Application evaluation of clinical practice guidelines for traditional Chinese medicine: a clinical analysis based on the analytic hierarchy process

Abstract Background Clinical Practice Guidelines (CPGs) play an important role in clinical practice, and they require appropriate evaluation, especially in application. This study explores the application evaluation method of CPGs for Traditional Chinese Medicines (TCM). It uses the Analytic Hierarc...

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Main Authors: Huayang Cai, Hui Li, Huizhen Zeng, Danping Xu, Wenwei Ouyang, Aiping Lv
Format: Article
Language:English
Published: BMC 2019-10-01
Series:BMC Complementary and Alternative Medicine
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12906-019-2683-5
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spelling doaj-acbe4ee558f147169d9d59cf7e0788fc2020-11-25T03:56:58ZengBMCBMC Complementary and Alternative Medicine1472-68822019-10-0119111110.1186/s12906-019-2683-5Application evaluation of clinical practice guidelines for traditional Chinese medicine: a clinical analysis based on the analytic hierarchy processHuayang Cai0Hui Li1Huizhen Zeng2Danping Xu3Wenwei Ouyang4Aiping Lv5The Second Clinical College of Guangzhou University of Chinese Medicine(Guangdong Provincial Hospital of Chinese Medicine)The Second Clinical College of Guangzhou University of Chinese Medicine(Guangdong Provincial Hospital of Chinese Medicine)The Second Clinical College of Guangzhou University of Chinese Medicine(Guangdong Provincial Hospital of Chinese Medicine)The Second Clinical College of Guangzhou University of Chinese Medicine(Guangdong Provincial Hospital of Chinese Medicine)The Second Clinical College of Guangzhou University of Chinese Medicine(Guangdong Provincial Hospital of Chinese Medicine)Hong Kong Baptist UniversityAbstract Background Clinical Practice Guidelines (CPGs) play an important role in clinical practice, and they require appropriate evaluation, especially in application. This study explores the application evaluation method of CPGs for Traditional Chinese Medicines (TCM). It uses the Analytic Hierarchy Process (AHP) and clinical cases to evaluate the consistency between CPGs of TCM and clinical practice. Methods To evaluate the consistency between CPGs of TCM and clinical cases, a 3-level AHP construction was built. Weightings were calculated by collecting questionnaires according to AHP theory. To test the evaluation system, a retrospective study was performed. The study evaluated the China Association of Chinese Medicine’s Guidelines for Diagnosis and Treatment of Common Internal Diseases in Chinese Medicine Diseases of Modern Medicine (CPGs of DTCID) (ZYYXH/T50–135-2008). A total of 150 cases were involved. The evaluation system was used to assess the consistency between CPGs of DTCID and clinical cases of angina pectoris. Results The results showed that the overall consistency between CPGs of DTCID and the 150 cases was 42.32 ± 6.94%, ranging from 35.21 to 63.37%. The overall consistency was not affected by age, gender, type of angina pectoris, condition of percutaneous coronary intervention (PCI), or angina classification as determined by the Canadian Cardiovascular Society. The consistencies of each index were as follows: Diagnosis of TCM, 100%; Diagnosis of Western medicine, 100%; Syndrome classification, 38.25 ± 4.40%; Syndrome key point, 34.17 ± 8.15%; TCM Decoction, 31.08 ± 23.64%; TCM particular treatment, 7.92 ± 19.13%; and Recuperation and prevention, 0. The most frequent syndromes were qi-deficiency, phlegm and blood stasis (n = 124) (82.7%). The overall consistency of qi-deficiency, turbid phlegm and blood stasis was lower than the overall consistency of the group without that syndrome. The difference was statistically significant (P < 0.05). 42 cases (28%) applied the TCM decoction recommended by CPGs of DTCID. Of these, Gualouxiebaibanxia decoction was applied in 34 cases. Wendan decoction, the most frequently used, was applied in 64 cases (42.7%). Conclusion This study indicates that the AHP system can perform quantitative evaluation of consistency between TCM CPG and clinical practice. It also found the factors affecting the application of TCM CPGs and might indicate the need for revisions of CPGs.http://link.springer.com/article/10.1186/s12906-019-2683-5Clinical practice guidelinesTraditional Chinese medicineApplication evaluationAngina pectorisAnalytic hierarchy process
collection DOAJ
language English
format Article
sources DOAJ
author Huayang Cai
Hui Li
Huizhen Zeng
Danping Xu
Wenwei Ouyang
Aiping Lv
spellingShingle Huayang Cai
Hui Li
Huizhen Zeng
Danping Xu
Wenwei Ouyang
Aiping Lv
Application evaluation of clinical practice guidelines for traditional Chinese medicine: a clinical analysis based on the analytic hierarchy process
BMC Complementary and Alternative Medicine
Clinical practice guidelines
Traditional Chinese medicine
Application evaluation
Angina pectoris
Analytic hierarchy process
author_facet Huayang Cai
Hui Li
Huizhen Zeng
Danping Xu
Wenwei Ouyang
Aiping Lv
author_sort Huayang Cai
title Application evaluation of clinical practice guidelines for traditional Chinese medicine: a clinical analysis based on the analytic hierarchy process
title_short Application evaluation of clinical practice guidelines for traditional Chinese medicine: a clinical analysis based on the analytic hierarchy process
title_full Application evaluation of clinical practice guidelines for traditional Chinese medicine: a clinical analysis based on the analytic hierarchy process
title_fullStr Application evaluation of clinical practice guidelines for traditional Chinese medicine: a clinical analysis based on the analytic hierarchy process
title_full_unstemmed Application evaluation of clinical practice guidelines for traditional Chinese medicine: a clinical analysis based on the analytic hierarchy process
title_sort application evaluation of clinical practice guidelines for traditional chinese medicine: a clinical analysis based on the analytic hierarchy process
publisher BMC
series BMC Complementary and Alternative Medicine
issn 1472-6882
publishDate 2019-10-01
description Abstract Background Clinical Practice Guidelines (CPGs) play an important role in clinical practice, and they require appropriate evaluation, especially in application. This study explores the application evaluation method of CPGs for Traditional Chinese Medicines (TCM). It uses the Analytic Hierarchy Process (AHP) and clinical cases to evaluate the consistency between CPGs of TCM and clinical practice. Methods To evaluate the consistency between CPGs of TCM and clinical cases, a 3-level AHP construction was built. Weightings were calculated by collecting questionnaires according to AHP theory. To test the evaluation system, a retrospective study was performed. The study evaluated the China Association of Chinese Medicine’s Guidelines for Diagnosis and Treatment of Common Internal Diseases in Chinese Medicine Diseases of Modern Medicine (CPGs of DTCID) (ZYYXH/T50–135-2008). A total of 150 cases were involved. The evaluation system was used to assess the consistency between CPGs of DTCID and clinical cases of angina pectoris. Results The results showed that the overall consistency between CPGs of DTCID and the 150 cases was 42.32 ± 6.94%, ranging from 35.21 to 63.37%. The overall consistency was not affected by age, gender, type of angina pectoris, condition of percutaneous coronary intervention (PCI), or angina classification as determined by the Canadian Cardiovascular Society. The consistencies of each index were as follows: Diagnosis of TCM, 100%; Diagnosis of Western medicine, 100%; Syndrome classification, 38.25 ± 4.40%; Syndrome key point, 34.17 ± 8.15%; TCM Decoction, 31.08 ± 23.64%; TCM particular treatment, 7.92 ± 19.13%; and Recuperation and prevention, 0. The most frequent syndromes were qi-deficiency, phlegm and blood stasis (n = 124) (82.7%). The overall consistency of qi-deficiency, turbid phlegm and blood stasis was lower than the overall consistency of the group without that syndrome. The difference was statistically significant (P < 0.05). 42 cases (28%) applied the TCM decoction recommended by CPGs of DTCID. Of these, Gualouxiebaibanxia decoction was applied in 34 cases. Wendan decoction, the most frequently used, was applied in 64 cases (42.7%). Conclusion This study indicates that the AHP system can perform quantitative evaluation of consistency between TCM CPG and clinical practice. It also found the factors affecting the application of TCM CPGs and might indicate the need for revisions of CPGs.
topic Clinical practice guidelines
Traditional Chinese medicine
Application evaluation
Angina pectoris
Analytic hierarchy process
url http://link.springer.com/article/10.1186/s12906-019-2683-5
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