Abstract
ObjectivesTo investigate how many traditional Chinese medicine (TCM) guidelines adopted a grading system and the differences among them, and the distribution of level of evidence used to support TCM recommendations.MethodsA comprehensive search of relevant guideline webpages and literature databases were undertaken from inception to August 2018 to identify guidelines including TCM interventions. Two independent reviewers extracted the information about grading systems and recommendations.ResultsOne hundred forty-two TCM guidelines were included, among which, 68 (47.9%) adopted a total of eight grading systems. The definitions, letters, and codes among these systems varied significantly. A total of 1284 recommendations were extracted from included TCM guidelines. More than 60% recommendations were based on a low and very low level of evidence (level C:33.4% and level D: 30.2%). Only 7.8% recommendations were rated as strong recommendation (grade I), while 76.2% recommendations were rated as conditional recommendation (grade II).ConclusionsVarious grading systems were used in TCM guidelines, which might confuse guideline users. The low proportion of high level of evidence in TCM recommendations might downgrade the confidence to TCM interventions.
Highlights
China is the only country where western medicine and traditional Chinese medicine (TCM) are practiced alongside each other at every level of the healthcare system. and traditional Chinese treatments account for about 40% of the total [1]
Our results showed that eight evidence grading systems were used in 47.8% TCM guidelines, while the rest 52.1% did not sue any evidence grading system
The definitions to the eight grading systems varied a lot, for example, the Grading of Recommendations Assessment (GRADE) system graded the quality of evidence according to bias which might decrease the confidence of included studies, that is to say, even Randomized controlled trial (RCT) might be at low quality of evidence if they were at high risk of bias [12]
Summary
China is the only country where western medicine and traditional Chinese medicine (TCM) are practiced alongside each other at every level of the healthcare system. and traditional Chinese treatments account for about 40% of the total [1]. China is the only country where western medicine and traditional Chinese medicine (TCM) are practiced alongside each other at every level of the healthcare system. Over the past two decades, an increasing number of TCM guidelines have been developed by academic associations and government organizations in China [2, 3]. The quality of evidence reflects the extent to which confidence in an estimate of the effect is adequate to support a particular recommendation [4, 5]. Several previous surveys indicated that many recommendations in important domains (such as oncology, cardiology, infectious disease, and screening) were based on a low level of evidence [7,8,9], even in the World Health Organization (WHO) guidelines, strong recommendations based on low levels of evidence are frequent [10]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
