Comparative efficacy of oral traditional Chinese patent medicine for acute cerebral infarction: protocol for network meta-analysis of randomized controlled trials

Journal article

Cui, R., Xing, L., Robinson, N., Yu, D., Zhao, J. and Zhao, H. (2019). Comparative efficacy of oral traditional Chinese patent medicine for acute cerebral infarction: protocol for network meta-analysis of randomized controlled trials. European Journal of Integrative Medicine. 32. https://doi.org/10.1016/j.eujim.2019.100977
AuthorsCui, R., Xing, L., Robinson, N., Yu, D., Zhao, J. and Zhao, H.
Abstract

Traditional Chinese patent medicines (TCPMs) are widely used in the treatment of ACI in China. Many oral traditional Chinese patent medicines have been reported to be effective for acute cerebral infarction (ACI). However, a comparison of randomized controlled trials (RCTs) to directly compare the efficacy of different oral TCPMs has not been performed. There is no evidence to demonstrate which of oral TCPMs more effective for clinicians. Therefore, we plan to conduct a systematic review and network meta-analysis (NMA) to compare the efficacy of 10 kinds of oral TCPMs for ACI. The aim is to provide the best currently available evidence base to guide the selection of oral TCPMs.

Methods
A systematic and comprehensive search will be performed from inception to July 2019 in both English and Chinese databases, involving Medline, Cochrane Library, Embase, China National Knowledge Infrastructure Database, Wanfang Database, Chongqing VIP information, and SinoMed. All RCTs related to TCPMs in the treatment of ACI will be included. The primary outcomes are mortality, as well as the the rate of cerebrovascular event including a recurrence event. The secondary outcomes include National Institutes of Health Stroke Scale and adverse drug reactions/adverse drug events. Two reviewers will independently screen the literature by using pre-specified eligibility criteria, and assess the quality of included studies according to the risk of bias tool of Cochrane Handbook 5.1.0. The GRADE approach will be used to rate the quality of evidence of estimates derived from NMA. Data analysis will be conducted by using STATA13.0 and WinBUGS1.4.3.

Results
This systematic review and NMA aims to summarize the direct and indirect evidence for 10 kinds of oral TCPMs and to rank these TCPMs. The findings of this NMA will be reported according to PRISMA-NMA statement. The results of the NMA will be submitted to a peer-reviewed journal once completed.

Conclusion
Using NMA, this study will offer new and informative evaluations of current TCPMs for ACI. The results will inform clinicians, provide optimal clinical treatment strategies, bridge the evidence gaps, and identify promising TCPMs for evaluation in future trials.

The protocol has been registered on PROSPERO (International Prospective Register of Systematic Reviews) (CRD42018110307).

Year2019
JournalEuropean Journal of Integrative Medicine
Journal citation32
PublisherElsevier
Digital Object Identifier (DOI)https://doi.org/10.1016/j.eujim.2019.100977
Web address (URL)https://www.sciencedirect.com/science/article/abs/pii/S1876382019306900
Publication dates
Online14 Sep 2019
PrintDec 2019
Publication process dates
Accepted13 Sep 2019
Deposited11 Oct 2019
Accepted author manuscript
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Women’s health and Chinese integrative medicine
Qu, F, Wang, FF, Robinson, N. and Hardiman, P (2017). Women’s health and Chinese integrative medicine. Journal of Zhejiang University: Science B. 18 (3), pp. 183-185. https://doi.org/10.1631/jzus.B17ed001
TRANSCUTANEOUS ELECTRICAL ACUPOINT STIMULATION IMPROVES THE OUTCOMES OF IN VITRO FERTILIZATION: A PROSPECTIVE, RANDOMIZED AND CONTROLLED STUDY
Qu, F, Wang, F-F, Wu, Y, Zhou, J, Robinson, N., Hardiman, P, Pan, J-X, He, Y-J, Zhu, Y-H, Wang, H-Z, Ye, X-Q, He, K-L, Cui, L, Zhao, H-L and Ye, Y-H (2017). TRANSCUTANEOUS ELECTRICAL ACUPOINT STIMULATION IMPROVES THE OUTCOMES OF IN VITRO FERTILIZATION: A PROSPECTIVE, RANDOMIZED AND CONTROLLED STUDY. Explore: The Journal of Science & Healing. 13 (5), pp. 306-312. https://doi.org/10.1016/j.explore.2017.06.004
The effects of acupuncture on polycystic ovary syndrome: A systematic review and meta-analysis
Qu, F., Yan, W., Hu, X-Y., Barry, J.A., Zhou, J., Wang, F-F., Ye, Y-H., Han, S-P., Li, R., Taw, M.B., Hardiman, P.J. and Robinson, N. (2016). The effects of acupuncture on polycystic ovary syndrome: A systematic review and meta-analysis. European Journal of Integrative Medicine. 8 (1), pp. 12-18. https://doi.org/10.1016/j.eujim.2016.02.001
The role of complementary and alternative medicine (CAM) in sexual and reproductive health
Qidwai, W, Wong, W, Nanji, K and Robinson, N. (2016). The role of complementary and alternative medicine (CAM) in sexual and reproductive health. European Journal of Integrative Medicine. 8 (1), pp. 1-3. https://doi.org/10.1016/j.eujim.2016.02.003
The Importance of Evidence for the Integration of Traditional and Complementary Medicine into Western Healthcare?
Robinson, N. (2016). The Importance of Evidence for the Integration of Traditional and Complementary Medicine into Western Healthcare? World Journal of Traditional Chinese Medicine. 2 (1), pp. 74 - 79. https://doi.org/10.15806/j.issn.2311-8571.2015.0029
Harmonising data collection from osteoarthritis studies to enable stratification: Recommendations on core data collection from an Arthritis Research UK clinical studies group
Kingsbury, SR, Corp, N, Watt, FE, Felson, DT, O'Neill, TW, Holt, CA, Jones, RK, Conaghan, PG, Arden, NK, Adams, J, Appleyard, I, Birrell, F, Blank, M, Callaghan, MJ, Cumming, J, Chapman, GJ, Halstead, J, Hamilton, DF, Hurley, M, Martin, K, Mason, DJ, Nuki, G, Redmond, AC, Reilly, K, Robinson, N., Roddy, E, Simpson, H, Smith, TO, Thomas, C, Thomas, E, Wilkinson, J and Wise, E (2016). Harmonising data collection from osteoarthritis studies to enable stratification: Recommendations on core data collection from an Arthritis Research UK clinical studies group. Rheumatology (United Kingdom). 55 (8), pp. 1394-1402. https://doi.org/10.1093/rheumatology/kew201
Introducing “Evidence for clinical practice” [Editorial]
Alper, BS, Malone-Moses, M, Manheimer, EW and Robinson, N. (2016). Introducing “Evidence for clinical practice” [Editorial]. European Journal of Integrative Medicine. 8 (3), pp. 147-149. https://doi.org/10.1016/j.eujim.2016.04.008
Pediatric integrative medicine needs research evidence to guide decision-making
Gardiner, P and Robinson, N. (2016). Pediatric integrative medicine needs research evidence to guide decision-making. European Journal of Integrative Medicine. 8 (2), pp. 79 - 80. https://doi.org/10.1016/j.eujim.2016.03.015
Bromelain and Cardiovascular Risk Factors in Diabetes: An Exploratory Randomized, Placebo Controlled, Double Blind Clinical Trial
Ley, C., NI, Q, Liao, X, Gao, H-L and Robinson, N. (2016). Bromelain and Cardiovascular Risk Factors in Diabetes: An Exploratory Randomized, Placebo Controlled, Double Blind Clinical Trial. Chinese Journal of Integrative Medicine. 22 (10), pp. 728-737. https://doi.org/10.1007/s11655-016-2521-2
General Practitioners’ use of and attitudes to acupuncture in relation to the UK’s National Institute for Health and Care Excellence (NICE) clinical guidelines—A pilot study
Czarnawska-Iliev, I and Robinson, N. (2016). General Practitioners’ use of and attitudes to acupuncture in relation to the UK’s National Institute for Health and Care Excellence (NICE) clinical guidelines—A pilot study. European Journal of Integrative Medicine. 8 (4). https://doi.org/10.1016/j.eujim.2016.07.004
Evidence is in the Eye of the Beholder: The case of the 2016 draft NICE Guidelines for Low Back Pain [editorial]
Hopper Koppelman, M, Bovey, M and Robinson, N. (2016). Evidence is in the Eye of the Beholder: The case of the 2016 draft NICE Guidelines for Low Back Pain [editorial]. European Journal of Integrative Medicine. 8 (4).
Common mistakes when using plant names and how to avoid them
Dauncey, EA, Irving, J, Allkin, R and Robinson, N. (2016). Common mistakes when using plant names and how to avoid them. European Journal of Integrative Medicine. 8 (5), pp. 597-601. https://doi.org/10.1016/j.eujim.2016.09.005
Integrating acupuncture: are there positive health outcomes for women?
Robinson, N. (2016). Integrating acupuncture: are there positive health outcomes for women? Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology). 18 (3), pp. 233-238. https://doi.org/10.1631/jzus.B1600260
Is traditional Chinese medicine recommended in Western medicine clinicalpractice guidelines in China? A systematic analysis.
Ren, J, Xun, Li, Sun,, J, Han, M, Yang, G-Y., Li, W-Y., Robinson, N. and Lewith, G. (2015). Is traditional Chinese medicine recommended in Western medicine clinicalpractice guidelines in China? A systematic analysis. BMJ Open. 5 (6), pp. e006572-e006572. https://doi.org/10.1136/bmjopen-2014-006572
Traditional Chinese Medicine - challenges for research
Robinson, N. (2015). Traditional Chinese Medicine - challenges for research. in: McCarthy, P.W. and Langweiler, M. (ed.) Methodologies for Effectively Assessing Complementary and Alternative Medicine (CAM) London Singing Dragon.
Acupuncture for the treatment of phantom limb syndrome in lower limb amputees: a randomised controlled feasibility study
Trevelyan, EG, Turner, WA, Summerfield-Mann, L and Robinson, N. (2015). Acupuncture for the treatment of phantom limb syndrome in lower limb amputees: a randomised controlled feasibility study. Trials. 16, p. 158. https://doi.org/10.1186/s13063-015-0668-3
The politics of integrative medicine: The case of CAM
Saks, M and Robinson, N. (2015). The politics of integrative medicine: The case of CAM. European Journal of Integrative Medicine. 7 (6), pp. 557-560. https://doi.org/10.1016/j.eujim.2015.11.019
GAP: From sound design to practical implementation in clinical trials for traditional chinese medicine
Shang, H, Zhang, B, Bian, Z, Li, Y, Clarke, M and Robinson, N (2014). GAP: From sound design to practical implementation in clinical trials for traditional chinese medicine. Evidence-based Complementary and Alternative Medicine. 2014, pp. 1-2. https://doi.org/10.1155/2014/560838
The quest for modernisation of traditional Chinese medicine
Xu, Q, Bauer, R, Hendry, BM, Fan, TP, Zhao, Z, Duez, P, Simmonds, MSJ, Witt, CM, Lu, A, Robinson, N, Guo, DA and Hylands, PJ (2013). The quest for modernisation of traditional Chinese medicine. BMC Complementary and Alternative Medicine. 13 (1), pp. 132-. https://doi.org/10.1186/1472-6882-13-132
A systematic review of experimental and clinical acupuncture in chemotherapy-induced peripheral neuropathy.
Franconi, G, Manni, L, Schröder, S, Marchetti, P and Robinson, N. (2013). A systematic review of experimental and clinical acupuncture in chemotherapy-induced peripheral neuropathy. Evidence-Based Complementary and Alternative Medicine (eCAM). 2013, p. 516916. https://doi.org/10.1155/2013/516916
The evidence for Shiatsu: A systematic review of Shiatsu and acupressure
Robinson, N, Lorenc, A and Liao, X (2011). The evidence for Shiatsu: A systematic review of Shiatsu and acupressure. BMC Complementary and Alternative Medicine. 11 (1), pp. 88-. https://doi.org/10.1186/1472-6882-11-88
The RCCM 2009 survey: Mapping doctoral and postdoctoral CAM research in the United Kingdom
Robinson, N and Lewith, G (2011). The RCCM 2009 survey: Mapping doctoral and postdoctoral CAM research in the United Kingdom. Evidence-based Complementary and Alternative Medicine. 2011, pp. 1-4. https://doi.org/10.1093/ecam/nep184
How parents choose to use CAM: A systematic review of theoretical models
Lorenc, A, Ilan-Clarke, Y, Robinson, N and Blair, M (2009). How parents choose to use CAM: A systematic review of theoretical models. BMC Complementary and Alternative Medicine. 9 (1), pp. 9-. https://doi.org/10.1186/1472-6882-9-9