国内肿瘤中医诊疗指南与专家共识方法学质量系统评价

Systematic Review on Methodological Quality of Domestic Traditional Chinese Medicine Oncology Guidelines and Expert Consensus

目的系统评价国内肿瘤中医诊疗指南/专家共识方法学质量,比较不同肿瘤中医诊疗指南、专家共识药物推荐的异同,促进对肿瘤中医诊疗指南与专家共识的理解与应用。方法以“肿瘤”“癌”“指南”“专家共识”“共识”“中医”等为主题词,检索中国知网(CNKI)、万方数据(WanFangData)、重庆维普(VIP)、医脉通(Medlive.cn)、中华中医药学会和中国中西医结合学会等中医相关学会官网刊载国内发表的中医诊疗指南/专家共识,检索时限均为建库至2021年3月15日;应用指南质量评价工具(Appraisal of Guidelines for Research and Evaluation,AGREE)AGREEⅡ与澳大利亚循证卫生保健中心的质量评价工具(Joanna Briggs Institute,JBI)对纳入诊疗指南与专家共识进行方法学质量评价,比较不同指南与共识对西药、口服中成药、中药注射液、中医外治法推荐差异。结果纳入12篇文献,6部指南,6部专家共识。指南6个领域平均得分依次为:范围和目的73.84%,参与人员65.74%,制订严谨性53.30%,明确清晰与表达性47.92%,适用性43.29%,编辑独立性47.57%。结论国内肿瘤中医循证指南数量少,方法学质量有待提高,相关临床研究与指南、共识制定规范性、严谨性有待加强。今后在指南制订中应按照国际公认指南制订规范和流程,以期制定出高质量的中医指南。

Objective To evaluate the quality of domestic TCM oncology diagnosis and treatment guidelines/expert consensus methodology,compare the similarities and differences between different TCM oncology diagnosis and treatment guidelines and expert consensus drug recommendations,and promote the understanding and application of TCM oncology diagnosis and treatment guidelines and expert consensus.Methods With tumor,cancer,guidelines,expert consensus,consensus and TCM as the main inscription,we retrieved TCM diagnosis and treatment guidelines/expert consensus published in CNKI,Wanfangdata,Chongqing VIP,Medlive.cn,the official websites of TCM related societies such as China Association of Chinese Medicine and Chinese Association of Integrative Medicine,and the retrieval time was from the establishment of the database to March 15,2021.Appraisal of Guidelines for Research and Evaluation(AGREE)AGREEⅡand the quality assessment tool of the Joanna Briggs Institute for Evidence Based Health Care in Australia(JBI)evaluated the methodological quality of the included diagnosis and treatment guidelines and expert consensus,and the differences in the recommendation of western medicine,oral Chinese patent medicine,Chinese medicine injection and external treatment of Chinese medicine by different guidelines and consensus were compared.Results 12 literatures,6 guidelines and 6 expert consensuses were included.The average scores of the six fields of the guideline were as follows:scope and purpose 73.84%,participants 65.74%,formulation rigor 53.30%,clarity and expression 47.92%,applicability 43.29%,and editorial independence 47.57%.Conclusion The number of evidence-based guidelines for TCM oncology in China is small.The methodological quality needs to be improved,and the standardization and rigor of relevant clinical research and guidelines and consensus formulation need to be strengthened.In the future,guidelines should be formulated according to the internationally recognized guidelines,so as to develop high quality TCM guidelines.