比较效果研究的内涵和外延及其用于中医临床评价的可行性分析

doi:10.3736/jcim20120403

Abstract

Comparative effectiveness research (CER) is well developed in international medical research. This article analyzes the basic connotations of CER from five aspects, including selection of objective, positioning of target population, comparison of intervention scheme, identification of contrast condition and analysis of therapeutic effects. The inclusiveness and advanced nature of CER were revealed by comparing with modern medical research methods, such as evidence-based medicine, patient-important outcome and randomized controlled trials. Based on the superiority of CER, the feasibility of applying CER in clinical evaluation of traditional Chinese medicine is explored. CER should be combined with the holistic concept, syndrome differentiation and individuality-concerned treatment so as to facilitate its development in research of traditional Chinese medicine in China.

Key words: comparative effectiveness research, traditional Chinese medicine, validation studies as topic, clinical trial

Hong-bo Cao, Hong-cai Shang . Connotations and extensions of comparative effectiveness research and feasibility analysis for clinical evaluation in traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2012, 10(4): 369-374.

/ / Recommend

Add to citation manager EndNote| Reference Manager|ProCite|BibTeX|RefWorks

URL: http://www.jcimjournal.com/EN/10.3736/jcim20120403

http://www.jcimjournal.com/EN/Y2012/V10/I4/369

TrendMD

Figures/Tables 3

Table 1

Figure 1

Figure 2

References 13

[1]	Xie YM, Liao X Wang YY. Introduce the idea of comparative effectiveness research to clinical research of Chinese medicine. J Chin Integr Med. 2011; 9(8): 813-818. Chinese with abstract in English.
	谢雁鸣, 廖星, 王永炎 . 将比较效益研究理念引入中医临床评价研究.中西医结合学报. 2011; 9(8):813-818.
[2]	Comparative effectiveness : its origin, evolution, influence on health care. J Oncol Pract. 2009 ; 5(2):80-82. doi: 10.1200/JOP.0926001
[3]	Steinbrook R . Health care and the American Recovery and Reinvestment Act. N Engl J Med. 2009; 360(11):1057-1060. doi: 10.1056/NEJMp0900665
[4]	The Congress of the United States, Congressional Budget Office. Research on the comparative effectiveness of medical treatments: issuesand options for an expanded federal role. ( 2007 -12) [2011-05-16]. .
[5]	Sackett DL, Straus S, Richardson S, Rosenberg W, Haynes RB . Evidence-based medicine : how to practice and teach EBM. 2nd ed. Philadelphia: Churchill Livingstone. 2000.
[6]	Center for Medical Technology Policy. Comparative effectiveness definitions. ( 2008)[ 2011-05-16] . .
[7]	Federal Coordinating Council for Comparative Effectiveness Research. Report to the President and the Congress. ( 2009 -06-30) [2011-05-16]. .
[8]	Miller ME . Report to the congress: reforming the delivery system. ( 2008 -09-16) [2011-05-16]. .
[9]	Sculpher M . Subgroups and heterogeneity in cost- effectiveness analysis. Pharmacoeconomics. 2008; 26(9):799-806. doi: 10.2165/00019053-200826090-00009
[10]	Manchikanti L, Falco FJ, Boswell MV, Hirsch JA . Facts, fallacies, and politics of comparative effectiveness research: Part I. Basic considerations. Pain Physician. 2010; 13(1) : E23-E54.
[11]	Liu BY. Measurement of patient-reported outcomes: theory, methods and applications. Beijing: People’s Medical Publishing House. 2011: 5. Chinese.
	刘保延 . 患者报告结局的测量——原理, 方法与应用. 北京:人民卫生出版社. 2011: 5.
[12]	National Information Center on Health Services Research and Health Care Technology(NICHSR). Comparative effectiveness research ( CER) ( Also known as patient centered outcomes research). ( 2010 -07-28) [2011-05- 16]. .
[13]	Witt CM . Clinical research on acupuncture — Concepts and guidance on efficacy and effectiveness research. Chin J Integr Med. 2011; 17(3):166-172. doi: 10.1007/s11655-011-0662-x

Related Articles 15

[1]	Sherman Gu, Arthur Yin Fan. Controversial conclusions from two randomized controlled trials for acupuncture's effects on polycystic ovary syndrome or in vitro fertilization support. Journal of Integrative Medicine, 2020, 18(2): 89-91.
[2]	Xue-qing Yu, Shu-guang Yang, Yang Xie, Jian-sheng Li. Traditional Chinese medicine in the treatment of idiopathic pulmonary fibrosis based on syndrome differentiation: Study protocol of exploratory trial. Journal of Integrative Medicine, 2020, 18(2): 163-168.
[3]	Chang-quan Ling. Traditional Chinese medicine is a resource for drug discovery against 2019 novel coronavirus (SARS-CoV-2). Journal of Integrative Medicine, 2020, 18(2): 87-88.
[4]	Pratya Phetkate, Tanawan Kummalue, Prasob-orn Rinthong, Somboon Kietinun, Kusuma Sriyakul. Study of the safety of oral Triphala aqueous extract on healthy volunteers. Journal of Integrative Medicine, 2020, 18(1): 35-40.
[5]	Wen Qiang Lee, Jeremy Teoh, Pei Zheng Kenneth Lee, Zhi Xiong Gerard Low, Xueling Sim, Foong Fong Mary Chong, Norbert Ludwig Wagner. Factors influencing communication of traditional Chinese medicine use between patients and doctors: a multisite cross-sectional study. Journal of Integrative Medicine, 2019, 17(6): 396-403.
[6]	Mikhail Teppone. Medicine has always been “Modern” and “Scientific” from ancient times to the present day. Journal of Integrative Medicine, 2019, 17(4): 229-237.
[7]	Charles Dalcanale Tesser, Ari Ojeda Ocampo Moré, Melissa Costa Santos, Emiliana Domingues Cunha da Silva, Fátima Terezinha Pelachini Farias, Lúcio José Botelho. Auriculotherapy in primary health care: A large-scale educational experience in Brazil. Journal of Integrative Medicine, 2019, 17(4): 302-309.
[8]	Arthur Yin Fan, Hui Ouyang, Xinru Qian, Hui Wei, David Dehui Wang, Deguang He, Haihe Tian, Changzhen Gong, Amy Matecki, Sarah Faggert Alemi. Discussions on real-world acupuncture treatments for chronic low-back pain in older adults. Journal of Integrative Medicine, 2019, 17(2): 71-76.
[9]	Rachael Farrington, Ian F.Musgrave, Roger W.Byard. Evidence for the efficacy and safety of herbal weight loss preparations. Journal of Integrative Medicine, 2019, 17(2): 87-92.
[10]	L. Elisabeth Burton, Fares Qeadan, Mark R. Burge. Efficacy of equine-assisted psychotherapy in veterans with posttraumatic stress disorder. Journal of Integrative Medicine, 2019, 17(1): 14-19.
[11]	Fung-Kei Cheng. An overview of the contribution of acupuncture to thyroid disorders. Journal of Integrative Medicine, 2018, 16(6): 375-383.
[12]	Chang-quan Ling, Jia Fan, Hong-sheng Lin, Feng Shen, Zhen-ye Xu, Li-zhu Lin, Shu-kui Qin, Wei-ping Zhou, Xiao-feng Zhai, Bai Li, Qing-hui Zhou, on behalf of the Chinese Integrative Therapy of Primary Liver Cancer Working Group. Clinical practice guidelines for the treatment of primary liver cancer with integrative traditional Chinese and Western medicine. Journal of Integrative Medicine, 2018, 16(4): 236-248.
[13]	Ubiratan Cardinalli Adler, Ana Carolina Acorinte, Fernando Oliveira Calzavara, Adriano Andréda Silva, Amarilys de Toledo Cesar, Maristela Schiabel Adler, Edson Zangiacomi Martinez, José Carlos Fernandes Galduróz. Double-blind evaluation of homeopathy on cocaine craving: A randomized controlled pilot study. Journal of Integrative Medicine, 2018, 16(3): 178-184.
[14]	Shahnaz Karkon Varnosfaderani, Fataneh Hashem-Dabaghian, Gholamreza Amin, Mahbubeh Bozorgi, Ghazaleh Heydarirad, Esmaeil Nazem, Mohsen Nasiri Toosi, Seyed Hamdollah Mosavat. Efficacy and safety of Amla (Phyllanthus emblica L.) in non-erosive reflux disease: A double-blind, randomized, placebo-controlled clinical trial. Journal of Integrative Medicine, 2018, 16(2): 126-131.
[15]	Fabiana de Almeida Andrade, Caio Fabio Schlechta Portella. Research methods in complementary and alternative medicine: An integrative review. Journal of Integrative Medicine, 2018, 16(1): 6-13.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

Comments

Recommended 10

[1]	A-gao Zhou, Yong Zhang, Gang Kui, De-Yun Kong, Hai-liang Ge, Qiu-hua Ren, Jia-rong Dong, Sheng Hong, Xu-ming Mao, Yin Wang, Hui-zheng Zhang, Shu-jun Wang. Influence of traditional Chinese compound recipes with different efficacy on body weight, tumor weight and immune function in H₂₂ cancer-bearing mice. Journal of Chinese Integrative Medicine, 2008, 6(1): 77-82
[2]	Xi Lin, Jian-ping Liu. Tai chi for treating rheumatoid arthritis. Journal of Chinese Integrative Medicine, 2008, 6(1): 82
[3]	Guo-hong Yuan, Xiao-jing Pang, He-chao Ma. Synergic effects of Danggui Buxue Decoction in reducing toxicity of cytoxan in tumor-bearing mice. Journal of Chinese Integrative Medicine, 2008, 6(1): 83-88
[4]	Li Zhou, Hong-xing Zhang, Ling-guang Liu, Wen-jun Wan. Effect of electro-acupuncture at Fenglong (GV 16) on nitric oxide and endothelin in rats with hyperlipidemia. Journal of Chinese Integrative Medicine, 2008, 6(1): 89-92
[5]	Daniel Weber, Janelle M Wheat, Geoffrey M Currie. Inflammation and cancer: Tumor initiation, progression and metastasis,and Chinese botanical medicines. Journal of Chinese Integrative Medicine, 2010, 8(11): 1006-1013
[6]	Ya-bing Zhou, Jian-er Yu, Jie Wu, Li Bai, Li-li Huo, Xin-guang Zhang, Li-qing Li . Effects of Chinese herbal medicine Bushen Gubiao Recipe on toll-like receptor 4 and CD4 ⁺CD25 ⁺foxp3 ⁺regulatory T cells in mice with recurrent respiratory tract infections. Journal of Chinese Integrative Medicine, 2010, 8(11): 1053-1059
[7]	Ya-hui Liang , Ping Li, Jing-xia Zhao, Xin Liu, Qi-fu Huang. Acetyl-11-keto-beta-boswellic acid and arsenic trioxide regulate the productions and activities of matrix metalloproteinases in human skin fibroblasts and human leukemia cell line THP-1. Journal of Chinese Integrative Medicine, 2010, 8(11): 1060-1069
[8]	Jing-yuan Mao, Chang-xiao Liu, Heng-he Wang, Guang-li Wei , Zhen-peng Zhang, Jie Xing, Wang Xian liang , Ying-fei Bi . Effects of Shenmai Injection on serum concentration and pharmacokinetics of digoxin in dogs with heart failure. Journal of Chinese Integrative Medicine, 2010, 8(11): 1070-1074
[9]	Zhao-guo Li . A discussion of English translation of 1995 and 1997 Chinese National Standards of Traditional Chinese Medical Terminologies for Clinical Diagnosis and Treatment. Journal of Chinese Integrative Medicine, 2010, 8(11): 1090-1096
[10]	Liang-ping Hu, Xiao-lei Bao. Three-factor designs unable to examine the interactions (Part 2). Journal of Chinese Integrative Medicine, 2012, 10(11): 1229-1232

Comparative aspect	Evidence-based medicine	Comparative effectiveness research
Same points
Theoretical origin	Clinical epidemiology	Clinical epidemiology
Base point	The best current evidence	In line with actual clinical evidence
Information sharing	A theoretical basis for comparative effectiveness research	Evidence optimization for evidence-based medicine
Different points
Research objective	To provide the best medical care demand	Integration of medical resources
Research perspective	Emphasis on evidence of internal validity	Emphasis on evidence of actual external validity
Maturity	Relatively mature	Method should be improved

Connotations and extensions of comparative effectiveness research and feasibility analysis for clinical evaluation in traditional Chinese medicine

RichHTML

PDF (PC)

Like