Article type
Abstract
Background: Over the past two decades, an increasing number of traditional Chinese medicine (TCM) guidelines have been developed by some academic associations and the government providing the normative diagnostic and therapeutic methods for the clinical practitioners in China.
Objectives: To investigate how many TCM guidelines adopted a grading system and what grading system was used and what types of evidence were used to support the recommendations of TCM guidelines.
Methods: A systematic search of relevant guideline websites and literature databases was undertaken from inception to December, 2015 to identify and select CPGs related to TCM.
Results: We found ten grading systems from 43 (37%) TCM guidelines, including TCM grading system, SIGN system, Agency for Healthcare Research and Quality (AHRQ) system, Oxford system, North of England Evidence Based Guidelines Development Project (NEEBGDP) system, and David Sackett system (a, b, c). A total of 1041 recommendations were extracted in 115 TCM guidelines. The highest level of evidence on each recommendation included 101 (9.7%) meta-analyses, 95 (9.4%) RCTs, 191 (18.3%) CCTs, 89 (8.5%) cohort studies, 257 (24.6%) case controlled studies, 63 (6.1%) pre-post studies, 21(2.0%) cross-sectional study, 112 (10.7%) case series, 78 (7.4%) animal studies, and 34 (3.3%) no references.
Conclusions: Various grading systems were used in TCM guidelines, which might confuse guideline users. And low proportion of TCM recommendations were based on a high level of evidence. Therefore a standardised grading system should be established so as to provide a clear information about the quality of evidence and the strength of recommendation for TCM guidelines users. More high-level evidence should be used to enhance the confidence of recommendations from TCM guidelines and promote the dissemination and implementation of TCM guidelines.
Objectives: To investigate how many TCM guidelines adopted a grading system and what grading system was used and what types of evidence were used to support the recommendations of TCM guidelines.
Methods: A systematic search of relevant guideline websites and literature databases was undertaken from inception to December, 2015 to identify and select CPGs related to TCM.
Results: We found ten grading systems from 43 (37%) TCM guidelines, including TCM grading system, SIGN system, Agency for Healthcare Research and Quality (AHRQ) system, Oxford system, North of England Evidence Based Guidelines Development Project (NEEBGDP) system, and David Sackett system (a, b, c). A total of 1041 recommendations were extracted in 115 TCM guidelines. The highest level of evidence on each recommendation included 101 (9.7%) meta-analyses, 95 (9.4%) RCTs, 191 (18.3%) CCTs, 89 (8.5%) cohort studies, 257 (24.6%) case controlled studies, 63 (6.1%) pre-post studies, 21(2.0%) cross-sectional study, 112 (10.7%) case series, 78 (7.4%) animal studies, and 34 (3.3%) no references.
Conclusions: Various grading systems were used in TCM guidelines, which might confuse guideline users. And low proportion of TCM recommendations were based on a high level of evidence. Therefore a standardised grading system should be established so as to provide a clear information about the quality of evidence and the strength of recommendation for TCM guidelines users. More high-level evidence should be used to enhance the confidence of recommendations from TCM guidelines and promote the dissemination and implementation of TCM guidelines.