Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, 430061, China.
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
Front Med. 2017 Dec;11(4):590-594. doi: 10.1007/s11684-017-0537-4. Epub 2017 Aug 12.
Grading of Recommendations Assessment, Development, and Evaluation (GRADE) offers a worldwide approach to guideline development for clinical practice. For the clinical practice of acupuncture therapy, 18 evidence-based guidelines have been developed in China using GRADE. In this study, we review the advantages and limitations of the GRADE approach in the guideline development for acupuncture and moxibustion and propose some solutions to these limitations. Scientific advantages of rating the quality of evidence, outcome-centric direction, overall progression to develop recommendations, and strength of recommendations providing specific clinical guidance are the advantages of GRADE. The limitations of GRADE in the development of guidelines for acupuncture and moxibustion include rating the quality of evidence for ancient literature and literature on famous traditional Chinese medicine experts' experiences and specific guidelines for formulating recommendations from evidence. In the guideline development for clinical practice with acupuncture and moxibustion, we suggest that a specific method should be explored based on the GRADE approach and the characteristics of acupuncture therapy.
推荐意见的评估、制定与评价（GRADE）为临床实践指南制定提供了一种全球性方法。在中国，已有 18 项基于循证的针灸疗法临床实践指南采用 GRADE 方法制定。本研究旨在探讨 GRADE 方法在针灸指南制定中的优缺点，并提出一些解决这些局限性的方法。GRADE 的优点在于评价证据质量、以结局为导向、全面制定推荐意见、推荐意见强度提供具体临床指导。GRADE 在针灸指南制定中的局限性包括评价古代文献和著名中医药专家经验文献的证据质量以及具体制定基于证据的推荐意见的指南。在针灸临床实践指南制定中，我们建议根据 GRADE 方法和针灸治疗的特点探索具体方法。
