Grade Evaluation System Of Domestic Acupuncture Treat Lumbago Clinical Research Literature Quality Methodology Research

Background:In recent years, with the rapid development of evidence-based medicine, medical literature evaluation in order to obtain the best evidence is in a large-scale expansion in various fields of clinical medicine. Same is true with clinical research literature of Acupuncture, a large number of systematic reviews^guidelines about clinical acupuncture have mushroomed in a variety of medical journals. In making systematic reviews、 guidelines, an important step is the evaluation of the clinical research literature quality, literature quality directly affects the authenticity scientificalness and applicability of the conclusions of systematic reviews, also relates to the formation of the guideline recommendation plan. We usually evaluate literature quality using quality evaluating tools concerning to literature quality methods.As early as the1970s, research on clinical trials quality evaluating tools had been started,but there is still no unified normative literature quality assessment method. Therefore the work of literature quality evaluation urgently need a quality evaluating tool with strong scientific verification good credibility> broad applicable scope and that is widely accepted. Clinical research literature of Acupuncture inevitably needs one.Objective:Using the GRADE system to evaluate the quality of clinical research literature on acupuncture treatment of low back pain, in order to discuss the methods of GRADE system on evaluating clinical research literature quality, hoping that GRADE system should become cross-sectional tool of clinical research literature quality assessment on acupuncture.Methods:Taking GRADE system evaluating clinical research literature quality assessment on acupuncture treatment for instance, systematically describe the whole process of GRADE system evaluating literature quality of acupuncture treatment on low back pain.The specific research method consists of four steps:literature search, telephone consultation, data extraction, evidence evaluation.1、 literature search:the initial step in collecting evidence. Firstly, clarify clinical problems, according to the PICO principle; then generate retrieval strategies, including database selection and searches design; finally, check literature, screen literature by developing inclusion and exclusion criteria, classify literature on the basis of different clinical search design.2. Telephone consultation:according to the literature screening, select the literature in randomized controlled trials(RCT) to conduct a telephone consultation, aiming to contact the author and then veritably assess the risk of bias of the research literature.3> Data extraction:work out a data extraction chart, the main contents include:general information (author, title, journal,year etc), study design, results of assessing risk of bias through telephone consultation, outcome measures.interventions measures of treatment group and control group, telephone verifier, data extractor etc.4^Evidence evaluation:use GRADE profiler software, grade the evidence quality in accordance with the content of the data extraction chart.Results:after finding duplicates, screening and classifying, we retrieved108articles fitting the RCT requirements,21non-randomized controlled trials(CCT) articles,243cases sequence reports, a total of372. Select108randomized controlled trials for telephone consultation, only10are authentic randomized controlled trials, the remaining98are not. After using GRADE profiler software to grade the quality of the10authentic randomized controlled trials, we found that2of them got low rating, the rest very low. Since the other articles like non-randomized controlled trials, pseudo-randomized controlled trials and observational study.significant flaws, a considerable risk of bias, weak scientificalness are found in research design, according to the evaluation criteria of GRADE system,the rating of the quality of these documents are very low. Therefore,the final result of the GRADE system evaluating the quality of acupuncture treatment on low back pain clinical research literature is:2articles are rating for low,370very low.Conclusion:the assessment results show that:1, the clinical research literature quality of acupuncture treatment on low back pain is generally in low level;2、 the GRADE system can relatively assess the clinical research literature quality of acupuncture treatment on low back pain objectively, veritably and scientifically.The GRADE system has scientific and strict norm during the development process, and constantly updates itself in time, now it has been recognized and adopted by many a international authoritative organizations including WHO and the Cochrane Collaboration Net. In the evaluation process,we found that the GRADE system is convenient, intelligible, scientific.rational, as well as has transparent process and wide applicable range, it evaluates the clinical literature quality in maximum, consequently,it is worthy of further promotion in the clinical literature quality evaluation on acupuncture.