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基于卫生技术评估建立中成药综合临床评价方法的研究

[Study on establishing a methodology of comprehensive clinical evaluation for Chinese patent medicine based on health technology assessment].

作者信息

Liao Xing, Guo Wu-Dong, Cao Zhuang, Xu Hai-Yu, Zhang Yun-Ling, Zhao Hui, Wang Yong-Yan

机构信息

Center for Evidence Based Chinese Medicine,Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences Beijing 100700,China.

Division of Appraisal and Transformation,Department of Health Technology Assessment,China National Health Development Research Center,National Health Commission Beijing 100037,China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2020 Aug;45(16):3749-3758. doi: 10.19540/j.cnki.cjcmm.20200624.501.

Abstract

At present, most of Chinese patent medicines have problems, such as weak scientific basis, unclear clinical value evaluation, etc., which lead to the lack of sufficient evidence for the entry into the essential medicine list, medical insurance catalog and other important health resource allocation tools. This has a negative impact on the development of traditional Chinese medicine. It is urgent to establish a comprehensive evaluation methodology system of Chinese patent medicine in China. There are at least three reasons including producing evidence for clinical rational use scientifically, developing an objective and transparent selecting strategy, eventuating and highlighting its clinical value. The process and method of health technology assessment(HTA) can provide reference for the establishment of comprehensive evaluation method of Chinese patent medicine. However, HTA is rarely carried out in the field of traditional Chinese medicine. The latest domestic and international research showed that HTA combined with multi-criteria decision analysis(MCDA) can increase the transparency of decision-making and improve the quality of decision-making. The combined two formed the EVIDEM framework, which is conducive to drug selection and its clinical use. In this paper, the EVIDEM framework was introduced to establish the methodology framework of the comprehensive clinical evaluation system of Chinese patent medicine. A preliminary research idea has been put forward. In the future, we can establish a set of comprehensive clinical evaluation methods for Chinese patent medicine in cooperation with relevant national drug decision-making departments and management departments. It is believed that such cooperation could promote the full implementation of the re-evaluation for Chinese patent medicine.

摘要

目前,大多数中成药存在科学依据薄弱、临床价值评估不明确等问题,导致其进入基本药物目录、医保目录等重要卫生资源配置工具缺乏充分证据。这对中医药的发展产生了负面影响。在中国,迫切需要建立一套中成药综合评价方法体系。至少有三个原因,包括科学地为临床合理用药提供证据、制定客观透明的遴选策略、彰显并突出其临床价值。卫生技术评估(HTA)的流程和方法可为建立中成药综合评价方法提供参考。然而,HTA在中医药领域很少开展。国内外最新研究表明,HTA与多标准决策分析(MCDA)相结合可以提高决策透明度,提升决策质量。两者结合形成了EVIDEM框架,有利于药物遴选及其临床应用。本文引入EVIDEM框架,建立中成药综合临床评价体系的方法框架,并提出了初步的研究思路。未来,我们可以与国家相关药品决策部门和管理部门合作,建立一套针对中成药的综合临床评价方法。相信这样的合作能够推动中成药再评价工作的全面实施。

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