摘要
目的分析我国发布的中医临床路径的证据引用情况,为中医临床路径的制订/修订提供参考。方法从国家中医药管理局网站和中华中医药学会网站获取已公开发布的中医临床路径,检索时限截至2019年6月。由2名研究者独立使用Excel标准化表格提取数据,并进行描述性分析。结果共发布中医临床路径405个,病种涉及内、外、妇、儿等科室,其中内科临床路径数量最多(133个)。405个路径均引用了证据,路径引用证据数量最大值为11个,最小值为1个,每个路径引用证据的中位数为3个。90%以上的路径在诊断和疗效评价部分均引用了证据,中、西医治疗部分引用证据的路径占比<75%,其它疗法及康复、护理部分引用证据的路径占比<2%。引用证据类型依次为标准指标(683次)、临床实践指南(488次)、教科书(236次)、共识意见、古籍和临床调研。89.25%的证据报告了发表时间,其中标准指标与路径发布时间间隔最久,在时间间隔大于15年的证据类型中标准指标占比最高(57.12%)。结论已发布的中医临床路径均基于证据制订,但不同部分内容证据引用率差异较大,部分中医临床路径未规范报告引用的证据,部分证据的时效性较差。
Objectives To analyze the citation of evidence in traditional Chinese medicine(TCM) clinical pathways in China, and to provide suggestions for future development and revision of TCM clinical pathways.Methods TCM clinical pathways released on the websites of national administration of TCM and China association of Chinese medicine were obtained, with the retrieval time limit to June 2019. Two researchers separately utilized the Excel to extract data and performed a descriptive analysis. Results A total of 405 TCM clinical pathways were included, involving internal medicine, surgery, gynecology and pediatrics. Internal medicine accounted for the largest proportion of the TCM clinical pathways(133). All the 405 pathways cited references as evidence, among which the maximum and minimum quantities of cited references were 11 and 1, respectively, and the median was 3. More than 90% of the TCM clinical pathways cited the evidence in the parts of diagnosis and efficacy evaluation. For parts of TCM and western medicine treatment, the proportion of TCM clinical pathways which cited evidence was less than 75%;for parts of rehabilitation and nursing, the proportion of TCM clinical pathways which cited evidence was less than 2%. The types of evidence being cited were standard indicators(683), clinical practice guidelines(488), textbooks(236), consensus opinions, ancient books and clinical surveys. The released time was reported in 89.25% of the cited evidence;the largest time interval was between the release time of the standard indicators(evidence) and that of the TCM pathways. Among the evidence released more than 15 years before the release of the TCM pathways, the proportion of standard indicators was the highest(57.12%).Conclusions The published TCM clinical pathways are all developed based on evidence, however, the evidence citation ratio in different parts varies greatly. In some TCM clinical pathways, the cited evidences are not reported normatively, and some evidence are poor in timeliness.
作者
李慧珍
刘美君
梁宁
刘玉祁
刘孟宇
王燕平
史楠楠
LI Huizhen;LIU Meijun;LIANG Ning;LIU Yuqi;LIU Mengyu;WANG Yanping;SHI Nannan(Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing,100700,P.R.China;Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine,Beijing,100700,P.R.China)
出处
《中国循证医学杂志》
CSCD
北大核心
2020年第3期306-310,共5页
Chinese Journal of Evidence-based Medicine
基金
国家中医药管理局课题(编号:GZY-FJS-2017-62,GZYYGJ2019030).
关键词
中医
临床路径
循证医学
证据引用
Traditional Chinese medicine
Clinical pathway
Evidence-based medicine
Citation of evidence
