Identifying Clinical Questions of Guidelines for Rational Use of Tripterygium Glycosides Tablet in the Treatment of Chronic Kidney Disease with Modified Delphi Method
To determine the clinical questions and outcome indicators of the Guidelines for Rational Use of Tripterygium Glycosides Tablet in the Treatment of Chronic Kidney Disease.Methods:Literature retrieval and expert brainstorming meetings were applied to set up a list of clinical questions and outcome indicators.Three rounds of questionnaire survey based on the modified Delphi method were employed for importance rating and ranking.Final clinical questions and outcome indicators were confirmed by an expert consensus voting meeting.Questionnaire quality control was based on an expert positivity coefficient,an authority coefficient,and the coefficient of variation.Results:Consensus was reached on 13 clinical questions,including if there is additional benefit when Tripterygium Glycosides Tablet is used alone or in combination with conventional Western medicine for the treatment of chronic kidney disease compared to the efficacy when conventional Western medicine is used alone; if it is necessary to halt taking Tripterygium Glycosides Tablet when abnormal liver function occurs; for people with fertility needs,how long is suitable regarding the withdrawal time.A total of 51 outcome indicators were determined,including 26 efficacy indicators and 25 safety indicators.The efficacy indicators comprised improvement in proteinuria,renal function evaluation,long-term prognosis,quality of life,and immune function.The safety indicators mainly included systemic toxicity,as well as decreased plasma albumin,elevated blood uric acid,abnormal blood glucose and lipid levels,etc.Conclusion:The clinical questions and outcome indicators of the Guidelines for Rational Use of Tripterygium Glycosides Tablet in the Treatment of Chronic Kidney Disease were determined through the modified Delphi method.The structural system of the guidelines was initially formed,which lays a foundation for the follow-up development of the guidelines.