Maculopathy caused by various fundus diseases in the late stage is a common cause of low vision. Medical technology is difficult to reverse the loss of macular function currently, so interventions that help improve the visual system, utilize residual visual function, and improve quality of life deserve attention. Damage to the fovea of the macula does not mean that the entire retinal function is impaired. There may be one or more retinal regions adjacent to the fovea that can serve as a fixation center. It is possible to form stable paracentral fixation, complete functional remodeling of the visual system, and effectively utilize residual visual function by taking appropriate training on these potential paracentral fixation points for most patients. In 2021, a clinical guideline has been published for low vision rehabilitation in China. In order to strengthen the precise management of diseases and develop a standard operating procedure for visual training specifically for patients with low vision due to macular disease, the National Clinical Research Center for Eye Diseases initiated and organized relevant domestic experts, utilizing the latest research experience at home and abroad, and through repeated discussions, this consensus (International Practice Guideline Registration Number: PREPARE-2023CN199) was formed as a reference for ophthalmologists, optometrists and rehabilitation physicians in their clinical research and practice.
Acute Retinal Necrosis Syndrome (ARN) is a severe, vision-threatening ocular disease caused by herpesvirus infections. It is characterized by abrupt onset and rapid progression, often leading to irreversible visual impairment due to complications in the affected eye such as rhegmatogenous retinal detachment, optic atrophy, and intractable hypotony, and potential involvement of the fellow eye if not promptly diagnosed and treated. As ARN is relatively uncommon, many ophthalmologists lack sufficient experience in diagnosing ARN. In addition, its management is complex, typically involving antiviral therapy, corticosteroids, and vitrectomy. Currently, diagnostic and therapeutic approaches to ARN in hospitals across China are largely based on individual clinical experience, underscoring the urgent need for a standardized clinical protocol. To address this, the Fundus Diseases Group in Ophthalmology Branch of Chinese Medical Association and the Professional Committee of Fundus Diseases in Ophthalmology Branch of Chinese Medical Doctor Association have jointly developed Expert consensus on the diagnosis and treatment of acute retinal necrosis syndrome. The consensus is informed by a comprehensive review of the literature, the latest clinical research findings, and consideration of the current socio-economic context in China. Following multiple rounds of expert review and revision, the final version has been completed. This document provides a detailed account of ARN, covering clinical manifestations, imaging and etiological assessments, diagnostic and differential diagnostic criteria, as well as medical and surgical treatment strategies. It is intended to serve as a practical guide for both subspecialized and general ophthalmologists. Developed in accordance with the principles of evidence-based medicine and adapted to China’s clinical realities, the consensus offers practical guidance for the diagnosis and management of ARN. While the proposed clinical pathway is designed to meet the needs of most patients, clinicians are encouraged to tailor treatment plans based on individual patient factors, including disease severity, therapeutic options, and economic considerations.
Objective To form the list of methodological quality evaluation and explanation for the selection of objective performance criteria in single arm trial, and initially construct a methodological guiding tool for the selection and evaluation of target value, so as far to provide a research basis for improving the system of single-arm trial quality evaluation by objective performance criteria method. Methods Combining the bias risk assessment method of observational study, interventional trails, domestic and foreign policy documents, and systematically collecting the common bias and evaluation key points, preliminarily proposing the list of methodological quality evaluation and explanation for the selection of objective performance criteria in single-arm trial, via two rounds of expert consensus voting using nominal group method, finally formulating the list based on the voting results and expert opinions. Results Through two rounds of discussion, sorting, comprehensive expert opinions, we improved the corresponding items in the list and finally formed the list of methodological quality evaluation and explanation for the selection of objective performance criteria in single-arm trial, which included four areas: authority, traceability, comparability, and reliability, including 10 items. The entries in each field considered both design and implementation throughout the clinical trial. Conclusion The methodology list developed in this study provides methodological guidance for the selection of objective performance criteria and quality evaluation, and provides a solid theoretical basis for the establishment of a complete methodological system of quality evaluation for objective performance criteria single arm trails.
Pneumoconiosis is the most harmful and common occupational disease in China. The development of a pneumoconiosis rehabilitation expert consensus can improve utilization of the unique advantages of Chinese and Western medicine rehabilitation strategies, and provide effective and feasible guidance for the clinical rehabilitation of pneumoconiosis. We conducted clinical problem investigation, evidence collection and evaluation, Delphi consultation, and other technical links following the WHO guidelines to formulate manual procedures. Relevant rehabilitation guidelines, systematic reviews, clinical researches, and other current best evidence and expert opinions were extensively solicited to formulate the consensus. The reporting of consensus followed the RIGHT statement. The 14 types of rehabilitation strategies recommended by this consensus can be used by clinical rehabilitation physicians, rehabilitation therapists, respiratory therapists, nursing staff, community rehabilitation, health education, and other professionals for the rehabilitation of pneumoconiosis patients.
Objective To explore the methodological characteristics of Chinese clinical practice guidelines/expert consensus based on usage of GRADE. MethodsCNKI, PubMed, WanFang Data databases, and Medlive.cn were electronically searched to collect Chinese clinical practice guidelines/expert consensus over the past 11 years from January 1st 2010 to December 31st 2020. Four reviewers independently extracted data according to the content of appraisal of guidelines quality evaluation tool AGREE Ⅱ. The clinical practice guidelines/expert consensus were divided into two groups based on whether GRADE was used or not. The changes and development of methodological quality in the past 11 years were explored between the two groups. ResultsIn recent years, the number of clinical practice guidelines/expert consensus which used the GRADE in China had increased annually. The practice guidelines/expert consensus which did not use GRADE had lower methodology quality (P<0.01). ConclusionsThe use of GRADE in clinical practice guidelines/expert consensus requires improvement, and mastering GRADE methodology can effectively improve the methodological quality of the clinical practice guidelines/expert consensus.
With the advancement of research on rare ocular diseases such as inherited retinal dystrophy (IRD) has advanced in recent years, especially breakthroughs in therapeutic approaches represented by cell and gene therapy, potential intervention strategies have emerged for these conditions. Establishing standardized endpoints and evaluation methods for visual function in patients with IRD has become crucial for assessing disease progression, safety, and therapeutic efficacy of innovative treatments. Best corrected visual acuity (BCVA) is widely recognized as one of the primary endpoints for assessing visual function. However, for IRD patients with severe rod photoreceptor dysfunction, who often present with profound low vision or even legal blindness, the applicability of BCVA as a traditional visual function indicator is limited. The multi-luminance mobility test (MLMT) has emerged as a functional visual assessment tool that evaluates the ability to navigate obstacle courses under varying illumination levels. By establishing graded evaluation standards, MLMT objectively quantifies the impact of lighting conditions on patients’ nobility and spatial orientation, providing a novel quantitative tool for assessing visual function in IRD clinical trials. Currently, there is a lack of unified and standardized guidelines for the use of MLMT in China, posing challenges to its implementation in practical clinical research. To address this, Ocular Fundus Disease Society of Chinese Medical Association and Chinese Medical Doctor Association convened a multidisciplinary team comprising clinical experts in genetic retinal diseases, statisticians, and optical specialists to investigate the current applications and technical characteristics of MLMT, ultimately formulating consensus recommendations for its use as a clinical trial endpoint for IRD gene therapies. This consensus aims to provide a set of MLMT operating norms applicable to China's national conditions, guide clinical practice and research in ophthalmology and related disciplines, and promote the standardization process of IRD clinical trials in China, so as to better serve the IRD patient population and promote the development of related fields.
The high incidence of hydatid disease in seven northwestern provinces, is one of the reason of "Poverty due to illness, and return poverty due to illness" in China. The incidence of chest hydatid disease in China after hepatic hydatid disease ranks second. Department of thoracic surgery in the First Affiliated Hospital of Xinjiang Medical University is on the domestic leading position of the treatment of chest hydatid disease. Since 1956 the first case of pulmonary hydatid cyst were completed, we have successfully finished the surgical treatment of pediatric chest hydatid disease, chest hydatid disease complex, huge pulmonary hydatid cyst, mediastinal and pleural hydatid cyst, and rib hydatid in our department. To further standardize the treatment of chest hydatid disease, a special formulation of "technical specification for chest hydatid disease diagnosis expert consensus" by our department were produced, in order to help clinicians treat chest hydatid disease by more suitable strategies. This consensus was released in July 2015, for the original version. The definition, diagnosis, treatment principle, and prevention of chest hydatid disease were elaborated and clinical experiences of 60 years were combined with in this consensus, in order to help the clinicians for diagnosis, treatment, and prevention of hydatid disease.
Pathological myopic tractional maculopathy (MTM), as an important type of macular lesions associated with high myopia, play a significant role in the prevention and treatment of myopic macular diseases. With the rapid development of retinal imaging technologies, especially the widespread application of optical coherence tomography, new technical support has been provided for the accurate diagnosis, clinical staging, treatment decision-making, and long-term follow-up of MTM. However, in clinical practice in China, there are still issues such as unclear definitions, inconsistent staging criteria, and significant differences in treatment strategies. To address these challenges, Fundus Diseases Group in Ophthalmology Branch of Chinese Medical Association and Professional Committee of Fundus Diseases in Ophthalmology Branch of Chinese Medical Doctor Association for Ophthalmologists jointly drafted the Expert consensus on management of pathologic myopic tractional maculopathy in China, based on a systematic literature review and the latest clinical evidence. The consensus was revised multiple times by the core expert group and finally finalized. This consensus systematically establishes a standardized diagnostic and therapeutic system for MTM, covering disease definition and staging, diagnostic pathways and follow-up protocols, treatment strategies based on staging, and surgical intervention plans. It aims to provide ophthalmologists at all levels with a scientifically sound and practically applicable clinical guidance. The development of the consensus strictly adheres to the principles of evidence-based medicine, fully considering the actual clinical conditions of medical institutions at different levels in China. It provides principled recommendations with broad guiding significance for the clinical practice of MTM. It is particularly emphasized that when applying this consensus, clinicians should comprehensively consider the patient’s clinical characteristics, treatment accessibility, and socioeconomic factors, and implement personalized and precise treatment strategies to meet the diverse clinical needs of patients with pathological myopia.
COVID-19 has been an established and continuing health problem. For the first time, this consensus focused on multi-scenario populations in the home/community, hospitalization and rehabilitation periods, and addressed medical nutrition management issues on which no consensus had yet been reached. This consensus was formulated on the basis of a comprehensive review of the existing evidence combined with the opinions of experts, with a view to complementing the existing guidelines/consensus.