1,720,991 research outputs found
"Defining best practice...? Elementary my dear researcher."
No full textIn this brief but engaging article, the author ruminates on the political nature of research and on the problems this poses for East Asian Medicine, and points to the fact that the thorny business of defining best (or at least 'good enough') practice is of central importance here. He concludes by offering a richly simple model - based on the Five Phases (wu xing) - for defining what best practice is.<br/
The role of Chinese herbal medicine in the treatment of endometriosis
No full textEThOS - Electronic Theses Online ServiceGBUnited Kingdo
Seeking an oracle: using the Delphi process to develop practice guidelines for the treatment of endometriosis with Chinese herbal medicine
No full textBackground: For most complementary and alternative medicine interventions, the absence of a high-quality evidence base to define good practice presents a serious problem for clinicians, educators, and researchers. The Delphi process may offer a pragmatic way to establish good practice guidelines until more rigorous forms of assessment can be undertaken. Objectives: To use a modified Delphi to develop good practice guidelines for a feasibility study exploring the role of Chinese herbal medicine (CHM) in the treatment of endometriosis. To compare the outcomes from Delphi with data derived from a systematic review of the Chinese language database. Design: An expert group was convened for a three-round Delphi that initially produced key statements relating to the CHM diagnosis and treatment of endometriosis (round 1) and then anonymously rated these on a 1-7 Likert scale (rounds 2 and 3). Statements with a median score of 5 and above were regarded as demonstrating positive group consensus. The differential diagnoses within Chinese Medicine and rating of the clinical value of individual herbs were then contrasted with comparable data from a review of Chinese language reports in the Chinese Biomedical Retrieval System (1978-2002), and China Academy of Traditional Chinese Medicine (1985-2002) databases and the Chinese TCM and magazine literature (1984-2004) databases. Results: Consensus (good practice) guidelines for the CHM treatment of endometriosis relating to common diagnostic patterns, herb selection, dosage, and patient management were produced. The Delphi guidelines demonstrated a high degree of congruence with the information from the Chinese language databases. Conclusions: In the absence of rigorous evidence, Delphi offers a way to synthesize expert knowledge relating to diagnosis, patient management, and herbal selection in the treatment of endometriosis. The limitations of the expert group and the inability of Delphi to capture the subtle nuances of individualized clinical decision-making limit the usefulness of this approac
The RUTI trial: a feasibility study exploring Chinese herbal medicine for the treatment of Recurrent Urinary Tract Infections
No full textThis dataset contains data which are used for generating the tables and graphs in the manuscript 'The RUTI trial: a feasibility study exploring Chinese herbal medicine for the treatment of Recurrent Urinary Tract Infections'
The trial data (without diary entry) is in the excel 'RUTI trial data (Final)'. A data tab gives information on how the numbering relates to the CRFs.
The diary data is supplied in two forms, one where the diary data is entered where the symptom score has been used continuously throughout the diary as some participants were never free of symptoms and another set where it is entered where a low score has been used with the assumption that this is not a UTI as would 'normally' be defined making episodic data.
This dataset supports the publication:The RUTI trial: a feasibility study exploring Chinese herbal medicine for the treatment of Recurrent Urinary Tract Infections.</span
Developing clinical practice guidelines for the treatment of polycystic ovary syndrome with Chinese herbal medicine: a mixed-method modified Delphi study
Full text linkBackground: polycystic ovary syndrome (PCOS) is the most common female reproductive endocrine disorder, affecting 6–18% of women of reproductive age. Chinese herbal medicine (CHM) is gaining popularity in the UK and has been historically effective for symptoms of PCOS. However, it remains unclear what constitutes routine clinical practice in CHM in order to conduct further rigorous research.Aim: the aim of this study was to develop clinical practice guidelines for the treatment of PCOS using CHM.Method: following a modified Delphi method, CHM practitioners were purposively sampled and interviewed to explore their views on CHM prescribing for PCOS. Interviews were transcribed verbatim and thematic and framework analysis was applied to transcriptions to formulate statements of key clinical practice points. These statements were distributed via an online questionnaire to the same herbalists who were invited to rate their agreement with each statement on a 7-point Likert scale. Group consensus on a statement was defined a priori as a median Likert score of 5 or more. Questionnaire statements not reaching consensus were re-distributed to herbalists for re-consideration via a further questionnaire.Results: eleven CHM practitioners based in the UK were recruited. Six themes emerged from interviews and 85 statements regarding clinical practice were produced. When these were distributed via a questionnaire, 83 reached group consensus (97.6%) with a response rate of 100%. In the subsequent questionnaire containing eight statements, six reached group consensus (75%) with a response rate of 100%. A total of 84 statements are presented in the concluding set of clinical practice guidelines, each one included following an assessment of relevance to clinical practice, which was independent of final group consensus rating. These statements were graded from A (strong consensus) to D (consensus not achieved), determined by considering the median and interquartile range of responses per statement.Conclusion: the Delphi method has been used successfully to facilitate a systematic and rigorous practitioner consultation exercise. This has resulted in the development of clinical practice guidelines that reflect routine CHM prescribing practices for PCOS. These guidelines will be used to inform the design of a forthcoming clinical stud
Comparison of effectiveness and safety between granules and decoction of Chinese herbal medicine: a systematic review of randomised clinical trials
No full textBackground: the clinical use of Chineseherbal medicine granules is gradually increasing. However, there is still no systematicreview comparing the effectiveness and safety of granules with the more traditional method of herbaldecoctions.Method: a literature search was conducted using China National Knowledge Infrastructure Databases (CNKI), Chinese Science and Technology Periodical Database (VIP), China Biomedical Database web (CBM), Wanfang Database, PubMed, and the Cochrane Library until March 10, 2011. Clinical controlled trials (CCTs) including randomized trials (RCTs) comparing the effectiveness and safety between Chineseherbal medicine granules and decoction were included. Two authors conducted the literature searches, and extracted data independently. The assessment of methodological quality of RCTs was based on the risk of bias from the Cochrane Handbook, and the main outcome data of trials were analyzed by using RevMan 5.0 software. Risk ratio (RR) or mean difference (MD) with a 95% confidence interval (CI) were used as effect measure.Results: 56 clinicaltrials (n = 9748) including 42 RCTs and 14 CCTs were included, and all trials were conducted in China and published in Chinese literature. 40 types of diseases and 15 syndromes of traditional Chinese medicine (TCM) were reported. Granules were provided by pharmaceutical companies in 13 trials. The included RCTs were of generally low methodological quality: 7 trials reported adequate randomization methods, and 2 of these reported allocation concealment. 10 trials used blinding, of which 5 trials used placebo which were delivered double blind (blinded participants and practitioners). 98.2% (55/56) of studies showed that there was no significant statistical difference between granules and decoctions of Chineseherbal medicine for their effectiveness. No severe adverse effects in either group were reported.Conclusions: due to the poor methodological quality of most of the included trials, it is not possible to reach a definitive conclusion whether both Chineseherbal medicine granules and decoctions have the same degree of effectiveness and safety in clinical practice, but this preliminary evidence supports the continued use of granules in clinical practice and research. Standardization of granules and further more rigorous pharmacological, toxicological and clinical studies are needed to demonstrate the equivalence with decoction
Chinese herbal medicine in treating primary Sjögren's syndrome: a systematic review of randomized trials
Full text linkBackground. There is no curative treatment for primary Sj¨ogren’s syndrome (PSS). Chinese herbal medicine (CHM) is widely used in the treatment of PSS in China. Objective. To evaluate the effectiveness and safety of CHM for PSS. Methods. PubMed, Cochrane Library, China Knowledge Resource Integrated Database, Chinese Biomedical Database, Wanfang Data, and the Database for Chinese Technical Periodicals were searched for randomized controlled trials (RCTs) of CHMor CHM plus conventional medicine for PSS compared with placebo or conventional medicine. RevMan 5.0.17 was employed to conduct data analyses and assess homogeneity. Statistical models were chosen according to heterogeneity. Results. A total of 52 RCTs were included. The overallmethodological quality of included trials was low. 49 trials reported response rates, of which 32 found significant improvements favoring CHM treatment against controls; 20 trials reported lacrimal function by Schirmer test scores, of which 16 trials reported a significant difference favoring CHM treatment. 21 trials reported salivary function by salivary flow rate, of which 10 reported significant favorable effects of CHM treatment. Other trials found no difference. The reported adverse effects of CHM included nausea, diarrhea, and other minor digestive symptoms, but more frequent adverse effects occurred in conventional medicine groups. Conclusions. Preliminary evidence from RCTs suggests the effect of CHM is promising for relieving symptoms, improvinglacrimal and salivary function in PSS. However, the poor methodological quality of the included trials means that further welldesigned, multicentered, larger trials are needed
The challenges of treating women with recurrent urinary tract infections in primary care: a qualitative study of GPs’ experiences of conventional management and their attitudes towards possible herbal options
No full textAim To explore GPs’ experiences of managing recurrent urinary tract infections (RUTIs) and their views on the use of herbal medicines for this condition.Background RUTIs are an important problem commonly managed in primary care. Antibiotic prophylaxis is an effective treatment for acute infections but growing microbial resistance, adverse effects, and the lack of sustained long-term benefits mean that novel treatments are required. There are a number of promising reports of herbal medicines being used to treat RUTIs.Methods A total of 15 GPs (seven female; aged 34–59 years; in practice from 3 to 31 years) were purposively sampled and took part in semi-structured face-to-face and telephone interviews. Interviews were digitally recorded, transcribed, and analysed using inductive thematic analysis. Data collection and analysis proceeded iteratively to allow emerging themes to inform subsequent interviews.Findings Participants were aware of the disabling effect of RUTIs on women’s lives. GPs experienced significant challenges in their management of RUTIs with decisions about the provision of antibiotics being particularly complex. While some participants were open to the possibility of herbal treatment options they required more research into effectiveness and safety, better regulation of herbal practitioners, and assurance about herbal quality control and potential herb–drug interactions.<br/
Developing clinical practice guidelines for Chinese herbal treatment of polycystic ovary syndrome: a mixed-methods modified Delphi study
Full text linkObjectivesPreliminary evidence suggests Chinese herbal medicine (CHM) could be a viable treatment option for polycystic ovary syndrome (PCOS). Prior to conducting a clinical trial it is important to consider the characteristics of good clinical practice. This study aims to use professional consensus to establish good clinical practice guidelines for the CHM treatment of PCOS.Design and settingCHM practitioners participated in a mixed-methods modified Delphi study involving three rounds of structured group communication. Round 1 involved qualitative interviews with practitioners to generate statements regarding good clinical practice. In round 2, these statements were distributed online to the same practitioners to rate their agreement using a 7-point Likert scale, where group consensus was defined as a median rating of ?5. Statements reaching consensus were accepted for consideration onto the guideline whilst those not reaching consensus were re-distributed for consideration in round 3. Statements presented in the guidelines were graded from A (strong consensus) to D (no consensus) determined by median score and interquartile range.Results11 CHM practitioners in the UK were recruited. After three Delphi rounds, 91 statement items in total had been considered, of which 89 (97.8%) reached consensus and 2 (2.2%) did not. The concluding set of guidelines consists of 85 items representing key features of CHM prescribing for PCOS.ConclusionsThese guidelines can be viewed as an initial framework that captures fundamental principles of good clinical practice for CHM
- …
