1. Backgrounds
Clinical practice guidelines (CPGs) of conventional medical treatment interventions for Parkinson’s disease (PD) have been developed by professional societies and government agencies, and are widely used in clinical practice. However, despite many patients with PD using Korean Medical treatments, there are currently no guidelines available for these patients that include recommendations on Korean Medicine interventions such as herbal medicines, acupuncture, moxibustion, pharmacoacupuncture, and Tai chi.
The present CPG on the use of Korean Medicine for PD is an updated version of the 2017 Evidence-Based Medicine (EBM) guideline. the updated CPG is published to reflect the recent results of additional clinical studies on Korean Medicine interventions since 2017, and is a response to urges by Korean Medicine clinical practitioners for signicant revisions on the previous CPGs. the purpose of this updated CPGs is to suggest revised recommendations, updated in line with the current clinical evidence and practice on Korean Medicine interventions for PD.
2. Methodology for the CPG development
To update the present CPG for Parkinson’s disease, the CPG development group de ned clinical questions through analysis of current researches and expert community’s opinions. An updated literature search since 2017 was conducted based on the principle of the first CPG development, using core electronic databases including results from PubMed, EMBASE, Cochrane Library, CNKI, and Korean databases using OASIS via the Korea Institute of Oriental Medicine, and NDSL from the Korea Science and Technology Information Service.
We assessed levels of evidence and recommendation grades according to the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guidance of National Clearinghouse for Korean Medicine (NCKM). the GRADE evaluation process is divided into two stages: assessment of evidence level and recommendation grade. Level of evidence is classified as High, Moderate, Low, Very Low or classical text-based (CTB). Recommendation grades are classified into five levels: A, B, C, D, and Good Practice Point (GPP).
the Delphi technique was adopted as the method of obtaining formal expert and clinician consensus. A questionnaire on the initial draft of the recommendation was prepared, and a panel of seven experts was established under the recommendation of the Review Committee of the CPG Development Group for PD. the expert panel answered questionnaires in two rounds, after which the final recommendation was drafted. the Society of Stroke on Korean Medicine then approved the final draft of the CPG.
