Thoughts and suggestions on the application of expert evidence in traditional Chinese medicine in clinical practice guidelines_Chinese Journal of Evidence-Based Medicine

Authors：

GAO Yicheng ^1,2,3 , WANG Jianxin ⁴ , SUN Yuanyuan ⁴ , LI Lei ⁵ , WANG Guihua ⁶ , XIA Ruyu ^1,2,3 , LIU Zhihan ^1,2,3 , TAO Liyuan ⁷ , CAO Rui ^1,2,3 , FENG Yuting ^1,2,3 ,  GAO Xuemin ⁸ ,  FEI Yutong ^1,2,3

1. Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, P. R. China;
2. Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, P. R. China;
3. Beijing GRADE Center, Beijing University of Chinese Medicine, Beijing 100029, P. R. China;
4. Standardization Project Office of China Traditional Chinese Medicine Association, Beijing 100061, P. R. China;
5. Research and Development Committee of Western and Chinese Medicine of China Traditional Chinese Medicine Association, Beijing 100061, P. R. China;
6. China Traditional Chinese Medicine Association, Beijing 100061, P. R. China;
7. Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, P. R. China;
8. Beijing University of Chinese Medicine, Beijing 100029, P. R. China;

Corresponding author：

GAO Xuemin, Email: xuemingao2011@163.com; FEI Yutong, Email: yutong_fei@163.com

Keywords：

Expert evidence; Expert opinion; Expert experience; Traditional Chinese medicine; Clinical practice guideline

DOI：

10.7507/1672-2531.202305124

Video：

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In the process of formulation, traditional Chinese medicine clinical practice guidelines are often faced with the dilemma of lack of evidence. Guidelines development groups tend to make final decisions based on expert experience or expert opinion, but the limitations of cognitive bias reduce the credibility and transparency of the guidelines. By clarifying the difference between the expert experience and expert opinion and expert evidence, the expert evidence of traditional Chinese medicine discipline advantages and necessity, providing the recommendation form link using expert evidence methodology design and implementation details, retaining the empirical characteristics of traditional Chinese medicine and improving the lack of evidence, has certain practical application value.

Citation： GAO Yicheng, WANG Jianxin, SUN Yuanyuan, LI Lei, WANG Guihua, XIA Ruyu, LIU Zhihan, TAO Liyuan, CAO Rui, FENG Yuting, GAO Xuemin, FEI Yutong. Thoughts and suggestions on the application of expert evidence in traditional Chinese medicine in clinical practice guidelines. Chinese Journal of Evidence-Based Medicine, 2023, 23(11): 1360-1364. doi: 10.7507/1672-2531.202305124 Copy

1.	Institute of Medicine. Clinical practice guidelines we can trust. Washington (DC): National Academies Press (US), 2011.
2.	陈耀龙, 杨克虎, 王小钦, 等. 中国制订/修订临床诊疗指南的指导原则(2022版). 中华医学杂志, 2022, 102(10): 697-703.
3.	National Institute for Health and Care Excellence (NICE). Developing NICE guidelines, the manual. 2020.
4.	American Academy of Neurology. Clinical practice guideline process manual. 2017.
5.	The American College of Occupational and Environmental Medicine. Practice guidelines methodology. 2017.
6.	Minds Guideline Center, Japan Council for Quality Health Care. Minds handbook for clinical practice guideline development. 2021.
7.	American Society of Clinical Oncology (ASCO). Methodology manual. 2021.
8.	European Society of Human Reproduction and Embryology. Manual for ESHRE guideline development. 2019.
9.	Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.
10.	Murad MH, Chang SM, Fiordalisi CV, et al. Improving the utility of evidence synthesis for decision makers in the face of insufficient evidence. J Clin Epidemiol, 2021, 135: 170-175.
11.	Legault K, Schunemann H, Hillis C, et al. McMaster RARE-Bestpractices clinical practice guideline on diagnosis and management of the catastrophic antiphospholipid syndrome. J Thromb Haemost, 2018, 16(8): 1656-1664.
12.	Pai M, Santesso N, Yeung CH, et al. Methodology for the development of the NHF-McMaster guideline on care models for haemophilia management. Haemophilia, 2016, 22(Suppl 3): 17-22.
13.	Nesrallah GE, Mustafa RA, MacRae J, et al. Canadian Society of Nephrology guidelines for the management of patients with ESRD treated with intensive hemodialysis. Am J Kidney Dis, 2013, 62(1): 187-198.
14.	Schünemann HJ, Zhang Y, Oxman AD, et al. Distinguishing opinion from evidence in guidelines. BMJ, 2019, 366: l4606.
15.	Mustafa RA, Garcia CAC, Bhatt M, et al. GRADE notes: how to use GRADE when there is "no" evidence? A case study of the expert evidence approach. J Clin Epidemiol, 2021, 137: 231-235.
16.	Merriam-Webster. Definition of opinion.
17.	孟醒, 岗卫娟, 修文萃, 等. 基于专家经验的针刺疗效影响因素分析. 中国针灸, 2022, 42(5): 585-589.
18.	徐伟超, 李佃贵, 杜艳茹. 基于当代京津冀名老中医药专家经验的慢性萎缩性胃炎病因病机及证素规律研究. 辽宁中医杂志, 2021, 48(4): 28-31.
19.	《中成药治疗优势病种临床应用指南》标准化项目组. 中成药治疗膝骨关节炎临床应用指南(2020年). 中国中西医结合杂志, 2021, 41(5): 522-533.
20.	梁葆朱, 赵子苇, 穆俊霞. 全国名老中医药专家经验方临床研究类文献常见问题分析. 山西中医药大学学报, 2020, 21(2): 83-86.
21.	陈立柱. 中医专家经验继承方法的拓展. 光明中医, 2015, 4(4): 901-902, 903.
22.	王丽颖. 基于专家经验和临床证据的中成药、西药合用临床实践指南制订的方法学研究. 中国中医科学院中医临床基础医学研究所, 2013.
23.	赵小玲. 武汉市名老中医专家经验传承数据库建设. 武汉市中医医院, 2012.
24.	蔡德英. 名老中医专家经验的撰写要点. 中国中医药信息杂志, 2012, 19(6): 97-97.
25.	Antman EM, Lau J, Kupelnick B, et al. A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts. Treatments for myocardial infarction. JAMA, 1992, 268(2): 240-248.
26.	The Oxford Centre for Evidence-Based Medicine (CEBM). Explanation of the 2011 OCEBM levels of evidence. 2019.
27.	Scottish Intercollegiate Guidelines Network 50: a guideline developer's handbook. 2019.
28.	SUNY Downstate EBM Tutorial. Guide to research methods: the evidence pyramid. 2019.
29.	程勇. 中医流派传承发展面临的问题与思考. 江苏中医药, 2017, 49(2): 69-70.
30.	陈仁寿. 中医流派研究中存在的问题与思考. 南京中医药大学学报(社会科学版), 2016, 17(4): 216-218.
31.	郜峦, 王振国, 张丰聪. 大数据背景下的地域性中医学术流派研究. 世界科学技术-中医药现代化, 2018, 20(1): 32-36.

1. Institute of Medicine. Clinical practice guidelines we can trust. Washington (DC): National Academies Press (US), 2011.
2. 陈耀龙, 杨克虎, 王小钦, 等. 中国制订/修订临床诊疗指南的指导原则(2022版). 中华医学杂志, 2022, 102(10): 697-703.
3. National Institute for Health and Care Excellence (NICE). Developing NICE guidelines, the manual. 2020.
4. American Academy of Neurology. Clinical practice guideline process manual. 2017.
5. The American College of Occupational and Environmental Medicine. Practice guidelines methodology. 2017.
6. Minds Guideline Center, Japan Council for Quality Health Care. Minds handbook for clinical practice guideline development. 2021.
7. American Society of Clinical Oncology (ASCO). Methodology manual. 2021.
8. European Society of Human Reproduction and Embryology. Manual for ESHRE guideline development. 2019.
9. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.
10. Murad MH, Chang SM, Fiordalisi CV, et al. Improving the utility of evidence synthesis for decision makers in the face of insufficient evidence. J Clin Epidemiol, 2021, 135: 170-175.
11. Legault K, Schunemann H, Hillis C, et al. McMaster RARE-Bestpractices clinical practice guideline on diagnosis and management of the catastrophic antiphospholipid syndrome. J Thromb Haemost, 2018, 16(8): 1656-1664.
12. Pai M, Santesso N, Yeung CH, et al. Methodology for the development of the NHF-McMaster guideline on care models for haemophilia management. Haemophilia, 2016, 22(Suppl 3): 17-22.
13. Nesrallah GE, Mustafa RA, MacRae J, et al. Canadian Society of Nephrology guidelines for the management of patients with ESRD treated with intensive hemodialysis. Am J Kidney Dis, 2013, 62(1): 187-198.
14. Schünemann HJ, Zhang Y, Oxman AD, et al. Distinguishing opinion from evidence in guidelines. BMJ, 2019, 366: l4606.
15. Mustafa RA, Garcia CAC, Bhatt M, et al. GRADE notes: how to use GRADE when there is "no" evidence? A case study of the expert evidence approach. J Clin Epidemiol, 2021, 137: 231-235.
16. Merriam-Webster. Definition of opinion.
17. 孟醒, 岗卫娟, 修文萃, 等. 基于专家经验的针刺疗效影响因素分析. 中国针灸, 2022, 42(5): 585-589.
18. 徐伟超, 李佃贵, 杜艳茹. 基于当代京津冀名老中医药专家经验的慢性萎缩性胃炎病因病机及证素规律研究. 辽宁中医杂志, 2021, 48(4): 28-31.
19. 《中成药治疗优势病种临床应用指南》标准化项目组. 中成药治疗膝骨关节炎临床应用指南(2020年). 中国中西医结合杂志, 2021, 41(5): 522-533.
20. 梁葆朱, 赵子苇, 穆俊霞. 全国名老中医药专家经验方临床研究类文献常见问题分析. 山西中医药大学学报, 2020, 21(2): 83-86.
21. 陈立柱. 中医专家经验继承方法的拓展. 光明中医, 2015, 4(4): 901-902, 903.
22. 王丽颖. 基于专家经验和临床证据的中成药、西药合用临床实践指南制订的方法学研究. 中国中医科学院中医临床基础医学研究所, 2013.
23. 赵小玲. 武汉市名老中医专家经验传承数据库建设. 武汉市中医医院, 2012.
24. 蔡德英. 名老中医专家经验的撰写要点. 中国中医药信息杂志, 2012, 19(6): 97-97.
25. Antman EM, Lau J, Kupelnick B, et al. A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts. Treatments for myocardial infarction. JAMA, 1992, 268(2): 240-248.
26. The Oxford Centre for Evidence-Based Medicine (CEBM). Explanation of the 2011 OCEBM levels of evidence. 2019.
27. Scottish Intercollegiate Guidelines Network 50: a guideline developer's handbook. 2019.
28. SUNY Downstate EBM Tutorial. Guide to research methods: the evidence pyramid. 2019.
29. 程勇. 中医流派传承发展面临的问题与思考. 江苏中医药, 2017, 49(2): 69-70.
30. 陈仁寿. 中医流派研究中存在的问题与思考. 南京中医药大学学报(社会科学版), 2016, 17(4): 216-218.
31. 郜峦, 王振国, 张丰聪. 大数据背景下的地域性中医学术流派研究. 世界科学技术-中医药现代化, 2018, 20(1): 32-36.

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