Application of Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to the guideline development for clinical practice with acupuncture and moxibustion

Abstract

Grading of Recommendations Assessment, Development, and Evaluation (GRADE) offers a worldwide approach to guideline development for clinical practice. For the clinical practice of acupuncture therapy, 18 evidence-based guidelines have been developed in China using GRADE. In this study, we review the advantages and limitations of the GRADE approach in the guideline development for acupuncture and moxibustion and propose some solutions to these limitations. Scientific advantages of rating the quality of evidence, outcome-centric direction, overall progression to develop recommendations, and strength of recommendations providing specific clinical guidance are the advantages of GRADE. The limitations of GRADE in the development of guidelines for acupuncture and moxibustion include rating the quality of evidence for ancient literature and literature on famous traditional Chinese medicine experts’ experiences and specific guidelines for formulating recommendations from evidence. In the guideline development for clinical practice with acupuncture and moxibustion, we suggest that a specific method should be explored based on the GRADE approach and the characteristics of acupuncture therapy.

Keywords

guideline / acupuncture / GRADE

References

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Acknowledgements

This study was supported by the Standardization Project of State Administration of Traditional Chinese Medicine (No. ZYYS-2009-0009-3).

Compliance with ethics guidelines

Hong Zhao, Fengxia Liang, Yigong Fang, and Baoyan Liu declare that they have no conflict of interest. This manuscript is a commentary article and does not involve a research protocol requiring approval by the relevant institutional review board or ethics committee.

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