Selection Of The Treatment Regimen In The Integrated System And Its Practice In The Deficiency Of Qi And Yin Deficiency In Type 2 Diabetes Mellitus

BackgroundThe applied areas of Hall for Workshop of Meta-synthetic Engineering (HWMSE) in Chinese medicine are majorly the remote consult for patients with intractable diseases, the achievement of expert consensus and the draft of medical guidelines. As the research in mobile medicine substantially progresses, HWMSE sheds light on new direction towards the development of individualized, non-realtime platform for decision-making. However, HWMSE is also limited by some of the inherent insufficiency of "expert module" such as an opaque process of integration of an expert’s personal experience, evidences as far as he knows and patient preference in mind. So much as it is, the approach tends to be influenced by his existing knowledge, experience and how well he updates and understands the academic literature as well as his mood or tiredness. Finally, the whole process becomes generally untraceable and irreproducible.Purpose1. Explore new approaches to facilitate the remote treatment under the framework of HWMSE, so that the process of treatment strategy determination can be more systematic, transparent, accountable and reproducible.2. To practice the new approaches in treatment prioritization of real-world HWMSE patient with type 2 diabetes of qi-yin deficiency, and to test the reliability and robustness of model.3. To evaluate the feasibility of planting the new approach in platform module of HWMSE.Method1. Perform scientific mapping of knowledge of literature on comparative effectiveness research based on Citespace and iterate the results until specific solution is found. Make subsequent comparison between each solutions with respect to their usability and suitability to Chinese medicine.2. Adapt the solution to Chinese medicine and HWMSE settings, so that it can be used in the real-world HWMSE practice to help the doctor prioritize treatment effectiveness. Then subject he result into sensitivity analysis to test its feasibility and reliability.3. Discuss the feasibility of docking the solution into proper HWMSE module.Result1.331 literatures on comparative effectiveness research were retrieved (2001-2015) in Web of Science. The co-citation analysis reported 18 domain hot-spots with 13 cut-edge terminologies, by which map of time slices was portrayed. The comparison between network meta-analysis and decision making method showed that the former, due to current lack of necessary high-quality evidences and inherent inability to maintain Chinese medicine features, does not apply to the research of Chinese medicine.2. Iterative mapping of 392 literatures (1992-2015) on multi-criteria decision making analysis was performed, which gave 8 domain hot spots with 6 cut-edge terminologies. By analyzing the map of time slices we have identified analytic hierarchy process (AHP) for solving real-world HWMSE problems.3. The results obtained showed that the Xiaoke Pill is the best prescription to treat T2D-QDP (normalized value:0.388), followed by Shenqi Granules (normalized value:0.269), then Liuwei Dihuang Pill (normalized value:0.230) and finally by Shengmai Injection (normalized value:0.113). CR of the model is acceptable with satisfactory robustness.Conclusion AHP, as a widely-adopted MCDA method, can be docked into the platform module of HWMSE to aide the decision making of experts by making the process standardized and reproducible.