To examine the association between physician–patient treatments shared decision making (SDM), patient satisfaction, and adoption of a new health technology.

A cross-sectional study was conducted from July 2016 to October 2016 in Fujian Province and Shanghai, in Eastern China. A total of 542 physicians and 619 patients in eleven hospitals were surveyed. Patients and their treating physicians completed self-reported questionnaires on patient–physician SDM, satisfaction with treatment decision making and adoption of a new health technology. Correlation analysis, multivariate logistic regression and multivariate linear regression were performed.

The majority (68.20 percent) of patients preferred SDM. Involvement of patients in SDM was positively associated with their satisfaction with treatment decision making (p < .001) and adoption of a new health technology (p < .05). Better concordance between their preference and actual SDM was positively associated with patients' adoption behavior (p < .05), but no statistically significant association was found between concordance and satisfaction.

SDM was the most important predictor of patients' satisfaction with decision making and adoption of a new health technology. Therefore, better communication between physicians and patients is recommended to improve their SDM, increase patient satisfaction and to assist with the adoption of new technologies. Training healthcare provider and teaching communication skills in working with patients in the initial stage of technology diffusion is required.

Physicians' attitudes and adoption behavior toward the delivery of prenatal tests take vital significance for its influence on their professional practice and patient acceptance. This study aimed to identify how physicians have perceived the diffusion of non-invasive prenatal testing (NIPT) in China.

A cross-sectional study was conducted from July 2016 to October 2016 in Shanghai, and Fujian and Sichuan Provinces in China. Physicians working on prenatal screening completed a self-report questionnaire. Following Roger's diffusion of innovation model, multivariable logistic regressions were performed separately for the following key elements of the theory which influence diffusion: physician-perceived attributes of NIPT, communication channels, the nature of the social system, the extent of change agent (who introduces innovations into a society), promotion efforts, and physicians' benefits from adopting NIPT.

Most specialists had a positive attitude (53.2 percent) toward NIPT, whereas 58.9 percent of physicians had already adopted NIPT in their clinical practice. Physician adoption of NIPT was positively associated with the strength of HTA evidence (p = .03), perceived communication frequency with colleagues (p = .04), adoption by other physicians (p = .07), hospital competition (p = .06), hospital teaching status (p = .02), perceived for-profit genetic testing company's promotion (p < .001), and perceived clinical practice skill improvement (p = .02). However, the adoption behavior toward NIPT may be negatively associated with physician-perceived ethical concerns of NIPT (p = .06).

Obstetricians and gynecologists’ positive perceptions facilitate the adoption of NIPT. Combined with cost-effectiveness analysis of prenatal screening methods, health policy makers can promote the adoption of appropriate, cost-effective prenatal screening in pregnant women.

There are multiple antidiabetic drugs available in China, which vary in their efficacy and safety. However, no study exists that compares all the classes of antidiabetic drugs simultaneously. This study aimed to estimate and compare the efficacy of alternative classes of antidiabetic drugs for Chinese patients with type 2 diabetes, either in a monotherapy regimen or combined with metformin.

A systematic literature review was conducted by searching various literature databases to identify relevant randomized controlled trials published from 1990 to 2016. A meta-analysis was conducted to compare the efficacy of antidiabetic drug monotherapy and placebo or lifestyle interventions (i.e., diet and exercise), and antidiabetic drug plus metformin versus metformin alone, in Chinese patients with type 2 diabetes. An indirect comparison was used to estimate the efficacy of antidiabetic drug plus metformin versus placebo or lifestyle-intervention using metformin as the common comparator.

The database search identified 354 relevant studies. Compared with placebo or lifestyle interventions, combination therapies achieved greater reductions in hemoglobin A1c (HbA1c) level (1.9% versus 0.9%), body mass index (BMI) (2.66 versus 0.98 kg/m2), and total cholesterol level (1.07 versus 0.35 mmol/L) than monotherapies. For monotherapies, the top three treatments for reducing HbA1c level were insulin, sulfonylurea, and glucagon-like peptide-1 (GLP-1) receptor agonist. The top three monotherapies for reducing BMI level were metformin, GLP-1 receptor agonist, and α-glycosidase inhibitor. The top three monotherapies for reducing total cholesterol level were metformin, GLP-1 receptor agonist, and dipeptidyl peptidase-4 (DPP-4) inhibitor. For combination therapies, the top three treatments for reducing HbA1c level were GLP-1 receptor agonist plus metformin, insulin plus metformin, and glinide plus metformin. The top three combination therapies for reducing BMI level were glinide plus metformin, GLP-1 receptor agonist plus metformin, and DPP-4 inhibitor plus metformin. The top three combination therapies for reducing total cholesterol level were insulin plus metformin, GLP-1 receptor agonist plus metformin, and α-glycosidase inhibitor plus metformin.

Pharmacological treatments had better efficacy than placebo or lifestyle interventions, while combination drug therapies were superior to monotherapies.

To analyze the current development of HTA in China and to identify areas for improvement, we mapped the level of HTA development in China and compared it with the level of HTA development in ten other countries using a survey instrument.

We launched a nationwide survey targeting different stakeholders. For this purpose, we used a validated instrument that enables mapping HTA development in a country using eight domains. The views of the respondents regarding the overall level of HTA development and for each domain were compared with the results of a mapping study that included ten countries.

In total, we received 222 responses, 33 from policy-makers, 158 from researchers, and 31 from industry, as well as health provider representatives including 8 from hospitals, centers for disease control and prevention. We calculated the mean score for the level of HTA development. The overall HTA development for China was scored at 76.4 (out of a maximum of 146). Although the total score for China was comparable to the mean score of 75.6 among the ten countries, China scored significantly lower than the mean score of 117.0 among the three developed countries. In addition, China scored significantly lower in the domain of institutionalization compared to the other ten countries.

China needs to tackle the issue of low HTA institutionalization to strengthen the foundation of HTA development. Future government initiatives that institutionalize HTA, for example, establishing a national HTA system or consortium, will improve the development of HTA in China.

Pulmonary vein isolation (PVI) is a new effective treatment for atrial fibrillation (AF) (1). The standard of care for ablation methods using radiofrequency (RF) is time-consuming and technically challenging (2), and restricted to a few specialized centers, which causes the limited availability of ablation therapy (3). Therefore, cryoballoon (CB) ablation has been developed to shorten and simplify the procedure. The objective of this systematic literature review and meta-analysis was to compare the effectiveness of cryoballoon ablation (CBA) with radiofrequency ablation (RFA) for the treatment of AF.

We searched the Cochrane Library and PubMed from 2009 to October 2016 to screen the eligible literature according to the inclusion and exclusion criteria. The effectiveness measures were the acute pulmonary vein (PV) isolation rate, procedure time, complications and the proportion of patients free from AF (follow-up > 3 months). Meta-analysis and descriptive statistics were used in this study.

A total of seventeen articles with 5,806 cases (2,288 from CBA group, 3,518 from RFA group) from seven different countries were reviewed and analyzed. Pooled analyses indicated that CBA was more beneficial in terms of procedural time (Standard mean difference, SMD = -.501; 95%CI: -.893– -.109; P<.05) for RFA; but the acute PV isolation rate (Odds ratio, OR = .06; 95 percent Confidence Interval, CI: .03–.13; P < .05) in RFA was higher than for CBA; also, after median follow-up of 14 months (range 9–28 months), the proportion of patients free from AF (OR = .965; 95 percent CI:.859—1.085; P = .554) and the total complication rates (OR = .937; 95 percent CI:.753–1.167; P = .562) were not significantly different between CBA and RFA.

In the four randomized controlled trials (RCTs) of the seventeen studies, the proportion of patients free from AF (OR = .951; 95 percent CI:.752–1.202; P = .672) and the complications (OR = 1.521; 95 percent CI:.570–4.058; P = .402) were not significantly different between CBA and RFA.

Overall, compared with RFA for the treatment of patients with AF, CBA had similar clinical effectiveness on the proportion of people free from AF and the number of complications, and yet greater improvement in total procedure time referred for CBA and higher acute PVI rate referred for RFA.