Objective:To explore the application of the Registered Nurses'Association of Ontario(RNAO)Best Practice Guideline(BPG)for Developing and Sustaining Nursing Leadership through the lens of nursing students transitio...Objective:To explore the application of the Registered Nurses'Association of Ontario(RNAO)Best Practice Guideline(BPG)for Developing and Sustaining Nursing Leadership through the lens of nursing students transitioning from classroom learning to clinical practice.Through this reflection,the authors hope to inspire and empower future nursing leaders to champion innovation,resilience,and excellence in healthcare.Methods:By integrating evidence-based leadership principles,the authors reflect on their personal experiences,challenges,and successes in implementing these guidelines in real-world settings.Results:The paper highlights the significance of leadership in fostering healthy work environments and improving patient outcomes,emphasizing the role of nursing students as emerging leaders.Practical strategies for applying BPG,the RNAO BPG suggests leadership skills on professional development,and recommendations for embedding leadership principles into nursing education and practice are discussed.Conclusions:Implementing nursing leadership from the beginning of a nursing student's journey is vital for shaping the next generation of healthcare leaders.By integrating leadership principles early in nursing education,students can develop the skills needed to navigate clinical challenges,collaborate effectively with healthcare teams,and advocate for positive change.Starting with leadership guidelines in nursing school ensures that future nurses are equipped to foster supportive work environments,improve patient outcomes,and drive innovation from the very start of their careers,making leadership an inherent part of their professional identity.展开更多
Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to ...Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.展开更多
Cervical radiculopathy(CR)poses a significant challenge due to its debilitating impact on physical function,daily activities,psychological well-being,and social engagement.Traditional Chinese Medicine(TCM)has emerged ...Cervical radiculopathy(CR)poses a significant challenge due to its debilitating impact on physical function,daily activities,psychological well-being,and social engagement.Traditional Chinese Medicine(TCM)has emerged as a valuable approach in managing CR.This study aims to present a comprehensive clinical practice guideline for the management of CR through TCM.Utilizing internationally recognized guideline standards,we meticulously developed this guideline.The Grading of Recommendations Assessment,Development,and Evaluation approach was employed to rigorously assess evidence quality and recommendation strength.Recommendations were formulated through the nominal group technique.Expert consensus identified nine clinical questions and twenty-three outcome indicators.After careful consideration of evidence quality,balance of benefits and harms,patient preferences,costs,clinical feasibility,accessibility,and clinical acceptability,the guideline working group formulated seventeen recommendations.These recommendations encompass various aspects such as diagnosis,TCM syndrome types,Chinese medicine compounds,Chinese patent medicines,acupuncture,manual therapy,traditional exercise therapy,surgical indications,and preventive measures.The majority of recommendations were weakly suggested or consensus-based,with the exception of acupuncture and manual therapy,which received strong recommendations.This guideline serves as a valuable resource for enhancing clinical decisionmaking and contributing to the comprehensive management of patients with CR.展开更多
Traditional Chinese medicine(TCM)is a well-accepted therapy for atopic dermatitis(AD).However,there are currently no evidence-based guidelines integrating TCM and Western medicine for the treatment of AD,limiting the ...Traditional Chinese medicine(TCM)is a well-accepted therapy for atopic dermatitis(AD).However,there are currently no evidence-based guidelines integrating TCM and Western medicine for the treatment of AD,limiting the clinical application of such combined approaches.Therefore,the China Association of Chinese Medicine initiated the development of the current guideline,focusing on key issues related to the use of TCM in the treatment of AD.This guideline was developed in accordance with the principles of the guideline formulation manual published by the World Health Organization.A comprehensive review of the literature on the combined use of TCM and Western medicine to treat AD was conducted.The findings were extensively discussed by experts in dermatology and pharmacy with expertise in both TCM and Western medicine.This guideline comprises 23 recommendations across seven major areas,including TCM syndrome differentiation and classification of AD,principles and application scenarios of TCM combined with Western medicine for treating AD,outcome indicators for evaluating clinical efficacy of AD treatment,integration of TCM pattern classification and Western medicine across disease stages,daily management of AD,the use of internal TCM therapies and proprietary Chinese medicines,and TCM external treatments.展开更多
On the basis of relevant literature and evidence, Clinical Practice Guidelines of Acupuncture-moxibust^on .for Cervical 5pondyloffc Radiculopathy has been formulated according to the quality of evidences and by adopti...On the basis of relevant literature and evidence, Clinical Practice Guidelines of Acupuncture-moxibust^on .for Cervical 5pondyloffc Radiculopathy has been formulated according to the quality of evidences and by adopting the method of Grades of Recommendations Assessment, Development and Evaluation （GRADE）, in which the objective of guidelines formulation, the scope of application of the guidelines, the principle of acupuncture-moxibustion treatment of cervical spondylotic radiculopathy, the time for intervention and different acupuncture-moxibustion regimens, etc. were specified.展开更多
In 2010, a panel of Chinese pathologists reported the first expert consensus for the pathological diagnosis of primary liver cancers to address the many contradictions and inconsistencies in the pathological character...In 2010, a panel of Chinese pathologists reported the first expert consensus for the pathological diagnosis of primary liver cancers to address the many contradictions and inconsistencies in the pathological characteristics and diagnostic criteria for PLC. Since then considerable clinicopathological studies have been conducted globally, prompting us to update the practice guidelines for the pathological diagnosis of PLC. In April 18, 2014, a Guideline Committee consisting of 40 specialists from seven Chinese Societies(including Chinese Society of Liver Cancer, Chinese Anti-Cancer Association; Liver Cancer Study Group, Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Pathology, Chinese Anti-Cancer Association; Digestive Disease Group, Chinese Society of Pathology, Chinese Medical Association; Chinese Society of Surgery, Chinese Medical Association; Chinese Society of Clinical Oncology, Chinese Anti-Cancer Association; Pathological Group of Hepatobiliary Tumor and Liver Transplantation, Chinese Society of Pathology, Chinese Medical Association) was created for the formulation of the first guidelines for the standardization of the pathological diagnosis of PLC, mainly focusing on the following topics: gross specimen sampling, concepts and diagnostic criteria of small hepatocellular carcinoma(SHCC), microvascular invasion(MVI), satellite nodules,and immunohistochemical and molecular diagnosis. The present updated guidelines are reflective of current clinicopathological studies, and include a novel 7-point baseline sampling protocol, which stipulate that at least four tissue specimens should be sampled at the junction of the tumor and adjacent liver tissues in a 1:1 ratio at the 12, 3, 6 and 9 o'clock reference positions. For the purposes of molecular pathological examination, at least one specimen should be sampled at the intratumoral zone, but more specimens should be sampled for tumors harboring different textures or colors. Specimens should be sampled at both adjacent and distant peritumoral liver tissues or the tumor margin in order to observe MVI, satellite nodules and dysplastic foci/nodules distributed throughout the background liver tissues. Complete sampling of whole SHCC ≤ 3 cm should be performed to assess its biological behavior, and in clinical practice, therapeutic borders should be also preserved, even in SHCC. The diagnostic criteria of MVI and satellite nodules, immunohistochemical panels, as well as molecular diagnostic principles, such as clonal typing, for recurrent HCC and multinodule HCC were also proposed and recommended. The standardized process of pathological examination is aimed at ensuring the accuracy of pathological PLC diagnoses as well as providing a valuable frame of reference for the clinical assessment of tumor invasive potential, the risk of postoperative recurrence, long-term survival, and the development of individualized treatment regimens. The updated guidelines could ensure the accuracy of pathological diagnoses of PLC, and provide a valuable frame of reference for its clinical assessment.展开更多
In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a n...In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.展开更多
Traditional Chinese medicine （TCM） is an important part of the treatment of primary liver cancer （PLC） in China; however, the current instructions for the integrative use of traditional Chinese and Western medicin...Traditional Chinese medicine （TCM） is an important part of the treatment of primary liver cancer （PLC） in China; however, the current instructions for the integrative use of traditional Chinese and Western medicine for PLC are mostly based on expert opinion. There is no evidence-based guideline for clinical prac-tice in this field. Therefore, the Shanghai Association of Chinese Integrative Medicine has established a multidisciplinary working group to develop this guideline, which focuses on the most important questions about the use of TCM during PLC treatment. This guideline was developed following the method- ological process recommended by the World Health Organization Handbook for Guideline Development. Two rounds of questionnaire survey were performed to identify clinical questions; published evidence was searched; the Grading of Recommendations Assessment, Development and Evaluation approach was used to evaluate the body of evidence; and recommendations were formulated by combining the quality of evidence, patient preferences and values, and other risk factors. The guideline was written based on the Reporting Items for Practice Guidelines in Healthcare tool. This guideline contains 10 recommendations related to 8 questions, including recommendations for early treatment by TCM after surgery, TCM combined with transcatheter arterial chemoembolization for advanced PLC, TCM drugs for external use, and acupuncture and moxibustion therapy.展开更多
Polycystic ovary syndrome （PCOS） is the most common metabolic and endocrine disorder in women. However, there is no agreement concerning how to diagnose and treat PCOS worldwide. Three practice guidelines or consens...Polycystic ovary syndrome （PCOS） is the most common metabolic and endocrine disorder in women. However, there is no agreement concerning how to diagnose and treat PCOS worldwide. Three practice guidelines or consensuses, including consensus from the European Society of Human Reproduction and Embryology （ESHRE）/the American Society for Reproductive Medicine （ASRM） in Rotterdam, diagnosis criteria and consensus in China, and clinical practice guideline from the Endocrine Society （ES） in the United States are widely recognized. The present paper may provide some guidance for clinical practice based on a comparative analysis of the above three practice guidelines or consensuses.展开更多
Objective:Formulating critical clinical questions and outcomes is essential for developing clinical practice guidelines(CPGs).This study aims to formulate the key clinical questions and outcomes for the CPG on acupunc...Objective:Formulating critical clinical questions and outcomes is essential for developing clinical practice guidelines(CPGs).This study aims to formulate the key clinical questions and outcomes for the CPG on acupuncture and moxibustion for allergic rhinitis(AR).Methods:PICO(patient,intervention,comparator,and outcome)question survey,Delphi survey,and consensus conference of the guideline development group(GDG)were employed.PICO questionnaires were used to gather and analyze the target users’key demands and interests.The GDG then selected the critical clinical questions and outcomes via a mixed method of Delphi survey and consensus conference.Results:Fifteen potential clinical questions and ten types of outcomes were formulated based on the analysis of 123 responses from seventeen countries on five continents.After two rounds of the Delphi survey and complete discussions,a consensus was reached by the GDG that all potential questions were included.After three rounds of the Delphi survey and complete debate,the consensus was reached that nine outcomes were considered important.Conclusion:Fifteen key clinical questions and nine important outcomes were formulated for the CPG.These covered issues elicited the most attention from global users in acupuncture therapy and AR.The results will contribute to the CPGs development and future clinical studies.展开更多
A systematic review was conducted to identify and qualitatively analyze the methods as well as recommendations of Clinical Practice Guidelines （CPG） and Best Practice Statements （BPS） concerning varicocele in the ...A systematic review was conducted to identify and qualitatively analyze the methods as well as recommendations of Clinical Practice Guidelines （CPG） and Best Practice Statements （BPS） concerning varicocele in the pediatric and adolescent population. An electronic search was performed with the MEDLINE, EMBASE, Science Direct, and Scielo databases, as well as guidelines＇ Web sites until September 2015. Four guidelines were included in the qualitative synthesis. In general, the recommendations provided by the CPG/BPS were consistent despite the existence of some gaps across the studies. The guidelines issued by the American Urological Association （AUA） and American Society for Reproductive Medicine （ASRM） did not provide evidence-based levels for the recommendations given. Most of the recommendations given by the European Association of Urology （EAU） and European Society of Pediatric Urology （ESPU） were derived from nonrandomized clinical trials, retrospective studies, and expert opinion. Among all CPG/BPS, only one was specifically designed for the pediatric population. The studied guidelines did not undertake independent cost-effectiveness and risk-benefit analysis. The main objectives of these guidelines were to translate the best evidence into practice and provide a framework of standardized care while maintaining clinical autonomy and physician judgment. However, the limitations identified in the CPG/BPS for the diagnosis and management of varicocele in children and adolescents indicate ample opportunities for research and future incorporation of higher quality standards in patient care.展开更多
Objective:This study aims to get the medical management of acupuncture and moxibustion in the countries and regions where the society members of World Federation of Acupuncture-Moxibustion Societies(WFAS)are located,i...Objective:This study aims to get the medical management of acupuncture and moxibustion in the countries and regions where the society members of World Federation of Acupuncture-Moxibustion Societies(WFAS)are located,including the educational background of acupuncture and moxibustion practitioners and the local clinical practice of acupuncture and moxibustion,and the demands of the content and evidence types of Clinical Practice Guidelines(CPGs)of acupuncture and moxibustion in accordance with WFAS standards,so as to provide requirements and reference principles for the development of CPGs of acupuncture and moxibustion in accordance with WFAS standards.Methods:The convenient sampling method was used to collect the questionnaires,and the WFAS secretariat distributed the questionnaires to 294 contacts of society members from 70 countries and regions in the form of Questionnaire Star four times in April 2020,July 2020,March 2021,and April 2021 respectively.They were then distributed to individual members of acupuncture-moxibustion societies by the contacts.The study content involved the basic information of respondents,including their nationality,occupation,educational background of acupuncture and moxibustion,their local clinical practice and medical management of acupuncture and moxibustion,as well as their demand for CPGs of acupuncture and moxibustion,etc.After the questionnaires were collected,the data were analyzed and described by quantitative research method.Results:In all,302 respondents from 37 countries of six continents responded.The 302 respondents were members of the WFAS society members.(1)Basic information of respondents.They all had acupuncture and moxibustion learning experience,among which,76.5%(231/302)had the education background of acupuncture and moxibustion professional college training,and 88.4%(267/302)had experience of acupuncture and moxibustion clinical practice.Acupuncturists or traditional Chinese medicine doctors accounted for 63.9%(193/302),western medicine doctors,nurses,and pharmacists accounted for 18.2%(55/302),and researchers and teachers accounted for 6.3%(19/302).(2)Local clinical practice and medical management of acupuncture and moxibustion.The level of clinical practice of acupuncture and moxibustion varies greatly among the regions where the WFAS society members lived.Among them,more countries in Europe have not included acupuncture and moxibustion in medical insurance than those in other continents(x^(2)=26.049,P<0.01),and more countries have not included acupuncture and moxibustion in public hospital treatment system than those in other continents(x^(2)=113.488,P<0.01).(3)Demand for CPGs of acupuncture and moxibustion.A total of 93.0%(281/302)respondents believed that WFAS CPGs of acupuncture and moxibustion would be helpful for their local practice.The order of their demand and concern for WFAS CPGs was:acupuncture manipulation>latest progress of acupuncture treatment>choice of acupuncture therapies>safety of acupuncture and moxibustion>combination of acupuncture and other programs.A total of 87.4%(264/302)respondents believed that ancient classics could guide clinical practice,and the ancient literature should be used as evidence for the development of guidelines.Conclusion:The respondents are those future practitioners of CPGs of acupuncture and moxibustion conforming to WFAS standards.Commonly they have clinical practice experience and professional education background.They believe that guidelines will be of help to the clinical practice of acupuncture and moxibustion,hope that WFAS CPGs would recommend effective guidelines for acupuncture manipulation and provide the latest progress in acupuncture treatment and so on,and they believe that classical ancient books can guide their clinical practice.It indicates the necessity and feasibility of formulating the WFAS CPGs of acupuncture and moxibustion.In view of the results of this study,it is suggested that the formulation process of WFAS CPGs of acupuncture and moxibustion should take into account the clinical practice level of acupuncture and moxibustion in each region,as well as its legislation and management situation of acupuncture and moxibustion,so as to meet the needs of users as much as possible.展开更多
Acupuncture is one of the most effective complementary therapies for allergic rhinitis(AR)and has been recommended by several clinical practice guidelines(CPGs)for AR.However,these CPGs mentioned acupuncture without m...Acupuncture is one of the most effective complementary therapies for allergic rhinitis(AR)and has been recommended by several clinical practice guidelines(CPGs)for AR.However,these CPGs mentioned acupuncture without making recommendations for clinical implementation and therapeutic protocols,therefore limiting the applicability of acupuncture therapies for AR.Hence,for the benefit of acupuncture practitioners around the world,the World Federation of Acupuncture-moxibustion Societies have initiated a project to develop the CPG for the use of acupuncture and moxibustion to treat AR.This CPG was developed according to the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)methodology,referring to the principles of the World Health Organization Handbook for Guideline Development.During the development of the CPG,the guideline development group(GDG)played an important role.The clinical questions,recommendations and therapeutic protocols were all formulated by the GDG using the modified Delphi method.The CPG contains recommendations for 15 clinical questions about the use of acupuncture and moxibustion interventions.These include one strong recommendation for the intervention based on high-quality evidence,three conditional recommendations for either the intervention or standard care,and 11 conditional recommendations for the intervention based on very low quality of evidence.The CPG also provides one filiform needle acupuncture protocol and five moxibustion protocols extracted based on the protocols presented in randomized controlled trials reviewed by the GDG.展开更多
Based on extensive accumulated evidence and using the Grading of Recommendations Assessment, Development and Evaluation（GRADE） system, we have developed clinical practice guidelines for the use of acupuncture to tre...Based on extensive accumulated evidence and using the Grading of Recommendations Assessment, Development and Evaluation（GRADE） system, we have developed clinical practice guidelines for the use of acupuncture to treat low back pain（LBP）. In the guidelines, we considered the objective and scope of this guide, the diagnostic criteria and syndrome differentiation standards of traditional Chinese medicine and western medicine for LBP, the treatment principles of acupuncture, intervention opportunities for acupuncture, and recommendations for use of different acupuncture therapies for acute/subacute and chronic LBP.展开更多
OBJECTIVE:To summarize the evidence from Traditional Chinese Medicine(TCM)practice in the treatment of coronavirus disease 2019(COVID-19)and provide timely clinical practice guidance.METHODS:The guidelines were develo...OBJECTIVE:To summarize the evidence from Traditional Chinese Medicine(TCM)practice in the treatment of coronavirus disease 2019(COVID-19)and provide timely clinical practice guidance.METHODS:The guidelines were developed in accordance with the World Health Organization rapid guideline process.The evidence on TCM for COVID-19 from published guidelines,direct and indirect published clinical evidence,first hand clinical data,and expert experience and consensus were collected.The grading of recommendations assessment,development and evaluation(GRADE)method was used to grade the evidence and make the recommendations.RESULTS:Based on the available evidence,the guidelines recommended 17 Chinese medicines for COVID-19:2 Chinese herbal granules,7 Chinese patent medicines,and 8 Chinese herbal injections.CONCLUSION:As the literature search was conducted on March,any subsequent versions of these guidelines require an up-to-date literature review.We hope that the evidence summary in these guidelines will be helpful in global efforts to address COVID-19.展开更多
Clinical Practice Guideline on Acupuncture and Moxibustion:Nonspecific low back pain was revised and released by the Standards Working Committee of World Federation of Acupuncture-Moxibustion Societies(WFAS)on October...Clinical Practice Guideline on Acupuncture and Moxibustion:Nonspecific low back pain was revised and released by the Standards Working Committee of World Federation of Acupuncture-Moxibustion Societies(WFAS)on October 9,2023.This is the first clinical practice guideline(CPG)on acupuncture and moxibustion for nonspecific low back pain approved by an international academic organization,which provides the evidence-based recommendations and practical therapeutic protocols for international acupuncture practitioners.This CPG was developed by following Grades of Recommendation,Assessment,Development,and Evaluation(GRADE)methodology,and the Principles of the World Health Organization Handbook for Guideline Development.The guideline development group(GDG)from different countries,with different professions,played a critical role in the formulation of clinical questions,recommendations,and therapeutic protocols.Recommendations are the key content of a CPG and the direct answers to clinical questions.Hence,this article focuses on the recommendations of this CPG.The recommendations were formulated using the modified Delphi method and the GRADE grid rules,based on the updated systematic reviews of clinical evidence.A total of seven recommendations for ten clinical questions were formulated in this CPG,including one conditional recommendation for either the intervention or the comparison based on very low quality of evidence,and six conditional recommendations for the intervention based on very low quality of evidence.展开更多
Objectives:To review,evaluate,and synthesize the recommendations of guidelines on preeclampsia(PE)from a nursing perspective.Methods:This is a systematic review of international and national guidelines on PE.Electroni...Objectives:To review,evaluate,and synthesize the recommendations of guidelines on preeclampsia(PE)from a nursing perspective.Methods:This is a systematic review of international and national guidelines on PE.Electronic databases and related guideline websites were searched from 2013 to 2023.After systematic retrieval and screening,we used the AGREE II tool to appraise the methodological quality of guidelines that met the eligibility criteria.Then,we analyzed and summarized the recommendations using descriptive analysis and the framework method.Furthermore,we rated the quality of evidence and the strength of the recommendations using the GRADE approach.Results:Ten guidelines were included,among which eight were deemed“clinically useful”and records were extracted.In total,31 recommendations,including 46 items on the nursing management of PE,were summarized from three aspects:1)antenatal care(18 recommendations),including the assessment and regular monitoring of PE,standardized blood pressure(BP)measurement,prevention education for PE,antihypertensive agent monitoring,and magnesium sulfate(MgSO_(4))use;2)intrapartum care(4 recommendations),including childbirth care;3)postpartum care(9 recommendations),including regular nursing monitoring,breastfeeding care and longer-term health counseling.Most of the evidence was rated as“very low”(19/46)or“moderate”(15/46)quality.For the strength of the recommendations,30 items were graded as“strong”and 16 items were rated as“weak”.Conclusions:This study provides professional,evidence-based nursing care resources both for preservice education for nursing staff and health care education for women with PE to help them detect and treat PE in a timely manner.展开更多
OBJECTIVE: To establish the guidelines on common cold treated with Traditional Chinese Medicine (TCM) in terms of pattern identification. METHODS: The guidelines were formulated by using the basic patterns of common c...OBJECTIVE: To establish the guidelines on common cold treated with Traditional Chinese Medicine (TCM) in terms of pattern identification. METHODS: The guidelines were formulated by using the basic patterns of common cold in ChinaPharmacopeia integrated with findings from systematic literature review and the experts' consensus on the issue in question. RESULTS: Common cold was divided into four patterns in the guidelines. The medications were recommended respectively: Ganmaoqingre granule for wind-cold exterior syndrome,Yinqiaojiedu granule for wind-heat exterior syndrome, Huoxiangzhengqi Wan for summer-heat dampness exterior syndrome and Shensu Wan for wind-cold exterior syndrome accompanied with Qi deficiency. CONCLUSION: The guidelines were primarily derived from the practice experience of TCM and the experts' consensus. The process was not strictly evidence-based because of lacking enough clinical studies. Further refinement of the guidelines should be needed as more studies are available.展开更多
OBJECTIVE:To develop a clinical practice guideline to guide the treatment of low back pain by acupuncture.METHODS:An integrative approach of systematic review of literature,clinical evidence classification,expert opin...OBJECTIVE:To develop a clinical practice guideline to guide the treatment of low back pain by acupuncture.METHODS:An integrative approach of systematic review of literature,clinical evidence classification,expert opinion surveying,and consensus establishing via a Delphi program was utilized during the developing process.Both evidence-based practice standards and the personalized features of acupuncture were taken into considerations.RESULTS:Based on clinical evidence and expert opinions,we developed a clinical practice guideline for the treatment of low back pain with acupuncture.These recommendations have a wide coverage spanning from Western Medicine diagnosis and Traditional Chinese Medicine syndrome differentiation,to acupuncture treatment procedures,as well as post treatment care for rehabilitation and follow-ups.The recommendations for acupuncture practice included treatment principles,therapeutic regimens,and operational procedures.The levels of evidence and strength of recommendation were rated for each procedure of practice.CONCLUSION:A clinical practice guideline for acupuncture treating low back pain was developed based on contemporary clinical evidence and experts'consensus to provide best currently agreeable practice guideline for domestic and international stakeholders.展开更多
Urinary incontinence (UI) is a common problem worldwide.It has a major impact on physical and social activities and interpersonal relationships.UI is common in women,but is under-reported and undertreated.It affects t...Urinary incontinence (UI) is a common problem worldwide.It has a major impact on physical and social activities and interpersonal relationships.UI is common in women,but is under-reported and undertreated.It affects the quality of life of female patients severely.Acupuncture and moxibustion have been proposed as potentially effective interventions for female UI.Hence,for the benefit of acupuncture practitioners around the world,the World Federation of Acupuncture-moxibustion Societies initiated a project to develop a clinical practice guideline (CPG) for the use of acupuncture and moxibustion to treat female UI.This CPG was developed according to the Grading of Recommendations Assessment,Development,and Evaluation (GRADE) methodology,referring to the principles of the World Health Organization Handbook for Guideline Development.During the development of the CPG,the guideline development group (GDG) played an important role.The clinical questions,recommendations and therapeutic protocols were all formulated by GDG using the modified Delphi method.This CPG contains ten recommendations about the use of acupuncture and moxibustion interventions for ten clinical questions,which include nine conditional recommendations for the intervention and one conditional recommendation for either the intervention or the comparison.This CPG also provides one protocol for conventional filiform needle therapy,two therapy protocols for deep needling stimulation on lumbosacral acupoints,and four moxibustion therapy protocols,based on the protocols presented in randomized controlled trials reviewed by the GDG.展开更多
文摘Objective:To explore the application of the Registered Nurses'Association of Ontario(RNAO)Best Practice Guideline(BPG)for Developing and Sustaining Nursing Leadership through the lens of nursing students transitioning from classroom learning to clinical practice.Through this reflection,the authors hope to inspire and empower future nursing leaders to champion innovation,resilience,and excellence in healthcare.Methods:By integrating evidence-based leadership principles,the authors reflect on their personal experiences,challenges,and successes in implementing these guidelines in real-world settings.Results:The paper highlights the significance of leadership in fostering healthy work environments and improving patient outcomes,emphasizing the role of nursing students as emerging leaders.Practical strategies for applying BPG,the RNAO BPG suggests leadership skills on professional development,and recommendations for embedding leadership principles into nursing education and practice are discussed.Conclusions:Implementing nursing leadership from the beginning of a nursing student's journey is vital for shaping the next generation of healthcare leaders.By integrating leadership principles early in nursing education,students can develop the skills needed to navigate clinical challenges,collaborate effectively with healthcare teams,and advocate for positive change.Starting with leadership guidelines in nursing school ensures that future nurses are equipped to foster supportive work environments,improve patient outcomes,and drive innovation from the very start of their careers,making leadership an inherent part of their professional identity.
文摘Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.
基金the National Traditional Chinese Medicine Inheritance and Innovation Team Project:Innovation Team for Traditional Chinese Medicine Prevention and Treatment of Degenerative Bone and Joint Diseases(No.ZYYCXTDC-202003)2022 Young Qihuang Scholars Training Program(The letter of Department of Personnel and Education,National Administration of Traditional Chinese Medicine[2022]No.256)+1 种基金Cross Cooperation Project of Beijing Nova Program of Science and Technology:Research on High-Precision Digital Traditional Chinese Medicine Manipulation Therapy Combining Medicine and Engineering(No.20220484228)Special Project on Evidence-based Clinical Research of Traditional Chinese Medicine in the High-level Traditional Chinese Medicine Hospital Construction Project of Wangjing Hospital,China Academy of Chinese Medical Sciences:Research on the Dose-Effect Regularity of Cervical Rotation Traction Manipulation in Treating Cervical Radiculopathy and Its Mechanism of Regulating Peripheral Muscle-Cerebral Cortex Hemodynamics(No.WJYY-XZKT-2023-05)。
文摘Cervical radiculopathy(CR)poses a significant challenge due to its debilitating impact on physical function,daily activities,psychological well-being,and social engagement.Traditional Chinese Medicine(TCM)has emerged as a valuable approach in managing CR.This study aims to present a comprehensive clinical practice guideline for the management of CR through TCM.Utilizing internationally recognized guideline standards,we meticulously developed this guideline.The Grading of Recommendations Assessment,Development,and Evaluation approach was employed to rigorously assess evidence quality and recommendation strength.Recommendations were formulated through the nominal group technique.Expert consensus identified nine clinical questions and twenty-three outcome indicators.After careful consideration of evidence quality,balance of benefits and harms,patient preferences,costs,clinical feasibility,accessibility,and clinical acceptability,the guideline working group formulated seventeen recommendations.These recommendations encompass various aspects such as diagnosis,TCM syndrome types,Chinese medicine compounds,Chinese patent medicines,acupuncture,manual therapy,traditional exercise therapy,surgical indications,and preventive measures.The majority of recommendations were weakly suggested or consensus-based,with the exception of acupuncture and manual therapy,which received strong recommendations.This guideline serves as a valuable resource for enhancing clinical decisionmaking and contributing to the comprehensive management of patients with CR.
基金Guidelines for the Diagnosis and Treatment of Atopic Dermatitis in Adults with Integrated Traditional Chinese and Western Medicine(No.ZYZB-2023-580)under the High-level Chinese Medicine Key Discipline Construction Project(Integrative Chinese and Western Medicine Clinic)of the National Administration of Traditional Chinese Medicine(No.zyyzdxk-2023065)Support for the Clinical Evidence-Based Capacity Building of High-Level Key Disciplines of Traditional Chinese Medicine in Shanghai in 2024 from the Shanghai Municipal Commission of Science and Technology(No.23Y31920300)the Young Qi Huang Scholar of the National Administration of Traditional Chinese Medicine。
文摘Traditional Chinese medicine(TCM)is a well-accepted therapy for atopic dermatitis(AD).However,there are currently no evidence-based guidelines integrating TCM and Western medicine for the treatment of AD,limiting the clinical application of such combined approaches.Therefore,the China Association of Chinese Medicine initiated the development of the current guideline,focusing on key issues related to the use of TCM in the treatment of AD.This guideline was developed in accordance with the principles of the guideline formulation manual published by the World Health Organization.A comprehensive review of the literature on the combined use of TCM and Western medicine to treat AD was conducted.The findings were extensively discussed by experts in dermatology and pharmacy with expertise in both TCM and Western medicine.This guideline comprises 23 recommendations across seven major areas,including TCM syndrome differentiation and classification of AD,principles and application scenarios of TCM combined with Western medicine for treating AD,outcome indicators for evaluating clinical efficacy of AD treatment,integration of TCM pattern classification and Western medicine across disease stages,daily management of AD,the use of internal TCM therapies and proprietary Chinese medicines,and TCM external treatments.
文摘On the basis of relevant literature and evidence, Clinical Practice Guidelines of Acupuncture-moxibust^on .for Cervical 5pondyloffc Radiculopathy has been formulated according to the quality of evidences and by adopting the method of Grades of Recommendations Assessment, Development and Evaluation （GRADE）, in which the objective of guidelines formulation, the scope of application of the guidelines, the principle of acupuncture-moxibustion treatment of cervical spondylotic radiculopathy, the time for intervention and different acupuncture-moxibustion regimens, etc. were specified.
基金Supported by the Innovative Research Groups of the National Natural Science Foundation of China No.81221061the National Natural Science Foundation of China No.81072026,No.81272662 and No.81472278
文摘In 2010, a panel of Chinese pathologists reported the first expert consensus for the pathological diagnosis of primary liver cancers to address the many contradictions and inconsistencies in the pathological characteristics and diagnostic criteria for PLC. Since then considerable clinicopathological studies have been conducted globally, prompting us to update the practice guidelines for the pathological diagnosis of PLC. In April 18, 2014, a Guideline Committee consisting of 40 specialists from seven Chinese Societies(including Chinese Society of Liver Cancer, Chinese Anti-Cancer Association; Liver Cancer Study Group, Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Pathology, Chinese Anti-Cancer Association; Digestive Disease Group, Chinese Society of Pathology, Chinese Medical Association; Chinese Society of Surgery, Chinese Medical Association; Chinese Society of Clinical Oncology, Chinese Anti-Cancer Association; Pathological Group of Hepatobiliary Tumor and Liver Transplantation, Chinese Society of Pathology, Chinese Medical Association) was created for the formulation of the first guidelines for the standardization of the pathological diagnosis of PLC, mainly focusing on the following topics: gross specimen sampling, concepts and diagnostic criteria of small hepatocellular carcinoma(SHCC), microvascular invasion(MVI), satellite nodules,and immunohistochemical and molecular diagnosis. The present updated guidelines are reflective of current clinicopathological studies, and include a novel 7-point baseline sampling protocol, which stipulate that at least four tissue specimens should be sampled at the junction of the tumor and adjacent liver tissues in a 1:1 ratio at the 12, 3, 6 and 9 o'clock reference positions. For the purposes of molecular pathological examination, at least one specimen should be sampled at the intratumoral zone, but more specimens should be sampled for tumors harboring different textures or colors. Specimens should be sampled at both adjacent and distant peritumoral liver tissues or the tumor margin in order to observe MVI, satellite nodules and dysplastic foci/nodules distributed throughout the background liver tissues. Complete sampling of whole SHCC ≤ 3 cm should be performed to assess its biological behavior, and in clinical practice, therapeutic borders should be also preserved, even in SHCC. The diagnostic criteria of MVI and satellite nodules, immunohistochemical panels, as well as molecular diagnostic principles, such as clonal typing, for recurrent HCC and multinodule HCC were also proposed and recommended. The standardized process of pathological examination is aimed at ensuring the accuracy of pathological PLC diagnoses as well as providing a valuable frame of reference for the clinical assessment of tumor invasive potential, the risk of postoperative recurrence, long-term survival, and the development of individualized treatment regimens. The updated guidelines could ensure the accuracy of pathological diagnoses of PLC, and provide a valuable frame of reference for its clinical assessment.
基金supported(in part)by the Entrusted Project of National Center for Medical Service Administration,National Health and Family Planning Commission China(No.[2019]099)the First Level Funding of the Second Medical Leading Talent Project in Hubei Provincethe Special Project for Emergency of the Ministry of Science and Technology(2020YFC0841300)。
文摘In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.
基金funded by the Shanghai Municipal Commission of Health and Family Planning(Grant Number ZY3-LCPT-2-1004)National Natural Science Foundation of China(Grant Number81503459)E-Institutes of Shanghai Municipal Education Commission(Grant Number E03008)
文摘Traditional Chinese medicine （TCM） is an important part of the treatment of primary liver cancer （PLC） in China; however, the current instructions for the integrative use of traditional Chinese and Western medicine for PLC are mostly based on expert opinion. There is no evidence-based guideline for clinical prac-tice in this field. Therefore, the Shanghai Association of Chinese Integrative Medicine has established a multidisciplinary working group to develop this guideline, which focuses on the most important questions about the use of TCM during PLC treatment. This guideline was developed following the method- ological process recommended by the World Health Organization Handbook for Guideline Development. Two rounds of questionnaire survey were performed to identify clinical questions; published evidence was searched; the Grading of Recommendations Assessment, Development and Evaluation approach was used to evaluate the body of evidence; and recommendations were formulated by combining the quality of evidence, patient preferences and values, and other risk factors. The guideline was written based on the Reporting Items for Practice Guidelines in Healthcare tool. This guideline contains 10 recommendations related to 8 questions, including recommendations for early treatment by TCM after surgery, TCM combined with transcatheter arterial chemoembolization for advanced PLC, TCM drugs for external use, and acupuncture and moxibustion therapy.
基金Project supported by the Zhejiang Province Science Foundation for Distinguished Young Scholars(No.LR16H040001)the National Natural Science Foundation of China(No.81401167)+1 种基金Medical and Health General Project of Zhejiang Province,China(No.2015KYA122)the Zhejiang Traditional Chinese Medicine Foundation(Nos.2017ZQ020 and 2017ZA091),China
文摘Polycystic ovary syndrome （PCOS） is the most common metabolic and endocrine disorder in women. However, there is no agreement concerning how to diagnose and treat PCOS worldwide. Three practice guidelines or consensuses, including consensus from the European Society of Human Reproduction and Embryology （ESHRE）/the American Society for Reproductive Medicine （ASRM） in Rotterdam, diagnosis criteria and consensus in China, and clinical practice guideline from the Endocrine Society （ES） in the United States are widely recognized. The present paper may provide some guidance for clinical practice based on a comparative analysis of the above three practice guidelines or consensuses.
基金Supported by the National Key R&D Program of China:2019YFC1712200。
文摘Objective:Formulating critical clinical questions and outcomes is essential for developing clinical practice guidelines(CPGs).This study aims to formulate the key clinical questions and outcomes for the CPG on acupuncture and moxibustion for allergic rhinitis(AR).Methods:PICO(patient,intervention,comparator,and outcome)question survey,Delphi survey,and consensus conference of the guideline development group(GDG)were employed.PICO questionnaires were used to gather and analyze the target users’key demands and interests.The GDG then selected the critical clinical questions and outcomes via a mixed method of Delphi survey and consensus conference.Results:Fifteen potential clinical questions and ten types of outcomes were formulated based on the analysis of 123 responses from seventeen countries on five continents.After two rounds of the Delphi survey and complete discussions,a consensus was reached by the GDG that all potential questions were included.After three rounds of the Delphi survey and complete debate,the consensus was reached that nine outcomes were considered important.Conclusion:Fifteen key clinical questions and nine important outcomes were formulated for the CPG.These covered issues elicited the most attention from global users in acupuncture therapy and AR.The results will contribute to the CPGs development and future clinical studies.
文摘A systematic review was conducted to identify and qualitatively analyze the methods as well as recommendations of Clinical Practice Guidelines （CPG） and Best Practice Statements （BPS） concerning varicocele in the pediatric and adolescent population. An electronic search was performed with the MEDLINE, EMBASE, Science Direct, and Scielo databases, as well as guidelines＇ Web sites until September 2015. Four guidelines were included in the qualitative synthesis. In general, the recommendations provided by the CPG/BPS were consistent despite the existence of some gaps across the studies. The guidelines issued by the American Urological Association （AUA） and American Society for Reproductive Medicine （ASRM） did not provide evidence-based levels for the recommendations given. Most of the recommendations given by the European Association of Urology （EAU） and European Society of Pediatric Urology （ESPU） were derived from nonrandomized clinical trials, retrospective studies, and expert opinion. Among all CPG/BPS, only one was specifically designed for the pediatric population. The studied guidelines did not undertake independent cost-effectiveness and risk-benefit analysis. The main objectives of these guidelines were to translate the best evidence into practice and provide a framework of standardized care while maintaining clinical autonomy and physician judgment. However, the limitations identified in the CPG/BPS for the diagnosis and management of varicocele in children and adolescents indicate ample opportunities for research and future incorporation of higher quality standards in patient care.
基金Supported by National Key R&D Program of China:No.2019YFC1712200,No.2019YFC1712201。
文摘Objective:This study aims to get the medical management of acupuncture and moxibustion in the countries and regions where the society members of World Federation of Acupuncture-Moxibustion Societies(WFAS)are located,including the educational background of acupuncture and moxibustion practitioners and the local clinical practice of acupuncture and moxibustion,and the demands of the content and evidence types of Clinical Practice Guidelines(CPGs)of acupuncture and moxibustion in accordance with WFAS standards,so as to provide requirements and reference principles for the development of CPGs of acupuncture and moxibustion in accordance with WFAS standards.Methods:The convenient sampling method was used to collect the questionnaires,and the WFAS secretariat distributed the questionnaires to 294 contacts of society members from 70 countries and regions in the form of Questionnaire Star four times in April 2020,July 2020,March 2021,and April 2021 respectively.They were then distributed to individual members of acupuncture-moxibustion societies by the contacts.The study content involved the basic information of respondents,including their nationality,occupation,educational background of acupuncture and moxibustion,their local clinical practice and medical management of acupuncture and moxibustion,as well as their demand for CPGs of acupuncture and moxibustion,etc.After the questionnaires were collected,the data were analyzed and described by quantitative research method.Results:In all,302 respondents from 37 countries of six continents responded.The 302 respondents were members of the WFAS society members.(1)Basic information of respondents.They all had acupuncture and moxibustion learning experience,among which,76.5%(231/302)had the education background of acupuncture and moxibustion professional college training,and 88.4%(267/302)had experience of acupuncture and moxibustion clinical practice.Acupuncturists or traditional Chinese medicine doctors accounted for 63.9%(193/302),western medicine doctors,nurses,and pharmacists accounted for 18.2%(55/302),and researchers and teachers accounted for 6.3%(19/302).(2)Local clinical practice and medical management of acupuncture and moxibustion.The level of clinical practice of acupuncture and moxibustion varies greatly among the regions where the WFAS society members lived.Among them,more countries in Europe have not included acupuncture and moxibustion in medical insurance than those in other continents(x^(2)=26.049,P<0.01),and more countries have not included acupuncture and moxibustion in public hospital treatment system than those in other continents(x^(2)=113.488,P<0.01).(3)Demand for CPGs of acupuncture and moxibustion.A total of 93.0%(281/302)respondents believed that WFAS CPGs of acupuncture and moxibustion would be helpful for their local practice.The order of their demand and concern for WFAS CPGs was:acupuncture manipulation>latest progress of acupuncture treatment>choice of acupuncture therapies>safety of acupuncture and moxibustion>combination of acupuncture and other programs.A total of 87.4%(264/302)respondents believed that ancient classics could guide clinical practice,and the ancient literature should be used as evidence for the development of guidelines.Conclusion:The respondents are those future practitioners of CPGs of acupuncture and moxibustion conforming to WFAS standards.Commonly they have clinical practice experience and professional education background.They believe that guidelines will be of help to the clinical practice of acupuncture and moxibustion,hope that WFAS CPGs would recommend effective guidelines for acupuncture manipulation and provide the latest progress in acupuncture treatment and so on,and they believe that classical ancient books can guide their clinical practice.It indicates the necessity and feasibility of formulating the WFAS CPGs of acupuncture and moxibustion.In view of the results of this study,it is suggested that the formulation process of WFAS CPGs of acupuncture and moxibustion should take into account the clinical practice level of acupuncture and moxibustion in each region,as well as its legislation and management situation of acupuncture and moxibustion,so as to meet the needs of users as much as possible.
基金financially funded by the National Key Research and Development Program of China(No.2019YFC1712200 and2019YFC1712203)。
文摘Acupuncture is one of the most effective complementary therapies for allergic rhinitis(AR)and has been recommended by several clinical practice guidelines(CPGs)for AR.However,these CPGs mentioned acupuncture without making recommendations for clinical implementation and therapeutic protocols,therefore limiting the applicability of acupuncture therapies for AR.Hence,for the benefit of acupuncture practitioners around the world,the World Federation of Acupuncture-moxibustion Societies have initiated a project to develop the CPG for the use of acupuncture and moxibustion to treat AR.This CPG was developed according to the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)methodology,referring to the principles of the World Health Organization Handbook for Guideline Development.During the development of the CPG,the guideline development group(GDG)played an important role.The clinical questions,recommendations and therapeutic protocols were all formulated by the GDG using the modified Delphi method.The CPG contains recommendations for 15 clinical questions about the use of acupuncture and moxibustion interventions.These include one strong recommendation for the intervention based on high-quality evidence,three conditional recommendations for either the intervention or standard care,and 11 conditional recommendations for the intervention based on very low quality of evidence.The CPG also provides one filiform needle acupuncture protocol and five moxibustion protocols extracted based on the protocols presented in randomized controlled trials reviewed by the GDG.
文摘Based on extensive accumulated evidence and using the Grading of Recommendations Assessment, Development and Evaluation（GRADE） system, we have developed clinical practice guidelines for the use of acupuncture to treat low back pain（LBP）. In the guidelines, we considered the objective and scope of this guide, the diagnostic criteria and syndrome differentiation standards of traditional Chinese medicine and western medicine for LBP, the treatment principles of acupuncture, intervention opportunities for acupuncture, and recommendations for use of different acupuncture therapies for acute/subacute and chronic LBP.
基金Supported by National Key Research&Development Program of China Research on the Development and Evaluation of International Standards of Traditional Chinese Medicine(No.2019YFC17120002019YFC1712005+2 种基金2019YFC1712003)National Science and Technology Major Project"The Belt and Road"Popularization and Application of Traditional Chinese Medicine Clinical Diagnosis and Treatment Project for Infectious Diseases(No.2018ZX10101001-005-0032018ZX10101001-005-004)。
文摘OBJECTIVE:To summarize the evidence from Traditional Chinese Medicine(TCM)practice in the treatment of coronavirus disease 2019(COVID-19)and provide timely clinical practice guidance.METHODS:The guidelines were developed in accordance with the World Health Organization rapid guideline process.The evidence on TCM for COVID-19 from published guidelines,direct and indirect published clinical evidence,first hand clinical data,and expert experience and consensus were collected.The grading of recommendations assessment,development and evaluation(GRADE)method was used to grade the evidence and make the recommendations.RESULTS:Based on the available evidence,the guidelines recommended 17 Chinese medicines for COVID-19:2 Chinese herbal granules,7 Chinese patent medicines,and 8 Chinese herbal injections.CONCLUSION:As the literature search was conducted on March,any subsequent versions of these guidelines require an up-to-date literature review.We hope that the evidence summary in these guidelines will be helpful in global efforts to address COVID-19.
基金Supported by the National Key Research and Development Program of China:2019YFC1712200,2019YFC1712203。
文摘Clinical Practice Guideline on Acupuncture and Moxibustion:Nonspecific low back pain was revised and released by the Standards Working Committee of World Federation of Acupuncture-Moxibustion Societies(WFAS)on October 9,2023.This is the first clinical practice guideline(CPG)on acupuncture and moxibustion for nonspecific low back pain approved by an international academic organization,which provides the evidence-based recommendations and practical therapeutic protocols for international acupuncture practitioners.This CPG was developed by following Grades of Recommendation,Assessment,Development,and Evaluation(GRADE)methodology,and the Principles of the World Health Organization Handbook for Guideline Development.The guideline development group(GDG)from different countries,with different professions,played a critical role in the formulation of clinical questions,recommendations,and therapeutic protocols.Recommendations are the key content of a CPG and the direct answers to clinical questions.Hence,this article focuses on the recommendations of this CPG.The recommendations were formulated using the modified Delphi method and the GRADE grid rules,based on the updated systematic reviews of clinical evidence.A total of seven recommendations for ten clinical questions were formulated in this CPG,including one conditional recommendation for either the intervention or the comparison based on very low quality of evidence,and six conditional recommendations for the intervention based on very low quality of evidence.
文摘Objectives:To review,evaluate,and synthesize the recommendations of guidelines on preeclampsia(PE)from a nursing perspective.Methods:This is a systematic review of international and national guidelines on PE.Electronic databases and related guideline websites were searched from 2013 to 2023.After systematic retrieval and screening,we used the AGREE II tool to appraise the methodological quality of guidelines that met the eligibility criteria.Then,we analyzed and summarized the recommendations using descriptive analysis and the framework method.Furthermore,we rated the quality of evidence and the strength of the recommendations using the GRADE approach.Results:Ten guidelines were included,among which eight were deemed“clinically useful”and records were extracted.In total,31 recommendations,including 46 items on the nursing management of PE,were summarized from three aspects:1)antenatal care(18 recommendations),including the assessment and regular monitoring of PE,standardized blood pressure(BP)measurement,prevention education for PE,antihypertensive agent monitoring,and magnesium sulfate(MgSO_(4))use;2)intrapartum care(4 recommendations),including childbirth care;3)postpartum care(9 recommendations),including regular nursing monitoring,breastfeeding care and longer-term health counseling.Most of the evidence was rated as“very low”(19/46)or“moderate”(15/46)quality.For the strength of the recommendations,30 items were graded as“strong”and 16 items were rated as“weak”.Conclusions:This study provides professional,evidence-based nursing care resources both for preservice education for nursing staff and health care education for women with PE to help them detect and treat PE in a timely manner.
基金Supported by West Pacific and Asian Region, WHO and China Academy of Chinese Medical Sciences the Innovative Team Project of Beijing University of Chinese Medicine(2011-CXTD-08)
文摘OBJECTIVE: To establish the guidelines on common cold treated with Traditional Chinese Medicine (TCM) in terms of pattern identification. METHODS: The guidelines were formulated by using the basic patterns of common cold in ChinaPharmacopeia integrated with findings from systematic literature review and the experts' consensus on the issue in question. RESULTS: Common cold was divided into four patterns in the guidelines. The medications were recommended respectively: Ganmaoqingre granule for wind-cold exterior syndrome,Yinqiaojiedu granule for wind-heat exterior syndrome, Huoxiangzhengqi Wan for summer-heat dampness exterior syndrome and Shensu Wan for wind-cold exterior syndrome accompanied with Qi deficiency. CONCLUSION: The guidelines were primarily derived from the practice experience of TCM and the experts' consensus. The process was not strictly evidence-based because of lacking enough clinical studies. Further refinement of the guidelines should be needed as more studies are available.
基金Supported by Hong Kong Hospital Authority-funded Project:Development of Chinese Medicine Acupuncture Clinical Practice Guideline(CPG)in Low Back Pain(HA105/48 PT 19(2013/14))National Center for Complementary and Integrative Health,National Institutes of Health(NIH NCCIH)-funded Project:“Cochrane Complementary Medicine Field:Resource for Research(R24 AT001293-02)。
文摘OBJECTIVE:To develop a clinical practice guideline to guide the treatment of low back pain by acupuncture.METHODS:An integrative approach of systematic review of literature,clinical evidence classification,expert opinion surveying,and consensus establishing via a Delphi program was utilized during the developing process.Both evidence-based practice standards and the personalized features of acupuncture were taken into considerations.RESULTS:Based on clinical evidence and expert opinions,we developed a clinical practice guideline for the treatment of low back pain with acupuncture.These recommendations have a wide coverage spanning from Western Medicine diagnosis and Traditional Chinese Medicine syndrome differentiation,to acupuncture treatment procedures,as well as post treatment care for rehabilitation and follow-ups.The recommendations for acupuncture practice included treatment principles,therapeutic regimens,and operational procedures.The levels of evidence and strength of recommendation were rated for each procedure of practice.CONCLUSION:A clinical practice guideline for acupuncture treating low back pain was developed based on contemporary clinical evidence and experts'consensus to provide best currently agreeable practice guideline for domestic and international stakeholders.
基金funded by the National Key Research and Development Program of China (No.2019YFC1712200)。
文摘Urinary incontinence (UI) is a common problem worldwide.It has a major impact on physical and social activities and interpersonal relationships.UI is common in women,but is under-reported and undertreated.It affects the quality of life of female patients severely.Acupuncture and moxibustion have been proposed as potentially effective interventions for female UI.Hence,for the benefit of acupuncture practitioners around the world,the World Federation of Acupuncture-moxibustion Societies initiated a project to develop a clinical practice guideline (CPG) for the use of acupuncture and moxibustion to treat female UI.This CPG was developed according to the Grading of Recommendations Assessment,Development,and Evaluation (GRADE) methodology,referring to the principles of the World Health Organization Handbook for Guideline Development.During the development of the CPG,the guideline development group (GDG) played an important role.The clinical questions,recommendations and therapeutic protocols were all formulated by GDG using the modified Delphi method.This CPG contains ten recommendations about the use of acupuncture and moxibustion interventions for ten clinical questions,which include nine conditional recommendations for the intervention and one conditional recommendation for either the intervention or the comparison.This CPG also provides one protocol for conventional filiform needle therapy,two therapy protocols for deep needling stimulation on lumbosacral acupoints,and four moxibustion therapy protocols,based on the protocols presented in randomized controlled trials reviewed by the GDG.
