Article type
Year
Abstract
Background: Clinical practice guidelines (CPGs) of integrative medicine are critical documents guiding clinical practice to optimize the medical service. The reliability and practicality of recommendations from CPGs depend largely on the quality of the evidence.
Objectives: To analyse the evidence sources for recommendations in guidelines of integrative medicine.
Methods: CNKI, Wanfang Data, CBM and VIP databases were searched systematically from inception to January 2015; a supplementary search of China Guideline Clearinghouse (CGC) was conducted and the references of included guidelines was checked. Two reviewers independently selected guidelines and extracted data, any disagreement was solved by discussion or consulting a third reviewer. Microsoft Excel 2013 was used for data abstraction and analysis.
Results: A total of 41 guidelines was included. A total of 375 references were cited to support recommendations, with 8.3 (0 to 68) in each guideline on average, and seven guidelines had no supported reference. Recommendations in integrative medicine guidelines contained two parts - traditional Chinese medicine (TCM) and western medicine. The evidence status was: recommendations of TCM had 118 references in 17 (41.46%) guidelines, and no reference was found in 24 (58.54%) guidelines; recommendations of western medicine had 257 references in 24 (58.54%) guidelines, and no reference was found in 17 (41.46%) guidelines. For the types of evidence: recommendations from TCM and western medicine were supported by: guidelines (15 vs 46), SRs (9 vs 16), RCTs (33 vs 62), cohort studies (0 vs 2), case series/reports (5 vs 17), reviews (19 vs 49), monographs or textbooks (18 vs 16), others (19 vs 49) including comments, experience summaries, animal experiments etc.
Conclusions: Developers of integrative medicine guidelines paid insufficient attention to evidence when developing recommendations.
Objectives: To analyse the evidence sources for recommendations in guidelines of integrative medicine.
Methods: CNKI, Wanfang Data, CBM and VIP databases were searched systematically from inception to January 2015; a supplementary search of China Guideline Clearinghouse (CGC) was conducted and the references of included guidelines was checked. Two reviewers independently selected guidelines and extracted data, any disagreement was solved by discussion or consulting a third reviewer. Microsoft Excel 2013 was used for data abstraction and analysis.
Results: A total of 41 guidelines was included. A total of 375 references were cited to support recommendations, with 8.3 (0 to 68) in each guideline on average, and seven guidelines had no supported reference. Recommendations in integrative medicine guidelines contained two parts - traditional Chinese medicine (TCM) and western medicine. The evidence status was: recommendations of TCM had 118 references in 17 (41.46%) guidelines, and no reference was found in 24 (58.54%) guidelines; recommendations of western medicine had 257 references in 24 (58.54%) guidelines, and no reference was found in 17 (41.46%) guidelines. For the types of evidence: recommendations from TCM and western medicine were supported by: guidelines (15 vs 46), SRs (9 vs 16), RCTs (33 vs 62), cohort studies (0 vs 2), case series/reports (5 vs 17), reviews (19 vs 49), monographs or textbooks (18 vs 16), others (19 vs 49) including comments, experience summaries, animal experiments etc.
Conclusions: Developers of integrative medicine guidelines paid insufficient attention to evidence when developing recommendations.