Critical appraisal and evidence-based Chinese medicine
Ever since an awareness of two distinct cultural conceptions of healthcare has emerged, the debate concerning whether evidence-based medicine and Traditional Chinese medicine (TCM) are incompatible or whether they can in fact be unified, has continued. The key issue is that TCM, originating from an oriental culture, has encountered a hard limit in the Western concept of efficacy evaluation. At present, there is no methodological solution that can reconcile these two disciplines, and this has limited the international development of TCM. More specifically, TCM scholars believe that the process of efficacy evaluation is blind to TCM’s positive characteristics and conceals its true curative effect. The flexibility and availability of syndrome differentiation and the corresponding treatment method cannot be expressed in data, which hampers TCM’s capacity to gain wider acknowledgement. Furthermore, the measurement and evaluation of integral syndrome has not been accepted. Given the current level of recognition of TCM, an in-depth consideration of the following aspects is necessary.
- Systematic reviews of high quality. Even though some may regard these kinds of reviews as excessive, we believe that, on the contrary, the number of excellent systematic reviews is too few. This special issue has selected five systematic reviews and one clinical study protocol outlining TCM and acupuncture studies relating to acute organophosphorus pesticide poisoning, chronic kidney disease (stage 3–4), plaque psoriasis, and chronic prostatitis/chronic pelvic pain syndrome. We believe that high quality systematic reviews are the basis for the critical appraisal and evaluation of the curative effect of TCM.
- Safety evaluation in real-world study. Safety is the core issue in drug development. This special issue selected two real-world studies on the safety evaluation of Chinese patent medicine, in which more than 10,000 cases were observed.
- Rigorous clinical design of TCM. The true evaluation of curative effect originates from good design, and this design should be both detailed-oriented and come close to the target. Two study protocols in this issue discuss medical diseases and acupuncture treatment respectively.
- Exploration of the curative clinical effect methodology. This special issue also focuses on the validity and reliability of doctor-patient co-construction efficacy evaluation. In order to explore and reflect on patients’ feelings in clinical treatment, we selected this doctor-patient co-construction study; the article uses data from clinical research to test validity and reliability.
In addition to the above, the following issues and related articles are also addressed and included:
- Practice of international standard guidelines for TCM;
- The quality of reports on acupuncture research;
- n-of-1 randomized controlled trial;
- Transformation from basic research to clinical practice;
- Learning from foreign policy research.
These nine aspects, forming a critical appraisal of evidence-based Chinese medicine, are explored to more deeply interpret the TCM research area. Indeed, the standardization of clinical efficacy evaluation for TCM is the foundation for the bridge linking TCM with the rest of the world.
Acknowledgements
We thank to the 86th to 92th Sessions of Evidence-based Clinical Club (EBC), for their discussion on the manuscripts of topic selection.
(English Language Editor: John Ayric Gray, AME Publishing Company)
