ABSTRACT
Low back pain (LBP) is one of the most common complaints of Japanese citizens, and is a symptom for which acupuncture has been applied since ancient times. We empirically recognize that acupuncture is effective for LBP, but in recent years, it became necessary to show evidence regarding its efficacy and effectiveness.Currently, to elucidate the effect of a medical intervention, randomized controlled trials (RCTs) are considered the gold standard and outcomes of RCTs are integrated as a systematic review (SR), and these are used to establish the degree of recommendation in the clinical practice guidelines (CPGs). Eventually, practitioners make their clinical decisions according to the recommendations in CPGs.In this report, the author compared CPGs of acupuncture for LBP between those of the United Kingdom (UK) and United States of America (USA). The NICE guideline development group of the UK did not fully understand Japanese-style acupuncture, and they considered clinical trials with placebo/sham as a control to be the most important, leading to underestimating the effect of acupuncture. On the other hand, the ACP guideline of the USA considers clinical trials with conventional treatment as a control to be more important, and accordingly the effect of acupuncture was evaluated realistically.
ABSTRACT
It is important for patients with colorectal cancer to receive standard and reasonable treatment. There are many clinical practice guidelines for diagnosis and treatment of colorectal cancer. However, the most influential guidelines are NCCN, ESMO and NICE guidelines. NCCN guidelines are the most world-renowned guidelines from National Comprehensive Cancer Network of the United States; ESMO guidelines are promulgated by the European Society for Medical Oncology; NICE guidelines are guidance of diagnosis and management for colorectal cancer issued by the National Institute for Health and Care Excellence of the United Kingdom. They are very similar in case management and treatment principles. However, there are still some differences in indications for drugs, treatment of hereditary colorectal cancer, laparoscopy indication and management of ileus. Here we discuss some of these differences and provide a reference for standardization of colorectal cancer treatment in China.