Collaborative Design of a Chinese Herbal Medicine Case Report Guideline (CHM-CARE)

Introduction Case reports have a long history in Chinese herbal medicine (CHM), and even into the modern day, case reports are still a preferred format for traditional East Asian medicine (TEAM) practitioners. However, the tradition of case reports in teaching and research is not nearly as common in the English-speaking world as in China, possibly due to the lack of a specific case report guideline. This study aimed to co-design a CHM guideline (CHM-CARE) to assist practitioners in compiling structured and comprehensive case reports. Methods A two-phased mixed approach was used to develop the case report guideline. In phase one, focus groups of TEAM practitioners were used to determine what components of existing guidelines (e.g., Case Report (CARE) and Case Report in Chinese Medicine (CARC)) were relevant to include, along with any additions or changes. Content analysis of phase 1 provided the checklist items for a two-round Delphi process (Phase 2). All checklist items from the first Delphi round with a median of three or higher were included in the second round, with consensus set at >70% for inclusion in the final guideline. Results A total of 18 CHM practitioners from four countries joined five separate focus group discussions. Focus group discussions led to 98 checklist items being used in the first round of the Delphi process. 15 international experts on case reports participated in two rounds of Delphi. 69 checklist items moved forward into the second round where 61 items (88%) reached consensus and formed the final CHM-CARE guideline. Conclusion Key elements of a herbal medicine case report checklist were identified, and a 61-item case report guideline (CHM-CARE) was produced, providing clear guidelines for case reports to TEAM practitioners operating in private practice.