Search

Health equity can narrow the health gap between different groups and enable citizens to enjoy fair health services. Clinical practice guideline makers have been paying more and more attention to health equity, and exploring and applying the consideration to the development of corresponding guidelines. However, existing clinical practice guideline development gives little consideration to the structured and systematic construction of health equity, and the guidance for future guidelines is limited. This paper aims to put forward methodological suggestions for in-depth consideration of health equity in clinical practice guideline development, withthe hope of providing reference for guideline developers.

In the process of developing clinical practice guidelines, consensus method is essential to determine clinical problems and recommendations, among which Delphi method and modified Delphi method are the most common. Therefore, scientific and standardized application of Delphi method to reach a consensus (such as expert selection, process design) has become an important topic in urgent need of study. In the process of using Delphi method, it is necessary to refer to mature methodological suggestions to make theconsensus process structured and transparent. This article focuses on the key elements of Delphi method in the development of clinical practice guidelines, and elaborates its basic methods and processes, including the number, composition, standards and selection methods of the 'expert group', as well as the key points of patients' participation. In terms of technical points, anonymity, consensus threshold and time control are described. Furthermore, the limitations of Delphi method and the highlights of the report are presented, in order to promote the standardized application of Delphi method in the development of the guidelines.

As an emerging international research hotspot, the development of guidelines with patient participation has seen great differences in related methodological research in China and abroad. This paper advocates the establishment of patient panel, and discusses the working methods of patient panel, the source and selection of patient representatives, participation phases, management, and support. Methodological optimization suggestions are also proposed, such as the sustainability of patients, structuring and two-way communication mode made by a consensus expert group involving patients' values and preferences, in order to provide a reference for the development of patient participation guidelines in China.

Layered queueing networks (LQNs) are an extension of ordinary queueing networks useful to model simultaneous resource possession and stochastic call graphs in distributed systems. Existing computational algorithms for LQNs have primarily focused on mean-value analysis. However, other solution paradigms, such as normalizing constant analysis and mean-field approximation, can improve the computation of LQN mean and transient performance metrics, state probabilities, and response time distributions. Motivated by this observation, we propose the first LQN meta-solver, called LN, that allows for the dynamic selection of the performance analysis paradigm to be iteratively applied to the submodels arising from layer decomposition. We report experiments where this added flexibility helps us to reduce the LQN solution errors. We also demonstrate that the meta-solver approach eases the integration of LQNs with other formalisms, such as caching models, enabling the analysis of more general classes of layered stochastic networks. Additionally, to support the accurate evaluation of the LQN submodels, we develop novel algorithms for homogeneous queueing networks consisting of an infinite server node and a set of identical queueing stations. In particular, we propose an exact method of moment algorithms, integration techniques for normalizing constants, and a fast non-iterative mean-value analysis technique. [ABSTRACT FROM AUTHOR]

Objectives: To compared the presentation of research priorities in the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) clinical practice guidelines (CPGs) developed under the guidance of the GRADE working group or its two co-chair, and the Chinese CPGs. Methods: This was a methodological empirical analysis. We searched PubMed, Embase, and four Chinese databases (Wanfang, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure and Chinese Biomedical Literature Database) and retrieved nine Chinese guideline databases or Society websites as well as GRADE Pro websites. We included all eligible GRADE CPGs and a random sample of double number of Chinese CPGs, published 2018 to 2022. The reviewers independently screened and extracted the data, and we summarized and analyzed the reporting on the research priorities in the CPGs. Results: Of the 135 eligible CPGs (45 GRADE CPGs and 90 Chinese CPGs), 668, 138 research priorities were identified respectively. More than 70% of the research priorities in GRADE CPGs and Chinese CPGs had population and intervention (PI) structure. 99 (14.8%) of GRADE CPG research priorities had PIC structures, compared with only 4(2.9%) in Chinese. And 28.4% (190) GRADE CPG research priorities reflected comparisons between PICO elements, approximately double those in Chinese. The types of research priorities among GRADE CPGs and Chinese CPGs were mostly focused on the efficacy of interventions, and the type of comparative effectiveness in the GRADE research priorities was double those in Chinese. Conclusions: There was still considerable room for improvement in the developing and reporting of research priorities in Chinese CPGs. Key PICO elements were inadequately presented, with more attention on intervention efficacy and insufficient consideration given to values, preferences, health equity, and feasibility. Identifying and reporting of research priorities deserves greater effort in the future. [ABSTRACT FROM AUTHOR]

High-precision position control of hydraulic systems is of great significance in industrial applications. However, unknown external force disturbance, measurement noise, and other uncertain nonlinearities widely exist in electro-hydraulic servo systems, which severely degrade the system performance. To handle this problem, a sliding-mode controller based on K-observer with nonlinear disturbance observer is proposed for electro-hydraulic position systems in this article. The nonlinear disturbance observer is to estimate and eliminate the time-varying external force disturbance. The sliding-mode controller based on K-observer is to reach low gain observation of states and improve the system performance by reducing the chattering of the sliding-mode algorithm. The proposed controller is proved to be stable by the Lyapunov stability criterion. Comparative experiments support that the controller has high precision and strong robustness. [ABSTRACT FROM AUTHOR]