Institute of Acupuncture-Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China.
Chin J Integr Med. 2023 Dec;29(12):1133-1141. doi: 10.1007/s11655-023-3641-0. Epub 2023 Sep 2.
To analyze the differences in the needs of users and the value orientation of clinical practice guidelines (CPGs) by comparing the contents and formation methods of clinical questions in Chinese and Korean CPGs of acupuncture-moxibustion (Acup-Mox).
The full text of CPGs was systematically searched from the official websites of Chinese and Korean traditional medicine societies and Acup-Mox associations, with the topic "Acup-Mox for treating diseases" and the retrieval time up to September 28, 2022. Two researchers screened the CPGs independently, and extracted the guidelines' topics, content, quantity and formation methods of clinical questions. The quantitative data were collected by counting the frequency, and the qualitative data were classified and described by thematic analysis.
A total of 29 guidelines were included in this study, including 20 Chinese guidelines (305 questions) and 9 Korean guidelines (223 questions). The differences lie in the aspects of content and diversity, and formation method. As for content and diversity, Chinese guidelines focused mainly on the questions related to treatment such as the operation of specific intervention (86, 28.2%), efficacy of intervention (78, 25.6%), and also involving questions in diagnosis, prevention, and prognosis. While the clinical questions in Korean guidelines were concentrated to efficacy of intervention (218, 97.8%). As for formation method, in Chinese guidelines, questions were usually collected directly from clinicians, and then determined and optimized by experts. In Korean guidelines, frequently used clinical Acup-Mox interventions would be screened first. Then the expert group would set up corresponding intervention control measures so as to form clinical questions related to treatment efficacy.
The differences reflect the different needs of clinical practitioners, and the different aims or concepts in developing Acup-Mox guidelines between China and South Korea. Chinese guidelines emphasized promoting operation protocols and techniques of Acup-Mox for practical use, while Korean guidelines emphasized promoting the frequently used clinical intervention therapies. It is speculated that the guidelines from these two countries would play different roles in guiding clinical operation and supporting medical decision. In terms of formation methods of clinical questions, it is suggested to attach importance to optimizing process in formatting clinical questions to improve the clinical applicability of CPGs of Acup-Mox.
通过比较中、韩针灸临床实践指南(CPG)中临床问题的内容和形成方法,分析用户需求和 CPG 实践价值取向的差异。
系统检索中、韩两国传统医学学会和针灸协会官方网站上以“针灸治疗疾病”为主题、检索时间截至 2022 年 9 月 28 日的 CPG 全文。由 2 名研究人员独立筛选指南,提取指南的主题、内容、数量和临床问题形成方法。对定量资料采用频数进行采集,对定性资料采用主题分析法进行分类和描述。
共纳入 29 篇指南,包括中文指南 20 篇(305 个问题)和韩文指南 9 篇(223 个问题)。差异主要体现在内容和多样性以及形成方法上。在内容和多样性方面,中文指南主要聚焦于具体干预操作(86 个,28.2%)、干预疗效(78 个,25.6%)等治疗相关问题,也涉及诊断、预防和预后方面的问题;而韩文指南的临床问题则集中在干预疗效(218 个,97.8%)。在形成方法方面,中文指南通常直接从临床医生收集问题,然后由专家确定和优化;韩文指南则首先筛选出常用的临床针灸干预措施,然后专家组设定相应的干预对照措施,从而形成与治疗疗效相关的临床问题。
差异反映了中、韩两国临床医生的不同需求,以及两国在制定针灸 CPG 方面的不同目标或理念。中文指南强调推广针灸的操作方案和技术,以实际应用为导向;而韩文指南则强调推广常用的临床干预疗法。推测两国的指南在指导临床操作和支持医疗决策方面可能发挥不同的作用。在临床问题形成方法方面,建议重视优化问题格式的过程,以提高针灸 CPG 的临床适用性。