Introduction
Methods
Eligibility criteria
Search strategy
CPGs/consensus selection and data extraction
Assessment for guideline quality and investigation of heterogeneity
Statistical analysis
Results
Literature search and selection
Characteristics of included CPGs and consensus
Variable |
N (%)
|
---|---|
Type of literature | |
CPG | 36 (73.5) |
Expert consensus | 13 (26.5) |
Region of organization/society responsible for CPGs/consensus development | |
America | 25 (51.0) |
Asia | 16 (32.7) |
Europe | 7 (14.3) |
Oceania | 1 (2.0) |
Original/updated | |
Original | 29 (59.2) |
Updated | 20 (40.8) |
Recommendation intention according to overall quality assessment of CPGs/consensus | |
Recommended | 4 (8.2) |
Recommended with modifications | 15 (30.6) |
Not recommend | 30 (61.2) |
AGREE II quality scores
Domains | Content | Median score (IQR, %) | Mean score (X±SD, %) | Score segmentation (number of included guidelines, %) | |||
---|---|---|---|---|---|---|---|
< 25% | 25%~50% | 50%~75% | > 75% | ||||
1 | Scope and purpose | 75.0 (52.0~92.5) | 73.1±21.9 | 0 (0.0) | 6 (16.7) | 12 (33.3) | 18 (50.0) |
2 | Stakeholder involvement | 39.0 (31.0~56.8) | 43.7±15.0 | 2 (5.6) | 21 (58.3) | 12 (33.3) | 1 (2.8) |
3 | Rigor of development | 59.0 (44.3~66.5) | 55.1±18.0 | 3 (8.3) | 9 (25.0) | 20 (55.6) | 4 (11.1) |
4 | Clarity of presentation | 57.5 (44.0~66.5) | 54.7±15.9 | 1 (2.8) | 9 (25.0) | 24 (66.7) | 2 (5.6) |
5 | Applicability | 30.0 (17.0~48.3) | 31.9±21.2 | 14 (38.9) | 14 (38.9) | 7 (19.4) | 1 (2.8) |
6 | Editorial independence | 50.0 (33.0~83.0) | 56.1±28.2 | 6 (16.7) | 5 (13.9) | 15 (41.7) | 10 (27.8) |
Scope and purpose
Stakeholder involvement
Rigor of development
Clarity of presentation
Applicability
Editorial independence
Domains | Content | Guidelines (mean,%) | Consensuses (mean,%) |
---|---|---|---|
1 | Scope and purpose | 73.1% | 33.2% |
2 | Stakeholder involvement | 43.7% | 18.0% |
3 | Rigor of development | 55.1% | 19.4% |
4 | Clarity of presentation | 54.7% | 9.8% |
5 | Applicability | 31.9% | 18.0% |
6 | Editorial independence | 56.1% | 26.9% |
Level of evidence and strength of recommendation
Grading system | Criteria for rating evidence | Criteria for grading recommendation (N) | Number of guidelines | Organization/author responsible for guideline development |
---|---|---|---|---|
GRADE | A, B, C, D | 1 (2), 2 (10) | 16 | CCGI, ACP, AOA, ACCP, TCM Recs, ASCO, JOA, NICE, John W. Devlin, SD Guy, |
System developed by OPTIMa Collaboration | / | Offer, consider (5), do not offer (3) | 2 | OPTIMa |
SIGN | 1++, 1+, 1-, 2++, 2+, 2-, 3, 4 | A, B, C, D | 4 | BGS, CCGPP, NICE |
System recommended by The Cochrane Collaboration Back Review Group and Oxman and Guyatt | A, B, C, D | Recommended (4), Consider using (1), we cannot recommend (3), we do not recommend | 2 | COST B13, CCA |
ACCP | High, moderate, low | Strong, weak (1) | 1 | ACCP |
USPSTF | High, Moderate, Low | A, B (2), C (1), D, I (2) | 1 | SIO |
Combined Grading system | A, B, C+, C, D, D+, D- | Strongly recommended (12), suggested use (4), neutral, suggested no use, strongly not recommended | 2 | OP |
Ranking of the Canadian Task Force on Preventive Health Care | I, II-1, II-2, II-3, III | A, B (1), C, D, E, I | 1 | SOGC |
Classification criteria of TCM literature | I, II, III, IV, V | A, B, C, D, E | 1 | Chen |
CPRC | I, II, III, IV | A, B (7), C, D (2) | CPRC |
Recommendations for massage interventions
General view of the recommendations
Target population
Intervention characteristics
Massage alone or with other interventions
|
N
(%)
|
Alone | 84 (70.59) |
With conventional medicine | 9 (7.56) |
With Chinese herbal medicine | 1 ( 0.84) |
With non-pharmacological intentions | 22 (18.49) |
Other | 3 (2.52) |
Type of massage interventions | N (%) |
Massage/Tuina | 47 (39.50) |
Acupressure | 8 (6.72) |
Manipulation | 32 (26.89) |
Structural massage | 1 (0.84) |
Relaxation massage | 1 (0.84) |
Reptrotherapy | 1 (0.84) |
Manual therapy | 9 (7.56) |
Compound manipulation with anesthesia | 1 (0.84) |
Therapeutic massage | 2 (1.68) |
Other | 8 (6.72) |
Not reported | 9 (7.56) |