tbuckley/cabot-search huggingface dataset:
Diagnostic accuracy of CT-staging of advanced gastric cancer following neoadjuvant chemotherapy.
Authors: Jong Keon Jang, Jong Seok Lee, Min-hee Ryu, Jeong Hwan Yook, Young-Kyu Park, Young Woo Kim, Jin Young Kim, Sun Young Rha, Ik-Joo Chung, In-Ho Kim, Sang Cheul Oh, Chang Hak Yoo, Jin-Hyuk Choi, Dae Young Zang, Gyunji Kim, YeonJu Lee, Sung Hoon Noh, Yoon-Koo Kang
Journal: Journal of Clinical Oncology (2020)

4551 Background: Neoadjuvant or perioperative chemotherapy has been accepted as a standard treatment globally in patients (pts) with locally advanced gastric cancer (LAGC). In PRODIGY phase III study (n = 530), we have demonstrated that neoadjuvant chemotherapy with DOS regimen (docetaxel, oxaliplatin, S-1) led to significant tumor downstaging and improved PFS in Korean LAGC pts (Kang, et al. ESMO 2019). Although CT has been performed to re-stage the tumor after neoadjuvant chemotherapy, there has been a relative paucity of diagnostic accuracy data. This study is to evaluate the diagnostic performance of restaging of LAGC after neoadjuvant chemotherapy using CT in PRODIGY study population. Methods: Of 266 pts, who had been diagnosed LAGC of T2-4 or N+ stage as assessed with CT and randomized to neoadjuvant chemotherapy arm (CSC) in PRODIGY study, 214 pts underwent gastrectomy were included in this analysis. The post-chemotherapy T- and N- stage was determined based on CT scan taken just prior to surgery and compared with the pathologic stage (AJCC 7th edition). Two experienced radiologists independently evaluated depth of primary tumor and reached consensus if any discrepancy between two readers. Diameter of short axis of the largest regional lymph node was measured to predict metastatic lymph node. Result of histopathologic T- and N-staging using surgical specimen was used as reference standard. Results: The study cohort consisted of pathologic T0 (n = 22), T1(n = 39), T2(n = 31), T3(n = 79), and T4(n = 43). The overall diagnostic accuracy of CT was 45%. For each T-stage, accuracy of T0,T1,T2,T3, and T4 was 0%, 26%, 29%, 55% and 79%, respectively. Rate of over- and under- staging was 47% and 8%, respectively. Accuracy for prediction of downstaging to early gastric cancer (T0-T1) was 83%. Interobserver agreement of T-staging was moderate (k = 0.41). There were 98 patients of N+ and 116 patients of N- at histopathology. Area under the curve of receiver operating characteristics to differentiate lymph node metastasis was 0.63. Sensitivity and specificity of size criteria of the largest lymph node (cut off value: &gt; 6mm, &gt; 7mm, and &gt; 8mm) to predict pathologic N+ were 90% and 17%, 78% and 34%, and 68% and 51%, respectively. Conclusions: Re-staging using CT after neoadjuvant chemotherapy showed suboptimal accuracy and over-staged residual tumor. However, it predicted downstaging of gastric cancer with high accuracy.
Physician global assessment in systemic lupus erythematosus: can we rely on its reliability?
Authors: Elisabetta Chessa, Matteo Piga, Laurent Arnaud
Journal: Annals of the Rheumatic Diseases (2020)

Physician global assessment in systemic lupus erythematosus: can we rely on its reliability?We read with great interest the recent paper by Aranow et al 1 about the impact of laboratory results on scoring of the Physician Global Assessment (PGA) of disease activity in systemic lupus erythematosus (SLE).PGA is an important tool for assessing disease activity, response to treatment (it is a component of the Systemic Lupus Erythematosus Responder Index (SRI)-4) and remission in SLE.Importantly, monitoring of SLE through PGA has been recommended in the recent European League against Rheumatism (EULAR) guidelines. 2 In their paper, 1 Aranow et al found very high inter-rater PGA reliability values (pre-lab PGA intraclass correlation coefficient (ICC) 0.98; post-lab PGA ICC 0.99) based on 50 clinical vignettes.In our recent systematic review of the psychometric properties of the PGA, 3 we show that this instrument is valid and responsive for assessing disease activity in SLE, but has a high variability.In the paper by Aranow et al, the inter-rater reliability of PGA was assessed using the ICC with a two-way random-effect model based on mean scorings (ICC 2,k).This has the effect of artificially increasing reliability estimates compared with the use of single measurement models (ICC 2,1), which would also be interesting to present.This further suggests a major need for both standardisation and training in the scoring of this increasingly used instrument, particularly among non-expert rheumatologists, as those may wish to follow the recent EULAR recommendations for SLE.
Enhanced co-expression extrapolation (COXEN) gene selection method for building anticancer drug response prediction models.
Authors: Yitan Zhu, Thomas S. Brettin, Fangfang Xia, Maulik Shukla, Alexander Partin, Hyunseung Yoo, Rick L. Stevens
Journal: Journal of Clinical Oncology (2020)

e14073 Background: Accurate prediction of tumor response to a drug treatment is of paramount importance for precision oncology. The co-expression extrapolation (COXEN) gene selection approach has been successfully used in multiple studies to select genes for predicting the response of tumor cells to a specific drug. Here, we enhance the original COXEN approach to select genes that are predictive of the efficacies of multiple drugs simultaneously for building general drug response prediction model. Methods: We implemented two methods to select predictive genes. The first method ranks the genes according to their prediction power for each individual drug and then takes a union of top predictive genes of all the drugs. The second method uses a linear regression model to evaluate the prediction power of a gene for all drugs while the drugs are one-hot encoded in the regression model. Among the predictive genes, we further select genes by evaluating the preservation of co-expression patterns between cancer cases with drug response data available and cancer cases for which drug response needs to be predicted, because the preservation of co-expression patterns indicates the similarity of genomic regulations between cancer cases. Results: To test the enhanced COXEN method, we used a lightGBM regression model to predict drug response based on the selected genes on two benchmark in vitro drug screening datasets. The table below compares the performance of prediction models built based on 200 genes selected by the enhanced COXEN method to that of models built on 200 genes randomly picked from the LINCS gene set, which includes 976 “landmark” genes well-representing cellular transcriptomic changes identified in the Library of Integrated Network-Based Cellular Signatures (LINCS) project. The enhanced COXEN approach selects genes better than random LINCS genes as demonstrated by the increased average coefficient of determination (R 2 ) for predicting the area under the dose response curve through cross-validation. Pair-wise t-test indicates the improvement is statistically significant (p-value ≤ 0.05) on both datasets. Conclusions: Our result demonstrates the benefit of using an enhanced COXEN approach to select genes for building general drug response prediction model. [Table: see text]
Comprehensive management model of health behavior for diabetic patients in community
Authors: Ling Tian, Qing Lin, Mei Leng, Jing Zhang, Dan Liu
Journal: BMJ (2017)

糖尿病是一种由多因素所致的慢性、终生性心身疾病，行为因素在疾病的发生、发展与转归过程中起到关键作用。立足于北京西罗园社区卫生服务中心组建的多学科健康管理团队建立了行为健康门诊 ，运用5A工作流程，融合健康教育、心理干预(心理疏导)、行为健康管理等手段，以糖尿病健康生活项目为实践，初步形成了糖尿病全科门诊－行为健康门诊之间相互转介、共同管理的糖尿病社区综合管理新模式。
Characterization of cytokine release syndrome (CRS) and neurological events (NEs) in the phase I TRANSCEND NHL 001 trial of lisocabtagene maraleucel (liso-cel) for patients (pts) with relapsed/refractory (R/R) large B-cell lymphoma (LBCL).
Authors: Jeremy S. Abramson, Tanya Siddiqi, Leo I. Gordon, Matthew Alexander Lunning, Michael Wang, Jon E. Arnason, Amitkumar N. Mehta, Enkhee Purev, David G. Maloney, Charalambos Andreadis, Alison R. Sehgal, Scott R. Solomon, Nilanjan Ghosh, Tina M. Albertson, Jacob Garcia, Ana Kostic, Daniel Li, Yeonhee Kim, Maria Lia Palomba
Journal: Journal of Clinical Oncology (2020)

e20046 Background: Clinical studies of liso-cel show low incidences of severe CRS and NEs. Pts with high tumor burden and inflammation are at higher risk of CRS and NEs (Borrega, Hemasphere 2019). Here, we characterize the presenting symptoms, timing, and management of CRS and NEs in pts with R/R LBCL treated with liso-cel in TRANSCEND NHL 001 (NCT02631044). A deeper understanding of CRS/NEs after liso-cel treatment may help clinicians identify and manage these toxicities. Methods: Pts with R/R LBCL and ≥2 lines of therapy received liso-cel after lymphodepletion (LD) with fludarabine and cyclophosphamide. Bridging therapy was allowed for pts with PET-positive disease before LD (Abramson, ASH 2019 #241). Investigators were educated on prospectively identifying liso-cel–related NEs and CRS, which were collected and graded per NCI CTCAE v4.03 (NEs) or 2014 Lee criteria (CRS). Timing and severity of individual CRS/NE symptoms and interventions were also collected. Results: The analysis included 269 pts (median age, 63 y): 38% had sum of perpendicular diameters ≥50 cm 2 or lactate dehydrogenase ≥500 U/L, and 59% received bridging therapy. CRS and NEs had delayed onset (median, 5 and 9 d, respectively) and a low incidence of grade (Gr) ≥3 events (CRS 2%; NE 10%). CRS occurred before NEs in most pts and was Gr 1/2 at onset in all but 2 pts (Table). The most common CRS symptoms were pyrexia (40%), hypotension (20%), and tachycardia (18%). Overall, 20% of pts received tocilizumab and/or corticosteroids for CRS (10% tocilizumab only; 2% corticosteroids only; 8% both); 3% received vasopressors. The most common NE symptoms were confusional state (11%), tremor (9%), and aphasia (8%); most were low grade. A total of 17% of pts received tocilizumab and/or corticosteroids for NEs (13% corticosteroids only; &lt; 1% tocilizumab only; 3% both); &lt; 1% received vasopressors. Overall, 4% of pts were admitted to the ICU for CRS and/or NEs. Additional analyses on timing of intervention and type/severity of initial symptoms will be presented. Conclusions: In pts with high-risk, aggressive R/R LBCL, liso-cel treatment was associated with a low incidence of severe CRS/NEs, late onset of mostly low-grade events at presentation, and low use of tocilizumab/corticosteroids. Clinical trial information: NCT02631044 . [Table: see text]
Risk factors for early treatment failure in hospitalized patients with community-acquired pneumonia
Authors: Hui Liu, Tian-tuo Zhang, Ben-quan Wu, Jing Huang, Hong-tao U, Yu-qi Zhou, Jia-xin Zhu
Journal: BMJ (2009)

Objective To determine risk factors associated with early treatment failure in hospitalized patients with community-acquired pneumonia ( CAP) . Methods Clinical data of 549 adult patients with CAP hospitalized at the No. 3 Hospital Affiliated to Sun Yat-Sen University, Guangzhou during January 2002 to January 2008 were analyzed retrospectively, and 68 of whom failed in early treatment Differences in baseline characteristics and clinical parameters including treatment and prognosis between those with and without early treatment failure were compared to identify relevant factors for early treatment failure with univariate and muitivariate logistic regression analysis. Results A total of 549 patients,including 341 elderly patients, were enrolled in the study, with a mean age of(61±23)years.Their mean length of hospital stay was 11 days, with 68 cases (12.4% ) in early treatment failure within 72 hours after admission and an in-hospital case-fatality of 10. 2 percent As compared to those of non-early treatment failure, aspiration pneumonia, concomitant neurological diseases, lesions in multilobar or bilateral lungs,hypotension (systolic blood pressure lower than 90 mm Hg) and inadequate antimicrobial therapy were more frequently seen in patients with early treatment failure. Results of muitivariate analysis indicated that risk factors independently associated with development of early treatment failure included aspiration pneumonia (95%CI= 2.752 - 17.553, P =0.011), multilobar or bilateral involvement of the lungs (95% CI =2. 043 -15. 241, P - 0. 020) and inadequate antimicrobial therapy ( 95% CI = 3. 478 - 18. 540, P =0. 001). Conclusions Early treatment failure associated with higher case-fatality rate and longer hospital stay for patients with CAP. Early detection and management of CAP require careful clinical assessment To decrease occurrence of early treatment failures, interventions need to be performed in advance to improve prognosis of patients with CAP.

Key words: 
Community-acquired infection;  Pneumonia;  Treatment failure
民营医院抓好继续医学教育的方法探索
Authors: 张功林, 章鸣, 朱圣斌, 应晓生
Journal: BMJ (2008)

继续医学教育是医学院校毕业后的一种终身教育,是人材培养和医院可持续发展的基础[1-3].我院是民营医院,结合实际制定出继续医学教育管理制度,使继续医学教育制度化、规范化,既重视人员与时间的落实,也注重实效与可操作性。
Predictors of recurrence and implications for overall survival in borderline resectable pancreatic cancer patients treated with total neoadjuvant therapy: A retrospective cohort study.
Authors: Jori Lee Kaplan, Benjamin Powers, Wenyi Fan, Michael J. Schell, Barbara Centeno, Dae Won Kim, Jessica Frakes, Sarah E. Hoffe, Mokenge Peter Malafa, Pamela Joy Hodul, Jason B. Fleming, Estrella M. Carballido
Journal: Journal of Clinical Oncology (2020)

e16781 Background: Borderline resectable pancreatic ductal adenocarcinoma (BR PDAC) is a subset of pancreatic cancer with unique prognostic implications. A multimodality, neoadjuvant therapy (NAT) approach has known benefits such as downstaging tumors, reducing the risk of a positive margin, and treating micrometastatic disease. Patient selection and therapy sequencing are controversial owing to the high risk of recurrence. Therefore, we aimed to identify factors predicting recurrence and overall survival (OS) in BR PDAC patients undergoing NAT. Methods: We identified BR PDAC patients treated with NAT followed by surgery at Moffitt Cancer Center between 2008-2015. We evaluated clinical, demographic, and perioperative factors to identify predictors of recurrence and OS. Statistical analyses were performed with univariate and multivariable Cox regression models. Results: 117 patients with BR PDAC who received NAT were evaluated; 53 (45%) were female and 64 (55%) were male. Of those, 91 (78%) received gemcitabine/xeloda/taxotere and the remainder received other gemcitabine or 5FU regimens. 107 (91%) patients received neoadjuvant radiation, mainly 5-day dose painted SBRT. Post- NAT CA 19-9 normalized in 39 (33%) and 11 (9%) additional patients normalized after surgery. Pathologic treatment effect was appreciated in 85 (73%) patients and pathologic complete response (pCR) was seen in 18 (15%). 95 (81%) patients initiated adjuvant therapy. In multivariable analysis, the strongest predictor of recurrence was higher log(10) post-operative CA 19-9 (HR 2.29; 95% CI, 1.40-3.75). Time from initiation of NAT to surgery ≥ 5 months also predicted recurrence (HR 2.08; 95% CI, 1.16-3.72). In OS analysis, 71 patients had recurrence after multimodality treatment; 61 (86%) died and 10 (14%) were alive. In multivariable analysis, the strongest predictors of prolonged OS from recurrence were female gender (HR 0.47; 95% CI, 0.26-0.84) and presence of a treatment effect (HR 0.37; 95% CI, 0.15-0.93). Conclusions: We observed treatment effects and pCR comparable to other institutions, supporting a multimodality approach to BR PDAC. Higher post-operative CA 19-9 and time to surgery ≥ 5 months from initiation of NAT were associated with an increased risk of recurrence. These data suggest that timely receipt of surgery after completion of NAT may impact recurrence and OS in BR PDAC.
非甾类抗炎药致消化性溃疡穿孔23例临床分析
Authors: 杨希中, 张富华, 侯连泽
Journal: BMJ (2006)

由于对以阿司匹林和吲哚美辛为代表的非甾类抗炎药(NSAIDs)在抗炎、镇痛、抗血栓、抗肿瘤等方面作用的研究和开发,其临床应用明显增加[1].然而NSAIDs却有明显的胃肠道不良反应,其中胃溃疡(GU)的发生率为12%～30%,十二指肠溃疡(DU)的发生率为2%～19%.NSAIDs使溃疡并发症(穿孔、出血等)发生的危险性增加4～6倍,约半数患者可无任何临床症状,而是以穿孔、出血等严重并发症为首发症状[2].我们分析23例NSAIDs所致消化性溃疡(PU)穿孔患者的临床资料,结合文献,对NSAIDs所致PU穿孔的临床特点进行讨论。
The relationship betweendyslipidemia and impaired glucose tolerance: a study on elderly patients
Authors: Li-qun Zhu, Hui-di Cui, Zhu Li
Journal: BMJ (2009)

：The study is toinvestigate the relationship between dyslipidemia and impaired glucose tolerance (IGT).Ninety elderly nondiabetic patients (60 -84 years old) were under long-term follow-up inoutpatient department. Blood lipid measurement and oral glucose tolerance test (OGTr) wereperformed,the two-hour glucose levels (2 hPBG) between normal and abnormal blood lipidgroups were compared. We found that patients with hypertriglyceridemia had a significantlyhigher 2 hPBG than patients with normal blood triglyceride(P＜0. 01 ). But there were no differences in 2 hPBG levelsbetween other dyslipidemias and normal lipid patients. OGTT screening in elderly patientswith hypertriglyceridemia can be helpful in early detection and prevention of diabetes.

Key words: 
Glucose tolerance test; Dyslipidemias
Long-term survivors and gilteritinib safety beyond one year in <i>FLT3</i>-mutated R/R AML: ADMIRAL trial follow-up.
Authors: Alexander E. Perl, Giovanni Martinelli, Andreas Neubauer, Ellin Berman, Maria R. Baer, Richard A. Larson, Amir Tahmasb Fathi, Hisayuki Yokoyama, Naoko Hosono, Nahla Hasabou, Qiaoyang Lu, Erkut Bahceci
Journal: Journal of Clinical Oncology (2020)

7514 Background: The phase 3 ADMIRAL trial showed that gilteritinib was superior to salvage chemotherapy (SC; median overall survival [OS]: 9.3 vs 5.6 mo, respectively) in FLT3 mut+ R/R AML patients (pts; Perl, et al. N Engl J Med. 2019). This follow up (FU) of the ADMIRAL trial assessed long-term (LT) survivors and gilteritinib safety beyond 1 year. Methods: A data cut was performed 1 year after the primary analysis. Response outcomes in LT survivors (OS ≥18 mo) in the gilteritinib arm, and safety during and after 12 mo of gilteritinib therapy were assessed. Results: At 1 year after the primary analysis, median FU for OS was 29.2 mo. Median OS remained longer with gilteritinib (9.3 mo) than with SC (5.6 mo; HR=0.679 [95% CI: 0.527, 0.875], nominal P=0.0026); 18-mo OS rates were 27% and 15%, respectively (Table). Of 49 censored pts in the gilteritinib arm, 20 continued treatment; 13 of these 20 pts underwent transplantation (HSCT) and received gilteritinib post-HSCT. Median gilteritinib exposure was 4.1 mo (IQR, 2.1-8.2) and median average dose was 120 mg/day (range, 43.8-192.3); 12% (n=30/246) of pts had ≥18 mo and 7% (n=17/246) had ≥24 mo of drug exposure. A total of 63 gilteritinib-treated pts had OS ≥18 mo (median exposure, 17.6 mo [IQR, 3.1-25.7 mo]). A high proportion of these LT survivors achieved remission pre-HSCT (Table); median durations of complete remission (CR) or CR with partial hematologic recovery (CRh) have not been reached. After a median of 3.5 mo, 35 of 63 (56%) LT survivors underwent HSCT; 25 of these 35 pts (71%) received post-HSCT gilteritinib therapy. Of 28 pts who did not undergo HSCT, 15 (54%) received gilteritinib for ≥18 mo. Most common grade ≥3 adverse events (AEs) during the first 12 mo of gilteritinib therapy were febrile neutropenia (45%), anemia (40%), and thrombocytopenia (23%); rates of these grade ≥3 AEs decreased to 8%, 10%, and 0, respectively, after 12 mo of treatment. Most common fatal AEs during the first 12 mo of gilteritinib therapy were AML (11%), infections (11%), and cardiac disorders (3%); after 12 mo of treatment, rates of these fatal AEs were 6%, 8%, and 2%, respectively. Conclusions: Results from this ADMIRAL trial FU suggest LT survival in pts receiving gilteritinib is related to ongoing remission, subsequent HSCT, or post-HSCT gilteritinib therapy. The safety profile of gilteritinib beyond 1 year was stable. Clinical trial information: NCT02421939 . [Table: see text]
<i>YES1</i> amplification as a primary driver of lung tumorigenesis and <i>YES1/YAP1</i> amplifications as mediators of acquired resistance (AR) to ALK and EGFR tyrosine kinase inhibitors (TKIs).
Authors: Hiroki Sato, Daisuke Kubota, Paul K. Paik, Huan Qiao, Achim A Jungbluth, Natasha Rekhtman, Adam Jacob Schoenfeld, Helena Alexandra Yu, Gregory J. Riely, Christine Marie Lovly, Marc Ladanyi, Pang-Dian Fan
Journal: Journal of Clinical Oncology (2020)

e21591 Background: Our previous work identified YES1 amplification as a mechanism of AR to EGFR TKIs. The current study investigates the potential role of YES1 amplification as a primary driver of tumorigenesis and of YES1/YAP1 amplifications as mediators of AR to ALK and EGFR TKIs. Methods: Models of ectopic expression were established and characterized for YES1 and YAP1 in human bronchial epithelial cells (HBECs) and ALK fusion-positive ( ALK+) and EGFR-mutant ( EGFRm) lung adenocarcinoma (LUAD) cell lines. MSK-IMPACT data for all LUAD cases and for ALK and EGFR TKI AR cases were surveyed for YES1 and YAP1 amplification. Results: YES1 was found to be amplified in 0.5% of all LUAD cases currently in the MSK-IMPACT database. To demonstrate its potential as a primary driver of tumorigenesis, YES1 was inducibly expressed in HBECs and shown to promote EGF-independent growth, focus formation, and increases in proliferation rate and sensitivity to Src family kinase (SFK) TKIs. Consistent with these findings, a partial response by RECIST criteria to third-line dasatinib was observed for a patient with stage IV LUAD in which MSK-IMPACT detected YES1 amplification and no established primary driver alteration. In models of AR, overexpression of either YES1 or YAP1 in multiple ALK+ and EGFRm cell lines conferred resistance to ALK and EGFR TKIs. Sensitivity to ALK or EGFR TKIs was partially recovered in YES1-overexpressing cells lines by siRNA-mediated gene knockdown of YAP1, and was restored in YAP1-overexpressing cells lines by knockdown of YES1 or mutation of the YES1-phosphorylation site on YAP1. ALK + or EGFR m cells overexpressing either YES1 or YAP1 were sensitive to dual inhibition of the primary driver and SFKs with single-agent repotrectinib or dasatinib, respectively. In contrast, treatment of YAP1-overexpressing ALK+ H3122 cells with alectinib induced changes in morphology and gene expression consistent with epithelial-to-mesenchymal transition (EMT) and rendered the cells insensitive to repotrectinib. Similar resistance to dual inhibition was seen in other YAP1-overexpressing cell lines after treatment with only ALK or EGFR blockade. To date, one LUAD case each of EGFR and ALK TKI AR has been found through MSK-IMPACT™ to be associated with YAP1 amplification. Conclusions: SFK inhibition can potentially be exploited to therapeutically target YES1 amplification as a primary driver in tumorigenesis and YES1/YAP1 amplifications as mediators of AR to ALK and EGFR TKIs.
不同糖耐量者血清游离脂肪酸与胰岛素抵抗及胰岛β细胞功能的关系
Authors: 陈黎红, 严励, 何扬, 唐菊英, 黎锋, 刘湘茹, 程桦
Journal: BMJ (2006)

比较不同糖耐量者空腹、糖负荷后30 min及120 min血清游离脂肪酸水平、各时间点游离脂肪酸与胰岛素抵抗以及胰岛β细胞功能的相关性.结果显示3组间空腹及糖负荷后游离脂肪酸水平差异有统计学意义,空腹、糖负荷后30 min及120 min游离脂肪酸水平与胰岛素分泌功能以及胰岛素敏感性指数呈负相关.提示游离脂肪酸对胰岛β细胞功能和胰岛素敏感性存在负面、毒性作用。
主诉腹痛的儿童危重症14例误诊分析
Authors: 侯梅荣, 王洽会, 王英文, 刘珊珊
Journal: BMJ (2010)

腹痛是儿科门诊及急诊常见主诉之一.由于小儿年龄、解剖生理特点等的特殊性,主诉腹痛的危重患者发生误诊和出现并发症的几率相对较高.现将我科2001年1月至2009年5月的门诊及病房有较完整资料的14例主诉腹痛的危重症患者进行回顾性分析。
Reliability and validity of the mini-clinical evaluation exercise for rotation examination in general practice training
Authors: 顾杰, 杨华, 寿涓, 张向杰, 王健, 祝墡珠
Journal: BMJ (2010)

Thirty four residents of general practice and 11 students of junior college to undergraduate program were evaluated with the mini-clinical evaluation exercise (mini-CEX) when they were rotated to community clinics or the ward of general practice in Zhongshan Hospital from September 2009 to February 2010. The reliability and validity of mini-CEX for rotation examination in general practice training was assessed. Forty five trainees and 9 clinical faculty members completed 81 mini-CEX evaluations. The Cronbach's alpha coefficient was 0. 932. Criterion-related validity for mini-CEX overall competence with the end examination of rotation was O.53 ( P ＜ 0.001 ). The results indicate that mini-CEX may be an appropriate evaluation tool for rotation examination in general practice training.

Key words: 
Reliability ;  Mini-clinical evaluation exercise ;