An Evidence-Based Medicine Analysis Of Therapeutic Articles On Acute Pancreatitis In China

Purpose: This study was to evaluate the current situation of therapeutic and randomized controlled trials/clinical controlled trials(RCT/CCT) on acute pancreatitis(AP) in China according to Evidence-Based Medicine(EBM), in order to understand whether treatment and clinical research and design of AP was reasonable, and it could offer reliable evidence for clinical practice. Methods: Fourteen Chinese clinical journals correlated with the acute pancreatitis from Jan.1989 to Dec.2004 were searched manually. The total amount of therapeutic articles on acute pancreatitis was registered and all articles of RCT/CCT were identified and analysed article by article according to the standards of Cochrane Collaboration. Results: From 1480 issues of 178 volumes, 204 therapeutic articles of acute pancreatitis were searched, of which 30 articles of RCT/CCT (14.7%) on acute pancreatitis were identified and assessed. Among 30 articles of the RCT/CCT: (1)There were only 5 articles with method of randomization (16.7%) and 4 articles with Completely randomization (13.3%), 19 articles with comparability of baseline (including description) (63.3%), but no one with blind trial; (2)There were 25 articles with the accurate conclusion standards(83.3%), 4 with exclusion standards (13.3%), 27 with accurate criteria of effect determination (90%) and 3 with adverse effect reported (10%); (3)There are 27 articles that the sample size was smaller than 100 (90%), but 28 articles with significance test (93.3%). Among 204 therapeutic articles of AP: (1) There were 132 articles written by general surgeon as the first author (64.7%) and 47 by digestive physician (23%); (2) There were 91 articles with diagnosis standard (77.8%), of which the standard of national pancreas meeting in China (1996) was adopted in 71 (60.7%); (3) There were 76 articles that patient was treated in general surgery department (65%) and 28 in digestive department(23.9%), but 80 articles with conservation treatment (69%). Conclusions: The conservation treatment is the main therapeutic method of acute pancreatitis in China at present. The Clinical research and design are not rational enough and the thesis is written unstandardly. A proportion of the therapeutic article of RCT/CCT on acute pancreatitis is less, in which the quantity and quality of RCT/CCT on acute pancreatitis are not good enough to serve the clinical practice. So that, in order to offer the reliable evidence for clinical practice, the knowledge of Evidence-Based Medicine (EBM) should be popularized and the training on clinical method of RCT/CCT should be strengthened as soon as possible.