者进行排除。 1.4 方法 对于所有老年原发性失眠患者，临床选择唑吡坦药物进行治疗，10毫克/片，7片/盒。5毫克/次，选择恒定的药物剂量对患者进行治疗。 1.5 统计学方法 对于所有老年原发性失眠患者数据的统计学分析，临床选择统计学软件SPSS17.0表示，PSQI评分实施t检验（以表示），当P<0.05为存在明显差异以及统计学意义。 2、结果 2.1 PSQI总分 对所有老年原发性失眠患者完成1周的治疗后，同基线进行比较，患者的PSQI量表总分表现出一定程度的下降（P<0.05），见表1。 3、讨论 唑吡坦作为一种新型催眠药物，其主要通过对患者大脑内GABAA进行作用，进而针对睡眠表现出显著的诱导作用。针对老年原发性失眠患者在选择唑吡坦进行治疗的过程中，通常控制药物剂量在5毫克/天与20毫克/天之间。控制药物剂量在5毫克/天与10毫克/天之间对老年唑吡坦进行治疗，可以将患者的睡眠潜伏期显著改善。 对本次研究结果进行分析发现，对所有老年原发性失眠患者完成1周的治疗后，同基线进行比较，患者的PSQI量表总分表现出一定程度的下降（P<0.05），从而证明选择5毫克/天用药剂量的唑吡坦对老年失眠患者加以治疗后，在提高临床疗效方面可以发挥显著效果。

关于商业银行信用风险的文献综述

龙源期刊网 https://www.sodocs.net/doc/1d8221598.html, 关于商业银行信用风险的文献综述 作者：余峰 来源：《大经贸》2016年第05期 【摘要】随着我国商业银行的快速发展，信用风险问题在商业银行的经营过程中日益突出。本文主要从银行信用风险的定义、传统的信用风险管理和现代银行信用风险量化研究几个方面对当前的信用风险管理研究进行了文献综述，最后对国内外信用风险管理的相关文献做出了总结。 【关键词】商业银行信用风险文献综述 一、银行信用风险的定义 信用风险（CreditRisk）又称违约风险，是指交易对手未能履行约定契约中的义务而造成经济损失的风险，即受信人不能履行还本付息的责任而使授信人的预期收益与实际收益发生偏离的可能性。很多学者分别从广义和狭义的角度来定义信用风险。他们认为，狭义的信用风险一般是指信贷风险，而广义的则是指因债务人的违约而引发的一系列风险，其中包括在资产业务中因债务人没有及时偿还所借贷款而导致资产质量变换，负债业务中客户大规模提前支取导致挤兑从而加剧支付的难度等。 根据巴塞尔新资本协议，金融风险分为市场风险、信用风险、操作风险三大类。麦肯锡通过研究发现，商业银行的风险60%来自信用风险，其余40%来自市场风险和操作风险；前银 监会主席刘明康也认为，信用风险是在中国经济体制改革的形势下，商业银行所面临的最主要也是最大的风险之一。 二、传统的商业银行信用风险管理方法 商业银行传统的信用风险管理方法有信贷决策的“6C”模型和信用评分模型等。“6C”模型是指由有关专家根据借款人的品德（character）、能力（capacity）、资本（capital）、抵押品（collateral）、经营环境（condition）、事业的连续性（continuity）等六个因素评定其信用程度和综合还款能力，决定是否最终发放贷款。运用这种方法的缺点是，专家用在“6C”上的权重有可能以借款人的不同而变化，专家难以确定共同要遵循的标准，造成评估的主观性、随意性和不一致性。 而信用评分模型主要是通过对企业财务指标进行加权计算，对借款企业实施信用评分，并将总分与临界值进行比较，低于该值的企业被归入不发放贷款的企业行列。信用评分模型中最具代表性的是爱德华·阿尔特曼（Altman）1968年对美国破产和非破产生产企业进行观察，采用了22个财务比率经过数理统计筛选建立的著名的5变量Z-score模型和在此基础上改进的“Zeta”判别分析模型。将Z值的大小同衡量标准相比，可以区分破产公司和非破产公司。

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The electrical power system rapid development to the relay protection propose unceasingly the new request, the electronic technology, computer technology and the communication rapid development unceasingly has poured into the new vigor for the relay protection technology development, therefore, the relay protection technology is advantageous, has completed the development 4 historical stage in more than 40 years time. After the founding of the nation, our country relay protection discipline, the relay protection design, the relay manufacture industry and the relay protection technical team grows out of nothing, has passed through the path in about 10 years which advanced countries half century passes through. The 50's, our country engineers and technicians creatively absorption, the digestion, have grasped the overseas advanced relay protection equipment performance and the movement technology , completed to have the deep relay protection theory attainments and the rich movement experience relay protection technical team, and grew the instruction function to the national relay protection technical team's establishment. The relay factory introduction has digested at that time the overseas advanced relay manufacture technology, has established our country relay manufacturing industry. Thus our country has completed the relay protection research, the design, the manufacture, the movement and the teaching complete system in the 60's. This is a time which the mechanical and electrical relay protection prospers, was our countries relay protection technology development has laid the solid foundation. From the end of the 50's, the transistor relay protection was starting to study. In the 60's to the 80's，it is the times which the transistor relay protection vigorous development and widely used. Tianjin University and the Nanjing electric power automation plant cooperation research 500kV transistor direction high frequency protection the transistor high frequency block system which develops with the Nanjing electric power automation research institute is away from the protection, moves on the Gezhou Dam 500kV line , finished the 500kV line protection to depend upon completely from the overseas import time. - 2 -

多中心临床大数据平台建设及深度应用

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在病种病情分布等方面范围比较广。以糖尿病多中心研究为例，在确诊和治疗前期，患者多选择到三级甲等医院就诊，确定适合个体的治疗方案。治疗方案稳定后，患者大多会选择到社区卫生服务中心进行长期治疗和监督控制。因此，多中心的研究可以覆盖更多的糖尿病患者。 虽然多中心临床研究已被众多的医院、科研机构、临床医生广泛采纳，但是在实际应用中，多中心临床研究也具有许多不足之处。 （1）样本量往往偏小（即参与临床科研的病例数偏少） 在选取参与科研的样本病例上，当前的多中心临床研究通常采取一种协商遴选的办法，即各个研究中心的临床医生根据临床科研目标提供候选病例，再由总负责的研究中心确定目标样本。这种协商遴选的方法难以在较短的时间内收集足够多的病例[3]。当前的多中心临床研究的样本数量规模大致为几百，样本规模偏小，病例数不多。 （2）临床科研相对封闭、开放程度不高 在临床科研上，多中心临床研究需要科研团队之间共享科研数据和临床研究设计。当前的多中心临床研究在组建科研团队上大多采用如下3种方式：针对某一研究问题正式指派组成团队；有相同研究兴趣的同事组成团队；先决定团队的带头人，再由带头人发现团队成员。无论采取哪种方式组织团队，临床科研数据的搜集与共享都依赖于参与多中心临床研究的医院、科室、临床医生，这使得临床科研相对比较封闭。 因此，本文针对当前多中心临床研究存在的“样本量偏少、相对封闭”的缺点，结合新近兴起的大数据与云计算等技术，将物理上分散的各医院临床中心融合成逻辑上统一的临床大数据，在此基础上构建多中心临床大数据

加护病房患者的变动成本：多中心前瞻性研究【外文翻译】

外文翻译 原文 Variable cost of ICU patients:a multicenter prospective study Material Source:Intensive Care Med(2006) 32:545-552 Author:Carlotta Rossi Abstract Objective To analyze thecosts of treating critically ill patients. Design and setting: Multicenter, observational, prospective, cohort,bottom-up study on variable costsin 51 ICUs. Patients and participants: A total of 1,034 patients aged over 14 years who either spent less than 48 h in the ICU or had multiple trauma, major abdominal surgery, ischemic stroke, chronic obstructive pulmonary disease, cardiac failure, isolated head injury, acute lung injury/adult respiratory distress syndrome (ALI/ARDS), nontraumatic Conclusions: Cost of treatment in an ICU varies widely for different types of patients. Strategies are needed to contain the major determinants of high costs and low cost-efficiency. Costing strategy The monetary cost of each item considered was recorded. Drug costs were one-half retail prices (which is what hospitals are charged in Italy). The 2000 national price list provided by theMinistry of Health was used to cost laboratory and imaging tests. For all the other 235 items ICUs were asked to provide the prices actually paid in 2000. Since only 32 ICUs (63%) were able to provide these, we calculated the mean price for each item from the available data and applied this to all ICUs. In some cases (21.9%) such as pulmonary artery catheters we found outliers (ICUs paying disproportionately high prices compared to others). When this happened and the data were not corrected after the proper query, we computed trimmed means. We then subdivided the cost structure for each single patient into seven headings: drugs, where the cost was related to the quantity consumed; nutrition, excluding nutritional devices; infusions, including blood and blood products; consumables, including nutritional devices, catheters, and all kinds of kits (e.g., for ventilation, dialysis); imaging; laboratory tests; and consultations from other intra-

金融银行信用风险管理外文翻译文献

金融银行信用风险管理外文翻译文献 (文档含中英文对照即英文原文和中文翻译) 原文: Managing Credit Risks with Knowledge Management for Financial Banks Pan Jin Department of Economics Economics and Management School of Wuhan University Wuhan,Hubei Province,430072,China Abstract-Nowadays,financial banks are operating in a knowledge society and there are more and more credit risks breaking out in banks.So,this paper first discusses the implications of knowledge and knowledge management, and then analyzes credit risks of financial banks

with knowledge management. Finally, the paper studies ways for banks to manage credit risks with knowledge management. With the application of knowledge management in financial banks, customers will acquire better service and banks will acquire more rewards. Index Terms–knowledge management; credit risk; risk management; incentive mechanism; financial banks I.INTRODUCTION Nowadays,banks are operating in a“knowledge society”.So, what is knowledge? Davenport(1996)[1]thinks knowledge is professional intellect, such as know-what, know-how, know-why, and self-motivated creativity, or experience, concepts, values, beliefs and ways of working that can be shared and communicated. The awareness of the importance of knowledge results in the critical issue of “knowledge management”. So, what is knowledge management? According to Malhothra(2001)[2], knowledge management(KM)caters to the critical issues of organizational adaptation, survival and competence in face of increasingly discontinuous environmental change. Essentially it embodies organizational processes that seek synergistic combination of data and information processing capacity of information technologies and the creative and innovative capacity of human beings. Through the processes of creating,sustaining, applying, sharing and renewing knowledge, we can enhance organizational performance and create value. Many dissertations have studied knowledge managementapplications in some special fields. Aybübe Aurum(2004)[3] analyzes knowledge management in software engineering and D.J.Harvey＆R.Holdsworth(2005)[4]study knowledge management in the aerospace industry. Li Yang(2007)[5] studies knowledge management in information-based education and Jayasundara＆Chaminda Chiran(2008)[6] review the prevailing literature on knowledge management in banking industries. Liang ping and Wu Kebao(2010)[7]study the incentive mechanism of knowledge management in Banking. There are also many papers about risks analysis and risks management. Before the 1980s, the dominant mathematical theory of risks analysis was to describe a pair of random vectors.But,the simplification assumptions and methods used by classical competing risks

电网事故外文翻译

英文原文名Power grid intelligent prevention 中文译名电网安全智能防护

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国际大规模多中心临床试验范例

国际大规模多中心临床试验范例 3．4．1大规模多中心临床试验基本概念 大规模多中心临床试验是指由多个医疗中心参加的大样本（一般为1000例以上）临床试验。大规模多中心临床试验常见有以下两种情况：一种是III期新药临床试验，是大样本随机临床试验。两者相同点是均评估某种治疗措施的临床效果，但有许多不同之处。III期新药临床试验是药品生产厂家为新药注册所进行的为药品法规定的必不可床试验过程，主要目的是评估该药的临床疗效及不良反应。大样本随机临床试验是医疗科研人员发起的为解决医学领域某些尚待解决的问题进行的临床研究，主要目的是评估某种治疗措施对患者生存率及重要临床事件的影响，见表7。 表7 III期临床试验与大样本随机临床试验的区别 国际大规模多中心临床试验一般指大样本随机临床试验。 以死亡率、发病率为终点的临床试验的特点是简单、大规模、随机。大规模（数千或数万例）就要求设计简明，指标少而精，过于复杂的指标或表格就会制约数量。寻求中间终点（例如左室肥厚）以代替死亡（冠心病死亡）终点，以便减小规模的研究工作正在进行。常用的随机方法有密闭信封系统、电话或传真随机。目前，多数治疗药物对常见心血管病（降低病死率）的疗效仅为轻度。由统计学家根据现有资料推算样本量。由于《抗心律失常试验》（CAST）提示因卡胺等抗心律失常药增加死亡的结果，以及某些药物相互作用的问题，目前有人建议药品上市前就应考虑进行以死亡率与发病率为终点的临床试验，以确保用药的安全性。 3．4．2大规模多中心临床试验与循证医学 大样本随机对照临床试验是评估某些治疗措施的最佳方法，是循证医学的良好实践。50年前，英国科学家首先开始了随机对照临床试验。近20多年，国际上先后完成了数百项大样本心血管（药物）随机临床试

重视前瞻性临床研究

万方数据

万方数据

万方数据

重视前瞻性临床研究 作者：韩德民， HAN De-min 作者单位：首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,100730 刊名： 中华耳鼻咽喉头颈外科杂志 英文刊名：CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 年，卷(期)：2011，46(1) 被引用次数：0次 参考文献(10条) 1.方积乾.生物医学研究的统计学方法.北京:高等教育出版社,2008:264-265. 2.魏强.循证医学的基本概念和由来.中华泌尿外科杂志,2003,24:69-70. 3.Wang J.Evidence-based medicine in https://www.sodocs.net/doc/1d8221598.html,ncet,2010,375:532-533. https://www.sodocs.net/doc/1d8221598.html,leron O,Pillière R,Foucher A,et al.Benefits of obstructive sleep apnoea treatment in coronary artery disease:a long-term follow-up study.Eur Heart J,2004,25:728-734. 5.Wang H,Parker JD,Newton GE,et al.Influence of obstructive sleep apnea on mortality in patients with heart failure.J Am Coll Cardiol,2007,49:1625-1631. 6.林其昌,黄瑞强,黄建钗,等.阻塞性睡眠呼吸暂停低通气综合征与高血压关系的前瞻性研究.国际呼吸杂志 ,2010,30:1038-1041. 7.黄腾波,陈德林,黄惠明,等.鼻咽粘膜异常与鼻咽癌相关的前瞻性观察.中华耳鼻咽喉科杂志,1995,30:216-218. 8.文浩,郎锦义,杨家林,等.超分割放射同期化疗治疗Ⅲ和Ⅳ期鼻咽癌前瞻性研究.中华放射肿瘤学杂志 ,2002,11:73-76. 9.朱红,袁君.放疗加紫杉醇化学治疗晚期鼻咽癌前瞻性研究.中国现代医学杂志,2003,13:84-85. 10.刘春杰,刘维良,李明众,等.晚期鼻咽癌综合治疗的前瞻性研究.西安医科大学学报,1996,17:201-202. 本文链接：https://www.sodocs.net/doc/1d8221598.html,/Periodical_zhebyhk201101002.aspx 授权使用：复旦大学图书馆(fddxlwxsjc)，授权号：06d81cb9-ba53-4c15-99dc-9e9a013c05f8 下载时间：2011年3月2日