Skip to main content
SpringerLink
Log in

Status Quo and Analysis of the Cardiovascular Clinical Practice Guidelines/Expert Consensuses of Chinese and Integrative Medicine: A Systematic Review

  • Evidence-Based Integrative Medicine
  • Published:
Chinese Journal of Integrative Medicine Aims and scope Submit manuscript

Abstract

Objective

To describe and analyze the status quo of cardiovascular clinical practice guidelines or expert consensuses including both Chinese medicine (CM) and integrative medicine, through systematic literatures searching and quality assessment.

Methods

Data bases including Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database were searched for published CM or integrative cardiovascular clinical practice guidelines or expert consensuses. The website www. medlive.cn was also retrieved as supplementary. The clinical practice evaluation tool AGREE II was used to assess the quality of included guidelines or consensuses.

Results

A total of 31 relevant clinical practice guidelines or expert consensuses were included, covering diagnosis, treatment, Chinese patent and patient fields. Common cardiovascular diseases like coronary heart diseases, heart failure and arrhythmia were also involved. Through analysis it was found that both the quantity and quality of included guidelines have been improved year by year. A total of 4 evidence-based clinical practice guideline has been found, one of which was a guideline project plan. Except that, the remaining 27 reports were all consensus-based guidelines. The scores of each field, from highest to lowest, were clarity of presentation (58%), scope and purpose (54%), stakeholder involvement (28%), rigor of development (21%), applicability (13%) and editorial independence (8%).

Conclusions

Although clinical practice guidelines in cardiovascular domain of Chinese have gained increasing concern, with both quantity and quality improved, there is still huge gap in methodology and reporting standards between CM guidelines and international ones. On the one hand, it is essential to improve and standardize the methodology of developing CM guidelines. On the other hands, the evaluation system of evidence and recommendation with CM characters should be developed urgently.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Institute of Medicine. Clinical practice guidelines: directions for a new program. Washington (DC): National Academies Press; 1990.

    Google Scholar 

  2. Institute of Medicine. Clinical practice guidelines we can trust. Washington (DC): National Academies Press; 2011.

    Google Scholar 

  3. Song J, Cheng KJ. Set clinical therapeutic guideline in traditional Medicine urgently. Chin J Integr Tradit West Med (Chin) 2006;26:581–584.

    Google Scholar 

  4. Liang WX. Problems-solving strategies in clinical treatment guideline for traditional Chinese medicine and integrative medicine. J Chin Integr Med (Chin) 2008;6:1–4.

    Article  Google Scholar 

  5. Chen YL, Zhou Q, Cui RR, Yang N, Xiao SJ, Shang HC. Quality evaluation of traditional Chinese medicine guidelines based on AGREE II instrument. Chin J Evid Based Med (Chin) 2016;16:1331–1337.

    Google Scholar 

  6. Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G, et al. AGREE next steps consortium. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ 2010;182:E839–842.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Wei D, Wang CY, Xiao XJ, Cheng YL, Yao L, Liang FX, et al. Interpretation of application of guideline research and assessment instrument (AGREE II). Chin J Evid Based Pediatr (Chin) 2013;8:316–319.

    Google Scholar 

  8. Wang SC, Zhao X, Yu S, Wang L, Lin LL. Quality evaluation of evidence-based Chinese medicine clinical diagnosis and treatment guideline: the AGREE II instrument and its application. Chin J Tradit Chin Med Pharm (Chin) 2016;31:2963–2967.

    Google Scholar 

  9. China Association of Chinese Medicine. Guidelines for diagnosis and treatment of common internal diseases in Chinese medicine (symptoms in Chinese medicine). Beijing: China Press of Traditional Chinese Medicine 2008:1–44.

    Google Scholar 

  10. China Association of Chinese Medicine. Guidelines for diagnosis and treatment of common internal diseases in Chinese medicine (diseases of modern medicine). Beijing: China Press of Traditional Chinese Medicine; 2008:37–39, 47–66.

    Google Scholar 

  11. Internal Medicine Branch of Cardiovascular Diseases, et al. Chinese expert consensus for the clinical application of Xuezhikang. Chin J Med (Chin) 2009;44:69–71.

    Google Scholar 

  12. China Academy of Chinese Medical Sciences. Chinese evidence-based clinical practice guideline-CM. Beijing: China Press of Traditional Chinese Medicine; 2011:227–281.

    Google Scholar 

  13. The Committee of Promoting Blood Circulation to Remove Blood Stasis, Chinese Association of the Integration of Traditional and Western Medicine. Expert consensus on the diagnosis and treatment of blood-stasis syndrome with integrated traditional Chinese and Western medicine. Chin J Integr Tradit West Med (Chin) 2011;31:839–844.

    Google Scholar 

  14. The Committee of Interventional Cardiology, China Association of Chinese Medicine, et al. Expert consensus on the CM diagnosis and treatment of pre-and-post-operative depression or anxiety with percutaneous coronary interventional therapy. Chin Circ J (Chin) 2014;29(Suppl):151–157.

    Google Scholar 

  15. The Committee of Interventional Cardiology, China Association of Chinese Medicine, et al. Expert consensus on the CM diagnosis and treatment of pectoralgia with percutaneous coronary interventional therapy. Chin Circ J (Chin 2014; 29(Suppl):141–146.

    Google Scholar 

  16. The Committee of Interventional Cardiology, China Association of Chinese Medicine. Expert consensus on the CM diagnosis of chest stuffiness and pains with internal wind syndrome. J Tradit Chin Med (Chin) 2014;55:1528–1530.

    Google Scholar 

  17. The Committee of Integrated Traditional Chinese and Western Medicine, Chinese Medical Doctor Association, et al. Expert consensus on the diagnosis and treatment of acute myocardial infarction with integrated traditional Chinese and Western medicine. Chin J Integr Tradit West Med (Chin) 2014;34:389–395.

    Google Scholar 

  18. CM Clinical Research Alliance of Coronary Heart Disease, et al. Expert consensus on the diagnosis and treatment of chronic cardiac failure with traditional Chinese medicine. J Tradit Chin Med (Chin) 2014;55:1258–1260.

    Google Scholar 

  19. Pulmonary System Branch of China Association of Chinese Medicine. Chinese medicine guideline on the diagnosis and treatment of chronic pulmonary heart disease. J Tradit Chin Med (Chin) 2013;55:526–531.

    Google Scholar 

  20. Chinese Integrative Medicine Association Cardiology Committee Heart Failure Group, et al. Expert consensus on the normative clinic application of Xinmailong Injection for chronic cardiac failure. Chin J Integr Tradit West Med (Chin) 2016;36:280–284.

    Google Scholar 

  21. The Committee of Neurology, Beijing Association of Integrative Medicine. Expert consensus on the diagnosis and treatment of acute hypertensive encephalorrhagia with integrated traditional Chinese and Western medicine. Chin Gen Prac (Chin) 2016;19:3641–3648.

    Google Scholar 

  22. Chinese Integrative Medicine Association Cardiology Committee, et al. Expert consensus on the diagnosis and treatment of chronic cardiac failure with integrated traditional Chinese and Western medicine. Chin J Integr Tradit West Med (Chin) 2016;36:133–141.

    Google Scholar 

  23. China Heart Federation, Chinese Society of Cardiovascular Prevention and Rehabilitation. Chinese expert consensus on the use of Zhibitai Capsules. Chin J Intern Med (Chin) 2017;56:628–632.

    Google Scholar 

  24. The Committee of Integrated Traditional Chinese and Western Medicine, Chinese Medical Doctor Association. Chinese expert consensus on the use of Safflower yellow. Chin J Integr Tradit West Med (Chin) 2017;37:1167–1173.

    Google Scholar 

  25. Chinese Integrative Medicine Association Cardiology Committee. Chinese expert consensus on the application of Shexiang Baoxin Pills for angina pectoris. Chin J Integr Tradit West Med (Chin) 2018;38:145–153.

    Google Scholar 

  26. Chinese Integrative Medicine Association Cerebral-Cardiac Committee, et al. Chinese expert consensus on the clinical application of Naoxintong Capsules. Chin J Integr Tradit West Med (Chin) 2017;37:1039–1042.

    Google Scholar 

  27. National Cardiovascular Disease Center, et al. Expert consensus on the I phase cardiac rehabilitation of coronary artery bypass grafting with integrated traditional Chinese and Western medicine. Chin Circ J (Chin) 2017;32:314–317.

    Google Scholar 

  28. The Committee of Interventional Cardiology, World Federation of Chinese Medicine Societies, et al. Expert consensus on the diagnosis and treatment of percutaneous coronary intervention for perioperative myocardial damage with traditional Chinese medicine. Chin J Integr Tradit West Med (Chin) 2017;37:389–393.

    Google Scholar 

  29. Chinese Integrative Medicine Association Cardiology Committee Psychocardiology Group. Expert consensus on the diagnosis and treatment of psycho-cardiological disease with integrated traditional Chinese and Western medicine. Chin Gen Prac (Chin) 2017;20:1659–1662.

    Google Scholar 

  30. Professional Group of Lipid and Atherosclerosis, Cardiovascular Disease Committee of the Integration of Traditional Chinese and Western Medicine. Expert consensus on the diagnosis and treatment of atherosclerosis by combination of traditional Chinese and Western medicine. Chin Gen Prac (Chin) 2017;20:507–511.

    Google Scholar 

  31. Professional Group of Lipid and Atherosclerosis, Cardiovascular Disease Committee of the Integration of Traditional Chinese and Western Medicine. Expert consensus on the diagnosis and treatment of dyslipidemia by combination of traditional Chinese and Western medicine. Chin Gen Prac (Chin) 2017;20:262–269.

    Google Scholar 

  32. Li Y, Chen YL, Chen J, Shang HC, Yang KH, Guo GF, et al. Guideline protocol of non-pharmacological secondary prevention for myocardial infarction. Chin J Evid-based Med (Chin) 2016;16:617–620.

    Google Scholar 

  33. Yuan S, Li YF. The developing methodology and evaluating principle of Chinese clinical practice guidelines. Chin J Breast Dis (Electronic Edition, Chin) 2014;8:283–287.

    Google Scholar 

  34. Hu J, Zhan SY. The status quo and suggestion of Chinese clinical practice guidelines. Chin J Evid Based Cardiovasc Med (Chin) 2013;5:217–218.

    Google Scholar 

  35. Chinese Society of Cardiology of Chinese Medical Association, et al. Chinese guideline for diagnosis and treatment of heart failure 2014. Chin J Cardiol (Chin) 2014;42:98–122.

    Google Scholar 

  36. State Administration of Traditional Chinese Medicine. The outline of the development plan for the standardization of traditional Chinese medicine (2006–2010). Chin News Tradit Chin Med (Chin) 2006-7-28(3).

    Google Scholar 

  37. State Administration of Traditional Chinese Medicine. The outline of the medium-and long-term development plan for the standardization of traditional Chinese medicine (2011–2020). Chin News Tradit Chin Med (Chin) 2012-12-20(3).

    Google Scholar 

  38. Wang LY, Han XJ, Shi NN, Yu WY, Lv AP. Analysis and reflection on the development of CM clinical practice guidelines. Modern Tradit Chin Med Mater Med World Sci Tech (Chin) 2011;13:728–729.

    Google Scholar 

  39. Alonso-Coello P, Irfan A, Sola I, Gich I, Delgado-Noguera M, Rigau D, et al. The quality of clinical practice guidelines over the last two decades: a systematic review of guideline appraisal studies. Qual Saf Health Care 2010;19:e58.

    PubMed  Google Scholar 

  40. Chen YL, Yang KH, Marusic A, Qaseem A, Meerpohi JJ, Flottorp S, et al. A reporting tool for practice guidelines in health care: the RIGHT statement. Ann Intern Med 2017;166:128–132.

    Article  PubMed  Google Scholar 

  41. Chen KJ, Jiang YR. Current status and problems in developing clinical guidelines for Chinese medicine and integrative medicine. J Chin Integr Med (Chin) 2009;7:301–305.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China

    Cheng-yu Li, Yao-long Chen, Jia-yuan Hu, Min Li, Xiao-yu Zhang, Yang Sun, Rui Zheng, Shi-qi Chen, Song-jie Han, Tian-mai He & Hong-cai Shang

  2. Evidence-Based Medicine Center, Lanzhou University, Lanzhou, 730000, China

    Yao-long Chen

Authors
  1. Cheng-yu Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yao-long Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jia-yuan Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Min Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xiao-yu Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yang Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rui Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shi-qi Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Song-jie Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tian-mai He
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Hong-cai Shang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Shang HC and Li CY conceived the study. Chen YL, Li CY and Hu JY developed the search strategy. Li CY and Hu JY conducted the collection of study data. Li M and Zhang XY implemented the title and abstract screening. Sun Y and Zheng R made the data extraction. Li CY, Hu JY, Han SJ and He TM made the quality assessment and synthesized the data. Li CY and Hu JY drafted the manuscript. Shang HC, Li M and Chen SQ critically revised the manuscript. Chen YL provided the technical support for the study. All authors participated in the study and approved the final version. (Appendixes) are available in the online version of this article at https://doi.org/10.1007/s11655-020-2725-3.

Corresponding author

Correspondence to Hong-cai Shang.

Ethics declarations

The authors declare that they have no competing interests in relation to this article.

Additional information

Supported by the National Key R&D Program of China (Nos. 2017YFC1700402, 2017YFC1700400)

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, Cy., Chen, Yl., Hu, Jy. et al. Status Quo and Analysis of the Cardiovascular Clinical Practice Guidelines/Expert Consensuses of Chinese and Integrative Medicine: A Systematic Review. Chin. J. Integr. Med. 27, 54–61 (2021). https://doi.org/10.1007/s11655-020-2725-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11655-020-2725-3

Keywords

Search

Navigation