Is traditional Chinese medicine recommended in Western medicine clinical practice guidelines in China? A systematic analysis
Is traditional Chinese medicine recommended in Western medicine clinical practice guidelines in China? A systematic analysis
Background
Evidence-based medicine promotes and relies on the use of evidence in developing clinical practice guidelines (CPGs). The Chinese healthcare system includes both traditional Chinese medicine (TCM) and Western medicine, which are expected to be equally reflected in Chinese CPGs.
Objective
To evaluate the inclusion of TCM-related information in Western medicine CPGs developed in China and the adoption of high level evidence.
Methods
All CPGs were identified from the China Guideline Clearinghouse (CGC), which is the main Chinese organisation maintaining the guidelines issued by the Ministry of Health of China, the Chinese Medical Association and the Chinese Medical Doctors’ Association.
TCM-related contents were extracted from all the CPGs identified. Extracted information comprised the institution issuing the guideline, date of issue, disease, recommendations relating to TCM, evidence level of the recommended content and references supporting the recommendations.
Results
A total of 604 CPGs were identified, only a small number of which (74/604; 12%) recommended TCM therapy and only five guidelines (7%) had applied evidence grading. The 74 CPGs involved 13 disease systems according to the International Classification of Diseases 10th edition. TCM was mainly recommended in the treatment part of the guidelines (73/74, 99%), and more than half of the recommendations (43/74, 58%) were related to Chinese herbal medicine (single herbs or herbal treatment based on syndrome differentiation).
Conclusions
Few Chinese Western medicine CPGs recommend TCM therapies and very few provide evidence grading for the TCM recommendation. We suggest that future guideline development should be based on systematic searches for evidence to support CPG recommendations and involve a multidisciplinary approach including TCM expertise.
1-9
Ren, J.
39786c58-b722-4795-bb2c-c33b4d099189
Xun, L.
dcd73ee5-fb2a-45e7-8fc6-e9ecb0b85159
Sun, J.
e1232949-4c7a-4320-af62-167e72dec5fe
Han, M.
58cc52a1-6022-483f-a586-97ac4aadeb98
Yang, G.Y.
5cb71937-8305-4a94-9724-0ba876813dec
Li, W.Y.
84900645-9afa-4ef3-a722-730128afe53c
Robinson, N.
a8d33c29-e61a-4829-aeff-be596e37342f
Lewith, G.
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Liu, J.P.
76d4b75b-a9f8-4e2f-a470-62f8accc9530
3 June 2015
Ren, J.
39786c58-b722-4795-bb2c-c33b4d099189
Xun, L.
dcd73ee5-fb2a-45e7-8fc6-e9ecb0b85159
Sun, J.
e1232949-4c7a-4320-af62-167e72dec5fe
Han, M.
58cc52a1-6022-483f-a586-97ac4aadeb98
Yang, G.Y.
5cb71937-8305-4a94-9724-0ba876813dec
Li, W.Y.
84900645-9afa-4ef3-a722-730128afe53c
Robinson, N.
a8d33c29-e61a-4829-aeff-be596e37342f
Lewith, G.
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Liu, J.P.
76d4b75b-a9f8-4e2f-a470-62f8accc9530
Ren, J., Xun, L., Sun, J., Han, M., Yang, G.Y., Li, W.Y., Robinson, N., Lewith, G. and Liu, J.P.
(2015)
Is traditional Chinese medicine recommended in Western medicine clinical practice guidelines in China? A systematic analysis.
BMJ Open, 5 (6), .
(doi:10.1136/bmjopen-2014-006572).
(PMID:26041487)
Abstract
Background
Evidence-based medicine promotes and relies on the use of evidence in developing clinical practice guidelines (CPGs). The Chinese healthcare system includes both traditional Chinese medicine (TCM) and Western medicine, which are expected to be equally reflected in Chinese CPGs.
Objective
To evaluate the inclusion of TCM-related information in Western medicine CPGs developed in China and the adoption of high level evidence.
Methods
All CPGs were identified from the China Guideline Clearinghouse (CGC), which is the main Chinese organisation maintaining the guidelines issued by the Ministry of Health of China, the Chinese Medical Association and the Chinese Medical Doctors’ Association.
TCM-related contents were extracted from all the CPGs identified. Extracted information comprised the institution issuing the guideline, date of issue, disease, recommendations relating to TCM, evidence level of the recommended content and references supporting the recommendations.
Results
A total of 604 CPGs were identified, only a small number of which (74/604; 12%) recommended TCM therapy and only five guidelines (7%) had applied evidence grading. The 74 CPGs involved 13 disease systems according to the International Classification of Diseases 10th edition. TCM was mainly recommended in the treatment part of the guidelines (73/74, 99%), and more than half of the recommendations (43/74, 58%) were related to Chinese herbal medicine (single herbs or herbal treatment based on syndrome differentiation).
Conclusions
Few Chinese Western medicine CPGs recommend TCM therapies and very few provide evidence grading for the TCM recommendation. We suggest that future guideline development should be based on systematic searches for evidence to support CPG recommendations and involve a multidisciplinary approach including TCM expertise.
Text
bmjopen-2014-006572.pdf
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More information
Accepted/In Press date: 8 April 2015
e-pub ahead of print date: 3 June 2015
Published date: 3 June 2015
Organisations:
Primary Care & Population Sciences
Identifiers
Local EPrints ID: 375967
URI: http://eprints.soton.ac.uk/id/eprint/375967
PURE UUID: 539c06ab-e087-4d80-9267-7f2e6b468ad3
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Date deposited: 21 Apr 2015 12:58
Last modified: 14 Mar 2024 19:36
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Contributors
Author:
J. Ren
Author:
L. Xun
Author:
J. Sun
Author:
M. Han
Author:
G.Y. Yang
Author:
W.Y. Li
Author:
N. Robinson
Author:
G. Lewith
Author:
J.P. Liu
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