Article type
Year
Abstract
Background: Assessing the quality of evidence and strength of recommendation with appropriate grading systems can promote the development of scientific recommendations, and help guideline users implement recommendations reasonably.
Objectives: To collect traditional Chinese medicine (TCM) guidelines systematically and investigate the status of the quality of evidence and strength of recommendation grading.
Methods: Systematically we searched Wanfang, VIP, CNKI, and CBM databases for TCM guidelines published in journals, and supplemented searches for guidelines published in the form of books through Google, Amazon and Dangdang; we also searched the references of TCM guidelines. Two reviewers independently conducted literature screening and data extraction, and any disagreements were solved by discussion. Excel 2013 was used to conduct data analysis.
Results: A total of 61 TCM guidelines with reference lists were included, of which 33 were published in journals, and 28 published as monographs. A total of 43 (70%) guidelines reported the quality of evidence and strength of recommendations with a total of 10 grading systems: 31 (73%) used classification recommendation of TCM, 31 (73%) used the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach, four (9%) used the international standard or its adaptation, five (11%) used other standards. Levels and symbols for the quality of evidence and strength of recommendations varied greatly between the 10 different grading systems: levels for quality of evidence ranged from three to ten, and strength of recommendations from two to six; furthermore, six or seven types of symbols were employed to indicate evidence quality and recommendation strength.
Conclusions: Currently, grading systems for quality of evidence and strength of recommendations varies greatly in TCM guidelines. The systems are very different in terms of grade levels and symbols, which could cause problems with correct interpretation of the recommendations.
Objectives: To collect traditional Chinese medicine (TCM) guidelines systematically and investigate the status of the quality of evidence and strength of recommendation grading.
Methods: Systematically we searched Wanfang, VIP, CNKI, and CBM databases for TCM guidelines published in journals, and supplemented searches for guidelines published in the form of books through Google, Amazon and Dangdang; we also searched the references of TCM guidelines. Two reviewers independently conducted literature screening and data extraction, and any disagreements were solved by discussion. Excel 2013 was used to conduct data analysis.
Results: A total of 61 TCM guidelines with reference lists were included, of which 33 were published in journals, and 28 published as monographs. A total of 43 (70%) guidelines reported the quality of evidence and strength of recommendations with a total of 10 grading systems: 31 (73%) used classification recommendation of TCM, 31 (73%) used the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach, four (9%) used the international standard or its adaptation, five (11%) used other standards. Levels and symbols for the quality of evidence and strength of recommendations varied greatly between the 10 different grading systems: levels for quality of evidence ranged from three to ten, and strength of recommendations from two to six; furthermore, six or seven types of symbols were employed to indicate evidence quality and recommendation strength.
Conclusions: Currently, grading systems for quality of evidence and strength of recommendations varies greatly in TCM guidelines. The systems are very different in terms of grade levels and symbols, which could cause problems with correct interpretation of the recommendations.