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Clinical Epidemiology in China series. Paper 1: Evidence-based medicine in China: An oral history study
Objective: To describe and record the evolution of EBM in China. Study Design and Setting: We conducted the study following the general methodology of oral history. The interviews were done at Lanzhou University, between 18th and 22 nd April 2019 using pre-defined questions. All interviews were videorecorded. Two investigators extracted and analyzed the information from the interviews independently. Results: One international expert and ten Chinese experts participated in the interviews. After the introduction of EBM in China in the mid-1990s, more than 20 EBM centres have been established. According to the interviewees, Gordon Guyatt, David Sackett and lain Chalmers are the international experts who played the most important role in the development of EBM in China. China has contributed to EBM on the international level by conducting systematic reviews, developing reporting checklists, and introducing the principles of EBM into Traditional Medicine. The Chinese Cochrane Centre and the EBM Centre of Lanzhou University were ranked the top two EBM Centres in China by the interviewees. Conclusion: EBM has been developing in China for nearly a quarter of a century. Many achievements have been reached, however, EBM is still facing many challenges in China, including shortages of funding support and personnel, as well as limited local high-quality evidence. (C) 2021 Elsevier Inc. All rights reserved.
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Acupoint injection treatment for primary osteoporosis: a systematic review and meta-analysis of randomized controlled trials
Background: Acupoint injection has currently received increasing attention as a treatment for primary osteoporosis (POP), This study aimed to evaluate the efficacy and safety of acupoint injection as a clinical treatment for POP. Methods: Randomized controlled trials (RCTs) of acupoint injection compared with conventional non-acupoint injection for POP were identified in searches of seven databases from their inception to March 2019. All data were assessed and extracted by two authors independently. The risk of bias assessment recommended by the Cochrane Collaboration was used to assess the quality of the selected studies. RevMan 5.3 was used to conduct meta-analysis for the efficacy and safety of acupoint injection. Results: Five trials with 337 patients (aged 45–86 years) with bone mineral density (BMD) ≤2 SD were included in our meta-analysis. The results showed that, compared with conventional intramuscular injection, acupoint injection significantly increased the BMD [mean difference (MD) =0.02; 95% CI, 0.01 to 0.03, P0.05). Individuals results showed that acupoint injection improved biochemical indicators, such as NBAP, IGF-I and reduced CTX and leptin levels. While the risk of bias was high in all five trials. Conclusions: This meta-analysis and systematic review suggests that acupoint injection improves BMD and some biochemical indicators in POP patients compared with the effects of conventional intramuscular injection. However, due to the high risk of bias in all the trials reviewed, the evidence remains inconclusive and future research will be required with improved methodological quality.
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CONSORT extension for reporting N-of-1 trials for traditional Chinese medicine (CENT for TCM) : Recommendations, explanation and elaboration
Background: N-of-1 trial is a desired and appropriate approach to assessing the efficacy and safety of traditional Chinese medicine (TCM) interventions. There have been an increasing number of N-of-1 trials for TCM published. However, a lack of preferred reporting guidance led in the general poor reporting quality of these trials. Due to the unique characteristics of TCM, the working group developed this CONSORT Extension for reporting N-of-1 Trials for Traditional Chinese Medicine (CENT for TCM) to assist TCM researchers in reporting N-of-1 trials for TCM. Methods: We registered CENT for TCM at the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network (available at equator-network.org). The development was a comprehensive process through collection of the initial reporting items, two-round scientific Delphi consensus survey with 17 panelists, revision and formation of the final reporting checklist. Results: The checklist includes 25 items within six domains, eight items in which were extended and elaborated on the items of the CENT 2015 checklist. Explanation of the items were listed adequately considering the nature of TCM, introducing the concept of TCM syndrome differentiation and TCM interventions. Conclusions: CENT for TCM can be used to assess the completeness of the reporting of N-of-1 trials for TCM. The working group expect that CENT for TCM could be a practical tool to enhance the comprehensiveness and transparency of the design, implementation and reporting of N-of-1 trials for TCM.
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