Fully Completed Spherical Fuzzy Approach-Based Z Numbers(PHIModel)for Enhanced Group Expert Consensus

This study aims to establish an expert consensus and enhance the efficacy of decision-making processes by integrating Spherical Fuzzy Sets(SFSs)and Z-Numbers(SFZs).A novel group expert consensus technique,the PHImodel,is developed to address the inherent limitations of both SFSs and the traditional Delphi technique,particularly in uncertain,complex scenarios.In such contexts,the accuracy of expert knowledge and the confidence in their judgments are pivotal considerations.This study provides the fundamental operational principles and aggregation operators associated with SFSs and Z-numbers,encompassing weighted geometric and arithmetic operators alongside fully developed operators tailored for SFZs numbers.Subsequently,a case study and comparative analysis are conducted to illustrate the practicality and effectiveness of the proposed operators and methodologies.Integrating the PHI model with SFZs numbers represents a significant advancement in decision-making frameworks reliant on expert input.Further,this combination serves as a comprehensive tool for decision-makers,enabling them to achieve heightened levels of consensus while concurrently assessing the reliability of expert contributions.The case study results demonstrate the PHI model’s utility in resolving complex decision-making scenarios,showcasing its ability to improve consensus-building processes and enhance decision outcomes.Additionally,the comparative analysis highlights the superiority of the integrated approach over traditional methodologies,underscoring its potential to revolutionize decision-making practices in uncertain environments.

Expert Consensus on Nutritional Support for Children with Congenital Heart Disease(2023 Edition)

The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the results of multi-center clinical nutrition research for congenital heart disease following thefirst Chinese consensus edition of 2016.The consensus was also shaped by the results of three discussion sessions and two questionnaires con-ducted by the 13-member collaboration group.This process was informed by both clinical guidelines and expert consensus.The quality of literature,both in English and Chinese,and the level of recommendations were evaluated using the Grading of Recommendations Assessment,Development,and Evaluations(GRADE)system.

Expert Consensus on Prevention and Treatment of COVID-19 Infection in Patients with Lung Cancer

Corona virus disease 2019(COVID-19)infection has become a major public health issue affecting human health.The main goal of epidemic prevention and control at the current stage in China is to“protect people’s health and prevent severe cases”.Patients with lung cancer who receive antitumor therapy have low immunity,and the risk of severe illness and death once infected is much higher than healthy people,so they are vulnerable to COVID-19 infection.At present,less attention has been paid to the prevention and treatment of COVID-19 infection in patients with lung cancer in domestic guidelines and consensus.Based on the published data in China and abroad,we proposed recommendations and formed expert consensus on the vaccination of COVID-19,the use of neutralizing antibodies and small molecule antiviral drugs for patients with lung cancer,for physician’s reference.

Chinese expert consensus on managing thrombocytopenia in patients with cancer and liver injury

Thrombocytopenia and liver injury are serious clinical problems in patients with cancer. The etiologyof thrombocytopenia in patients with cancer and liver injury (TCLI) is complicated. Managing cancertherapy-induced thrombocytopenia has gradually become standardized, and managing liver injuryassociatedthrombocytopenia has become more effective with the approval and marketing of relevantdrugs. However, the optimal strategy for managing thrombocytopenia in patients with cancer and liverinjury remains unclear, and the superposition of thrombocytopenia and liver injury further increasesthe difficulty of cancer treatment. Therefore, the Committee of Cancer Support Therapy of the ChineseAnti-Cancer Association has organized experts to analyze and discuss relevant literature to form aChinese expert consensus on managing thrombocytopenia in patients with cancer and liver injury(2022 Edition) to guide clinical practice.

Chinese expert consensus on prevention and treatment of delayed nausea and vomiting(2022 Edition)

Nausea and vomiting are common adverse reactions of antitumor therapy,among which chemotherapy-induced nausea and vomiting(CINV)has been studied most intensively.Because of insufficient prevention or insufficient attention,CINV brings a series of harms to can-cer patients and even lead to the delay or termination of antitumor therapy.Delayed CINV is often underestimated because it mostly occurs outside the hospital,and patients cannot report it immediately.In recent years,the proportion of outpatient chemotherapy and day-time chemotherapy patients in China has increased year by year.Therefore,the prevention of delayed CINV is particularly important.Currently,the challenges faced by delayed CINV include the need to deeply explore its physiological and pathological mechanisms,improve its risk assessment standards,and optimize its prevention programs.However,there is still lack of practice guidelines or consensus on delayed CINV.Therefore,the Committee of Neoplastic Supportive-Care of China Anti-Cancer Association organized multidisciplinary experts in this field to formulate this consensus based on the analysis and discussion of current evidence-based medical research in combination with clinical problems that need to be solved urgently.

Expert Consensus on Clinical Management of T2DM Combined with Obesity Reversal Treatment in China(2023 Edition)

With lifestyle changes,the incidence of type 2 diabetes(T2DM)and obesity has significantly increased,becoming major chronic diseases that seriously threaten the health of China’s residents.Both domestic and international guidelines and consensus exist regarding the diagnosis and management of this disease.In recent years,T2DM treatment has focused more on new tactics that lean towards a patient-centered comprehensive management approach,replacing the traditional glucose-centered approach.Additionally,an increasing amount of evidence in medicine suggests that the reversal of diabetes is possible.However,there is currently no expert consensus on the clinical management of T2DM combined with obesity reversal treatment.Therefore,experts and scholars in China with extensive experience in T2DM combined with obesity reversal treatment have been invited to develop this consensus.The content includes early identification and diagnosis of T2DM combined with obesity,definition and mechanisms of diabetes reversal,disease assessment and grading,staging of diabetes and goals of reversal,the 2+N reversal strategy,inpatient system treatment combined with comprehensive outpatient management(including weight control,precise nutrition,scientific exercise,glucose-lowering medication,psychological intervention,rehabilitation therapy,and remote follow-up through online platforms),and evaluation of post-reversal efficacy.The aim is to further improve the level of T2DM combined with obesity reversal diagnosis,treatment,and management in China,and to implement the Healthy China strategy.

Chinese expert consensus on cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal malignancies

Locoregional spread of abdominopelvic malignant tumors frequently results in peritoneal carcinomatosis(PC). The prognosis of PC patients treated by conventional systemic chemotherapy is poor, with a median survival of < 6 mo. However, over the past three decades, an integrated treatment strategy of cytoreductive surgery(CRS) + hyperthermic intraperitoneal chemotherapy(HIPEC) has been developed by the pioneering oncologists, with proved efficacy and safety in selected patients. Supported by several lines of clinical evidence from phases Ⅰ, Ⅱ and Ⅲ clinical trials, CRS + HIPEC has been regarded as the standard treatment for selected patients with PC in many established cancer centers worldwide. In China, an expert consensus on CRS + HIPEC has been reached by the leading surgical and medical oncologists, under the framework of the China Anti-Cancer Association. This expert consensus has summarized the progress in PC clinical studies and systematically evaluated the CRS + HIPEC procedures in China as well as across the world, so as to lay the foundation for formulating PC treatment guidelines specific to the national conditions of China.

Expert consensus on the diagnosis and treatment of heat stroke in China

Heat stroke(HS)is a fatal disease caused by thermal damage in the body,and it has a very high mortality rate.In 2015,the People’s Liberation Army Professional Committee of Critical Care Medicine published the first expert consensus on HS in China,Expert consensus on standardized diagnosis and treatment for heat stroke.With an increased understanding of HS and new issues that emerged during the HS treatment in China in recent years,the 2015 consensus no longer meet the requirements for HS prevention and treatment.It is necessary to update the consensus to include the latest research evidence and establish a new consensus that has broader coverage,is more practical and is more in line with China’s national conditions.This new expert consensus includes new concept of HS,recommendations for laboratory tests and auxiliary examinations,new understanding of diagnosis and differential diagnosis,On-site emergency treatment and In-hospital treatment,translocation of HS patients and prevention of HS.

Chinese Association for the Study of Pain:Expert consensus on diagnosis and treatment for lumbar disc herniation

Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis and treatment of lumbar disc herniation have been published domestically and internationally.According to the expert consensus,clinicians could adopt tailored and personalized diagnosis and treatment management strategies for lumbar disc herniation patients.

Chinese expert consensus on the non-invasive imaging examination pathways of stable coronary artery disease

1 Introduction Early detection and diagnosis of stable coronary artery disease （SCAD） is essential for proactive secondary prevention of myocardial infarction （MI）, control of disease progress, and reduction of mortality. Clinical decision-making in modem medicine is increasingly dependent on cardiovascular imaging techniques. 2012 ACCF/AHA/ACP/AATS/ PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease has been issued by American Heart Association （AHA）. European Society of Cardiology （ESC） has issued 2013 ESC guidelines on the management of stable coronary artery disease.

Expert consensus on the diagnosis and treatment of thrombocytopenia in adult critical care patients in China

Thrombocytopenia is a common complication of critical care patients.The rates of bleeding events and mortality are also significantly increased in critical care patients with thrombocytopenia.Therefore,the Critical Care Medicine Committee of Chinese People’s Liberation Army(PLA)worked with Chinese Society of Laboratory Medicine,Chinese Medical Association to develop this consensus to provide guidance for clinical practice.The consensus includes five sections and 27 items:the definition of thrombocytopenia,etiology and pathophysiology,diagnosis and differential diagnosis,treatment and prevention.

An expert consensus on the evaluation and treatment of acute thoracolumbar spine and spinal cord injury in China

This is an expert consensus on the evaluation and treatment of thoracolumbar spinal injury, estab- lished from February 2009 to July 2010. The expert consensus consists mainly of six parts with a total of 54 recommendations including the overview （one item）; pre-hospital care （one item）; evaluation and diagnosis （13 items）; treatment （23 items）; prevention and treatment of major com- plications （12 items）; and rehabilitation （four items）. This is the first time that Chinese experts have published a consensus on spine and spinal cord injury. The expert consensus was established based on Delphi methods, literature analysis, and clinical experiences. Each recommendation is supported by and was interpreted using multi-level evidences. The level of agreement with the rec- ommendation among the panel members was assessed as either low, moderate, or strong. Each panel member was asked to indicate his or her level of agreement on a 5-point scale, with ＂1＂ cor- respondJng to neutrality and ＂5＂ representJng maxJmum agreement. Scores were aggregated across the panel members and an arithmetic mean was calculated. This mean score was then translated into low, moderate, or strong. After all of the votes were collected and calculated, the results showed no low-level recommendations, 10 moderate-level recommendations, and 44 strong-level recom- mendations. An expert consensus was reached and was recognized by Chinese spine surgeons. Wide-scale adoption of these recommendations is urgent in the management of acute thora- columbar spine and spinal cord injury in a broader attempt to create a standard evaluation and treatment strategy for acute thoracolumbar spine and spinal cord injury in China.

Expert consensus of Chinese Association for the Study of Pain on the application of ozone therapy in pain medicine

This consensus was compiled by first-line clinical experts in the field of pain medicine and was organized by the Chinese Association for the Study of Pain.To reach this consensus,we consulted a wide range of opinions and conducted indepth discussions on the mechanism,indications,contraindications,operational specifications and adverse reactions of ozone iatrotechnique in the treatment of pain disorders.We also referred to related previous preclinical and clinical studies published in recent years worldwide.The purpose of this consensus is to standardize the rational application of ozone iatrotechnique in pain treatment,to improve its efficacy and safety and to reduce and prevent adverse reactions and complications in this process.

Expert consensus of the Chinese Association for the Study of Pain on ion channel drugs for neuropathic pain

Neuropathic pain(NPP)is a kind of pain caused by disease or damage impacting the somatosensory system.Ion channel drugs are the main treatment for NPP;however,their irregular usage leads to unsatisfactory pain relief.To regulate the treatment of NPP with ion channel drugs in clinical practice,the Chinese Association for the Study of Pain organized first-line pain management experts from China to write an expert consensus as the reference for the use of ion channels drugs.Here,we reviewed the mechanism and characteristics of sodium and calcium channel drugs,and developed recommendations for the therapeutic principles and clinical practice for carbamazepine,oxcarbazepine,lidocaine,bulleyaconitine A,pregabalin,and gabapentin.We hope this guideline provides guidance to clinicians and patients on the use of ion channel drugs for the management of NPP.

Expert Consensus on Laparoscopic Hepatectomy(2013 Version)

Background： Laparoscopic hepatectomy has many advantages over open surgery, including minimiza- tion of local injury, reduced systemic reactions, and faster postoperative recovery. The aim of this ＂Consensus＂ is to provide guidance and reference to surgeons who perform, or are interested in per- forming laparoscopic liver surgeries. Methods： The National Hepatic Surgery Group of the Society of Surgery, a professional society of the Chinese Medical Association, gathered 60 expert hepatic surgeons in Wuhan, China in December 2012, and an ＂Expert Consensus on Laparoseopic Hepatectomy＂ was developed. Results： The types of hepatectomy, indications and contraindications, preoperative preparation, anes- thesia, patient position, insuffiation pressure, port position, control of hepatic inflow and outflow, indi- cations for conversion to open surgery, and surgical devices and equipment are reviewed. Techniques and procedures of various laparoscopic hepatectomies are also discussed.

Expert consensus on early childhood caries management

Early childhood caries(ECC)is a significant chronic disease of childhood and a rising public health burden worldwide.ECC may cause a higher risk of new caries lesions in both primary and permanent dentition,affecting lifelong oral health.The occurrence of ECC has been closely related to the core microbiome change in the oral cavity,which may be influenced by diet habits,oral health management,fluoride use,and dental manipulations.So,it is essential to improve parental oral health and awareness of health care,to establish a dental home at the early stage of childhood,and make an individualized caries management plan.Dental interventions according to the minimally invasive concept should be carried out to treat dental caries.This expert consensus mainly discusses the etiology of ECC,caries-risk assessment of children,prevention and treatment plan of ECC,aiming to achieve lifelong oral health.

2016 Chinese expert consensus and guidelines for the diagnosis and treatment of papillary thyroid microcarcinoma

The incidence of papillary thyroid carcinoma(PTC)has exponentially increased in recent years.Papillary thyroid microcarcinoma(PTMC)accounts for the majority of the reported cases of PTC.The debates and crucial issues in PTMC management have received researchers'attention.To further improve the clinical management of PTMC in China,

2017 Chinese expert consensus on the clinical application ofserum marker for thyroid cancer

In recent years, the clinical incidence of thyroid cancer has been increasing year by year, and its risk assessment and clinical management methods have also been accordingly modified and constantly improved. There are great differences between the clinical diagnostic and therapeutic modes and disease management of thyroid cancer employed by various medical institutions in China, particularly with regard to the clinical application of serum marker of thyroid cancer. To this end, the China Anti-Cancer Association Thyroid Cancer Specialized Committee Chinese Association of Thyroid Oncology organized this compilation of ExpertConsensus on Clinical Application of Serum Marker of Thyroid Cancer to help and impel relevant clinical institutions and professionals to standardize clinical diagnosis, treatment, and long-term management of thyroid cancer, and to properly utilize the serum marker for scientific auxiliary clinical diagnosis and assessment of thyroid cancer before and after operation.

Expert consensus of Chinese Association for the Study of Pain on the radiofrequency therapy technology in the Department of Pain

On the basis of continuous improvement in recent years,radiofrequency therapy technology has been widely developed,and has become an effective method for the treatment of various intractable pain.Radiofrequency therapy is a technique that uses special equipment and puncture needles to output ultra-high frequency radio waves and accurately act on local tissues.In order to standardize the application of radiofrequency technology in the treatment of painful diseases,Chinese Association for the Study of Pain(CASP)has developed a consensus proposed by many domestic experts and scholars.

Expert Consensus on Nurses'Human Caring for COVID-19 Patients in Different Sites

Summary:This study aims to develop the expert consensus on nurse's human caring for Corona Virus Disease 2019(COVID-19)patients in different sites,and thus provide a guideline on providing whole process and systematic caring for COVID-19 patients.Based on the frontline experiences of human caring for COVID-19 patients and the review of literature,the initial draft of consensus was made and finalized after online meeting and revisions.The experts reached consensus on the following parts:terms and definitions,principles of human caring for COVID-19 patients,and human caring measures for COVID-19 patients in different sites.The expert consensus is practical,concise,and reasonable for guiding the nurses providing human caring for COVID-19 patients,as well as other similar infectious diseases.