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Quality Evaluation of TCM Clinical Practice Guidelines/Consensus:based on Two Guideline Evaluation Tools

  

  1. 1.National Regional TCM(Cardiovascular)Diagnosis and Treatment Center,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China ;2.The First Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450000,China
  • Received:2024-10-24 Revised:2024-12-24 Accepted:2025-01-22
  • Contact: LIU Xincan,Chief physician;E-mail:liu.xin.can@126.com

中医药临床实践指南/共识的质量评价:基于两种指南评价工具

  

  1. 1.450000 河南省郑州市,河南中医药大学第一附属医院国家区域中医(心血管)诊疗中心;2.450000 河南省郑州市,河南中医药大学第一临床医学院
  • 通讯作者: 刘新灿,主任医师;E-mail:liu.xin.can@126.com
  • 基金资助:
    河南省中医药科学研究专项课题(2023ZY1001)

Abstract: Background Clinical practice guidelines are able to regulate the clinical behavior of clinicians and provide appropriate suggestions and references for patients. In recent years,the number of clinical practice guidelines in China has been on the rise. However, the quality of the guidelines,especially traditional Chinese medicine (TCM) is very uneven. At present, there have been some studies on the application of guideline evaluation tools,but studies on the evaluation of TCM guidelines are scant. Objective To evaluate the selected TCM clinical practice guidelines using two guideline evaluation tools, and to analyze the important dimensions influencing the quality of TCM clinical practice guidelines. Methods TCM clinical practiceguidelines for common and frequently occurring diseases in the Gastroenterology,Pediatrics,Orthopedics and Gynecology were searched in China National Knowledge Infrastructure (CNKI),Wanfang,VIP and SinoMed databases from November 1, 2023 to June 30,2024. Two guidelines of each specialty were selected after a negotiation with 2 clinical doctors. Journals that published the guidelines,publishing institutions/groups,tools used for evidence grading and recommendation intensity,number of references,number of authors,number of experts formulated,whether to update the guidelines,the evaluation results of the AGREE-China evaluation,the evaluation results of the list of suggestions for quality evaluation of TCM clinical practice guidelines,and the evaluation time of the guidelines were collected. Results Among the 8 guidelines evaluated, 6 guidelines were strongly recommended after the AGREE-China evaluation,and only 3 guidelines had more than half of the reports after the evaluation of the list of suggestions for quality evaluation of TCM clinical practice guidelines. The median time required for AGREE-China evaluation was 22 min. The median time required for the list of suggestions for quality evaluation of TCM clinical practice guidelines was 18.75 min. Conclusion Although AGREE-China evaluates 6 high-quality guidelines,the tool lacks an evaluation of TCM content and takes a relatively long time. Although the list of suggestions for the quality evaluation of TCM clinical practice guidelines has increased the content of TCM evaluation and shortened the time consuming,only three guideline reports have reached more than half in the number,and the evaluation results are not quantitative and intuitive. Therefore, there are still some inconveniences in clinical use.

Key words: Traditional Chinese medicine therapy, Integrated Chinese traditional and western medicine therapy, Guidebook, Consensus, AGREE-China, List of suggestions for quality evaluation of TCM clinical practice guidelines

摘要: 背景 临床实践指南能够规范临床医生的诊疗行为,为患者提供合适的建议与参考。近年来,我国临床实践指南的数量呈上升趋势,但中医药指南/共识(以下简称指南)的质量良莠不齐。目前已有研究应用指南评价工具评价指南,但有关中医药指南评价的研究相对较少。目的 应用两种指南评价工具对筛选的中医药临床实践指南进行评价,分析影响中医药临床实践指南质量的重要维度。方法 检索中国知网、万方数据知识服务平台、维普网与中国生物医学数据库收录的消化科、儿科、骨科、妇科常见病、多发病中医药临床实践指南,检索时间为2023-11-01—2024-06-30,每个专业选取2位临床医生协商后分别选取2篇指南,收集指南发表的期刊、发表机构/团体、证据分级与推荐强度使用的工具、引用文献数量、编写人数、制定专家数、是否是更新指南、中国临床实践指南评价体系(AGREE-China)评价结果、中医药临床实践指南质量评价建议清单评价结果、评价指南耗时。结果 纳入评价的8篇指南中,AGREE-China评价后强推荐的指南有6篇,中医药临床实践指南质量评价建议清单评价后仅有3篇指南的报告数量达到一半以上。在评价耗时方面,采用AGREE-China评价所需的中位时间是22 min;中医药临床实践指南质量评价建议清单所需的中位时间是18.75 min。结论 虽然AGREE-China评价出6篇高质量指南,但该工具缺乏对中医内容的评价,且耗时相对较长;中医药临床实践指南质量评价建议清单虽增加了中医评价内容,耗时也有所缩短,但仅有3篇指南报告的数量达到一半以上,且评价结果缺乏量化、不直观,临床使用仍有不便之处。

关键词: 中医药疗法, 中西医结合疗法, 指南, 共识, AGREE-China, 中医药临床实践指南质量评价建议清单

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