Skip to main content
Log in

Methodological approaches to developing and establishing the body of evidence on post-marketing chinese medicine safety

  • Feature Article
  • Published:
Chinese Journal of Integrative Medicine Aims and scope Submit manuscript

Abstract

Evidence based medicine demands the highest form of scientific evidence to demonstrate the efficacy and clinical effectiveness for any therapeutic intervention in order to provide best care. It is however accepted that in the absence of scientific evidence, personal experience and expert opinion together with professional judgement are critical. Obtaining evidence for drug safety, postmarketing surveillance (PMS) has focussed on follow up of observational cohorts exposed to a particular drug in order to estimate the incidence of adverse drug reactions (ADRs). Evidence on PMS of Chinese herbal products is still limited, in particular for herbal injections. The aim of this article is to suggest a new model of ascertaining the safety of Chinese medicine using a more comprehensive approach for collecting data. To collect safety data on the Chinese herbal injection, Kudiezi, a mixed methods approach is proposed using 18 hospital information systems to detect ADRs in order to prospectively observe 30,000 patients over 3 years. Evidence will also be collected using a questionnaire survey and through a sample of semi structured interviews. This information based on the expert opinion and the experience of clinicians will produce additional data on the frequency and types of side effects in clinical practice. Furthermore semi structured interviews with a random sample of patients receiving the injection will be carried out to ascertain any potential side effects missed. It is hoped that this comprehensive approach to data collection will accumulate wider evidence based on individual traditional Chinese medicine care and treatment and provide important feedback to the national data collection system to ensure completeness of ADR data recording, monitoring and any potential wider effects through developing improved ADR guidelines.

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

Access this article

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

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Claridge J, Fabian T. History and development of evidence based medicine. World J Surg 2005;29:547–553.

    Article  PubMed  Google Scholar 

  2. Sackett DL, Strauss SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-based medicine: how to practice and teach EBM. 2nd ed. Edinburgh: Churchill Livingstone; 2000.

    Google Scholar 

  3. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71–72.

    Article  PubMed  CAS  Google Scholar 

  4. Evidence-Based Medicine Working Group. Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA 1992;268:2420–2425.

    Article  Google Scholar 

  5. “Evidence-based health care and systematic reviews”. The Cochrane Collaboration. http://www.cochrane.org/about-us/evidence-based-health-care. Retrieved 4 January 2013.

  6. “What is EBM?”. CEBM — Centre for Evidence Based Medicine. http://www.cebm.net/?o=1014. Retrieved Retrieved 4 January 2013.

  7. Tonelli MR. In defense of expert opinion. Acad Med 1999;74:1187–1192.

    Article  PubMed  CAS  Google Scholar 

  8. Rawlins M. De testimonio: on the evidence for decisions about the use of therapeutic interventions. Lancet 2008;372:2152–2161.

    Article  PubMed  Google Scholar 

  9. Li NY, Abbott KV, Rosen C, An G, Hebda PA, Vodovotz Y. Translational systems biology and voice pathophysiology. Laryngoscope 2010;120:511–515.

    Article  PubMed  Google Scholar 

  10. McNeil JJ, Piccenna L, Ronaldson K, Ioannides-Demos LL. The value of patient-centred registries in phase IV drug surveillance. Pharm Med 2010;24:281–288.

    Article  Google Scholar 

  11. Wang H, Ye X, Gao Q, Wu C, Qian Y, Luo B, et al. Pharmacovigilance in traditional Chinese medicine safety surveillance. Pharmacoepidemiol Drug Safety (Chin) 2009;18:357–361.

    Article  Google Scholar 

  12. Lu QL, Fang JJ. A survey of twenty years ADR caused by traditioonal Chinese medicine. Adverse Drug Reactions J (Chin) 2001;91:18–21.

    Google Scholar 

  13. Zhang LL. Research on marketing strategy of Tong Hua Die mai ling. Masters Thesis (Chin) 2007;F830:33.

    Google Scholar 

  14. Liao X, Shen H, Xie YM, Zhang W, Yang W, LU ZG. Literature review report on safety evaluation about Kudiezi injection. China J Chin Mate Med (Chin) 2012;18:2786–2788.

    Google Scholar 

  15. Zuo ZJ, Huang QM. A systematic review of Kudiezi Injection in the treatment of angina pectoris. China Med Herald (Chin) 2011;4:32–35,73.

    Google Scholar 

  16. Jiang YB, Chen KJ.Systematic evaluation on the effect of Diemaining Injection in treating acute cerebral infarction. Chin J Clin Rehabil (Chin) 2006;27:100–101.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nicola Robinson.

Additional information

Supported by National Natural Science Foundation of China (General Program, No. 81202776) and the Sixth-Science Foundation of Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences (No. Z0215)

Rights and permissions

Reprints and permissions

About this article

Cite this article

LIao, X., Robinson, N. Methodological approaches to developing and establishing the body of evidence on post-marketing chinese medicine safety. Chin. J. Integr. Med. 19, 494–497 (2013). https://doi.org/10.1007/s11655-013-1502-y

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11655-013-1502-y

Keywords

Navigation