| ObjectiveThe study aimed to evaluate the domestic integrative medicine clinical practice guidelines(CPGs) and research the foreign guideline development methodologies, to establish the devlopment methodology and reporting elements based on the above studies, to retrieve,screen, evalute primary headache sytematic reviews of chinese medicine.Methods1. We conduceted a sytematic search of the scientific literature published before 2014 to select integrative medicine CPGs. Four major Chinese integrated databases, the China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Database (CBM), WANFANG DATA, and VIP were searched. Four reviewers independently assessed the quality of the included guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument. Overall consensus among the reviewers was assessed using the intra-class correlation coefficient (ICC).Guideline development handbooks published by Scottish Intercollegiate Guidelines Network (SIGN), World Health Organization (WHO) were analyzed.2. We searched the domestic databases,CNKI, CBM, WANFANG DATA, VIP and foreign databases, Pubmed, Embase, Cochrane Library, Web of Science to collect primary headache symatic reviews of chinese medicine. Two reviewers independently evaluated the quality of included systematic reviews, five systematic reviews were slected to conduct a preliminary experiment,ICC was used to test the consensus. Sytematic review scored above 70 would be used as evidence for headache disorder guidelines of integratice medicine.Resultsl.A total of 41 guidelines published from 2003 to 2014 were included. The overall consensus among the reviewers was good (ICC:0.928; 95%confidence interval (CI):0.920 to 0.935). The scores on the six AGREE domains were:17% for scope and purpose (range:6 to 32%),11%for stakeholder involvement (range: 0 to 24%),10%for rigor of development (range:3 to 22%),39%for clarity and presentation (range:25 to 64%),11%for applicability (range:4 to 24%), and 1%for editorial independence (range:0 to 15%). Subclass analysis showed guidelines developed by multi-organizations scored higher than single organization, guidelines which adopted evidence grading system got more scores than which not. The reporting of interest of conflicts, sponsor and update plan were insufficient.2. we got 43 systematic reviews,30 of them were Chiniese,13 were English, the R-AMSTAR assement result was:3 articles (≦60),11 articles(＜60≦70),17 articles(＜70≦80),9 articles(＜80≦90),3 articles(＜90≦ 100),29 systematic review were included, some of them published abroad scored higher than domestic, which outcome were multiple-index scored higher than single index, which intervention were acupuncture were superior to others in R-AMSTAR.Conclusion1. The number of integrative medicine guidelines is increasing, but the scientific nature of development has not improved, More emphasis should be placed on multi-disciplinary guideline development groups, quality of evidence, management of funding and conflicts of interest, guideline updates, and the standardization reporting in the process of developing integrative medicine CPGs in China.2. The mian headache type of primary headache systematic reviews were migraine and tension-type headache, the main interventions were acupuncture, Chuanxiong chatiao powder, Tianshu capsule, Yangxue qingnao grain.3.The outcome of systematic review was multiple-index(effective rate), however single index would be better for intervention evaluation.4. The primary headache systematic reviews of chinese medicine published in China should put more concentration on standardization reporting (refer to Cochrane systematic reviews), it will benefit the users’better evaluation of systematic reviews.5. We should put more emphasis on primary headache sytematic reviews of chinese medicine which intervention are not acupuncture. |
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