Appraising the quality of clinical practice guidelines in Chinese patent medicine

Background:Chinese patent medicine(CPM)is a type of traditional Chinese medicine(TCM)that utilizes Chi-nese medicinal materials as its raw ingredients.Following the principles of TCM theory,it undergoes specific processing techniques to create various dosage forms for the prevention and treatment of diseases.The current CPM guidelines,both domestically and internationally,are constrained by limitations in methodological quality and reporting,which do not adequately address the requirements of the majority of clinicians and patients.Objective:To evaluate the methodological rigor and reporting quality of clinical practice guidelines(CPGs)in CPM,with aim to assess their current quality and to provide recommendations for improving guideline develop-ment.Methods:The study utilized the Appraisal of Guidelines for Research and Evaluation II(AGREE II)tool and the Reporting Items for Practice Guidelines in Healthcare for Traditional Chinese Medicine(RIGHT for TCM)checklist to evaluate the methodological rigor and reporting quality of CPM guidelines.After the training session,the four investigators were divided into two groups to evaluate the guidelines of patent Chinese medicine included in this study based on the aforementioned criteria.In case of any discrepancies,a secondary analysis was conducted by all four researchers under the guidance of two clinical experts,ensuring an impartial evaluation outcome.Average score or average reporting rate were calculated for each domain.Results:A total of 32 CPM guidelines that met the inclusion criteria were analyzed.The AGREE II yielded an average score of 67.2%.The domain scores were as follows:scope and purpose(93.3%),stakeholder involve-ment(50.1%),rigor of development(76.8%),clarity of presentation(79.4%),applicability(40.1%),and editorial independence(63.6%).The average reporting rate of the RIGHT for TCM checklist was 70.0%,with the report-ing rates for the seven domains as follows:basic information(94.2%),background(87.9%),evidence(97.5%),recommendation(57.5%),review and quality assurance(11.4%),funding and declaration and management of interests(26.6%),and other information(68.8%).Conclusions:The methodological and reporting quality of CPGs for CPM have been deemed acceptable since 2020.However,there is still room for improvement,particularly in enhancing the reporting quality to provide clinicians and patients with more effective and comprehensive guidance.Additionally,it may be beneficial to develop a comprehensive reporting checklist specifically tailored for CPM guideline development.

International clinical practice guideline of Chinese medicine - Gout (SCM73–2024)

Background:Gout is a metabolic rheumatic disease that seriously endangers human health,with a relatively high prevalence and disability rate worldwide.Current international clinical practice guidelines provide recommendations from the diagnosis,treatment,and management of gout.The increasing influence of Chinese medicine globally raises the attention of adopting Chinese medicine prevention and treatment strategies.Current Chinese medicine or integrated traditional Chinese and Western medicine guidelines for gout have provide recommendations from the view of disease combined with syndrome,however,recommendations on the specific Chinese medicine prevention and treatment regimens at different stages are lacking.Methods:To this end,this document summarized Chinese medicine regimens and recommendation opinions for diagnosing and treating gout of different stages after thoroughly considering the clinical practice of Chinese medicine in diagnosing and treating gout,collecting and evaluating evidence on Chinese medicine’s efficacy on gout,and consulting experts at home and abroad,hoping to provide reference for Chinese medicine and integrated Chinese and Western medicine clinicians worldwide in gout diagnosis and treatment.Results:This document specifies the terms and definitions of gout,diagnosis of syndromes,Chinese medicine treatment regimens,etc.Conclusion:This document is a declarative document based on existing research evidence and specific methods,instead of a standard or norm for medical behavior.In clinical practice,physicians can refer to this document to formulate personalized treatment plans based on the specific conditions of patients.