Developing a Core Outcome Set for Clinical Trials of Traditional Chinese Medicine for Lumbar Disc Herniation

Xiaokuan Qin , Kai Sun , Xiangyu Xiao , Junhua Zhang , Chengliang Wu , Bin Shi , Bo Pang , Liguo Zhu , Xu Wei

Journal of Evidence-Based Medicine ›› 2026, Vol. 19 ›› Issue (1) : e70117

PDF (2356KB)
Journal of Evidence-Based Medicine ›› 2026, Vol. 19 ›› Issue (1) :e70117 DOI: 10.1111/jebm.70117
ARTICLE
Developing a Core Outcome Set for Clinical Trials of Traditional Chinese Medicine for Lumbar Disc Herniation
Author information +
History +
PDF (2356KB)

Abstract

Background: Traditional Chinese medicine (TCM) is widely used in managing lumbar disc herniation (LDH), but heterogeneous outcome reporting in its trials hinders evidence synthesis. This study intends to develop a core outcome set (COS) for TCM-LDH to standardize reporting and improve research quality.

Methods: Candidate outcomes were identified via a systematic review of TCM-related randomized controlled trials (RCTs) for LDH, with studies retrieved from multiple databases between January 1 2019 and December 31 2023 and supplemented by clinical trial registry searches. Semistructured interviews with LDH patients and clinician questionnaires were conducted to refine candidate outcomes. Two Delphi rounds were carried out among clinicians, pharmaceutical researchers, journal editors, methodologists, and patients, followed by an online–offline consensus meeting to finalize the COS.

Results: A candidate outcome pool was established via a systematic review (413 RCTs, 51 registered studies), 30 LDH patient interviews, and 73 clinician surveys. After integration, deduplication, and steering committee refinement, two rounds of Delphi surveys were conducted. Following a consensus meeting attended by 24 multidisciplinary experts, 7 core outcomes were finalized for LDH: lumbar dysfunction, pain/discomfort, recurrence rate, straight leg raise angle, adverse reactions/adverse events, TCM syndromes, and sciatica frequency.

Conclusion: The developed COS for TCM-related LDH clinical trials provides standardized recommendations for outcome selection and reporting, which can enhance the consistency of research evidence, facilitate meta-analysis, and ultimately advance the quality of TCM-based interventions for LDH.

Keywords

core outcome set / Delphi survey / lumbar disc herniation / systematic review / traditional Chinese medicine

Cite this article

Download citation ▾
Xiaokuan Qin, Kai Sun, Xiangyu Xiao, Junhua Zhang, Chengliang Wu, Bin Shi, Bo Pang, Liguo Zhu, Xu Wei. Developing a Core Outcome Set for Clinical Trials of Traditional Chinese Medicine for Lumbar Disc Herniation. Journal of Evidence-Based Medicine, 2026, 19 (1) : e70117 DOI:10.1111/jebm.70117

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

A. S. Zhang, A. Xu, K. Ansari, et al., “Lumbar Disc Herniation: Diagnosis and Management,” American Journal of Medicine 136, no. 7 (2023): 645–651.

[2]

D. S. Kreiner, S. W. Hwang, J. E. Easa, et al., “An Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Lumbar Disc Herniation With Radiculopathy,” The Spine Journal: Official Journal of the North American Spine Society 14, no. 1 (2014): 180–191.

[3]

H. Haro, S. Ebata, G. Inoue, et al., “Japanese Orthopaedic Association (JOA) Clinical Practice Guidelines on the Management of Lumbar Disc Herniation, Third Edition—Secondary Publication,” Journal of Orthopaedic Science 27, no. 1 (2022): 31–78.

[4]

F. Omidi-Kashani, H. Hejrati, and S. Ariamanesh, “Ten Important Tips in Treating a Patient With Lumbar Disc Herniation,” Asian Spine Journal 10, no. 5 (2016): 955–963.

[5]

C. Sun, K. Sun, S. Wang, et al., “Effect of Baimai Ointment on Lumbar Disc Herniation: A Multicentre, Prospective, Randomised, Double-Blind, Placebo-Controlled Trial,” Phytomedicine 122 (2024): 155138.

[6]

J. L. Dieleman, J. Cao, A. Chapin, et al., “US Health Care Spending by Payer and Health Condition, 1996-2016,” Jama 323, no. 9 (2020): 863–884.

[7]

B. O. Zhang, H. Xu, J. Wang, B. Liu, and G. Sun, “A Narrative Review of Non-Operative Treatment, Especially Traditional Chinese Medicine Therapy, for Lumbar Intervertebral Disc Herniation,” BioScience Trends 11, no. 4 (2017): 406–417.

[8]

B.-L. Chen, J.-B. Guo, H.-W. Zhang, et al., “Surgical versus Non-Operative Treatment for Lumbar Disc Herniation: A Systematic Review and Meta-Analysis,” Clinical Rehabilitation 32, no. 2 (2018): 146–160.

[9]

X. Qin, K. Sun, W. Xu, et al., “An Evidence-Based Guideline on Treating Lumbar Disc Herniation With Traditional Chinese Medicine,” Journal of Evidence-Based Medicine 17, no. 1 (2024): 187–206.

[10]

P. Williamson, D. Altman, J. Blazeby, M. Clarke, and E. Gargon, “Driving up the Quality and Relevance of Research Through the Use of Agreed Core Outcomes,” Journal of Health Services Research & Policy 17, no. 1 (2012): 1–2.

[11]

R. J. Qiu, M. Li, J. Y. Hu, et al., “Methods for Development of a Core Outcome Set for Clinical Trials Integrating Traditional Chinese Medicine and Western Medicine,” JIM 19, no. 5 (2021): 389–394.

[12]

COMET Initiative, “Core Outcome Measures in Effectiveness Trials,” COMET Initiative, https://www.comet-initiative.org/.

[13]

P. R. Williamson, D. G. Altman, J. M. Blazeby, et al., “Developing Core Outcome Sets for Clinical Trials: Issues to Consider,” Trials 13 (2012): 132.

[14]

L. Zhu and X. Wei, “Study on the Core Outcome Set for Clinical Trials of Traditional Chinese Medicine in Lumbar Disc Herniation,” ChiCOS (Clinical Trial Core Indicators Study Center), https://www.chicos.org.cn/cos/1689243637039824898.

[15]

P. R. Williamson, D. G. Altman, H. Bagley, et al., “The COMET Handbook: Version 1.0,” Trials 18, no. Suppl 3 (2017): 280.

[16]

J. J. Kirkham, S. Gorst, D. G. Altman, et al., “Core Outcome Set-STAndards for Reporting: The COS-STAR Statement,” PLoS Medicine 13, no. 10 (2016): e1002148.

[17]

G. H. Guyatt, A. D. Oxman, R. Kunz, et al., “GRADE Guidelines: 2. Framing the Question and Deciding on Important Outcomes,” Journal of Clinical Epidemiology 64, no. 4 (2011): 395–400.

[18]

X. Jin, B. O. Pang, J. Zhang, et al., “Core Outcome Set for Clinical Trials on Coronavirus Disease 2019 (COS-COVID),” Engineering 6, no. 10 (2020): 1147–1152.

[19]

The Lancet Psychiatry, “A Good Enough Measure,” Lancet Psychiatry 7, no. 10 (2020): 825.

[20]

C. A. C. Prinsen, S. Vohra, M. R. Rose, et al., “How to Select Outcome Measurement Instruments for Outcomes Included in a "Core Outcome Set"—A Practical Guideline,” Trials 17, no. 1 (2016): 449.

RIGHTS & PERMISSIONS

2026 The Author(s). Journal of Evidence-Based Medicine published by Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

PDF (2356KB)

0

Accesses

0

Citation

Detail

Sections
Recommended

/