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Article ; Online: GRADE Methods in traditional medicine

Jian-Ping Liu

Integrative Medicine Research, Vol 11, Iss 2, Pp 100836- (2022)

2022

Abstract: The GRADE (Grading of Recommendation, Assessment, Development and Evaluation) methods was developed to evaluate the quality of evidence and make recommendations, which has been widely adopted in clinical practice guidelines. The GRADE methods address the ...

Abstract	The GRADE (Grading of Recommendation, Assessment, Development and Evaluation) methods was developed to evaluate the quality of evidence and make recommendations, which has been widely adopted in clinical practice guidelines. The GRADE methods address the classification of outcomes, systematic collection, appraisal and synthesis of research evidence based on each outcome, evaluate the overall quality of the evidence, and making recommendations. This essay summarized the GRADE methods and its use in clinical practice guidelines of traditional, complementary, and integrative medicine as well as highlighting some of the challenges.
Keywords	Grade methods ; Traditional medicine ; Clinical practice guideline ; Quality of evidence ; Strength of recommendations ; Miscellaneous systems and treatments ; RZ409.7-999
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Eye acupuncture for pain conditions

Yuan Chi / Jürgen Barth / Mei Wang / Nicola Robinson / Zan-Hua Li / Jian-Ping Liu

BMC Complementary Medicine and Therapies, Vol 21, Iss 1, Pp 1-

a scoping review of clinical studies

2021 Volume 10

Abstract: Abstract Background Chinese eye acupuncture, focuses on treating different diseases by applying needle stimulation around the orbit of the eye. Since 1970, it has been used in China for the management of pain-related disorders. This scoping review ... ...

Abstract	Abstract Background Chinese eye acupuncture, focuses on treating different diseases by applying needle stimulation around the orbit of the eye. Since 1970, it has been used in China for the management of pain-related disorders. This scoping review systematically collected clinical studies on the use of eye acupuncture to treat pain conditions and identify any adverse events. Methods Six databases including PubMed, the Cochrane Library, CNKI, VIP, Wan Fang Data and SinoMed were searched from 1970 to March 2019. Randomized controlled trials (RCTs), clinical controlled trials (CCTs) and case series on eye-acupuncture for pain conditions meeting the inclusion criteria were identified. Data were extracted on patients, interventions, details of eye acupuncture, control treatments and outcomes. Results Searches identified 81 clinical studies and a trend demonstrating an increasing number of published studies. All studies were conducted in China and published in Chinese. These included, 45 (55.6%) RCTs, 5 (6.2%) CCTs, and 31 (38.3%) case series, treating 7113 patients with 44 different pain-related diseases or symptoms. The most frequently reported conditions were headache (18, 16.2%), acute lumbar pain (7, 6.3%) and lumbar disc herniation (7, 6.3%). Treatment using small needles (φ0.25 × 13 mm), retained ≤30 min, needling the horizontal outer orbital edge and the avoidance of manipulation during treatment were the most frequent descriptions of the interventions used. Eye acupuncture was used alone in about half of the studies and of the remaining studies it was combined with other treatment. All studies suggested some beneficial effects including: pain relief, improved quality of life and mental health, and 18 (22.2%) adverse events. Conclusion Eye acupuncture, predominantly studied in China, may be a promising intervention for managing diverse pain conditions. However, given the variety of study designs and reported treatment outcomes, conclusions about the evidence for eye acupuncture for specific conditions are not ...
Keywords	Pain relief ; Traditional Chinese medicine ; Eye acupuncture ; Clinical studies ; Scoping review ; Other systems of medicine ; RZ201-999
Subject code	610
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Determining the safety and effectiveness of Tai Chi

Guo-Yan Yang / Jennifer Hunter / Fan-Long Bu / Wen-Li Hao / Han Zhang / Peter M. Wayne / Jian-Ping Liu

Systematic Reviews, Vol 11, Iss 1, Pp 1-

a critical overview of 210 systematic reviews of controlled clinical trials

2022 Volume 27

Abstract: Abstract Background This overview summarizes the best available systematic review (SR) evidence on the health effects of Tai Chi. Methods Nine databases (PubMed, Cochrane Library, EMBASE, Medline, Web of Science, China National Knowledge Infrastructure ( ... ...

Abstract	Abstract Background This overview summarizes the best available systematic review (SR) evidence on the health effects of Tai Chi. Methods Nine databases (PubMed, Cochrane Library, EMBASE, Medline, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Sino-Med, and Wanfang Database) were searched for SRs of controlled clinical trials of Tai Chi interventions published between Jan 2010 and Dec 2020 in any language. Effect estimates were extracted from the most recent, comprehensive, highest-quality SR for each population, condition, and outcome. SR quality was appraised with AMSTAR 2 and overall certainty of effect estimates with the GRADE method. Results Of the 210 included SRs, 193 only included randomized controlled trials, one only included non-randomized studies of interventions, and 16 included both. Common conditions were neurological (18.6%), falls/balance (14.7%), cardiovascular (14.7%), musculoskeletal (11.0%), cancer (7.1%), and diabetes mellitus (6.7%). Except for stroke, no evidence for disease prevention was found; however, multiple proxy-outcomes/risks factors were evaluated. One hundred and fourteen effect estimates were extracted from 37 SRs (2 high, 6 moderate, 18 low, and 11 critically low quality), representing 59,306 adults. Compared to active and/or inactive controls, 66 of the 114 effect estimates reported clinically important benefits from Tai Chi, 53 reported an equivalent or marginal benefit, and 6 an equivalent risk of adverse events. Eight of the 114 effect estimates (7.0%) were rated as high, 43 (37.7%) moderate, 36 (31.6%) low, and 27 (23.7%) very low certainty evidence due to concerns with risk of bias (92/114, 80.7%), imprecision (43/114, 37.7%), inconsistency (37/114, 32.5%), and publication bias (3/114, 2.6%). SR quality was often limited by the search strategies, language bias, inadequate consideration of clinical, methodological, and statistical heterogeneity, poor reporting standards, and/or no registered SR protocol. ...
Keywords	Tai Chi ; Overview ; Systematic review ; Treatment ; Prevention ; Rehabilitation ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Use of antibiotics and other treatments in Chinese adults with acute cough

Xiao-Yang Hu / Ru-Yu Xia / Michael Moore / Beth Stuart / Ling-Zi Wen / Bertrand Graz / Lily Lai / Jian-Ping Liu / Yu-Tong Fei / Merlin Willcox

Integrative Medicine Research, Vol 12, Iss 1, Pp 100920- (2023)

An online survey

2023

Abstract: Background: Acute respiratory tract infections are common worldwide and there has been a rapid increase in antibiotic consumption. This study aimed to identify use of various treatments and their association with the use of antibiotics and patient ... ...

Abstract	Background: Acute respiratory tract infections are common worldwide and there has been a rapid increase in antibiotic consumption. This study aimed to identify use of various treatments and their association with the use of antibiotics and patient reported clinical recovery in Chinese adults with acute cough. Methods: An online survey recruiting people who had recently experienced cough was conducted. Their sociodemographic, clinical characteristics, treatments received and their perceived changes in symptoms were collected. Factors influencing avoidance of antibiotics and improvement in symptoms were explored. Results: A total of 22,787 adults with recent acute cough completed the questionnaire, covering all 34 province-level administrative units in China. Most respondents were male (68.0%), young (89.4%, aged 18–45), educated to university/degree or postgraduate level (44.6%), with a median cough severity of 6/10 on a numerical rating scale. Nearly half of the participants (46.4%) reported using antibiotics, among which 93.1% were for presumed upper respiratory tract infections (URTIs). Pharmacies (48.8%) were the most common source of antibiotics. Fewer patients took antibiotics after taking CHM (14.9%), compared to those who started with home remedies (18.0%), or allopathic non-antibiotic medication (25.0%). Antibiotics, allopathic non-antibiotic medications, CHM and home remedies were all perceived beneficial in relieving cough. Conclusions: Chinese adult responders report use of a considerable variety of treatments alone or in combination for acute cough. Patient-reported clinical recovery was similar regardless of treatment. There is likely a high proportion of inappropriate use of antibiotics for treatment of simple acute cough. As the majority of respondents did not use antibiotics as a first-line, and use of CHM was associated with relief of cough symptoms and reduction in the use of antibiotics, this presents an important opportunity for prudent antibiotic stewardship in China.
Keywords	Antibiotics ; Acute cough ; Respiratory tract infection ; Chinese herbal medicine ; Survey ; Miscellaneous systems and treatments ; RZ409.7-999
Subject code	310
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Evidence synthesis of Chinese medicine for monkeypox

Hong-guo Rong / Xiao-wen Zhang / Mei Han / Xin Sun / Xiao-dan Wu / Xiao-zhen Lai / Chen Shen / Wei-jie Yu / Hai Fang / Yu-tong Fei / Jian-ping Liu

Frontiers in Pharmacology, Vol

Suggestions from other contagious pox-like viral diseases

2023 Volume 14

Abstract: Background: Monkeypox, a zoonotic disease caused by an Orthopoxvirus, presents an etiology similar to smallpox in humans. Currently, there are no licensed treatments for human monkeypox, so clear and urgent research on its prophylaxis and treatment is ... ...

Abstract	Background: Monkeypox, a zoonotic disease caused by an Orthopoxvirus, presents an etiology similar to smallpox in humans. Currently, there are no licensed treatments for human monkeypox, so clear and urgent research on its prophylaxis and treatment is needed.Objective: The purpose of this study was to explore the evidence of Chinese medicine for contagious pox-like viral diseases and provide suggestions for the multi-country outbreak management of monkeypox.Methods: The review was registered on INPLASY (INPLASY202270013). Ancient classics in China and clinical trials involving randomized controlled trials , non-RCTs, and comparative observational studies of CM on the prevention and treatment of monkeypox, smallpox, measles, varicella, and rubella were retrieved from the Chinese Medical Code (fifth edition), Database of China Ancient Medicine, PubMed, the Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP, Wanfang, Google Scholar, International Clinical Trial Registry Platform, and Chinese Clinical Trial Registry until 6 July 2022. Both quantitative and qualitative methods were applied to present the data collected.Results: The use of CM to control contagious pox-like viral diseases was traced back to ancient Chinese practice cited in Huangdi’s Internal Classic, where the pathogen was recorded nearly two thousand years back. There were 85 articles (36 RCTs, eight non-RCTs, one cohort study, and 40 case series) that met the inclusion criteria, of which 39 studies were for measles, 38 for varicella, and eight for rubella. Compared with Western medicine for contagious pox-like viral diseases, CM combined with Western medicine showed significant improvements in fever clearance time (mean difference, −1.42 days; 95% CI, −1.89 to −0.95; 10 RCTs), rash/pox extinction time (MD, −1.71 days; 95% CI, −2.65 to −0.76; six RCTs), and rash/pox scab time (MD, −1.57 days; 95% CI, −1.94 to −1.19; five RCTs). When compared with Western medicine, CM alone could reduce the time of rash/pox extinction and fever ...
Keywords	monkeypox ; smallpox ; measles ; varicella ; rubella ; Chinese medicine ; Therapeutics. Pharmacology ; RM1-950
Subject code	610
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Chinese patent herbal medicine Huaiqihuang for Henoch-Schonlein purpura nephritis in children

Xue Xue / Xue-han Liu / Chun-li Lu / Xin-yan Jin / Qiang Liu / Xiao-qin Wang / Jian-ping Liu

BMC Complementary Medicine and Therapies, Vol 21, Iss 1, Pp 1-

a systematic review of randomized controlled trials

2021 Volume 14

Abstract: Abstract Background Henoch-Schönlein purpura nephritis (HSPN) is listed as the most common secondary glomerular diseases among children. Approximately 15 to 20% of children eventually could develop into chronic renal failure. Chinese patent herbal ... ...

Abstract	Abstract Background Henoch-Schönlein purpura nephritis (HSPN) is listed as the most common secondary glomerular diseases among children. Approximately 15 to 20% of children eventually could develop into chronic renal failure. Chinese patent herbal medicine Huaiqihuang (HQH) has been widely used in children with HSPN. This study aimed to evaluate the effectiveness and safety of HQH for HSPN in children, so as to provide evidence for clinical use. Methods Randomized controlled trials (RCTs) on HQH for HSPN in children were searched in eight Chinese and English databases from their inception to December 2020. We included children with HSPN received HQH combined with conventional medicine. Cochrane “Risk of bias” tool was used to assess methodological quality, and “Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach” to summarize the certainty of evidence for main findings. Effect estimates were presented as risk ratio (RR), mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI) in meta-analyses using RevMan 5.3. Data not suitable for statistical pooling were synthesized qualitatively. Results In total seven RCTs were identified. Compared with conventional medicine alone, HQH plus conventional medicine showed the better effect in improving clinical cure rate (RR 1.58; 95%CI 1.17 to 2.14; n = 6) and total effective rate (RR 1.34; 1.16 to 1.54; n = 6); reducing urine sediment erythrocyte count (MD -9.23; − 10.76 to − 7.69; n = 3) and urine β2 micro-globulin level (MD -0.09; − 0.12 to − 0.06; n = 2). No serious adverse event was recorded in all included trials. Conclusions Limited evidence showed HQH combined with conventional medicine had a beneficial effect for children with HSPN, and the side effects were mild. HQH may be a promising complementary therapy. However, long term follow-up, high quality and multicenter RCTs are required to confirm the findings.
Keywords	Chinese patent herbal medicine ; Huaiqihuang ; Henoch-Schonlein purpura nephritis ; Children ; Randomized controlled trials ; Systematic review ; Other systems of medicine ; RZ201-999
Subject code	610
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: An evidence mapping of systematic reviews and meta-analysis on traditional Chinese medicine for ulcerative colitis

Yu-Xin Sun / Xiao Wang / Xing Liao / Jing Guo / Wen-Bin Hou / Xin Wang / Jian-Ping Liu / Zhao-Lan Liu

BMC Complementary Medicine and Therapies, Vol 21, Iss 1, Pp 1-

2021 Volume 21

Abstract: Abstract Background Traditional Chinese Medicine (TCM) has been a proposed treatment option for ulcerative colitis (UC), however it has been difficult to understand the breadth and depth of evidence as various Chinese medicine therapies may produce ... ...

Abstract	Abstract Background Traditional Chinese Medicine (TCM) has been a proposed treatment option for ulcerative colitis (UC), however it has been difficult to understand the breadth and depth of evidence as various Chinese medicine therapies may produce effects differently. The aim of this evidence mapping is to visually understand the available evidence in the use of TCM in the treatment of UC, and to identify gaps in evidence to inform priorities of future research. Methods A systematic electronic literature search of six databases were performed to identify systematic reviews (SRs) on different Chinese medicine therapies in the treatment in UC. Methodological quality of the included SRs was assessed using AMSTAR 2. Results The mapping was based on 73 SRs, which included nine interventions that met eligibility criteria. The quality of the included SRs was very low. The diseases stages of patients with UC varied greatly, from active to remission, to non-acute outbreak, to not reported. The results mostly favored the method of intervention. Oral administration combined with enema was the most widely used route of administration in secondary research. Conclusion Based on the current evidence, the treatment of UC with TCM can only be recommended cautiously. A majority of included SRs did not report the location of the disease, the disease classification, and the route of administration of the intervention. Further research is needed on the effectiveness of Chinese medicine alone in the treatment of UC. The effectiveness of combined Chinese and conventional medicine combined with different routes of administration cannot be confirmed. Attention should be paid to the methodological quality of the systematic review. Unifies the outcome indicators used in the evaluation of effectiveness.
Keywords	Evidence-based medicine ; Mapping review ; AMSTAR 2 ; Herbal ; Digestion ; Other systems of medicine ; RZ201-999
Subject code	610
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Evidence-based medicine and individualized health care

Jian-ping LIU

Journal of Integrative Medicine (JIM), Vol 7, Iss 6, Pp 505-

2009 Volume 508

Abstract: In 21st century, clinical medicine moves toward a model of individualized health care. The development of the individualized model is based on the research findings of human genomics project including genotype and single nucleotide polymorphisms (SNPs), ... ...

Abstract	In 21st century, clinical medicine moves toward a model of individualized health care. The development of the individualized model is based on the research findings of human genomics project including genotype and single nucleotide polymorphisms (SNPs), as well as the new health care model, that is, biological-psychological-social-environmental-spiritual. It reflects the idea of patient-centered care, and corresponds to the traditional practice of Chinese medicine, which addressed the individualized therapy on the basis of symptom pattern differentiation. However, the era of evidence-based medicine affords new meanings of individualized health care and promotes the research on the practice. The practice based on evidence would happen upon the integration of external research evidence, the expertise and experience of practitioners, and the value and preference of patients, so the decision of health care will be conscientious, explicit and judicious. This assay describes the meanings of individualized health care in different medical contexts, the characteristics of individualized practice in Chinese medicine, and proposals for further research in practice.
Keywords	evidence-based medicine ; clinical practice patterns ; individualized medicine ; syndrome differentiation treatment ; Medicine (General) ; R5-920 ; Medicine ; R ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	360
Language	English
Publishing date	2009-06-01T00:00:00Z
Publisher	Journal of Chinese Integrative Medicine Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Nationwide survey of physicians’ familiarity and awareness of diabetes guidelines in China

Bing Yan / Shu-Yu Yang / Jian-Ping Liu / Le Li / Na Zhan / Li-yan Jia / Cao-xin Huang / Neng-jiang Zhao / Bao-yong Lai / Zhi-hai Zhang / Yuan-bing Lin / Miao-na Cai / Shun-qin Wang

BMJ Open, Vol 13, Iss

a cross-sectional study

2023 Volume 12

Abstract: Objective This study aims to investigate physicians’ familiarity and awareness of four diabetes guidelines and their practice of the recommendations outlined in these guidelines.Design A cross-sectional study.Setting An online questionnaire survey was ... ...

Abstract	Objective This study aims to investigate physicians’ familiarity and awareness of four diabetes guidelines and their practice of the recommendations outlined in these guidelines.Design A cross-sectional study.Setting An online questionnaire survey was conducted among physicians affiliated with the Specialist Committee for Primary Diabetes Care of China Association of Chinese Medicine, using the snowball sampling method to ensure a broader representation of physicians.Participants 1150 physicians from 192 cities across 30 provinces in China provided complete data.Results Tertiary care hospital physicians (TCPs) exhibited the highest familiarity with the Guideline for the Prevention and Treatment of Type 2 Diabetes Mellitus in China (91.3%), followed by the National Guidelines for the Prevention and Control of Diabetes in Primary Care (76.8%), the Standards of Medical Care in Diabetes (72.2%) and the Guidelines for Prevention and Treatment of Diabetes in Chinese Medicine (63.8%). Primary care practitioners (PCPs) exhibited familiarity with these four guidelines at about 50% or less. Self-reported reference to modern diabetes guidelines by physicians is more frequent than traditional Chinese medicine (TCM) diabetes guidelines, with rates at 73.2% and 33.8%, respectively. Approximately 90% of physicians provided instructions on self-monitoring of blood glucose to their patients with diabetes. Less than one-third of physicians referred patients to a specialised nutritionist. In terms of health education management, TCPs reported having a diabetes health management team at the rate of 75.7%, followed by secondary care hospital physicians at 57.0% and PCPs at 27.5%. Furthermore, approximately 40% of physicians did not fully grasp hypoglycaemia characteristics.Conclusions Familiarity and awareness of the screening guidelines varied among physicians in different hospital settings. Importantly, significant discrepancies were observed between physicians’ awareness and their self-reported reference to modern medicine ...
Keywords	Medicine ; R
Subject code	360
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Design, implementation and methodological issues in cohort study

Jian-ping LIU

Journal of Integrative Medicine (JIM), Vol 6, Iss 4, Pp 331-

2008 Volume 336

Abstract: Abstract: Cohort study is graded as level Ⅱ in evidence grading system of evidence-based medicine, secondary to randomized controlled trial. It is one of the important evidence for the evaluation of health care interventions, and it has been applied ... ...

Abstract	Abstract: Cohort study is graded as level Ⅱ in evidence grading system of evidence-based medicine, secondary to randomized controlled trial. It is one of the important evidence for the evaluation of health care interventions, and it has been applied recently in the evaluation of traditional medicine. The author of the article introduces the basic concept, principle, design, and implementation as well as relevant methodological issues when applied in traditional Chinese medicine.
Keywords	cohort studies ; evidence-based medicine ; evaluation studies ; Medicine (General) ; R5-920 ; Medicine ; R ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2008-04-01T00:00:00Z
Publisher	Journal of Chinese Integrative Medicine Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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