Establishment And Application Of Clinical Practice Guidelines Database Of Traditional Chinese Medicine

[Objective] By building the " Clinical Practice Guidelines Database of Traditional Chinese Medicine(G-TCM)",the existing clinical practice guidelines of Chinese medicine are comprehensively summarized to provide technical support for research and clinical decision-making to quickly access guidelines and guideline recommendations.[Methods] 1.Top-level design and platform construction: A multidisciplinary expert group was established to develop the system with the help of Spring,MyBatis,Vue,Element-UI,Redis,Elasticsearch,Flowable and other software,and set up 4 modules of data management,evaluation report,system management and authority management.The expert group formulated guidelines management principles,extraction/entry fields and quality control specifications with reference to RIGHT.The methodological quality and reporting specifications of TCM CPGs were evaluated using the AGREE Ⅱ and the RIGHT.2.Collection,management and evaluation of TCM clinical practice guidelines: Guidelines were collected through multiple channels,including(1)computer search of CNKI,Wanfang Data,VIP and Sino Med,(2)manual search of Dangdang.com,Amazon and Tianjin University of Traditional Chinese Medicine Library,and(3)search of the websites of relevant national institutions for guideline development and publication.Note Express was used to process and manually check the bibliographic entries of each database,and the guidelines were selected according to the preset naming criteria.The process of guide screening,data entry,data standardization and guide evaluation are all tested by training.Data entry strictly implements the standard of "double record + check" to ensure the comprehensiveness and accuracy of information.3.Application of G-TCM: Based on this system,the TCM clinical practice guidelines related to diabetes were searched and statistically analyzed to summarize the recommended information and methodological quality of the guidelines.and compare with manual search to verify the reliability and functionality of the platform.[Results] The G-TCM is already online and running,and has completed the extraction and evaluation of 658 TCM clinical practice guidelines;it enables rapid access to information on TCM guidelines related to diseases/diseases and TCM therapies recommended by the guidelines,including the rating of the level of evidence and strength of recommendation of the therapy by experts in guideline methodology.Users can quickly assess the quality of relevant guidelines and obtain recommendations by viewing the quality of the guidelines and reporting the evaluation results of the norms,which helps to promote the utilization and update of the guidelines.Based on this platform,a demonstration study was conducted with diabetes as the theme,and a total of 32 CPGs were included,and 87.5% of the guidelines focused on diabetes comorbidity/complications,and the recommendation information involved a variety of Chinese medical methods such as prescriptions,proprietary Chinese medicines,acupuncture,and Chinese external treatments.19 guidelines were developed using evidence-based methods,and the types of evidence for the guidelines were mostly randomized controlled trials.However,the evidence citations were older and the sample sizes of the cited studies were lower,resulting in generally lower levels of evidence.In addition,some areas of methodological quality and quality of reporting were rated low for inclusion in the CPGs,which may provide a reference for subsequent guideline updates and revisions.[Conclusion] This study designed and constructed G-TCM to provide a platform for clinicians,researchers,guideline developers and evaluators to quickly query and access clinical guideline information,which will play a supporting role in promoting the standardization and accessibility of Chinese medicine clinical practice guidelines and better guiding clinical practice.