Abstract
Objective This study aimed to develop a scale for evaluating and grading the evidence of prevention and treatment in ancient books of traditional Chinese medicine (TCM), in view of providing a reference for TCM clinicians, supporting the compilation or revision of evidence-based practice guidelines for TCM, improving the level of evidence-based research on ancient TCM books, and supplementing the development of evidence-based ancient TCM books. Methods The Delphi method was used for consultation among 40 experts in relevant fields. Excel 2016 and SPSS 21.0 were used to analyze the positive coefficient, authority coefficient, degree of concentration, degree of coordination, and degree of expert consensus. Results In the first round of the questionnaire, a total of 17 evaluation indexes were formulated in three aspects: 5 were deleted, 1 was modified according to the expert opinions, and no additional index was added. In addition, quantitative standards, weight assignment, and grading standards were developed according to the findings of the expert consultation. The positive coefficients of experts in the first and second rounds of questionnaires were 87.5% and 82.9%, respectively. The authority coefficient was 0.835 (>0.7). The coefficient of variation of the first and second rounds were 0.14∼0.29 and 0.09∼0.27, respectively. Kendall's coefficient of concordance of the first and second rounds were 0.135 (p < 0.05) and 0.081 (p < 0.05), respectively. Conclusion The evaluation indexes and quantitative reference values of the developed scale conform to the characteristics of prevention and treatment evidence in ancient TCM books. It can provide a useful exploration tool for the evaluation and grading of evidences in TCM ancient books.
Highlights
Ancient books of traditional Chinese medicine (TCM) compiled and published in 1911 and before are the only books to carry the text on hand-made paper and are important and direct carriers of TCM knowledge
The evidence in ancient TCM books was divided into the following two categories: evidence of knowledge and evidence of case. e evidence of knowledge refers to the evidence recorded in canons, medical classics, formula books, and clinical specialty books that mainly expound on theoretical viewpoints without clinical practices, or those summarized as the evidence in ancient books other than that in medical cases and medical notes
A2, which is an index on source ancient books and a score on experts’ consensus and importance, met the inclusion criteria; several experts suggested its exclusion from the note column, as they believe that this index has poor operability due to the characteristics of TCM ancient books
Summary
Ancient books of traditional Chinese medicine (TCM) compiled and published in 1911 and before are the only books to carry the text on hand-made paper and are important and direct carriers of TCM knowledge. The contents of ancient books on prevention and treatment, which are known to have very important practical value, have been repeatedly verified by physicians in the past dynasties in clinical practice. With the rapid development of evidence-based medicine, evidence plays an increasingly important role in medical practice. E ancient books of TCM are the main source of evidence for the treatments in TCM clinical medicine. There are no relevant standards for evidence-based research in evidence quality evaluation and classification and the current research status in this field is still being explored [1]. Liu et al suggested that expert consultation should be adopted to screen the objective evaluation indicators of evidence in ancient books [2, 3].
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