The evidence bridge: Advancing integrated Chinese-Western medicine from clinical research to practice in Hong Kong

1. Importance of integrated Chinese-Western medicine

Western medicine (WM), also referred to as conventional medicine, is the predominant system in global healthcare. Grounded in rigorous research methodologies, robust evidence bases, and advanced technologies, it delivers systematic and standardized diagnosis, treatment, and prevention for patients, particularly in the management of acute illnesses and critical conditions.¹ Chinese Medicine (CM), classified as Traditional Medicine in the 11th revision of the World Health Organization’s International Statistical Classification of Diseases,² employs the holistic concept and syndrome differentiation and draws on diverse interventions, such as Chinese herbal medicine, acupuncture, and tuina, to promote functional recovery, symptom relief, and long-term health management. Rooted in distinct philosophical underpinnings and theoretical systems, WM and CM each possess unique diagnostic and therapeutic strengths.

The global disease profile is undergoing rapid changes. The 2023 Global Burden of Disease study, published in 2025, reveals that chronic diseases cause approximately two-thirds of global deaths.³ For chronic diseases and rehabilitation management that require sustained and multidimensional support, a single medical model is clearly insufficient. The integration between CM and WM, leveraging complementary strengths, can provide patients with more comprehensive and individualized care.⁴ In specific conditions such as rheumatoid arthritis and post-stroke rehabilitation, it is evident that integrated Chinese-Western medicine (ICWM) treatment can significantly improve patient outcomes.^5,6 Therefore, advancing ICWM is an inevitable choice for enhancing medical services and adapting to the evolving global disease landscape.

2. Integrated Chinese-Western medicine in Hong Kong

Hong Kong Special Administrative Region (hereafter “Hong Kong”) serves as a global brokerage hub for multiple sectors, including finance, education, research, and healthcare, and plays a particularly important bridging role between mainland China and international markets. In the healthcare sector, Hong Kong has long enjoyed numerous advantages, such as a rigorous and well-developed regulatory framework and high-quality care services, but it has still faced substantial challenges in recent years. According to statistics, Hong Kong is a global outlier for rapid ageing, and the pace of ageing is expected to peak in the next decade; in 2020, about 55% of deaths in Hong Kong were attributable to chronic diseases.⁷ These trends have imposed a heavy burden of disease and significant fiscal pressure on the public healthcare system. Hong Kong runs on a dual-track system encompassing the public and the private sectors with a separation between WM and CM, which substantially limits the WM-CM deep integration and collaboration. To address health challenges more effectively, Hong Kong's healthcare system urgently needs to shift from a WM-CM "parallel coexistence" model to a "collaborative integration" model.

Encouragingly, the Hong Kong government has attached great importance to the CM development and has made ICWM one of its policy priorities in recent years. Initiatives have included the ICWM Pilot Programme in designated public hospitals,⁸ the gradual expansion of hospital sites offering ICWM services,⁹ and the establishment of Hong Kong’s first Chinese Medicine Hospital—The Chinese Medicine Hospital of Hong Kong (CMHHK).^10,11 These measures signify strong policy support and are essential for exploring clinical pathways, management models, and outcome evaluation framework for ICWM practice.

3. Introduction of ACE-iMed platform

Evidence is the foundation of clinical practice and indispensable in advancing ICWM. Although there are currently multiple ICWM evidence databases and platforms, they are commonly limited to practical applications due to not being clinical-question-oriented, lacking transparency in development methodology and process, insufficient coverage of literature types of evidence, and no evidence summary provided.^12,13 It is therefore necessary to develop a dedicated ICWM evidence platform that presents multilingual, cross–study-design research in a standardized, visualized, and traceable manner, thereby shortening the translation distance from ICWM clinical research to practice and promoting evidence-based decision-making.

In response to this critical need, Hong Kong Baptist University and Lanzhou University have jointly developed the AI-empowered Clinical Evidence for Integrated Chinese-Western Medicine (ACE-iMed) platform (https://www.aceimed.org).¹⁴ This is a globally accessible, artificial intelligence (AI)-empowered, interpretable, user-friendly, and regularly updated clinical evidence platform for ICWM. Its vision is to leverage cutting-edge AI to integrate the wisdom of traditional medicine with modern evidence-based medicine, establishing an open, intelligent, and reliable global knowledge hub to advance the scientific rigor and standardization of ICWM practice.

The core functionality of the ACE-iMed platform includes, oriented to specific clinical questions (i.e., population, intervention, comparison, and outcome) within priority diseases in the ICMW field, perform systematical searching and screening of relevant literature; include multi-type eligible evidence from clinical practice guidelines/consensus statements (CPGs/CSs), systematic reviews, and randomized controlled trials; conduct extraction, evaluation, and visualization of the key information of each study. Simultaneously, it stratifies evidence by literature types, provides summaries for each type and across types separately, and further details for interventions recommended in all included CPGs/CSs (i.e., intervention name, target population, and intervention dosage and administration) to help users quickly grasp the core results and conclusions of current evidence, providing a basis for decision-making. Built upon large-scale, cross-language, and cross–type evidence, the platform applies AI to empower the entire chain, achieving a fully automated process from literature screening, data extraction, quality assessment, to content summarization. In terms of information presentation and usage of the ACE-iMed platform, to enhance the user experience and retrieval efficiency, it offers a user-friendly, structured navigation based on the logic of “disease–intervention–clinical question” and also a semantic search method supporting natural language queries with precise AI-generated responses. More importantly, the platform is designed with a needs-driven closed loop based on user behavior and feedback to steer and expand the scope of its knowledge coverage.

Taken together, the ACE-iMed platform is tightly aligned with the application needs of ICWM clinical scenarios, reducing the time cost of evidence retrieval and acquisition and holding substantial potential to empower diverse interest-holders, including clinicians, researchers, patients, and policymakers. Based on current experience and achievements, the working group has launched the ACE-iMed Series, focusing on the fusion application of ICWM, evidence-based medicine, and AI, and aiming to promote the platform’s translation and application in clinical practice.

4. Future implementation of ICWM in Hong Kong

Despite the policy support available to Hong Kong, there are still multiple challenges in implementing ICWM. Firstly, siloed regulatory frameworks for different health professionals may lead to several problems in the integration process, such as ambiguities in legal liability and scope-of-practice boundaries, and more complex monitoring and regulation of herbal and drug interactions. Secondly, interprofessional collaboration often leads to a gap between protocol design and real-world implementation because its processes and organizational structures are complex and often lack implementation details. Thirdly, clinical pathway development is time-consuming, and translation from evidence to pathways often lags, making it difficult to align with local clinical practices and emerging needs in a timely manner. To address these issues, we suggest: 1) developing clear standard operating procedures on roles and responsibilities—led by the Health Bureau and in collaboration with relevant departments—specifying operational procedures for referrals, consultations, and record-keeping; 2) conducting pilots for ICWM clinical pathway of priority diseases, setting key steps and quality indicators, and continuously improving implementation details through monitoring and evaluation; 3) establishing AI-empowered "real-time evidence" update mechanism to further help realize living clinical pathways and decisions making. This point is precisely where the ACE-iMed platform can play a crucial role in the future.

Hong Kong stands at a historic juncture in advancing the development of ICWM. The CMHHK can serve as a practical base, and the ACE-iMed platform can serve as a scientific bridge; together, they can help build a safe, effective, and efficient new paradigm for ICWM. This paradigm will not only enable Hong Kong to better serve its local citizens but also contribute valuable "Hong Kong experience" to the world.

Funding

This project was funded by the Vincent and Lily Woo Foundation. The funders have no role in the study design, data collection and analysis, manuscript writing, or publication process.

Ethics statement

Not applicable.

Data availability

Not applicable.

CRediT authorship contribution statement

Yanfang Ma: Conceptualization, Writing – original draft. Xuan Yu: Conceptualization, Writing – review & editing. Xufei Luo: Conceptualization, Writing – review & editing. Yaolong Chen: Conceptualization, Writing – review & editing. Zhaoxiang Bian: Conceptualization, Writing – review & editing.

Conflict of interest

Y.M., X.L., and Y.C. are the staff and Z.B. serves as the founding director and co-director of the Vincent V.C. Woo Chinese Medicine Clinical Research Institute, which receives funding from the Vincent and Lily Woo Foundation. Y.M., X.Y., Y.C., and Z.B. are members of the editorial board of this journal but had no role in the peer review or editorial decision for this article.