Chinese Guidelines For Diagnosis Research Articles

Chinese expert consensus on diagnosis and treatment of antirheumatic drug-induced liver injury(2024)

Rheumatic diseases are a common group of chronic diseases that typically require long-term medication to control. Antirheumatic drugs may cause liver damage which requires prompt detection treatment to avoid irreversible damage. Liver damage induced by medication for rheumatoid arthritis has unique clinical manifestations and is difficult to distinguish from liver diseases related to the primary illness, often requiring the involvement of hepatologists to discuss and determine the treatment plan. To improve the understanding and management of anti rheumatic drug-induced liver injury among clinicians, especially rheumatologists, the Rheumatology Branch of the Chinese Medical Association and other experts in related fields formed this consensus after multiple discussions and revisions based on relevant research progress in recent years. Based on the Chinese Guidelines for diagnosis and management of drug-induced liver injury (2023), this consensus highlights the characteristics of rheumatic diseases and rheumatology medications, clarifies the anti rheumatic drugs that can cause liver injury, the liver injury caused by rheumatic diseases, the susceptible groups of anti rheumatic drug-induced injury, the diagnostic process of anti rheumatic drug-induced liver injury, and the indications for rheumatology physicians' consultation in the case of anti rheumatic drug-induced liver injury. It is hoped that the content of this consensus will be useful for practicing rheumatologists and that it can provide guidance for rheumatologists in the scientific management of anti rheumatic drug-induced liver injury.

Chinese guidelines for diagnosis and treatment of vulvovaginal candidiasis (2024 edition)

Chinese guidelines for diagnosis and treatment of vulvovaginal candidiasis (2024 edition)

Chinese guideline for diagnosis and treatment of adult acute lymphoblastic leukemia (2024)

Adult acute lymphoblastic leukemia (ALL) is one of the most common acute leukemia in adults. There are relatively unified diagnostic criteria and systematic treatment regimens reported by different research groups in the world. Since 2013, three versions of expert consensus/guidelines on the diagnosis and treatment of adult ALL in China have been published, which are of great significance for improving the level of diagnosis and treatment of this disease. In 2022, the classification of ALL (precursor lymphocyte neoplasms-lymphoblastic leukemias/lymphomas) had been updated in the WHO classification of haematolymphoid tumors, and some new concepts had been proposed. In recent years, the rapid development of immunotherapy has improved the efficacy of adult ALL, and commercial antibodies and CAR-T cell products have been available in China, the clinical practice is increasing. In order to promote the standardization of clinical diagnosis and treatment of adult ALL, by referring to the latest guidelines and literatures all over the world, this guideline may contribute to the better understanding of diagnosis, treatment and efficacy monitoring for adult ALL.

Chinese guideline for diagnosis and treatment of hairy cell leukemia (2023)

Chinese guideline for diagnosis and treatment of hairy cell leukemia (2023)

Chinese guidelines for diagnosis and treatment of adult acute myeloid leukemia (not APL) (2023)

Chinese guidelines for diagnosis and treatment of adult acute myeloid leukemia (not APL) (2023)

Chinese guideline for diagnosis and management of drug-induced liver injury (2023 version)

Drug-induced liver injury (DILI) is an important adverse drug reaction that can lead to acute liver failure or even death in severe cases. Currently, the diagnosis of DILI still follows the strategy of exclusion. Therefore, a detailed history taking and a thorough and careful exclusion of other potential causes of liver injury is the key to correct diagnosis. This guideline was developed based on evidence-based medicine provided by the latest research advances and aims to provide professional guidance to clinicians on how to identify suspected DILI timely and standardize the diagnosis and management in clinical practice. Based on the clinical settings in China, the guideline also specifically focused on DILI in chronic liver disease, drug-induced viral hepatitis reactivation, common causing agents of DILI (herbal and dietary supplements, anti-tuberculosis drugs, anti-neoplastic drugs), and signal and assessment of DILI in clinical trials.

Chinese guidelines for diagnosis and treatment of systemic mastocytosis in adult patients (2022)

Chinese guidelines for diagnosis and treatment of systemic mastocytosis in adult patients (2022)

Chinese guideline for diagnosis and treatment of transfusion dependent β-thalassemia (2022)

Chinese guideline for diagnosis and treatment of transfusion dependent β-thalassemia (2022)

Chinese guideline for diagnosis and treatment of lymphoplasmacytic lymphoma/Walderström macroglobulinemia (2022)

Chinese guideline for diagnosis and treatment of lymphoplasmacytic lymphoma/Walderström macroglobulinemia (2022)

Chinese guideline for diagnosis and treatment of allergic rhinitis (2022, revision)

Chinese guideline for diagnosis and treatment of allergic rhinitis (2022, revision)

Chinese guidelines for diagnosis and treatment of HIV/AIDS (2021 edition)

Acquired immunodeficiency syndrome(AIDS) is an important public health problem in China. In 2005, the first edition of the guidelines for the diagnosis and treatment of AIDS was formulated by the AIDS Professional Group of Society of Infectious Diseases of Chinese Medical Association, which was updated in 2011, 2015, and 2018, respectively. The 2021 edition of the guidelines was revised on the basis of the 2018 edition and updated according to national clinical practice and the latest research results. The new research progress in opportunistic infections, antiretroviral therapy, post-exposure prophylaxis (PEP), pre-exposure prophylaxis (PrEP), whole course management of human immunodeficiency virus(HIV) infection, and prevention of mother to child transmission was updated in this guidelines. In the 2021 edition, the indications, medication regimen, follow-up and monitoring, and precautions of PrEP were introduced in detail.

Chinese guidelines for diagnosis, prevention and treatment of thrombophilia (2021)

Chinese guidelines for diagnosis, prevention and treatment of thrombophilia (2021)

Construction of the cervical cancer common terminology for promoting semantic interoperability and utilization of Chinese clinical data

BackgroundWe aimed to build a common terminology in the domain of cervical cancer, named Cervical Cancer Common Terminology (CCCT), that will facilitate clinical data exchange, ensure quality of data and support large scale data analysis.MethodsThe standard concepts and relations of CCCT were collected from ICD-10-CM Chinese Version, ICD-9-PC Chinese Version, officially issued commonly used Chinese clinical terms, Chinese guidelines for diagnosis and treatment of cervical cancer and Chinese medical book Lin Qiaozhi Gynecologic Oncology. 2062 cervical cancer electronic medical records (EMRs) from 16 hospitals, belong to different regions and hospital tiers, were collected for terminology enrichment and building common terms and relations. Concepts hierarchies, terms and relationships were built using Protégé. The performance of natural language processing results was evaluated by average precision, recall, and F1-score. The usability of CCCT were evaluated by terminology coverage.ResultsA total of 880 standard concepts, 1182 common terms, 16 relations and 6 attributes were defined in CCCT, which organized in 6 levels and 11 classes. Initial evaluation of the natural language processing results demonstrated average precision, recall, and F1-score percentages of 96%, 72.6%, and 88.5%. The average terminology coverage for three classes of terms, clinical manifestation, treatment, and pathology, were 87.22%, 92.63%, and 89.85%, respectively. Flexible Chinese expressions exist between regions, traditions, cultures, and language habits within the country, linguistic variations in different settings and diverse translation of introduced western language terms are the main reasons of uncovered terms.ConclusionsOur study demonstrated the initial results of CCCT construction. This study is an ongoing work, with the update of medical knowledge, more standard clinical concepts will be added in, and with more EMRs to be collected and analyzed, the term coverage will be continuing improved. In the future, CCCT will effectively support clinical data analysis in large scale.

Chinese guidelines for diagnosis and treatment of adult acute lymphoblastic leukemia (2021)

Chinese guidelines for diagnosis and treatment of adult acute lymphoblastic leukemia (2021)

A nationwide survey of otolaryngologists’ compliance with Chinese guidelines for diagnosis and treatment of allergic rhinitis

BackgroundA higher compliance with clinical guidelines helps improve treatment outcomes. But the clinical practice of otolaryngologists is not always consistent with guidelines. ObjectiveTo describe otolaryngologists’ compliance with guidelines about allergic rhinitis (AR) management and identify factors responsible for the discordance between clinical practice and guideline recommendations in China. MethodsA cross-sectional nationwide survey was designed and conducted via an online platform. Recruitment was done by emailing otolaryngologists registered in the Chinese Society of Otorhinolaryngology-Head and Neck Surgery or by inviting otolaryngologists to scan a Quick Respond (QR) code that linked to the questionnaire at various academic meetings. ResultsA total of 2142 otolaryngologists were eligible and completed the survey. Of them, 64.7% had over 10 years work experience and 97.4% had a bachelor's degree or higher. About 18.3% of the participants strictly copied the guideline in clinical practice, while 73.7% used the guideline that had been adjusted according to their clinical experience. Otolaryngologists were most concerned about the efficacy, safety, and minimum age of AR medications, and least concerned about patient preferences. Regarding the use of intranasal steroids (INS), leukotriene receptor antagonists (LTRA), and H1-antihistamines, 86.8%, 55.7% and 51.2% of otolaryngologists complied with the guideline recommendations, respectively. Educational background was a factor affecting the compliance with guidelines and acceptance of INS. ConclusionA vast majority of Chinese otolaryngologists complied with the current Chinese AR guidelines. A difference still existed between the otolaryngologists' real-world and guideline-recommended management. The otolaryngologists should pay more attention to patient preferences. A higher education could improve otolaryngologists’ adherence to the guidelines.

Current status of surgical treatment of rectal cancer in China.

With the changing lifestyle and the acceleration of aging in the Chinese population, the incidence and mortality of colorectal cancer (CRC) have risen in the last decades. On the contrary, the incidence and mortality of CRC have continued to decline in the USA since the 1980s, which is mainly attributed to early screening and standardized diagnosis and treatment. Rectal cancer accounts for the largest proportion of CRC in China, and its treatment regimens are complex. At present, surgical treatment is still the most important treatment for rectal cancer. Since the first Chinese guideline for diagnosis and treatment of CRC was issued in 2010, the fourth version has been revised in 2020. These guidelines have greatly promoted the standardization and internationalization of CRC diagnosis and treatment in China. And with the development of comprehensive treatment methods such as neoadjuvant chemoradiotherapy, targeted therapy, and immunotherapy, the post-operative quality of life and prognosis of patients with rectal cancer have improved. We believe that the inflection point of the rising incidence and mortality of rectal cancer will appear in the near future in China. This article reviewed the current status and research progress on surgical therapy of rectal cancer in China.

PCV21 COST-EFFECTIVENESS ANALYSIS OF PLUS ASPIRIN VS PLACEBO PLUS ASPIRIN IN THE TREATMENT OF ISCHEMIC STROKE BASED ON A RANDOMIZED CLINICAL TRIAL

Stroke is the leading cause of death and long-term disability in China with high-incidence, high-mortality and heavy-disease-burden. In addition to the chemical drugs, Chinese guidelines for diagnosis and treatment of acute ischemic stroke recommends the application of Chinese patent medicines. Ginkgolide injection is commonly used in the clinical treatment of stroke in China for its effect in promoting blood circulation and removing blood stasis, clearing channels and activating collaterals. A GISAA RCT study evaluated the efficacy and safety between Ginkgolide plus Aspirin and Placebo plus Aspirin. This study intends to evaluate the long-term cost-effectiveness of Ginkgolide plus Aspirin compared with placebo plus Aspirin based on the RCT results and literature. A Markov model is constructed consisting 4 states: No significant disability, Disability, Stroke recurrence and Death. Therapeutic data is from GISAA study. Utilities, transition probabilities are extracted from literatures. Costs data is from China Health Statistics Yearbook and hospital record survey. Expected costs and QALYs of 13 years’ circles (Calculated by average age of subjects and Chinese life expectancy) are calculated through TreeagePro11 software. The WTP threshold is the Chinese per capita GDP in 2018, ￥64644/QALY. The results are analyzed by single factor and probability sensitivity analysis. Ginkgolide plus Aspirin is found to have higher expected per-patient cost than placebo plus Aspirin, but also higher QALYs. Compared to placebo plus Aspirin, Ginkgolide plus Aspirin produces an incremental cost effectiveness ratio of ￥14920.17/QALY, which is below the WTP threshold. Probabilistic sensitivity analysis suggests that the acceptability of Ginkgolide plus Aspirin is higher than that of placebo plus Aspirin. The cost-effectiveness analysis based on RCT shows that the addition of ginkgolides to conventional treatment is cost-effective at the threshold of Chinese per capita GDP.

Current Status and Future Directions of Chronic Cough in China.

Chronic cough is one of the most common complaints for which patients in China seek medical attention. However, there are no nationwide data on the prevalence and socioeconomic burden of chronic cough. Although approximately 50% of Chinese men smoke, the vast majority of patients presenting for evaluation of chronic cough are never smokers. An equal sex distribution and a middle-aged predominance have been observed in the Chinese chronic cough population, despite demonstration of a higher cough reflex sensitivity in females and older patients. The role of air pollution in the distinct age and sex distribution requires further study. In terms of the etiologies of chronic cough in China, cough-variant asthma, upper airway cough syndrome, nonasthmatic eosinophilic bronchitis, and atopic cough are the most common causes, comprising 75.2% to 87.6% of cases across different regions. Chinese Guidelines for Diagnosis and Treatment of Cough were initially published in 2005, and updated in 2009 and 2016. In addition, the China Cough Coalition was established in 2016. Great progress has been made in both cough-related clinical practice and research in recent years, however, there are still challenges ahead. To facilitate optimal management of chronic cough in China, efforts promoting the dissemination and application of published guidelines will be essential, especially in community-based healthcare and in rural regions. As chronic refractory cough has been identified as a huge challenge to clinicians worldwide, continued international cooperation will be essential in optimizing evaluation and management of chronic cough.

Chinese guidelines for diagnosis and treatment of diabetic foot

Chinese guidelines for diagnosis and treatment of diabetic foot

Comments on Chinese guidelines for diagnosis and treatment of gastric cancer 2018 (English edition).

Comments on Chinese guidelines for diagnosis and treatment of gastric cancer 2018 (English edition).