Traditional Chinese medicine (TCM) has a history of thousands of years in China and is officially sanctioned by the government as a treatment option for Chinese citizens alongside, what we will refer to here as western medicine, which is also very well developed in China. In the west, TCM is becoming increasingly popular with some people who become worried about the efficacy and side effects of western medicine. In the west, TCM falls under the umbrella term of complementary and alternative medicine (CAM) and adherents to CAM will most likely be adherents to TCM. As editors, we also see an increase in the submission of studies on TCM to our journals and we are keen to ensure that standards for the publication of studies on TCM adhere to the highest possible standards. In the UK, CAM is described by the National Health Service (NHS, 2018) as: ‘…treatments that fall outside of mainstream healthcare. These medicines and treatments range from acupuncture and homeopathy, to aromatherapy, meditation and colonic irrigation’. The list includes acupuncture which is probably the best known example of TCM but TCM is wider than this and, according to the National Institute for Health (NIH, 2013) in the USA: ‘…TCM practitioners use various mind and body practices (such as acupuncture and tai chi) as well as herbal products to address health problems’. As you can imagine, TCM is controversial and not only in the west. In both China and the west, TCM has its adherents and its detractors. However, we do not wish to enter that debate. We are aware that hard evidence to support many TCM practices is lacking; and TCM is not alone. The evidence‐base for some western medical and surgical practices is quite thin. What we do believe is that, as a matter of fact, TCM exists, it is being used widely and it is being tested extensively in China. We want to outline what we think are the minimum practices required to ensure that only studies of the highest quality are published in our journals. These standards do not differ from those required for any type of study that purports to test a treatment; nevertheless, we consider that it will be useful to reiterate them here.

1 THINGS TO BE AVOIDED We start with the assumption that those investigating TCM maintain an open mind about the outcomes of their studies. There can be a problem among adherents which leads people to want to ‘prove’ that something works. Therefore, we urge investigators of TCM to maintain the highest ethical standards and these include understanding what constitutes fabrication of data and especially the falsification of data (COPE, 2019). With regard to the latter, full disclosure of study outcomes is required and we increasingly expect raw, unmanipulated, data to be made available to statistical reviewers and that aspects of the data that may exaggerate the difference between treatment and control groups, specifically outlying results, have been checked and accounted for and that the usual analytical precautions such as intention to treat analysis have been applied.

2 PUBLISHING STANDARDS The following stipulations will be required by all major high‐quality international journals, especially those included on the Science Citation Index. First, all intervention studies involving patients must be registered as mandated under the AllTrials agreement (www.alltrials.net) to which all the major academic publishers have signed. Registration means that the protocol for the study must be made publicly available and that aspects of the study such as the primary outcome must be specified. Registration should be on a recognized trials registry. The most notable of these is ClinicalTrials.gov (https://clinicaltrials.cov/) but, as many studies on TCM emanate from China, it is probably more appropriate to use the Chinese Clinical Trial Registry (http://www.chictr.org.cn) which is internationally recognized. Strictly speaking, registration should be prospective, and journals are increasingly reluctant to allow retrospective registration. Please note that having a study approved by an ethics committee or Institutional Review Board is not considered to be registration. Moreover, in registering a study with a trials registry you are committed to publishing the outcome of the study whether the outcome is in favour of the TCM or not. Next, studies involving an intervention and a control group must be presented according to the CONSORT (http://www.consort-statement.org/) guidance. The appropriate set of guidance must be selected according to the type of trial and the submitted manuscript must include a CONSORT flow chart and a CONSORT checklist. Specific guidance exists for both acupuncture (http://www.consort-statement.org/extensions/overview/acupuncture-interventions) and Chinese herbal MEDICINE (http://www.consort-statement.org/extensions/overview/chineseherbalmeds) studies. Moreover, the checklist must include a positive response to trials registration indicating the page of the manuscript where registration details are recorded—the name of the database and the registration number—can be found.

3 ADDITIONAL POINTS TO CONSIDER In reporting your study ensure that you are reporting the primary outcome and that any secondary outcomes are identified as such in the manuscript. Do not try to convince an editor or reviewers with a title which suggests that your treatment works if it does not have a positive effect on the primary outcome. For example, if you conducted a study of the effect of acupressure on nausea during chemotherapy and the primary outcome is nausea but there is no effect on nausea then that must be reported. There may well have been secondary outcomes such as patient satisfaction, patient comfort, or patient compliance with the intervention. You must not claim efficacy in relation to the primary outcome if any of these were positive, yet there was no effect on nausea. Your study must be reported such that it is clear that, despite some positive benefits of the intervention, there was no effect on the primary outcome. If your TCM intervention does show a positive result in terms of a primary outcome, you should be measured and modest about your study. One study is not definitive and only adds a single data point to the field. You should appreciate, due to the unavoidable phenomenon of regression towards the mean, that a replication of your study may not favour treatment or may even favour the control group. Specify the limitations to your study and that further studies will always be required. Finally, many studies in TCM are rejected because the relevance to nursing is not made clear. In some countries TCM can only be practiced by properly trained medical staff and nurses are not permitted to be practitioners. This applies, for example, to Mainland China and Hong Kong. Therefore, studies of TCM are often submitted either by non‐nurses or by nurses who are not licensed to practice. Clearly, if the latter is apparent then it could be deemed inappropriate to publish. If studies are submitted by non‐nurses, then the relevance to nursing should be clarified, bearing in mind that nurses may be TCM practitioners in some countries.