Details

Autor(en) / Beteiligte

• Fu, Qin-Wei
• Liu, Yang
• Chen, Shu-Cheng
• Zhang, Lan-Zhi
• Liu, Wei-Ting
• Liu, Zhi-Qing
• Liu, Ying
• Xie, Yan
• Fu, Li
• Liu, Min
• Zhang, Da-Zheng
• Yang, Sha-Sha
• Zhang, Fu-Bin
• Huang, He-Yin
• Zhong, Juan
• Pang, Kai-Yun
• Chen, Yong-Na
• Yang, Ye-Peng
• Dai, Meng-Lin
• Liu, Shu-Yun
• Zhang, Shi-Peng
• Xiang, Feng
• Tang, Mi
• Li, Pei-Jia
• Fang, Cai-Shan
• Zhang, Qin-Xiu
• Yeung, Wing-Fai
• Li, Xin-Rong

Titel

Extending the Grading of Recommendations Assessment, Development and Evaluation (GRADE) in Traditional Chinese Medicine (TCM): The GRADE-TCM

Ist Teil von

• Phytomedicine (Stuttgart), 2024-05, Vol.127, p.155487, Article 155487

Ort / Verlag

Germany: Elsevier GmbH

Erscheinungsjahr

2024

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• To extend and form the “Grading of Recommendations Assessment, Development and Evaluation in Traditional Chinese Medicine” (GRADE-TCM). Methodologies were systematically reviewed and analyzed concerning evidence-based TCM guidelines worldwide. A survey questionnaire was developed based on the literature review and open-end expert interviews. Then, we performed expert consensus, discussion meeting, opinion collection, external examination, and the GRADE-TCM was formed eventually. 265 Chinese and English TCM guidelines were included and analyzed. Five experts completed the open-end interviews. Ten methodological entries were summarized, screened and selected. One round of consensus was conducted, including a total of 22 experts and 220 valid questionnaire entries, concerning 1) selection of the GRADE, 2) GRADE-TCM upgrading criteria, 3) GRADE-TCM evaluation standard, 4) principles of consensus and recommendation, and 5) presentation of the GRADE-TCM and recommendation. Finally, consensus was reached on the above 10 entries, and the results were of high importance (with voting percentages ranging from 50 % to 81.82 % for “very important” rating) and strong reliability (with the Cr ranging from 0.93 to 0.99). Expert discussion meeting (with 40 experts), opinion collection (in two online platforms) and external examination (with 14 third-party experts) were conducted, and the GRADE-TCM was established eventually. GRADE-TCM provides a new extended evidence-based evaluation standard for TCM guidelines. In GRADE-TCM, international evidence-based norms, characteristics of TCM intervention, and inheritance of TCM culture were combined organically and followed. This is helpful for localization of the GRADE in TCM and internationalization of TCM guidelines. RCT: Randomized controlled trial; SRMA: Systematic review and meta-analysis; GRADE: Grading of Recommendations Assessment, Development and Evaluation; TCM: Traditional Chinese medicine. A, B, C, and D level: The initial GRADE ratings; AU, BU, CU, DU and E level: The updated GRADE-TCM ratings. In summary, this graphic abstract showed the research processes and key methodology of the GRADE-TCM, which was extended and formed in this study. In brief, the upper part of the graph presents the six steps about how the GRADE-TCM was initiated, innovated, extended, formed, validated and examined. In the lower left part of the graph, the smaller triangle shows the four initial GRADE ratings, including “high”, “moderate”, “low” and “very low”. In the GRADE, applicable types of inclusions for SRMA are RCT and observational study. However, in the GRADE-TCM, observational study is restricted for direct inclusion temporarily, and only RCTs are eligible for SRMA and the initial GRADE ratings. Then, the column lists the GRADE-TCM upgrading criteria, which are also significant sources of supplemented evidence in TCM. Based on this, the lower middle part displays the modular and threshold evaluation standard extends from the GRADE. The higher the initial GRADE ratings are, the more the GRADE-TCM upgrading criteria needed to meet at once. In addition, up to one level could be updated. The lower right part shows basic logics of upgrading or not in the GRADE-TCM, together with advantages and characteristics of the GRADE-TCM. Overall, based on RCTs, the GRADE-TCM extended from the GRADE, and shaped a pyramid-like upgraded ratings. [Display omitted]