The evidence on whether Chinese herbal medicines affect outcome in patients with chronic kidney disease (CKD) is limited. Here we retrospectively explored the association of prescribed Chinese herbal medicine use and the risk of end-stage renal disease (ESRD) in patients with CKD. Patients with newly diagnosed CKD in the Taiwan National Health Insurance Research Database from 2000 to 2005 were categorized into new use or nonuse of prescribed Chinese herbal medicine groups. These patients were followed until death, dialysis initiation, or till the end of 2008. Among the 24,971 study patients, 11,351 were new users of prescribed Chinese herbal medicine after CKD diagnosis. Overall, after adjustment for confounding variables, the use group exhibited a significant 60% reduced ESRD risk (cause-specific hazard ratio 0.41, 95% confidence interval 0.37-0.46) compared with the nonuse group. The change was significantly large among patients using wind dampness-dispelling formulas (0.63, 0.51-0.77) or harmonizing formulas (0.59, 0.46-0.74), suggesting an independent association between specific Chinese herbal medicines and reduced ESRD risk. The findings were confirmed using propensity score matching, stratified analyses, and three weighting methods. However, dampness-dispelling and purgative formulas were associated with increased ESRD risk. Thus, specific Chinese herbal medicines are associated with reduced or enhanced ESRD risk in patients with CKD.

This study proposes a software quality evaluation model and its computing algorithm. Existing software quality evaluation models examine multiple characteristics and are characterized by factorial fuzziness. The relevant criteria of this model are derived from the international norm ISO. The main objective of this paper is to propose a novel Analytic Hierarchy Process (AHP) approach for addressing uncertainty and imprecision in service evaluation during pre-negotiation stages, where comparative judgments of decision makers are represented as fuzzy triangular numbers. A new fuzzy prioritization method, which derives crisp priorities from consistent and inconsistent fuzzy comparison matrices, is proposed. The Fuzzy Analytic Hierarchy Process (FAHP)-based decision-making method can provide decision makers or buyers with a valuable guideline for evaluating software quality. Importantly, the proposed model can aids users and developers in assessing software quality, making it highly applicable for academic and commercial purposes.

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