临床试验报告规范 CONSORT（Consolidated Standards of Reporting Trials，CONSORT）声明旨在提高随机对照试验（randomized controlled trail，RCT）的报告质量，然而该声明却缺少专门关于患者报告结局（patient-reported outcomes，PROs）的指引，而这部分内容恰恰也是临床试验经常报告不足的内容。患者报告结局指标数据的缺失影响了临床试验结果的价值。本文报告了依据“提高医疗卫生研究的质量和透明度协作网”（EQUATOR Network）所提出的报告规范研发方法学框架制定的临床试验报告规范—CONSORT 患者报告结局扩展版（CONSORT PROs）。最终推荐 5 个 CONSORT 患者报告结局清单条目，用于以患者报告结局为主要或关键的次要结局指标的随机对照试验。这些推荐条目强烈要求：① 在摘要中需明确说明将患者报告结局作为主要或次要结局指标；② 提供针对患者报告结局指标及其相关适用范畴的假设（如是否使用了多维度患者报告结局指标的检测工具）；③ 提供或引用患者报告结局测量工具效度和信度的证据；④ 明确说明处理缺失数据的统计学方法；⑤ 讨论以患者报告结局指标为研究结果指标的特定局限性和结果对其他人群和临床实践的影响。本文还提供了相关条目的示例和附有患者报告结局的 CONSORT 流程图。建议在报告以患者报告结局作为主要结局指标或关键的次要结局指标时，以 CONSORT 患者报告结局扩展版与原版的 CONSORT 报告规范相互参考进行报告。改进后的患者报告结局试验数据将大大促进对随机对照试验结果的全面解释，并较好指导患者的治疗。
ObjectivesTo analyze the current methodological and reporting quality of both domestic and overseas clinical practice guidelines on acupuncture, and to provide reference for the development of high quality acupuncture clinical practice guidelines.MethodsGIN, NICE, AHRQ, PubMed, EMbase, AMED, CINAHL, WanFang Data, CNKI, VIP and CBM databases were electronically searched to collect domestic and overseas clinical practice guidelines on acupuncture from inception to September, 2018. Two reviewers independently screened literature, extracted data and evaluated the methodological and reporting quality by using AGREE Ⅱ and RIGHT tools.ResultsA total of 23 acupuncture clinical practice guidelines were included, in which three were developed by foreign institutions, and the remaining 20 guidelines were jointly developed by WHO Western Pacific Region and China Institute of Acupuncture and Moxibustion. Three foreign and two domestic guidelines were selected for evaluation. The AGREE Ⅱ evaluation showed that the domestic guidelines have higher scores in terms of " scope and purpose”, " stakeholder involvement”, " rigor of development”, " applicability” and " clarity of presentation”, while only " editorial independence” is lower. The overall recommendation is stronger than the foreign guidelines. The RIGHT evaluation showed that for three foreign guidelines, the " reported” items accounted for 52.38%, " unreported” items accounted for 38.09%, " partly reported” items accounted for 6.66%%; however, for domestic guidelines, the " reported” accounted for 45.71%, " unreported” items accounted for 40%, and " partly reported” items accounted for 14.28% respectively. Overall, the difference is not significant (SD<10%). Due to the specificity of acupuncture interventions, the use of AGREEⅡ and RIGHT to evaluate acupuncture clinical practice guidelines still had barriers to some extend on its applicability.ConclusionThe methodological and reporting quality of acupuncture clinical practice guidelines are relatively low. It is urgent to further improve the methodological level and reporting standards of the guidelines, and to develop evaluation tools for the acupuncture field guidelines.