AI-empowered clinical evidence for integrated Chinese-Western medicine: Introduction to the ACE-iMed series and platform dissemination

1. Introduction to the AI-empowered Clinical Evidence for Integrated Chinese-Western Medicine (ACE-iMed) series

As the paradigm of integrated Chinese–Western medicine (ICWM) continues to be evaluated, implemented, and disseminated, clinical evidence has assumed an increasingly influential role in practice as an essential element of this collaborative mode. In parallel, the rapid advancement of artificial intelligence (AI) in medicine has demonstrated distinctive advantages across the entire evidence lifecycle, from generation, synthesis, and appraisal to dissemination, implementation, and translation.1, 2, 3 Against this backdrop, led by Hong Kong Baptist University and Lanzhou University, China, and in collaboration with partner institutions and a multidisciplinary working group, we have developed ACE-iMed (AI-empowered Clinical Evidence for Integrated Chinese-Western Medicine), a platform focused on the intersection of ICWM, clinical evidence, and AI. To advance ICWM, elicit broad feedback on the ACE-iMed platform, and facilitate its adoption in real-world clinical practice so that it can provide empirical support and decision guidance for diverse stakeholders, including clinicians of Chinese and Western medicine, patients and the public, policymakers, and researchers engaged in real-world evidence-based practice and research, we have published the ACE-iMed series. This series comprises eight papers: (1) a methodological paper detailing the design and development of the ACE‑iMed platform; (2) six disease-focused clinical evidence papers that apply the ACE-iMed methodology and platform to characterize and summarize the clinical evidence; and (3) a scoping review examining current progress in integrating large language models (LLMs) into evidence‑based Chinese medicine (EBCM). Brief summaries of these eight papers are provided below.

1.1. Design and methodology of the AI-empowered clinical evidence for integrated Chinese-Western medicine (ACE-iMed) platform

This methodological paper⁴ provides a detailed description of the design, architecture, and functionality of the ACE‑iMed platform (https://www.aceimed.org/);⁵ demonstrates its application across eight diseases (including rheumatoid arthritis, atopic dermatitis, primary dysmenorrhea, perimenopausal syndrome, stroke rehabilitation, depressive disorder, psoriasis, and chronic low back pain); and delineates six core workflow steps that underpin the platform’s design and operation: (1) constructing literature databases; (2) defining clinical questions; (3) literature screening and downloading; (4) data extraction; (5) assessment of risk of bias and methodological quality; and (6) summarizing the evidence and recommendations. The paper also provides guidance for end users on platform use.

1.2. Clinical evidence on integrated Chinese-western medicine for stroke rehabilitation

Across three pre-defined representative Chinese medicine (CM) modalities (acupuncture, moxibustion, and Chinese herbal medicine (CHM)) and seven post-stroke outcomes (motor function, swallowing function, activities of daily living and neurological deficits, mood disorders, quality of life, and cognitive function), this paper⁶ specified 21 clinical questions relevant to stroke rehabilitation. A systematic search and screening identified 4316 studies, comprising 30 clinical practice guidelines (CPGs) or consensus statements (CSs), 275 systematic reviews (SRs), and 4011 randomized controlled trials (RCTs). Underpinned by principles of evidence representativeness and clinical relevance, two clinical questions were selected for detailed description in the paper, as they encompassed the largest bodies of eligible evidence and exemplified distinct CM intervention strategies (acupuncture and CHM) and different outcome domains (motor function and activities of daily living and neurological deficits).

1.3. Clinical evidence on integrated Chinese-western medicine for rheumatoid arthritis

Across pre-defined ten CM modalities (Oral CHM, acupuncture, moxibustion, external therapy of CHM, tuina/massage, cupping, scraping, and Chinese movement exercise, acupoint injection, and small needle-knife therapy) and 19 outcomes in six domains (comprehensive evaluation indicators, disease activity, overall health assessment, severity of primary symptoms, fatigue, and imaging indicators), this paper⁷ specified 18 clinical questions relevant to rheumatoid arthritis. A systematic search and screening identified 556 studies, comprising 17 CPGs/CSs, 35 SRs, and 504 RCTs. To provide focused evidence summaries, this paper selected two questions with the largest evidence bases, representing different CM modalities: integrated oral CHM and Western medication (WM) versus WM alone, and integrated external therapy of CHM and conventional Western therapy (CWT) versus CWT alone.

1.4. Clinical evidence on integrated Chinese-western medicine for primary dysmenorrhea

Across pre-defined seven CM modalities (oral CHM, acupuncture, moxibustion, external therapy of CHM, tuina/massage, cupping, and Chinese movement exercise) and 36 outcomes in nine domains (pain intensity, pain relief, use of analgesics, patient global impression of change, interference from dysmenorrhea symptoms, absenteeism and presenteeism, quality of life, safety, and laboratory/imaging indicators), this paper⁸ specified 14 clinical questions relevant to primary dysmenorrhea. A systematic search and screening identified 219 studies, comprising 4 CPGs, 37 SRs, and 178 RCTs. To provide focused evidence summaries, this paper selected two clinical questions with the largest evidence bases: oral CHM versus WM and acupuncture versus CWT.

1.5. Clinical evidence on integrated Chinese-western medicine for depressive disorder

Across pre-defined four CM modalities (oral CHM, acupuncture, moxibustion, and Chinese movement exercise) and 13 outcomes in three main domains (symptom severity scales, clinical efficacy, and safety), this paper⁹ specified 8 clinical questions relevant to depressive disorder. A systematic search and screening identified 1402 studies, comprising 23 CPGs/CSs, 147 SRs, and 1232 RCTs. Two clinical questions were selected for detailed description based on the representativeness of CM interventions and the number of included RCTs. Ultimately, oral CHM and Chinese movement exercise were chosen as the representative intervention categories; the two clinical questions examine integrated oral CHM and WM versus WM alone, and integrated Chinese movement exercise and CWT versus CWT alone.

1.6. Clinical evidence on integrated Chinese-western medicine for atopic dermatitis

Across pre-defined seven CM modalities (oral CHM, external therapy of CHM, acupuncture, moxibustion, tuina/massage, cupping, and scraping) and 13 specific outcomes, this paper¹⁰ specified 14 clinical questions relevant to atopic dermatitis. A systematic search and screening identified 285 studies, comprising 19 CPGs/CSs, 16 SRs, and 250 RCTs. Most evidence was concentrated in studies of oral CHM and external CHM therapy, while no evidence was identified for scraping. Two clinical questions were selected for detailed presentation based on the largest evidence bases: integrated oral CHM and CWT versus CWT alone, and external CHM therapy (e.g., plaster/patch, bath, fumigation, wet compress) versus CWT alone.

1.7. Clinical evidence on integrated Chinese-western medicine for perimenopausal syndrome

Across pre-defined eight CM modalities (oral CHM, external therapy of CHM, acupuncture, moxibustion, tuina/massage, cupping, scraping, and Chinese movement exercise) and 18 outcomes in four main domains (vasomotor symptoms, menopause-specific quality of life, hormonal biomarkers, and safety), this paper¹¹ specified 16 clinical questions relevant to perimenopausal syndrome. A systematic search and screening identified 280 studies, comprising 5 CPGs/CSs, 38 SRs, and 237 RCTs. Evidence was available for all clinical questions except cupping versus CWT. Nearly 70% of the evidence focused on oral CHM versus WM alone or integrated oral CHM and WM versus WM alone. Given that acupuncture and oral CHM have accumulated the most substantial evidence, these two modalities were prioritized for presentation in the paper.

1.8. Integration of large language models and evidence-based Chinese medicine: a scoping review

This scoping review¹² systematically maps the integration of LLMs with EBCM, characterizes the current state of progress, and identifies research gaps. A systematic search yielded 12 eligible studies. Collectively, these studies demonstrate emerging applications of LLMs across the evidence ecosystem—from evidence generation and synthesis to translation and implementation. Overall, existing evidence indicates that LLMs are beginning to contribute at multiple stages in the EBCM, although the distribution of studies across these stages remains uneven.

2. ACE-iMed platform dissemination and next step

2.1. Pilot implementation

The ACE-iMed platform is an internationally oriented clinical evidence platform for ICWM, currently open-access and free of charge to users worldwide.⁵ To more effectively implement the platform and obtain real-world usage evidence and feedback, the ACE-iMed working group plans to pilot the platform at a suitable hospital. The Chinese Medicine Hospital of Hong Kong (CMHHK), Hong Kong’s first dedicated CM hospital, is committed to integrating CM into the modern healthcare system, actively advancing collaboration between Chinese and Western medicine, and establishing a reference model for such collaboration within hospital settings.¹³ The hospital provides three service models for specified diseases: pure CM services, services with CM playing the predominant role, and ICWM services. These models are tailored to patients' diverse needs and health statuses to deliver safe, convenient, personalized, and high-quality services.¹³ In light of the above, and given that the eight diseases currently targeted by ACE-iMed are included among these specific diseases, piloting at CMHHK represents a strategic, mutually beneficial opportunity for both ACE-iMed and the hospital.

Within this pilot, the ACE-iMed platform⁵ will provide structured, tiered evidence support for clinical practice. Clinicians will be able to rapidly access disease-specific summaries and comparisons across three main evidence types (e.g., CPGs/CSs, SRs, and RCTs), assess the concordance and divergence of summaries across different levels of evidence, and further examine individual studies to review detailed data and methodological quality appraisals. These capabilities are expected to enhance the efficiency of evidence retrieval and the transparency and traceability of evidence-based decision-making.

The pilot will emphasize standardized monitoring and evaluation of usage frequency, use scenarios, and user satisfaction among clinicians, researchers, and policymakers, thereby informing the optimization of platform functionalities and content. In parallel, the ACE-iMed working group will systematically collect feedback on usability, content completeness, and clinical applicability during the pilot. Coupled with usage analytics, this feedback will guide iterative optimization of the evidence base and user interface, strengthen the platform’s practicality and scalability in hospital settings, accelerate the translation of evidence into clinical decision-making, and ultimately improve patient outcomes and population health.

2.2. Expansion of disease coverage and evidence updates

The ACE-iMed platform currently presents clinical evidence for eight diseases. Selection was informed by disease burden and service volume, urgency of clinical need, the breadth and quality of the existing evidence base, representativeness for ICWM clinical practice, and scalability for wider adoption. For each disease, a dedicated multidisciplinary working group was convened to refine clinical questions using the PICO (Population, Intervention, Comparison, Outcomes) framework, specify CM interventions (e.g., acupuncture, tuina, oral CHM), CWT interventions, and prioritize patient-important and safety outcomes while aligning, where feasible, with established core outcome sets. Beginning in the second half of 2026, the working group will initiate work on approximately 15 additional priority diseases.

Furthermore, the platform will institute a routine evidence surveillance and update mechanism, with comprehensive updates across all covered diseases conducted at regular intervals. In parallel, a fast-track pathway will prioritize monitoring and rapid incorporation of newly released CPGs/CSs, and practice-changing studies to safeguard timeliness in clinical use. All updates will be governed by version control with a public change log documenting the last search date, study additions and removals, modifications to summaries and their rationale, alongside ongoing retraction and erratum surveillance to prevent invalid evidence from influencing summaries. For major updates, concise methodological notes and interpretive statements will be provided to assist users in assessing the robustness and applicability of the revised conclusions.

2.3. Website optimization and user-centered enhancements

ACE-iMed has established a standardized user feedback portal through which users may submit comments on platform functionality and content, as well as clinical questions arising from practice. Platform-level issues will be periodically collated and categorized, summarized in internal reports, and following team deliberation, addressed through a defined change-management process, with salient version changes publicly communicated to ensure transparency and traceability. Feedback on clinical questions, typically nominating additional diseases or specific clinical questions, will be reviewed at regular intervals and assessed against clinical demand, evidence availability, and methodological feasibility. Multidisciplinary discussion will be used to reach consensus on inclusion, with subsequent updates reflected on the platform. Without compromising methodological rigor, the platform will improve page responsiveness and query performance, enhance bookmarking and update alerts, and conduct periodic usability evaluations; iterative development will be driven jointly by usage analytics and user research.

Building on pilot experience and feedback, the platform will pursue ongoing refinement of disease coverage, update strategies, and user support. Dissemination and implementation will be pursued in collaboration with professional societies, clinical departments, academic institutes, and guideline-development and training organizations, integrating the platform into continuing medical education and clinical pathway optimization. Disease-focused workshops and outreach activities will provide standardized operating guidance and case exemplars to facilitate adoption. To evaluate impact, the platform will track key indicators, including adoption rate, usage frequency, the proportion of evidence queries informing clinical decisions, and user satisfaction, and it will undertake necessary localization to align with regional policies and terminologies, thereby progressively expanding its reach and influence in integrative decision-making.

Authors’ contribution

Conceptualization: XY, YFM, XFL, YLC, and ZXB. Writing – Original Draft: XY. Writing – Review and Editing: XY, YFM, XFL, YLC, and ZXB. All authors read and approved the final manuscript.

Funding

This study was supported by two independent funders: (i) the Vincent and Lily Woo Foundation; and (ii) Project “Integrative Chinese and Western Medicine Treatment Pathway for the Chronic Diseases (Project Code: TFD2024-P08)” from Hong Kong Baptist University. The funders have no role in the study design, data collection, data analysis, manuscript writing, or publication process.

Ethics statement

Not applicable.

Data availability

Not applicable.

Declaration of competing interest

YFM, XFL, and YLC are staff members and ZXB is the founding director and current co-director of the Vincent V.C. Woo Chinese Medicine Clinical Research Institute, which receives funding from the Vincent and Lily Woo Foundation. ZXB is the principal investigator of Project "Integrative Chinese and Western Medicine Treatment Pathway for the Chronic Diseases (Project Code: TFD2024-P08)". XY, YFM, YLC, and ZXB are members of the editorial board of this journal but had no role in the peer review or editorial decision for this article.