The issue of waste in medical research has been widely concerned in recent years. Research waste is also significant in the field of traditional Chinese medicine (TCM). This study summarized the causes of research waste in TCM and provided suggestions to researchers and administrators for reducing research waste and promoting rational use of medical research resources.
ObjectivesTo evaluate the clinical efficacy of massage in the treatment of primary dysmenorrhea (PD).MethodsCNKI, VIP, WanFang Data, CBM, The Cochrane Library, PubMed and EMbase databases were searched to collect randomized controlled trials (RCTs) on the treatment of primary dysmenorrhea from inception to January 6th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. RevMan 5.3 software was used for meta-analysis.ResultsA total of 10 RCTs were included, including 758 patients with PD. Meta-analysis results showed that the total effective rate (RR=1.14, 95% CI 1.03 to 1.26, P<0.000 01; RR=1.24, 95% CI 1.15 to 1.34, P<0.000 01) and the dysmenorrhea symptom score (MD=–2.59, 95% CI –3.08 to –2.29, P<0.000 1) in massage group were superior to the control group.ConclusionCurrent evidence suggests that massage for PD has certain advantages. However, due to the limited quality of the included studies, high-quality clinical trials are required to further verify the clinical efficacy of massage in the treatment of primary dysmenorrhea.
ObjectivesTo evaluate the methodology quality and report quality of the published systematic reviews/meta-analyses (SRs/MAs) of pediatric tuina domestically and abroad.MethodsCBM, VIP, CNKI, WanFang Data, PubMed, EMbase, and The Cochrane Library were electronically searched to collect published pediatric tuina SRs/MAs from inception to December 10th, 2018. The SRs/MAs which includes scale evaluation used AMSTAR2 and the PRISMA report quality evaluation tool to systematically review methodology, adopts Excel to carry out data collation and statistical analysis. ResultsA total of 18 studies (14 in Chinese and 4 in English) on the SRs/MAs of pediatric tuina were finally included. In terms of methodological quality, 6 studies were of low quality and 12 studies were of very low quality. All studies did not explain the reasons for adopting a particular research design type, and few of them explained the pre-plan, exclusion list, reasons and funding. In terms of report quality, 7 studies were relatively complete, 10 studies had certain defects and one study had serious defects. The existing problems were program and registration, comprehensive retrieval, information sources, financial support and so on. ConclusionsSRs/MAs of pediatric tuina have different degrees of issues in terms of methodological quality and report quality which still require further improvement and continuous strengthening.
ObjectiveTo provide an overview of systematic reviews on the efficacy and safety of massage for the treatment of cervical spondylotic radiculopathy.MethodsCNKI, WanFang Data, VIP, CBM, PubMed, The Cochrane Library and EMbase databases were electronically searched to collect the systematic reviews on the efficacy and safety of massage for the treatment of cervical spondylotic radiculopathy from inception to December 30th, 2018. Two reviewers independently screened the literature and extracted the data, applied the AMSTAR2 scale to evaluate its methodological quality, and GRADE to evaluate the quality of the evidence.ResultsA total of 7 systematic reviews/meta-analysis were included. The AMSTAR2 scale evaluation showed that the quality of the included studies was extremely low. The GRADE evidence grading results showed that the quality of the VAS score outcome index of the two literatures was intermediate, and the quality of the OASCSR outcome index of one literature was intermediate. The quality of the remaining outcome indicators reported is low or very low.ConclusionThe available evidence shows that the efficacy and safety of manual treatment of cervical spondylotic radiculopathy is acceptable, but the overall methodological quality of the systematic review is extremely low, and the quality level of evidence is generally low. The future clinical trials and systematic reviews should be strictly followed. The scientific research design of the medical science provides high-quality evidence and provides reference for clinical practice.
Core Outcome Set (COS) is an important approach to address problems in which the outcomes are inconsistent, non-essential and reporting biased in clinical researches. In order to ensure the standardization of the COS development process, the Core Outcome Measures in Effectiveness Trials (COMET) has initiatively developed the Core Outcome Set-STAndards for Development (COS-STAD). The recommendation includes 11 minimum standards, involving 3 common key domains: the scope, the stakeholders, and the consensus process. The COS-STAD is used by COS developers for standardizing research design, determining the quality of the methodology to develop a COS. Based on the background and conditions of clinical practice and clinical trials in China, especially the characteristics of the development of Core Outcome Set of Traditional Chinese Medicine (TCM-COS), this paper interprets the recommendations of COS-STAD, providing a reference for the potential users of COS in China.
ObjectivesTo investigate the status of clinical trial registrations (CTRs), ethical reviews (ERs) and informed consent forms (ICFs) of randomized controlled trials (RCTs), which were published in the top 20 journals included by Chinese Science Citation Database (CSCD), and evaluate the methodological quality of RCTs.MethodsWe selected top 20 high impact factor Chinese medical journals indexed by CSCD, the RCTs published between 2016 and 2017 were searched. The CTR, ER and ICFs for all RCTs were analyzed.ResultsA total of 395 RCTs were included for data analysis. Nineteen RCTs (4.8%) reported the information of registration. For the 4 traditional Chinese medicine journals, only 4 (1.9%) of 207 RCTs reported the registered information. For the 16 western medical journals, only 15 (8%) of 188 RCTs reported the registered information. There were 185 RCTs (46.8%) which reported the information of ethical review. Among them, 66 RCTs (31.9%) were published in traditional Chinese medical journals and 119 RCTs (63.3%) were published in western medical journals. There were 253 RCTs (64.1%) which reported the information of informed consent. Among them, 154 RCTs (74.4%) were published in Chinese medical journals and 199 RCTs (52.7%) were in western medical journals. In terms of methodology, approximately 299 RCTs (75.7%) reported the type of randomization where 60 RCTs (15.2%) reported the information of allocation concealment and 38 RCTs (59.6%) reported blinding.ConclusionsThe proportion of RCTs registration, ethical review and informed consent is still low and the methodological quality of the studies require to be improved. Therefore, it is necessary to strengthen the training of clinical trial methodology.
To describe the construction and application of clinical evidence database of traditional Chinese medicine (TCM-CED) so as to provide evidence for TCM research. The construction process primarily includes: expert team building, TCM-CED function module design, evidence collection and quality control. The applications of TCM-CED primarily include the following aspects: automatic generation of systematic review/meta-analysis in TCM, automatic generation of evidence reports on dominant diseases of TCM, automatic generation of evidence index of Chinese patent medicine, optimizing the selection of outcomes in TCM research, tracking methodological and reporting quality of TCM research, and promoting international dissemination of TCM evidence. With the rapid development of information technology and artificial intelligence, TCM-CED will be combined with artificial intelligence to achieve the construction of all-dimensional TCM evidence chain and the automation of the whole process.
ObjectiveTo analysis the regularity of prescriptions of Chinese Medicine for syndrome of intense fire and heat (syndrome of Shi-Re-Huo-Du), and to provide evidences for the clinical treatment.MethodsCNKI, Sinomed, WanFang Data, VIP and Chinese medical databases were electronically searched to collect literatures about traditional Chinese Medicine for syndrome of Shi-Re-Huo-Du from inception to October, 2018. Two reviewers independently screened literature and extracted data. Then BICOMS 2 software was used to generate the co-occurrence matrix, NetDraw software was used to draw network maps.ResultsA total of 381 literatures involving 335 patients were included. There were 716 prescriptions of Shi-Re-Huo-Du (390 Chinese medicinal herbs), in which the frequently used herb included radix glycyrrhizae (346), Scutellariae Radix (255), Fructus Gardeniae (241), Rehmanniae Radix (239), Moutan Cortex (218), etc. The classification was performed according to traditional efficacy, Qing-re herbs (73), Bu-xu herbs (47), and Hua-tan-zhi-ke-ping-chuan herbs (39), accounted for 40.77% of the total herbs. The results of the analysis showed that the top herbs in Degree and Betweenness were consistent with high-frequency herbs. Among them, Rehmanniae Radix, Fructus Gardeniae, Scutellariae Radix, Moutan Cortex are the most important traditional Chinese herbs. High-frequency herbs are mainly based on Qing-re herbs, and the highest frequency of the herbs combination is Scutellariae Radix-Fructus Gardeniae.ConclusionAlthough there are kinds of herbs for syndrome of Shi-Re-Huo-Du, the commonly used herbs are relatively concentrated, and there is obvious interaction between high-frequency herbs, which is in line with the principle of compatibility of Chinese medicine. The high-frequency Chinese herbs and herb pairs were main components of the Chinese patent medicines and classic prescription. It reflected the rule of medicine used and essence in the treatment of syndrome of Shi-Re-Huo-Du.
The systematic review/meta-analysis database of traditional Chinese medicine (SMD-TCM) was focused on incubation and application of the secondary research achievement. At present, the establishment of front and back websites, evidence input and evaluation have been completed. In the near future, the automation of overview and the visual presentation of evidence information will be realized, which provides the technical support for integration, analysis and application of evidence in the secondary research of TCM. This paper introduces the construction of SMD-TCM database which includes: requirements of construction, design principles, working process, evidence processing, ensuring quality of data input, data analysis and application, etc.