School of Chinese Medicine
Appraisal of clinical practice guidelines for the management of rheumatoid arthritis in traditional Chinese medicine using the AGREE II instrument: A systematic review
An increasing number of clinical practice guidelines (CPGs) in traditional Chinese medicine (TCM) for rheumatoid arthritis (RA) have been issued, and all have been developed in China but their quality is unclear. This study aimed to systematically review the quality and consistency of recommendations on the TCM CPGs for RA in China using the AGREE II instrument.
TCM CPGs identified from five electronic databases and hand searches through related handbooks published between January 1990 and December 2012. The CPG were categorized into Evidence Based (EB) guideline, Consensus Based with no explicit consideration of Evidence Based (CB–EB) guideline and Consensus Based (CB) guideline according to the method reported previously. Four reviewers independently appraised the CPGs based on the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument, and compared the recommendation on TCM pattern (Zheng) classification and treatment.
Five TCM CPGs satisfied the inclusion criteria. The quality score of EB guideline was higher than CB–EB and CB guidelines. Five TCM patterns in the CPGs were recommended in the EB CPG. The herbal preparations including Tripterygium wilfordiirecommended in the EB CPG were mostly recommended for RA treatment. The recommendations on non-drug management in the CPGs were fairly consistent, and the recommendations are different based on the different TCM patterns accordingly.
EB CPG for RA treatment in TCM show higher quality with measurement of AGREE II instrument, and it suggested that TCM CPG could be better developed with clinical evidence.
AGREE II, Clinical practice guideline, Rheumatoid arthritis, Systematic review, Traditional Chinese medicine
Source Publication Title
European Journal of Integrative Medicine
Copyright © 2014 Elsevier GmbH. All rights reserved.
This research was supported by projects from the State Administration of Traditional Chinese Medicine (No. ZYYS-2011-2), and from the China Academy of Chinese Medical Sciences (Nos. Z0135, Z0260), and from the Hong Kong Hospital Authority.
Link to Publisher's Edition
Yuwen, Ya, Xuejie Han, Nannan Shi, Liying Wang, Xing Liao, Lidan Zhong, Zhaoxiang Bian, and Aiping Lu. "Appraisal of clinical practice guidelines for the management of rheumatoid arthritis in traditional Chinese medicine using the AGREE II instrument: A systematic review." European Journal of Integrative Medicine 6.2 (2014): 176-185.