Science & Technology Review >

2024 , Vol. 42 >Issue 21: 20 - 38

DOI: https://doi.org/10.3981/j.issn.1000-7857.2024.05.00465

Exclusive: The paradigm and application of clinical research in traditional Chinese medicine

Construction of clinical practice guidelines for TCM intervention in coronary heart disease and analysis of real world evidence application status

  • WANG Kewen ,
  • LUO Wenye ,
  • ZHANG Jing ,
  • HAO Xiuwei ,
  • KONG Dezhao
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  • 1. The First Clinical College of Liaoning University of Traditional Chinese Medicine, Shenyang 110000, China;
    2. Peking University First Hospital, Beijing 100034, China

Received date: 2024-06-20

  Revised date: 2024-11-07

  Online published: 2024-12-14

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Abstract

In order to facilitate clinicians to make faster choices from many clinical guidelines, this paper evaluates the quality of clinical guidelines on Chinese medicine interventions for coronary heart disease using AGREE II and RIGHT reporting standards, and summarises their diagnostic and therapeutic opinions.It also assesses the role played by real world studies in the guidelines for TCM intervention in coronary heart disease and evaluates the quality of real world studies on TCM intervention in coronary heart disease.The results show that of the 10 guidelines included, 8 are evaluated as grade B and 2 as grade C.After summarizing the diagnostic and therapeutic opinions it is found that coronary heart disease is classified into different types of evidence in different guidelines, and the classification criteria have not yet been unified, among which the probabilities of cardioblood stasis and obstruction, qi and yin deficiency, cardio-kidney and yang deficiency, qi and blood stasis and qi and blood stasis are higher, and all of them are recommended in 5 or more guidelines.The recommended GRADE levels for herbal medicines are B, C and D.The former studies on which these guidelines were based were randomized controlled trials, systematic reviews, or expert consensus, and there were no real world studies as the source of evidence, and the evidence-based evidence of the characteristics of TCM was insufficiently reflected.Therefore, this study proposes the following recommendations for the development of guidelines on coronary heart disease in TCM.In the future, emphasis should be placed on constructing guideline evaluation tools that are consistent with the characteristics of TCM, standardising the process of guideline or consensus development, carrying out high-level, high-quality prospective studies, and considering controlling for the effects of bias, confounders, uncertainties, limitations and other influences on the quality of real world studies, in order to obtain high-quality real world research evidence with better quality, higher level of evidence, and more precise and reliable efficacy, focusing on the application of high-quality real world evidence, and also focusing on the promotion of its application, in order to better improve the clinical outcomes of patients with coronary heart disease, enhance clinical efficacy, and promote the long term development of Chinese medicine.

Key words： traditional Chinese medicine; coronary heart disease; clinical practice guidelines; real world study; recommendations

Cite this article

WANG Kewen , LUO Wenye , ZHANG Jing , HAO Xiuwei , KONG Dezhao . Construction of clinical practice guidelines for TCM intervention in coronary heart disease and analysis of real world evidence application status[J]. Science & Technology Review, 2024 , 42(21) : 20 -38 . DOI: 10.3981/j.issn.1000-7857.2024.05.00465

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