Objective To explore the methods used for developing evidence-based clinical practice guidelines for acupuncture. Methods Based on the characteristics of acupuncture in traditional Chinese medicine,and principles of evidence-based medicine, this article introduces and summarizes the processes and methods for developing an evidence-based clinical practice guideline for acupuncture. We analyzed similarities and differences between clinical practice guidelines for acupuncture and for other interventions. We used an evidence-based clinical practice guideline of acupuncture for depression as an example to illustrate the methods of literature search, grading of evidence and recommendations, evidence evaluation and consensus formation. Results Preliminary recommendations on the methods for developing evidence-based clinical practice guidelines for acupuncture were made. Conclusion Based on the optimized rational methodology for developing clinical guidelines, evidence-based high-quality clinical practice guidelines for acupuncture could be established.
New interventions are rapidly progressing into clinical practice through the preclinical study stage. The animal experiments should be comprehensive and critically evaluated for their pivotal role in this process. To integrate the evidence of animal studies by systematic review throws light on intervention outcomes and could decrease risk of participants in human trials. The methodological weakness of animal studies is easy to highlight but robust methods to synthesize evidence is essential. Here, we discuss some problems in systematic review of animal experiments and whether animal models of diverse species contribute to bias of meta-analysis conclusions.
The use of core outcome sets reduces heterogeneity in the reporting of outcomes in clinical trials, increasing the value and significance of research. This paper first introduces and interprets “core outcome sets for myocardial infarction (COS-MI) in clinical trials of traditional Chinese medicine and Western medicine”, in order to help Chinese researchers better understand and use it. Second, this study surveyed the use of COS-MI in MI related clinical trials from January 1, 2023 to June 1, 2024, showing that 91% (10/11) of the 35 acute myocardial infarction clinical studies included reported core outcomes, and the median percentage of using core outcome sets was only 36% (4/11). As the publication time of the core outcome set is close to the literature search time, the understanding of domestic researchers about it is still unclear. Further research is needed to explore the application of core outcome sets for myocardial infarction in clinical trials of traditional Chinese medicine and Western medicine, providing a reference for its update and improvement.
This paper explores the methodological characteristics and key considerations of umbrella trials. By allocating different treatment strategies based on patients' molecular features, umbrella trials significantly enhance screening efficiency and can quickly identify ineffective therapies. Through the analysis of patient allocation strategies, statistical model selection, and error control methods, we can better utilize this design to accelerate drug development and achieve more efficient personalized treatment. However, despite significant progress in methodology and practice, umbrella trials still face multiple challenges during implementation, including trial design, sample size calculation, patient recruitment, informed consent, and resource allocation. Addressing these challenges in the future will help further optimize the application of umbrella trials. This study aims to provide thoughts and inspirations for researchers conducting umbrella trials and promote the steady development of this field.
Objective To compare the efficiency of epidermis cell culture between big graft method and small strip method. Methods The big graft method was to cut the skin tissue reticularly from dermis layer while the epidermis were not cut off. After it was digested fully in trypsin, theepidermis was separated from skin and was used to culture epidermal cells. The small strip method was routine. The time to cut the skin and to separate the epidermis was recorded, and the number and quality of cells were compared between two methods. Results It took 8-10 minutes to cut an area of 5 cm2 skin into small strips and 1-2 minutes into big grafts. It took 10-15 minutes to separate the epidermis from the same area skin by small strip method and 2 minutes by big graft method. The cells showed better vigor and its number was more by big grafts than by small strips.The chance of fibroblast contamination was reduced obviously. Conclusion The big graft method is simpler than the small strip method and can culture more epidermis cells with less chance of fibroblast contamination.
In the process of formation of recommendations of clinical practice guidelines, experts have many difficult problems of lack of transparency and high subjectivity in making final decisions, such as incomplete comprehensive consideration of dimensions and great heterogeneity in the evaluation of importance between dimensions, etc. As a decision-making tool, multi-criterion decision analysis improves the decision-making level of recommendation by adding the combination of qualitative and quantitative methods. By analyzing the challenges facing the formation of recommendations, this paper introduces the decision assistance of multi-criterion decision, and analyzes and summarizes the advantages and methods of the application of multi-criterion decision, so as to provide reference and guidance for guide makers to solve the difficulties in the formation of recommendations.
Using the AGREE Ⅱ standard, this paper interpretated from methodological perspective of the Korean Guidelines for Appropriate use of cardiac CT which was made by Korean Society of Radiology and the Korean Society of Cardiology.
In the process of guideline development and construction of clinical questions, it is necessary to guide clinicians to propose clinical problems into PICO (population, intervention, control, outcome) structured clinical questions. However, there are still unclear criteria to define and judge the appropriateness of the width of the PICO elements of a clinical question. Either too wide or too narrow can make the PICO question unsuitable to be a question for clinical practice guidelines to answer. We graded the clinical questions to be eight grades (3, 2, 1, 0, ?1, ?2, ?3, mixed) according to the number of the PIC elements, which obviously needed to be adjusted to evaluate applicability of the appropriateness of the width of the clinical questions. Our work can provide methodological references for clinicians and guideline developers.
Does-response meta-analysis, which has being developed for more than 30 years, is a type of regression function and can be both linear and non-linear model. It plays an important role in investigating the relationship between dependent and independent variable. With its special advantages, dose-response meta-analysis has been widely used in evidence-based practice and decision. Currently there are several models can be used to perform dose-response metaanalysis with various advantages and disadvantages. It is vital to choose best model to perform dose-response metaanalysis in evidence-based practice. In this paper, we briefly introduce and summarize the methodology of dose-response meta-analysis.