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《柳叶刀》综述防治心血管疾病“中国模式”

2015-10-15 王璐 宣男 中国科学报

10月10日,由科技部资助、中国医学科学院阜外医院国家心血管疾病临床研究中心撰写的大型综述性文章——《通过提高医疗服务质量构建学习型医疗卫生体系,让中国心血管疾病患者取得最佳诊疗结果》,在英国《柳叶刀》杂志上刊出。 国家心血管病中心副主任、中国医学科学院阜外医院院长胡盛寿及其团队,通过系统分析目前我国心血管疾病临床研究、医疗质量和医疗质量评价体系现状、与英美及印度等国的对比分析,深刻剖析了在我国

10月10日,由科技部资助、中国医学科学院阜外医院国家心血管疾病临床研究中心撰写的大型综述性文章——《通过提高医疗服务质量构建学习型医疗卫生体系,让中国心血管疾病患者取得最佳诊疗结果》,在英国《柳叶刀》杂志上刊出。

国家心血管病中心副主任、中国医学科学院阜外医院院长胡盛寿及其团队,通过系统分析目前我国心血管疾病临床研究、医疗质量和医疗质量评价体系现状、与英美及印度等国的对比分析,深刻剖析了在我国医改进入深水区的当下,应如何通过进一步完善我国心血管疾病的医疗质量评价体系,最终以最小的花费,让数亿中国心血管疾病患者取得最佳诊疗效果。

目前,我国心血管疾病患者已超过2.9亿,而其日益加剧的流行趋势更令人担忧。尽管我国在医疗服务可及性方面已取得长足进步,但心血管领域的医疗服务仍面临着诊疗质量亟待改善和临床研究证据匮乏的双重挑战。

该综述全面评价了我国医疗实践和临床科研中“有据不依”与“无据可依”并存的现状,深入分析了上述问题产生的原因,并结合“新医改”和“临床大数据”的政策和技术机遇,提出了应对建议——立足已有平台并借鉴美英先进经验,一方面通过加强医疗质量评价体系建设,驱动医疗质量持续改善行动的不断推广和深化;另一方面通过构建学习型医疗体系,提高我国重要临床相关科研产出的能力,为指导国家卫生政策制定和适宜国人的诊疗策略选择持续提供可靠证据。

该综述第一作者、国家心血管病中心主任助理蒋立新表示,如果上述策略建议能得以实施,不仅对我国心血管研究领域的发展具有关键性意义,还将对其他疾病的防控起到积极的示范作用,并有望向世界,特别是同样面临持续加剧的慢病负担的发展中国家,展示值得借鉴的“中国模式”。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=44071, encodeId=4c3e440e11f, content=这篇文章好像改了四十多次吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sun Nov 29 07:30:00 CST 2015, time=2015-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39473, encodeId=7b47394e3df, content=我国心血管疾病患者已超过2.9亿,这个人数太吓人了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201205/e96b3d935daf4e258fba69d60175f0ab/b6d3ee4a3a414b8eafaf7c5e905937a2.jpg, createdBy=ad4b83208, createdName=vpssa, createdTime=Mon Oct 19 10:03:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39428, encodeId=0edb39428db, content=???, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150904/IMG55E8DB68F05883098.jpg, createdBy=e00a1631985, createdName=fengzhigu, createdTime=Mon Oct 19 06:57:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39129, encodeId=656339129d6, content=呵呵, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 20:07:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497918, encodeId=7749149e918ec, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Sat Oct 17 02:42:00 CST 2015, time=2015-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38958, encodeId=0bf838958f5, content=任重道远!, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151015/IMG561F6B44A9B937746.jpg, createdBy=2faa1656315, createdName=Godlovekk1130, createdTime=Thu Oct 15 17:02:00 CST 2015, time=2015-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38959, encodeId=a6a438959a4, content=任重道远!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151015/IMG561F6B44A9B937746.jpg, createdBy=2faa1656315, createdName=Godlovekk1130, createdTime=Thu Oct 15 17:02:00 CST 2015, time=2015-10-15, status=1, ipAttribution=)]
    2015-11-29 老段

    这篇文章好像改了四十多次吧

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=44071, encodeId=4c3e440e11f, content=这篇文章好像改了四十多次吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sun Nov 29 07:30:00 CST 2015, time=2015-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39473, encodeId=7b47394e3df, content=我国心血管疾病患者已超过2.9亿,这个人数太吓人了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201205/e96b3d935daf4e258fba69d60175f0ab/b6d3ee4a3a414b8eafaf7c5e905937a2.jpg, createdBy=ad4b83208, createdName=vpssa, createdTime=Mon Oct 19 10:03:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39428, encodeId=0edb39428db, content=???, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150904/IMG55E8DB68F05883098.jpg, createdBy=e00a1631985, createdName=fengzhigu, createdTime=Mon Oct 19 06:57:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39129, encodeId=656339129d6, content=呵呵, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 20:07:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497918, encodeId=7749149e918ec, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Sat Oct 17 02:42:00 CST 2015, time=2015-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38958, encodeId=0bf838958f5, content=任重道远!, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151015/IMG561F6B44A9B937746.jpg, createdBy=2faa1656315, createdName=Godlovekk1130, createdTime=Thu Oct 15 17:02:00 CST 2015, time=2015-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38959, encodeId=a6a438959a4, content=任重道远!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151015/IMG561F6B44A9B937746.jpg, createdBy=2faa1656315, createdName=Godlovekk1130, createdTime=Thu Oct 15 17:02:00 CST 2015, time=2015-10-15, status=1, ipAttribution=)]
    2015-10-19 vpssa

    我国心血管疾病患者已超过2.9亿,这个人数太吓人了。

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=44071, encodeId=4c3e440e11f, content=这篇文章好像改了四十多次吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sun Nov 29 07:30:00 CST 2015, time=2015-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39473, encodeId=7b47394e3df, content=我国心血管疾病患者已超过2.9亿,这个人数太吓人了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201205/e96b3d935daf4e258fba69d60175f0ab/b6d3ee4a3a414b8eafaf7c5e905937a2.jpg, createdBy=ad4b83208, createdName=vpssa, createdTime=Mon Oct 19 10:03:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39428, encodeId=0edb39428db, content=???, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150904/IMG55E8DB68F05883098.jpg, createdBy=e00a1631985, createdName=fengzhigu, createdTime=Mon Oct 19 06:57:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39129, encodeId=656339129d6, content=呵呵, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 20:07:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497918, encodeId=7749149e918ec, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Sat Oct 17 02:42:00 CST 2015, time=2015-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38958, encodeId=0bf838958f5, content=任重道远!, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151015/IMG561F6B44A9B937746.jpg, createdBy=2faa1656315, createdName=Godlovekk1130, createdTime=Thu Oct 15 17:02:00 CST 2015, time=2015-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38959, encodeId=a6a438959a4, content=任重道远!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151015/IMG561F6B44A9B937746.jpg, createdBy=2faa1656315, createdName=Godlovekk1130, createdTime=Thu Oct 15 17:02:00 CST 2015, time=2015-10-15, status=1, ipAttribution=)]
    2015-10-19 fengzhigu

    ???

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=44071, encodeId=4c3e440e11f, content=这篇文章好像改了四十多次吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sun Nov 29 07:30:00 CST 2015, time=2015-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39473, encodeId=7b47394e3df, content=我国心血管疾病患者已超过2.9亿,这个人数太吓人了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201205/e96b3d935daf4e258fba69d60175f0ab/b6d3ee4a3a414b8eafaf7c5e905937a2.jpg, createdBy=ad4b83208, createdName=vpssa, createdTime=Mon Oct 19 10:03:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39428, encodeId=0edb39428db, content=???, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150904/IMG55E8DB68F05883098.jpg, createdBy=e00a1631985, createdName=fengzhigu, createdTime=Mon Oct 19 06:57:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39129, encodeId=656339129d6, content=呵呵, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 20:07:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497918, encodeId=7749149e918ec, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Sat Oct 17 02:42:00 CST 2015, time=2015-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38958, encodeId=0bf838958f5, content=任重道远!, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151015/IMG561F6B44A9B937746.jpg, createdBy=2faa1656315, createdName=Godlovekk1130, createdTime=Thu Oct 15 17:02:00 CST 2015, time=2015-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38959, encodeId=a6a438959a4, content=任重道远!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151015/IMG561F6B44A9B937746.jpg, createdBy=2faa1656315, createdName=Godlovekk1130, createdTime=Thu Oct 15 17:02:00 CST 2015, time=2015-10-15, status=1, ipAttribution=)]
    2015-10-18 sunlong28

    呵呵

    0

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  6. [GetPortalCommentsPageByObjectIdResponse(id=44071, encodeId=4c3e440e11f, content=这篇文章好像改了四十多次吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sun Nov 29 07:30:00 CST 2015, time=2015-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39473, encodeId=7b47394e3df, content=我国心血管疾病患者已超过2.9亿,这个人数太吓人了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201205/e96b3d935daf4e258fba69d60175f0ab/b6d3ee4a3a414b8eafaf7c5e905937a2.jpg, createdBy=ad4b83208, createdName=vpssa, createdTime=Mon Oct 19 10:03:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39428, encodeId=0edb39428db, content=???, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150904/IMG55E8DB68F05883098.jpg, createdBy=e00a1631985, createdName=fengzhigu, createdTime=Mon Oct 19 06:57:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39129, encodeId=656339129d6, content=呵呵, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 20:07:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497918, encodeId=7749149e918ec, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Sat Oct 17 02:42:00 CST 2015, time=2015-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38958, encodeId=0bf838958f5, content=任重道远!, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151015/IMG561F6B44A9B937746.jpg, createdBy=2faa1656315, createdName=Godlovekk1130, createdTime=Thu Oct 15 17:02:00 CST 2015, time=2015-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38959, encodeId=a6a438959a4, content=任重道远!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151015/IMG561F6B44A9B937746.jpg, createdBy=2faa1656315, createdName=Godlovekk1130, createdTime=Thu Oct 15 17:02:00 CST 2015, time=2015-10-15, status=1, ipAttribution=)]
    2015-10-15 Godlovekk1130

    任重道远!

    0

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    2015-10-15 Godlovekk1130

    任重道远!

    0

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