Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
Evidence-Based Medicine Center, Lanzhou University, Lanzhou, 730000, China.
Chin J Integr Med. 2021 Jan;27(1):54-61. doi: 10.1007/s11655-020-2725-3. Epub 2020 May 22.
To describe and analyze the status quo of cardiovascular clinical practice guidelines or expert consensuses including both Chinese medicine (CM) and integrative medicine, through systematic literatures searching and quality assessment.
Data bases including Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database were searched for published CM or integrative cardiovascular clinical practice guidelines or expert consensuses. The website www. medlive.cn was also retrieved as supplementary. The clinical practice evaluation tool AGREE II was used to assess the quality of included guidelines or consensuses.
A total of 31 relevant clinical practice guidelines or expert consensuses were included, covering diagnosis, treatment, Chinese patent and patient fields. Common cardiovascular diseases like coronary heart diseases, heart failure and arrhythmia were also involved. Through analysis it was found that both the quantity and quality of included guidelines have been improved year by year. A total of 4 evidence-based clinical practice guideline has been found, one of which was a guideline project plan. Except that, the remaining 27 reports were all consensus-based guidelines. The scores of each field, from highest to lowest, were clarity of presentation (58%), scope and purpose (54%), stakeholder involvement (28%), rigor of development (21%), applicability (13%) and editorial independence (8%).
Although clinical practice guidelines in cardiovascular domain of Chinese have gained increasing concern, with both quantity and quality improved, there is still huge gap in methodology and reporting standards between CM guidelines and international ones. On the one hand, it is essential to improve and standardize the methodology of developing CM guidelines. On the other hands, the evaluation system of evidence and recommendation with CM characters should be developed urgently.
通过系统文献检索和质量评估，描述和分析包含中医和整合医学的心血管临床实践指南或专家共识的现状。
检索中国生物医学文献数据库、中国知网、万方数据、中国科技期刊数据库等数据库，查找发表的中医或整合心血管临床实践指南或专家共识。还检索了 www.medlive.cn 网站作为补充。使用 AGREE II 临床实践评估工具评估纳入指南的质量。
共纳入 31 项相关临床实践指南或专家共识，涵盖诊断、治疗、中药和患者领域。常见心血管疾病如冠心病、心力衰竭和心律失常也包括在内。通过分析发现，纳入指南的数量和质量逐年提高。共发现 4 项基于证据的临床实践指南，其中 1 项为指南项目计划。除此之外，其余 27 份报告均为共识指南。各领域得分从高到低依次为表述清晰度（58%）、范围和目的（54%）、利益相关者参与度（28%）、制定严谨性（21%）、适用性（13%）和编辑独立性（8%）。
尽管中医心血管领域的临床实践指南受到越来越多的关注，数量和质量都有所提高，但中医指南与国际指南在方法学和报告标准方面仍存在巨大差距。一方面，有必要改进和规范中医指南的制定方法。另一方面，迫切需要制定具有中医特色的证据和推荐评估体系。
