Methodology for the selection and evaluation of outcomes for Chinese herbal injection in acute exacerbation of chronic obstructive pulmonary disease (AECOPD): a comprehensive study

Ann Med. 2024 Dec;56(1):2396567. doi: 10.1080/07853890.2024.2396567. Epub 2024 Sep 10.

Abstract

Objective: To develop a comprehensive framework for selecting outcomes in evaluating the clinical efficacy of Chinese herbal injections and to scientifically select outcomes for the clinical randomized controlled trial (RCT) of Tan-Re-Qing injection intervening AECOPD.

Methods: A comprehensive literature review and consensus methods, including focus groups and Delphi surveys, were utilized.

Results: Literature analysis identified 513 publications, encompassing regulatory guidance, guidelines, expert consensus, and RCTs. Initial dimensions include clinical efficacy, safety, and health economics. Primary outcomes should align with study objectives. Recommended evaluation domains include death, treatment outcome, future impact, quality of life, and safety. Commonly recommended outcomes comprise mortality, arterial blood gases, CAT, exacerbation frequency, adverse events, and lung function. Network meta-analysis identified specific therapeutic efficacy markers (white blood cell count, IL-6, IL-8). Quality of life assessment recommended SF-12, EQ-5D, or CAT. Emphasis on AECOPD frequency and lung function was noted. Delphi survey yielded 41 outcomes across various domains for evaluating Tan-Re-Qing in AECOPD.

Conclusion: The findings contribute to developing a robust and reliable trial design for Tan-Re-Qing injection in AECOPD. The methodology employed in this study ensures a systematic and comprehensive approach to the selection of outcomes for the clinical evaluation of future studies in this field.

Keywords: AECOPD; Chinese herbal injection; Outcomes selection; clinical evaluation; methodology.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Delphi Technique*
  • Drugs, Chinese Herbal* / administration & dosage
  • Drugs, Chinese Herbal* / adverse effects
  • Humans
  • Injections
  • Network Meta-Analysis
  • Pulmonary Disease, Chronic Obstructive* / drug therapy
  • Pulmonary Disease, Chronic Obstructive* / physiopathology
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Drugs, Chinese Herbal
  • tanreqing

Grants and funding

This study was supported by the National Natural Science Foundation of China (NSFC) (grant no. 81803978), China Postdoctoral Science Foundation (grant no. 2021M703618), Innovation Project of Science and Technology of China Academy of Chinese Medical Sciences (CI2021A05501), Science and Technology Research Project of the Department of Education of Liaoning Province (grant no. L201713), Shenyang Youth Science and Technology Innovation Talent Support Program (grant no. RC200104), Liaoning Talent Development Program (XLYC2203035), The Chinese Association of Traditional Chinese Medicine Youth Talent Support Program (2022–2024).