Initiating Population-Based “5A” Evidence-Based Clinical Practice Model - EBM anti-Coronavirus Action in China

Article type
Authors
Fei Y1, Liu J1, Yu M1, EBM AA2
1Beijing University of Chinese Medicine (BUCM)
2Evidence-Based Chinese Medicine
Abstract
Background:COVID-19 pandemic is an unprecedented public health emergency.In the beginning of the epidemic in China, there was completely no direct experience and evidence that can be used as reference to guide medical actions.However, the experience and evidences gained from handling previous epidemic situations can be used as indirect evidence to support current practice, when waiting for direct scientific research evidence to be produced.At the same time, fast growing real-world first-hand experience of health care professionals needs to be collected, summarized, consented and disseminated as soon as possible to complement clinical decision making in a most efficient way.The “Ask-Acquire-Appraise-Apply-Assess”-“5A” evidence-based clinical practice (EBCP) model needs to be extended population-based “5A” EBCP model.
Objectives:To identify clinical needs for the medical prevention and control of COVID-19 infection,prioritize them and collaborate with evidence teams all over China to provide reliable information and evidence to frontline workers.
Methods:Evidence-Based Medicine (EBM) anti-Coronavirus Action was initiated calling on all Chinese EBM professional teams to collaborate to provide evidence for urgent clinical questions or information needs, which were collected by online PICO structured questionnaire sent out via public media WeChat to clinicians and nurses, mainly working in Wuhan city.Structured evidence summary tables were developed to facilitate the work of the collaborative teams.
Results:EBM anti-Coronavirus Action was initiated on February 20th, 2020,by Institute of Excellence in Evidence-Based Chinese Medicine.Twenty-four EBM teams, plus one public health team and one psychiatry team from 13 provinces/autonomous regions/ municipalities in China, and one health economics team from Canada, joint the action and contributed until March 30th, 2020, 85 evidence summaries. The topics of those summaries were selected by each team from 184 questions we collected from the online survey, in which 1,343 clinicians participated.The questions covered a very broad range, including transmission of the virus, identification and control the source of infectious pathogenesis, diagnosis, treatment, prognosis, social and psychological impacts, and prevention of secondary disasters, etc.The 58 evidence summaries that were sent out via WeChat were read 16448 times.14 media in China reported on EBM anti-Coronavirus Action.
Conclusions:The successfully initiated EBM anti-Coronavirus Action was based on the rapid responses of both the clinicians asking important queries and the collaborative evidence-providing teams answering the queries.This action serves adequately as a pilot for the theoretical population-based “5A” EBCP model,which might benefit the world in the continuing COVID-19 pandemic in clinical medicine area, as well as other health related areas.
Patient or healthcare consumer involvement:Clinicians in Wuhan were consulted and involved in the designing of the online questionnaires and the initiation of the action.