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Development of an Evidence-Based Clinical Practice Guideline of Korean Medicine for Stroke: A Study Protocol

  • Han, Chang-ho (Department of Internal Medicine, College of Korean Medicine, Dongguk University) ;
  • Kim, Mikyung (Department of Internal Medicine, College of Korean Medicine, Sangji University)
  • Received : 2018.03.14
  • Accepted : 2018.05.08
  • Published : 2018.12.31

Abstract

Introduction: The aim of this study protocol is to share and disclose the methodology used to develop an evidence-based clinical practice guideline (CPG) of therapeutic interventions used in Korean medicine for patients with stroke. Methods: The CPG development process will consist of two phases. In phase I, a development committee will be established, and they will decide the key questions to be answered. A systematic review and meta-analysis will be performed to answer these key questions by searching relevant randomized controlled trials and systematic reviews. Draft recommendations will be developed according to the evidence level and recommendation grades primarily determined using the GRADE methodology. Panels comprised of external experts will be formed, and surveys and a face-to-face meeting will be conducted to reach a consensus on the recommendations. A preliminary guideline will be created after final review by the development committee. In phase II, we will conduct clinical trials and economic analysis to supplement the lack of evidence found in the phase I. Conclusion: The CPG is expected to help doctors practicing Korean medicine in clinics or hospitals with making decisions based on the most reliable evidence, ultimately leading to the provision of optimal care for patients with stroke.

Keywords

References

  1. Feigin VL, Norrving B, Mensah GA. Global burden of stroke. Circulation research. 2017;120(3):439-48. https://doi.org/10.1161/CIRCRESAHA.116.308413
  2. Hong KS, Bang OY, Kang DW, Yu KH, Bae HJ, Lee JS, et al. Stroke statistics in Korea: part I. Epidemiology and risk factors: a report from the korean stroke society and clinical research center for stroke. Journal of Stroke. 2013;15(1):2-20. https://doi.org/10.5853/jos.2013.15.1.2
  3. Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al. Guidelines for adult stroke rehabilitation and recovery. Stroke. 2016;47(6):e98-e169. https://doi.org/10.1161/STR.0000000000000098
  4. Ahmed N, Steiner T, Caso V, Wahlgren N. Recommendations from the ESO-karolinska stroke update conference, Stockholm 13-15 November 2016. European Stroke Journal. 2017;2(2):95-102. https://doi.org/10.1177/2396987317699144
  5. Liao CC, Lin JG, Tsai CC, Lane HL, Su TC, Wang HH, et al. An Investigation of the Use of Traditional Chinese Medicine in Stroke Patients in Taiwan. Evidence-Based Complementary and Alternative Medicine. 2012;2012:8.
  6. Wells RE, Phillips RS, Schachter SC, McCarthy EP. Complementary and alternative medicine use among US adults with common neurological conditions. Journal of Neurology. 2010;257(11):1822-31. https://doi.org/10.1007/s00415-010-5616-2
  7. Ministry of Health and Welfare. The third utilization of oriental medical services survey 2014 (Korean). Available at:URL: http://www.ndsl.kr/ndsl/commons/util/ndslOriginalView.do?cn=TRKO201600011606&dbt=TRKO.
  8. Darling G. The impact of clinical practice guidelines and clinical trials on treatment decisions. Surgical Oncology. 2002;11(4):255-62. https://doi.org/10.1016/S0960-7404(02)00046-4
  9. Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, et al. Guidelines for the primary prevention of stroke. A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2010;42(2):517-84. https://doi.org/10.1161/STR.0b013e3181fcb238
  10. The writing group of clinical practice guideline for stroke. Clinical Practice Guideline for Stroke. 1st ed. Clinical Research Center for Stroke 2009.
  11. Kim YH, Han TR, Jung HY, Chun MH, Lee J, Kim DY, et al. Clinical Practice Guideline for Stroke Rehabilitation in Korea. Brain &Neurorehabilitation. 2009;2(1):1-38. https://doi.org/10.12786/bn.2009.2.1.1
  12. Hong KS, Yu KH, Rha JH, Kim HY, Koo J, Park JM, et al. Review of Evidences and Updates of the Korean Clinical Practice Guidelines for Stroke in 2013. Journal of the Korean Neurological Association. 2013;31(3):143-57.
  13. Rah UW, Kim YH, Ohn SH, Chun MH, Kim MW, Yoo WK, et al. Clinical Practice Guideline for Stroke Rehabilitation in Korea 2012. Brain & Neurorehabilitation. 2014;7(Suppl 1):S1-S75. https://doi.org/10.12786/bn.2014.7.1.1
  14. Ministry of Health and Welfare. Launch of Korean Medicine Standard Clinical Practice Guideline Development Team (Korean). 2016; Available at:URL: http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=333629&SEARCHKEY=TITLE&SEARCHVALUE=%C7%A5%C1%D8%C0%D3%BB%F3%C1%F8%B7%E1%C1%F6%C4%A7.
  15. Han CH. Clinical Practice Guideline of Korean Medicine for Stroke : Preliminary Guideline and Recommendation. The Journal of Internal Korean Medicine. 2012;33(4):347-66.
  16. Choi J, Choi TY, Jun JH, Lee JA, Lee MS. Preferred reporting items for the development of evidencebased clinical practice guidelines in traditional medicine (PRIDE-CPG-TM): explanation and elaboration. European Journal of Integrative Medicine. 2016;8(6):905-15. https://doi.org/10.1016/j.eujim.2016.07.027
  17. Chen ZG, Luo H, Xu S, Yang Y, Wang SC. Study on the methodology of developing evidence-based clinical practice guidelines of chinese medicine. Chinese journal of integrative medicine. 2015;21(11):874-80. https://doi.org/10.1007/s11655-014-1896-1
  18. Ya Y, Shi NN, Han XJ, Gao Y, Xu JL, Liu DS, et al. Appraisal of clinical practice guidelines for ischemic stroke management in Chinese medicine with appraisal of guidelines for research and evaluation instrument: A systematic review. Chinese journal of integrative medicine. 2015;21(9):707-15. https://doi.org/10.1007/s11655-014-1834-2
  19. Shi N, Zhong LL, Han X, Ziea TC, Ng B, Bian Z, et al. Enhanced evidence-based Chinese medicine clinical practice guidelines in Hong Kong: a study protocol for three common diseases. Evidence-Based Complementary and Alternative Medicine. 2015;2015.
  20. Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. Vol. 4. John Wiley & Sons. 2011.
  21. Shea BJ, Hamel C, Wells GA, Bouter LM, Kristjansson E, Grimshaw J, et al. AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. Journal of clinical epidemiology. 2009;62(10):1013-20. https://doi.org/10.1016/j.jclinepi.2008.10.009
  22. Canadian Agency for Drugs and Technologies in Health (CADTH). Intervention Directed to Consumers. Available at:URL: https://www.cadth.ca/interventions-directed-consumers.
  23. Schunemann H, Brozek J, Guyatt G, Oxman A. GRADE handbook for grading quality of evidence and strength of recommendations. Updated October 2013. The GRADE Working Group. 2013. 2014.
  24. Zhang X, Liu XT, Kang DY. GRADE in systematic reviews of acupuncture for stroke rehabilitation: recommendations based on high-quality evidence. Sci Rep. 2015;5:16582. https://doi.org/10.1038/srep16582
  25. GRADE Working Group. GRADEpro GDT. Available at:URL: https://gradepro.org/.
  26. Kim MK, Han CH. E-mail survey on the current status of clinical practice and activation measures for Korean medicine in stroke care. The Journal of Korean Medicine. 2017;38(3):143-59. https://doi.org/10.13048/jkm.17032
  27. Zhou L, Chen Y, Liu J, Liu Zl, Gao Y. Evaluating the implementation of evidence-based TCM Clinical Practice Guidelines for Cerebral Infarction. European Journal of Integrative Medicine. 2014;6(2):147-55. https://doi.org/10.1016/j.eujim.2014.03.006
  28. China Academy of Chinese Medical Sciences. Evidence-based guidelines of clinical practice in Chinese medicine. 2011.
  29. Japan Society for Oriental Medicine EBM Committee. Clinical Practice Guidelines Containing Kampo Products in Japan. Available at:URL: http://www.jsom.or.jp/medical/ebm/.
  30. Ottawa Panel. Ottawa panel evidence-based clinical practice guidelines for post-stroke rehabilitation. Topics in stroke rehabilitation. 2006;13(2):1-269. https://doi.org/10.1310/3TKX-7XEC-2DTG-XQKH
  31. Canadian Partnership for Stroke Recovery. Stroke Engine. Available at:URL: https://www.strokengine.ca/clinician-info/acupuncture-clinician-info/.
  32. Management of Stroke Rehabilitation Working Group. VA/DOD Clinical practice guideline for the management of stroke rehabilitation. Journal of rehabilitation research and development. 2010;47(9):1-43. https://doi.org/10.1682/JRRD.2009.07.0095
  33. Smith L. Management of Patients With Stroke: Rehabilitation, Prevention and Management of Complications, and Discharge Planning: a National Clinical Guideline. SIGN. 2010.
  34. NICE. 2010 Evidence Update on Stroke Rehabilitation. Available at:URL:https://arms.evidence.nhs.uk/resources/hub/37918/attachment.
  35. Intercollegiate Stroke Working Party. National clinical guideline for stroke. 4th ed. Royal College of Physicians. 2012.
  36. Intercollegiate Stroke Working Party. National clinical guideline for stroke. 5th ed. Royal College of Physicians. 2016.
  37. Stroke Foundation of New Zealand and New Zealand Guidelines Group. Clinical Guidelines for Stroke Management 2010. Wellington: Stroke Foundation of New Zealand; 2010.; Available at:URL: http://www.stroke.org.nz/resources/NZClinicalGuidelinesStrokeManagement2010ActiveContents.pdf.
  38. Boddice G, Brauer S, Gustafsson L, Kenardy J, Hoffmann T. Clinical Guidelines for Stroke Management 2010. Melbourne, Australia: National Stroke Foundation. 2010.
  39. National Stroke Foundation. Clinical Guidelines for Stroke Management 2017 (draft). Melbourne Australia.; Available at:URL: http://www.opalinstitute.org/uploads/1/5/3/9/15399992/draft_clinical_guidelines_for_stroke_management_2017__summary_of_recommendations_public_consultation__1_.pdf.
  40. Chuma T. Stroke Treatment Guideline. The Japanese Journal of Rehabilitation Medicine. 2011;48(2):117-20. https://doi.org/10.2490/jjrmc.48.117
  41. Shinohara Y. Japanese Guidelines for the Management of Stroke 2009 : important revised points necessary for the neurologist. Rinsho shinkeigaku = Clinical Neurology. 2010;50(11):808-11. https://doi.org/10.5692/clinicalneurol.50.808
  42. Kim JS, Shin SW, Lee1 EJ, Shin BC, Lee MS, Lim SM, et al. Clinical Practice Guideline on Acupuncture for Post-stroke Spasticity. Journal of Korean Medicine. 2015;36(1):1-8.
  43. Lee JW, Lee EJ, Shin BC, Lee MS, Lim SM, Cho CS, et al. Clinical Practice Guideline for acupuncture in Post-stroke urinary retention. Journal of Korean Medicine. 2016;37(1):1-9.

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