1. Least cost analysis: also known as cost analysis, it is a special case of cost-effectiveness analysis, which compares which drug treatments (including other healthcare intervention programs) are least costly in the case of identical clinical outcomes. It must first demonstrate that the difference between the results obtained from two or more drug regimens is not statistically significant, i.e., p > 0.05, and then analyze it to find the one that minimizes costs.
2. Cost-effectiveness analysis: one of the more complete forms of comprehensive economic evaluation, mainly comparing the difference in health effects and cost differences, the results of which are expressed in terms of the cost per unit of increase in health effects (i.e., the ratio of cost-effectiveness analysis). It is characterized by the treatment results do not use monetary units to express, but the use of clinical indicators, is a common means of pharmacoeconomic research.
3. Cost-utility analysis: the development of cost-effectiveness, and cost-effectiveness has many similarities. Cost-utility analysis compares the economic rationality of different treatment options, taking into account the willingness, preferences and quality of life of the users. To some extent, both do not use monetary measures of cost, and both use clinical indicators as final outcome measures. The difference is that the cost-effectiveness is a purely biological indicator (e.g., increased life expectancy, weight gain, etc.). In contrast, outcomes in cost-utility analyses are closely related to quality, noting the patient's demand for quality of life, and utilizing a utility function change (often in quality of life adjusted years) rather than a change in health outcomes.
4. Cost-effectiveness analysis: a method of comparing the costs and resulting outcome values (benefits) between single or multiple drug regimens or other interventions, which requires that both costs and benefits be expressed in monetary terms.
Cost-effectiveness analysis is generalizable: it can compare the benefits of different drugs for the same disease, as well as comparisons between different disease treatments, and even comparisons between disease treatments and other public **** investment programs (e.g., public **** investment in education), and is applicable to a full range of health as well as public **** investment decisions.
☆ ☆ ☆ ☆ ☆ Exam point 162: Concepts
1. Pharmacy information: refers to a variety of knowledge about pharmacy transmitted through print, CD-ROM or network and other carriers. It involves the field of drug research, production, distribution and use, is a branch of information science.
2. Drug information: referred to as DI, refers to the use of some of the field of clinical pharmacy related to a variety of pharmacy information.
3. Evidence-based drug information: referred to as EBDI, EBDI is a multi-center, large sample, randomized, double-blind, controlled clinical trials as the main body of the computer / database technology to achieve efficient and accurate mathematical statistics as a means of making an objective assessment of the efficacy of the drug, and sufficient evidence of DI.
☆ ☆ Exam point 163: drug information (DI) services Significance and purpose
1. The significance of the DI service
(1) the social significance of the DI service: the reform of the health care system is for the benefit of the majority of low-income people, optimize the allocation of resources, the establishment of the "community health service centers", in the designated hospitals and designated pharmacies for the masses to provide a high level of DI service, to solve the problem of drug treatment. To solve the problem of drug treatment for the masses.
(2) The economic significance of DI services: In 1999, the government of China resolved to launch a comprehensive reform of medical insurance, which mentioned that "designated medical institutions really introduce a competitive mechanism to standardize medical behavior and improve the quality of service; designated pharmacies to introduce the system of out-of-prescription dispensing, to ensure that the use of medicines is safe and effective, and to control the quality and price; the "List of Essential Medicines" mainly restricts the use of large prescriptions, and controls the quality and price of medicines. The Basic Medicines List mainly restricts the use of large prescriptions, eliminating the misuse of expensive medicines and the undesirable phenomenon of "big cure for small illnesses". These reform measures can greatly save our health resources.
(3) The technical significance of the DI service: the clinical pharmacist's work is based on the shift from "things" to "people", i.e., from the drug to the patient, which is pharmacotherapeutic care (PC). Therefore, clinical pharmacists themselves should be experts in DI.
2. Purpose of DI service
(1) To promote the rational use of medication is widely carried out.
(2) To accelerate the pace of pharmacotherapy health care integration.
(3) Reflect the value of practicing pharmacists themselves.
2. Secondary literature: the most commonly used to access domestic pharmacy literature is China Pharmaceutical Abstracts (CPA), followed by Chinese Science and Technology Information Catalog o Medicine and Health and Chinese Science and Technology Information Catalog o Chinese Herbal Medicine. For foreign pharmacy literature, the most commonly used is International Pharmaceutical Abstracts (IPA).
(1) "China Pharmaceutical Abstracts" (CPA): for the State Drug Administration Information Center I published.
(2) International Pharmaceutical Abstracts (IPA): published by the American Society of Hospital Pharmacists (ASHP).
(3) Chemical Abstracts (CA): by the American Chemical Society Chemical Abstracts Service (CAS) I published, claiming to be a key to open the world of chemical literature.
(4) Biological Abstracts (BA): published by the U.S. Bioscience Information Service (BIOSIS) me.
(5) Index Medicus (IM): first published by the Carnegie Institution of Washington, USA, and currently published by the National Library of Medicine (NLM).
(6) Medical Abstracts (EM): published by the Medical Abstracts Foundation (MAF), an international non-profit organization in Amsterdam, the Netherlands.
3. Three documents
(1) Pharmacopoeia: Chinese Pharmacopoeia (Chinese Pharmacopoeia), British Pharmacopoeia (BP), United States Pharmacopoeia (USP), as well as the International Pharmacopoeia, the Pharmacopoeia, the Japanese Pharmacopoeia, etc.
(2) The Pharmacopoeia: the Japanese Pharmacopoeia.
(2) drug collection: there are the "New Pharmacopoeia", "Martindale The EXtra-Pharmacopoeia" (Martindale Special Pharmacopoeia), "Physician's Desk Reference" referred to as PDR (Physician's Desk Reference), "AMA Drug Annual" (American Medical Association Drug Evaluation).
(3) Encyclopedias: such as China Pharmacy Yearbook, China Pharmaceutical Yearbook, and China Traditional Chinese Medicine Yearbook.
(4) Monographs: such as Modern Pharmacotherapeutics - Basis of Clinical Pharmacology and Pathophysiology, Pharmacoepidemiology (the first monograph on pharmacoepidemiology in China), and so on.
(5) tools: commonly used "English-Chinese chemical and chemical vocabulary" (Science Publishing House), "English-Chinese compilation of medical terminology" (People's Health Publishing House), "China Drugs Common Names" (Pharmacopoeia Committee Office), "chemical nomenclature" (Science Publishing House) and so on.
☆☆☆☆ Exam Point 165: Organize Question Sentences with Logical Operations
1. Logical and: also known as logical multiplication, indicated by "AND" or "*". In the statement "A AND B" or "A * B" means to find out both to meet the subject line A, but also to meet the subject line B literature. This search method can make the retrieval of literature more targeted, is currently commonly used.
2. Logical or: also known as logical and, with "OR" or "+". In the statement "A OR B" or "A + B" means to find out all the literature to meet the A and B.
3.
3. Logical non-: also known as logical minus, which is represented by the symbol: "NOT" or "-". In the statement "A NOT B" or "A-B" that to find out containing the search term A to remove the search term B literature.
☆ Exam 166: Classification of medical device products
1. Class I: through routine management is sufficient to ensure the safety and effectiveness of medical devices.
2. Class II: its safety, effectiveness should be controlled medical devices.
3. Class III: implanted in the human body, used to support life support, potentially dangerous to the human body, its safety, effectiveness must be strictly controlled medical devices.
For example, most of the surgical instruments, stethoscopes, medical X-ray film, medical X-ray protection, automatic electrophoresis, medical centrifuges, slicers, dental chairs, boiling sterilizers, gauze bandages, band-aids, surgical gowns, surgical hats, masks, urinary catheterization bags and so on classified as Class I.
Thermometers, sphygmomanometers, cardiac and electroencephalographic diagnostic instruments, non-invasive monitoring instruments, optical endoscopes, portable ultrasound diagnostic instruments, automatic biochemical analyzers, constant temperature incubators, dental comprehensive treatment instrument, medical degreasing cotton, medical degreasing gauze and so on, is classified as the second category.
Implantable cardiac pacemakers, extracorporeal shock wave lithotripter, invasive patient monitoring systems, IOLs, invasive endoscopy, ultrasound scalpel, color ultrasound imaging equipment, laser surgical equipment, high-frequency scalpel, microwave therapy instrument, medical magnetic **** vibration imaging equipment, X-ray therapy equipment, more than 200mA X-ray machine, medical high-energy equipment, artificial heart-lung machine, internal fixation devices, artificial heart Valves, artificial kidneys, respiratory anesthesia equipment, single-use sterile syringes, single-use infusion sets, blood transfusion, CT equipment, etc. are classified as Category III.
☆☆ Exam point 167: Medical Rubber Paste
1. Use: for general surgical tripping or other medical paste fixed.
2. Basic quality requirements: peel strength should not be less than 1.1N/cm; holding adhesive not more than 2.0mm; zinc oxide content should not be less than 10.0%; the amount of paste should not be less than 115g/m2.
3. Notes on purchasing and selling: you should buy clean and not oozing paste, paste cloth rolled up and flat rubber paste.
☆ Exam 168: single-use urine collection bag
1. Use: connected to the catheter introduced into the body for a variety of urinary incontinence, surgical coma patients and people with mobility problems.
2. Basic quality requirements
(1) urine bag volume: milliliters as a unit of measurement, the allowable error of ± 15%.
(2) The connection parts should withstand 40N static tension without separation.
(3) Sterile.
3. Purchase notes
(1) First of all, we must look at the finished product packaging identification and product instructions. Packaging should be "sterile" words or graphic symbols, single-use instructions or graphic symbols, packaging damage should be disabled instructions or signs.
(2) buy and sell urine collection bags of bags should be clear and firm handwriting, hanging hooks and holes without breakage and plastic deformation, no leakage by falling.
☆☆☆☆ ☆☆☆☆ Exam point 169: single-use sterile syringes and injection needles
1. Usage: for pumping liquids or injecting liquids immediately after the subcutaneous or intramuscular injection.
2. Main quality requirements
(1) syringe part: the syringe will be inhaled into the nominal capacity of water, with the prescribed axial force and lateral force, the role of the mandrel 3Os, the jacket and piston contact parts shall not have leakage; less than 1/2 nominal capacity and more than 1/2 nominal capacity of the tolerance should be in line with the standard; the total content of lead, zinc, tin and iron should be ≤ 5 μg / ml, cadmium content should be ≤ 0.5 μg / ml, the total content of cadmium should be ≤ 0.5 μg / ml. The total content of lead, zinc, tin and iron should be ≤5μg/ml, and the content of cadmium should be ≤0.1μg/ml; the difference in pH value should not exceed 1.0; easy oxidizers ≤0.5 ml; ethylene oxide residue ≤10μg/g; the biological properties of sterile, non-pyrogenic, non-hemolytic reaction, no acute systemic toxicity.
(2) injection needle part: injection needle needle tube should have good rigidity, toughness and corrosion resistance; injection needle needle seat and needle tube connection firmness in the specified tension under the pull test, the two shall not be loose or separation; injection needle tip sharpness of 0.3 to 0.6 specifications, piercing force ≤ 0.7N; pH difference of not more than 1.0; lead, zinc, tin and iron should be ≤ 5 μg / ml, cadmium content should be ≤ 0.5 ml, cadmium content should be ≤ 10 μg / g; biological properties of sterile, no pyrogen, no hemolytic reaction, no acute systemic toxicity. ml, the content of cadmium should be ≤ 0.1μg/ml; biological properties are sterile and non-pyrogenic.
☆ Exam point 170: mercury thermometer
1. Use: clinical and home measurement of body temperature.
2. Basic quality requirements
(1) temperature-sensing bubble: bubble shall not have obvious bubbles.
(2) display value: newborn stick thermometer display value tolerance ± 0.15 ℃, the rest of the thermometer tolerance -0.15 ℃ ~ +0.10 ℃.
(3) The glass tube shall not be burst.
(4) Thermometer temperature sensing liquid column should not be interrupted.
(5) The thermometer temperature sensing liquid column should not be self-flowing, should not be difficult to throw.
3. Purchase and use precautions
(1) first check the glass bubble with or without cracks, otherwise into the body cavity, in case of mercury overflow, may cause mercury poisoning.
(2) Before measuring the body temperature, the mercury column should be dumped below 35 ℃.
(3) Insanity and high fever delirious patients, young children and can not use the nose to breathe the person can not measure the oral temperature, and measure the anal temperature.
(4) thermometer after use with cold water first rinse, and then soaked in 7O% alcohol, or wash with soapy water after preservation, and then use ethanol cotton swabs to disinfect before use.
☆ Exam 171: mercury (mercury) sphygmomanometer
1. Basic quality requirements
(1) sphygmomanometer value: the permissible error of ± 0.5kPa (± 3.75mmHg).
(2) The sphygmomanometer has good air tightness.
(3) The sphygmomanometer should not leak mercury.
2. Purchase and use precautions
(1) Purchase sphygmomanometer should choose the sphygmomanometer with flexible rise of the mercury column, no disconnection, and no leakage of mercury.
(2) the sphygmomanometer should not be too hard to use, moving the mercury sphygmomanometer should be vertical (that is, the mercury tank below), after use in a timely manner will be tilted 45 degrees to the right sphygmomanometer and then close the mercury valve. Otherwise, the mercury column is likely to overflow, resulting in mercury contamination.
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