Priority of interventions in the question formulation of traditional Chinese medicine clinical practice guidelines selection-methodological recommendations based on expert evidence_Chinese Journal of Evidence-Based Medicine

Authors：

GAO Yicheng ^1,2,3 , LIU Zhihan ^1,2,3 , XIA Ruyu ^1,2,3 , FENG Yuting ^1,2,3 , WANG Yaqi ^1,2,3 , CHAI Qianyun ^1,2,3 , LUO Minjing ^1,2,3 , CAO Rui ^1,2,3 ,  FEI Yutong ^1,2,3

1. Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, P. R. China;
2. Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, P. R. China;
3. Beijing GRADE Center, Beijing University of Chinese Medicine, Beijing 100029, P. R. China;

Corresponding author：

FEI Yutong, Email: yutong_fei@163.com

Keywords：

Expert evidence; Priority selection; Clinical question; Methodology; Clinical practice guideline

DOI：

10.7507/1672-2531.202212055

Video：

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In the formulation of the clinical question of traditional Chinese medicine clinical practice guidelines, even if the intervention elements (intervention or control) have an appropriate scope, guideline developers are still faced with a variety of interventions. By analyzing the difficulty and necessity of priority selection of intervention interventions, we propose the approach of extending expert evidence to the process of priority selection of intervention interventions, and further provide the methodology of expert evidence data collection table design, application, data presentation and expert decision-making method to provide references and guidance for guideline developers.

Citation： GAO Yicheng, LIU Zhihan, XIA Ruyu, FENG Yuting, WANG Yaqi, CHAI Qianyun, LUO Minjing, CAO Rui, FEI Yutong. Priority of interventions in the question formulation of traditional Chinese medicine clinical practice guidelines selection-methodological recommendations based on expert evidence. Chinese Journal of Evidence-Based Medicine, 2023, 23(4): 433-438. doi: 10.7507/1672-2531.202212055 Copy

1.	Institute of Medicine (US) Committee to advise the public health service on clinical practice guidelines. Clinical practice guidelines: directions for a new program. Washington: National Academies Press, 1990.
2.	Institute of Medicine (US) Committee on standards for developing trustworthy clinical practice guidelines. Clinical practice guidelines we can trust. Washington: National Academies Press, 2011.
3.	Hoogendam A, de Vries Robbé PF, Overbeke AJ. Comparing patient characteristics, type of intervention, control, and outcome (PICO) queries with unguided searching: a randomized controlled crossover trial. J Med Libr Assoc, 2012, 100(2): 121-126.
4.	Schardt C, Adams MB, Owens T, et al. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak, 2007, 7: 16.
5.	Richardson WS, Wilson MC, Nishikawa J, et al. The well-built clinical question: a key to evidence-based decisions. ACP J Club, 1995, 123(3): A12-A13.
6.	Sackett DL, Rosenberg WM, Gray JA, et al. Evidence based medicine: what it is and what it isn't. BMJ, 1996, 312(7023): 71-72.
7.	《中成药治疗优势病种临床应用指南》标准化项目组. 中成药治疗功能性消化不良临床应用指南(2021年). 中国中西医结合杂志, 2022, 42(1): 5-12.
8.	中华中医药学会肺系病分会, 中国民族医药学会肺病分会. 急性气管-支气管炎中医诊疗指南. 中国循证医学杂志, 2021, 21(12): 1365-1372.
9.	李邻峰, 李元文. 中成药治疗湿疹临床应用指南(2020年). 中国中西医结合杂志, 2021, 41(2): 133-142.
10.	Oxford Dictionaries. Definition of opinion.
11.	Ponce OJ, Alvarez-Villalobos N, Shah R, et al. What does expert opinion in guidelines mean: a meta-epidemiological study. Evid Based Med, 2017, 22(5): 164-169.
12.	Center for Evidence-Based Medicine. Explanation of the 2011 OCEBM levels of evidence.
13.	SIGN. SIGN 50: a guideline developer's handbook.
14.	SUNY Downstate EBM Tutorial. Guide to research methods: the evidence pyramid.
15.	Neumann I, Schünemann HJ. Guideline groups should make recommendations even if the evidence is considered insufficient. CMAJ, 2020, 192(2): E23-E24.
16.	Schünemann HJ, Zhang Y, Oxman AD, et al. Distinguishing opinion from evidence in guidelines. BMJ, 2019, 366: l4606.
17.	Akl EA, Mustafa R, Slomka T, et al. An educational game for teaching clinical practice guidelines to Internal Medicine residents: development, feasibility and acceptability. BMC Med Educ, 2008, 8: 50.
18.	Merriam-Webster. Definition of opinion.
19.	Legault K, Schunemann H, Hillis C, et al. McMaster RARE-Bestpractices clinical practice guideline on diagnosis and management of the catastrophic antiphospholipid syndrome. J Thromb Haemost, 2018, 16(8): 1656-1664.
20.	Pai M, Santesso N, Yeung CH, et al. Methodology for the development of the NHF-McMaster guideline on care models for haemophilia management. Haemophilia, 2016, 22(Suppl 3): 17-22.
21.	Nesrallah GE, Mustafa RA, MacRae J, et al. Canadian Society of Nephrology guidelines for the management of patients with ESRD treated with intensive hemodialysis. Am J Kidney Dis, 2013, 62(1): 187-198.
22.	Mustafa RA, Garcia CAC, Bhatt M, et al. GRADE notes: How to use GRADE when there is "no" evidence. A case study of the expert evidence approach. J Clin Epidemiol, 2021, 137: 231-235.
23.	Murphy MK, Black NA, Lamping DL, et al. Consensus development methods, and their use in clinical guideline development. Health Technol Assess, 1998, 2(3): i-iv,1-88.
24.	Chapple M, Murphy R. The nominal group technique: extending the evaluation of students' teaching and learning experiences. Assess Eval High Edu, 1996, 21(2): 147-160.
25.	Fink A, Kosecoff J, Chassin M, et al. Consensus methods: characteristics and guidelines for use. Am J Public Health, 1984, 74(9): 979-983.
26.	Coughlin SS. Recall bias in epidemiologic studies. J Clin Epidemiol, 1990, 43(1): 87-91.

1. Institute of Medicine (US) Committee to advise the public health service on clinical practice guidelines. Clinical practice guidelines: directions for a new program. Washington: National Academies Press, 1990.
2. Institute of Medicine (US) Committee on standards for developing trustworthy clinical practice guidelines. Clinical practice guidelines we can trust. Washington: National Academies Press, 2011.
3. Hoogendam A, de Vries Robbé PF, Overbeke AJ. Comparing patient characteristics, type of intervention, control, and outcome (PICO) queries with unguided searching: a randomized controlled crossover trial. J Med Libr Assoc, 2012, 100(2): 121-126.
4. Schardt C, Adams MB, Owens T, et al. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak, 2007, 7: 16.
5. Richardson WS, Wilson MC, Nishikawa J, et al. The well-built clinical question: a key to evidence-based decisions. ACP J Club, 1995, 123(3): A12-A13.
6. Sackett DL, Rosenberg WM, Gray JA, et al. Evidence based medicine: what it is and what it isn't. BMJ, 1996, 312(7023): 71-72.
7. 《中成药治疗优势病种临床应用指南》标准化项目组. 中成药治疗功能性消化不良临床应用指南(2021年). 中国中西医结合杂志, 2022, 42(1): 5-12.
8. 中华中医药学会肺系病分会, 中国民族医药学会肺病分会. 急性气管-支气管炎中医诊疗指南. 中国循证医学杂志, 2021, 21(12): 1365-1372.
9. 李邻峰, 李元文. 中成药治疗湿疹临床应用指南(2020年). 中国中西医结合杂志, 2021, 41(2): 133-142.
10. Oxford Dictionaries. Definition of opinion.
11. Ponce OJ, Alvarez-Villalobos N, Shah R, et al. What does expert opinion in guidelines mean: a meta-epidemiological study. Evid Based Med, 2017, 22(5): 164-169.
12. Center for Evidence-Based Medicine. Explanation of the 2011 OCEBM levels of evidence.
13. SIGN. SIGN 50: a guideline developer's handbook.
14. SUNY Downstate EBM Tutorial. Guide to research methods: the evidence pyramid.
15. Neumann I, Schünemann HJ. Guideline groups should make recommendations even if the evidence is considered insufficient. CMAJ, 2020, 192(2): E23-E24.
16. Schünemann HJ, Zhang Y, Oxman AD, et al. Distinguishing opinion from evidence in guidelines. BMJ, 2019, 366: l4606.
17. Akl EA, Mustafa R, Slomka T, et al. An educational game for teaching clinical practice guidelines to Internal Medicine residents: development, feasibility and acceptability. BMC Med Educ, 2008, 8: 50.
18. Merriam-Webster. Definition of opinion.
19. Legault K, Schunemann H, Hillis C, et al. McMaster RARE-Bestpractices clinical practice guideline on diagnosis and management of the catastrophic antiphospholipid syndrome. J Thromb Haemost, 2018, 16(8): 1656-1664.
20. Pai M, Santesso N, Yeung CH, et al. Methodology for the development of the NHF-McMaster guideline on care models for haemophilia management. Haemophilia, 2016, 22(Suppl 3): 17-22.
21. Nesrallah GE, Mustafa RA, MacRae J, et al. Canadian Society of Nephrology guidelines for the management of patients with ESRD treated with intensive hemodialysis. Am J Kidney Dis, 2013, 62(1): 187-198.
22. Mustafa RA, Garcia CAC, Bhatt M, et al. GRADE notes: How to use GRADE when there is "no" evidence. A case study of the expert evidence approach. J Clin Epidemiol, 2021, 137: 231-235.
23. Murphy MK, Black NA, Lamping DL, et al. Consensus development methods, and their use in clinical guideline development. Health Technol Assess, 1998, 2(3): i-iv,1-88.
24. Chapple M, Murphy R. The nominal group technique: extending the evaluation of students' teaching and learning experiences. Assess Eval High Edu, 1996, 21(2): 147-160.
25. Fink A, Kosecoff J, Chassin M, et al. Consensus methods: characteristics and guidelines for use. Am J Public Health, 1984, 74(9): 979-983.
26. Coughlin SS. Recall bias in epidemiologic studies. J Clin Epidemiol, 1990, 43(1): 87-91.

Chinese Journal of Evidence-Based Medicine

Priority of interventions in the question formulation of traditional Chinese medicine clinical practice guidelines selection-methodological recommendations based on expert evidence

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