Objective To explore the methodological characteristics of Chinese clinical practice guidelines/expert consensus based on usage of GRADE. MethodsCNKI, PubMed, WanFang Data databases, and Medlive.cn were electronically searched to collect Chinese clinical practice guidelines/expert consensus over the past 11 years from January 1st 2010 to December 31st 2020. Four reviewers independently extracted data according to the content of appraisal of guidelines quality evaluation tool AGREE Ⅱ. The clinical practice guidelines/expert consensus were divided into two groups based on whether GRADE was used or not. The changes and development of methodological quality in the past 11 years were explored between the two groups. ResultsIn recent years, the number of clinical practice guidelines/expert consensus which used the GRADE in China had increased annually. The practice guidelines/expert consensus which did not use GRADE had lower methodology quality (P<0.01). ConclusionsThe use of GRADE in clinical practice guidelines/expert consensus requires improvement, and mastering GRADE methodology can effectively improve the methodological quality of the clinical practice guidelines/expert consensus.
Meige Syndrome (MS) is a neurological disorder characterized by blepharospasm, oromandibular dystonia, and spasmodic torticollis as its primary clinical manifestations. With advancements in neuroscience research and the accumulation of clinical experience, significant progress has been made in understanding the pathophysiological mechanisms, diagnostic criteria, and therapeutic strategies for MS both domestically and internationally. To standardize clinical practice and promote academic development, Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association, in collaboration with Neuro-ophthalmology Society, Chinese Research Hospital Association, organized a panel of authoritative experts. This expert panel conducted a comprehensive review of the latest research evidence and clinical experiences. Through multiple rounds of expert consultations and in-depth discussions, the original consensus was thoroughly revised and updated. The new consensus aims to provide standardized diagnostic and treatment guidelines for clinicians, foster research innovation and the development of therapeutic techniques in the field of neuro-ophthalmology, address new challenges in the diagnosis and treatment of MS, and ultimately improve patients' quality of life.
Retinopathy of prematurity (ROP) is a blinding eye disease of neonates. Early screening and regular follow-up can prevent the disease from leading to serious functional impairment. Rop is classified by the World Health Organization as the prevention target of avoidable blindness in neonates. Since the National Health Commission of the People's Republic of China issued "Guidelines for the treatment of oxygen and the prevention and treatment of retinopathy in prematurity" in 2004, the Ophthalmology Group of the Chinese Academy of Ophthalmology has actively promoted the screening and treatment of ROP, and updated "Guidelines for screening retinopathy of prematurity" in China in 2014. After nearly 20 years of hard work, the disease of stage 5 ROP in China has basically disappeared. In order to reasonably grasp the classification criteria of ROP and the indications of drug treatment, Fundus Disease Group of Ophthalmological Society of Chinese Medical Association, Fundus Disease Group of Ophthalmologist Branch of Chinese Medical Doctor Association organize experts in related fields to reach consensus opinions through serious, comprehensive and full discussion, and update the classification of ROP in China and the Chinese translation of new terms with reference to international standard terms. The standard of anti-vascular endothelial growth factor drug treatment indication is also added to provide reference for clinicians in clinical practice.
Heart transplantation is a key treatment option for patients with end-stage heart failure. However, post-transplant recipients often face complex rehabilitation challenges due to cardiac denervation, lifelong immunosuppressive therapy, and common complications such as hypertension, dyslipidemia, and post-transplant diabetes mellitus. This article aims to interpret the 2024 position paper jointly released by the European Society of Cardiology and the European Society for Organ Transplantation on post-transplant rehabilitation, and to systematically summarizes the core strategies proposed in rehabilitation management, including optimizing immunosuppressive therapy, individualized exercise prescriptions, lifestyle interventions, and psychosocial support
Objective To form the list of methodological quality evaluation and explanation for the selection of objective performance criteria in single arm trial, and initially construct a methodological guiding tool for the selection and evaluation of target value, so as far to provide a research basis for improving the system of single-arm trial quality evaluation by objective performance criteria method. Methods Combining the bias risk assessment method of observational study, interventional trails, domestic and foreign policy documents, and systematically collecting the common bias and evaluation key points, preliminarily proposing the list of methodological quality evaluation and explanation for the selection of objective performance criteria in single-arm trial, via two rounds of expert consensus voting using nominal group method, finally formulating the list based on the voting results and expert opinions. Results Through two rounds of discussion, sorting, comprehensive expert opinions, we improved the corresponding items in the list and finally formed the list of methodological quality evaluation and explanation for the selection of objective performance criteria in single-arm trial, which included four areas: authority, traceability, comparability, and reliability, including 10 items. The entries in each field considered both design and implementation throughout the clinical trial. Conclusion The methodology list developed in this study provides methodological guidance for the selection of objective performance criteria and quality evaluation, and provides a solid theoretical basis for the establishment of a complete methodological system of quality evaluation for objective performance criteria single arm trails.
Retinal vein occlusion (RVO) is a common clinical disease in ophthalmology. In recent years, with the emergence of drugs such as anti-vascular endothelial growth factor drugs and sustained release of intraocular glucocorticoids, the therapeutic effect and prognosis of RVO patients have been significantly improved. Nevertheless, in different regions and hospitals at all levels in China, the diagnosis and treatment strategies for RVO are mostly based on their own accumulated experience, and there is still room for improvement in the awareness of ophthalmologists on early intervention of RVO and the popularity of related knowledge, and a set of standardized clinical diagnosis and treatment paths is urgently needed. To this end, Fundus Diseases Group in Ophthalmology Branch of Chinese Medical Association, Professional Committee of Fundus Diseases in Ophthalmology Branch of Chinese Medical Doctor Association through systematic and in-depth literature research and analysis of the latest clinical research results, and combined with the current social and economic development of China, jointly drafted the draft of Expert consensus on clinical diagnosis and treatment path of retinal vein occlusion in China. After several reviews and revisions by the core expert group, the consensus was finalized. This consensus is elaborated in terms of the definition and classification of RVO, etiology and pathogenesis, initial diagnosis and treatment path consensus, and follow-up diagnosis and treatment assessment and follow-up management, aiming to provide easy to understand and grasp practical guidance for ophthalmic specialists and general ophthalmology practitioners. This consensus strictly follows the basic principles of evidence-based medicine, fully considers China's national conditions and existing diagnosis and treatment conditions, and puts forward principled recommendations with general guiding significance for the clinical diagnosis and treatment practice of RVO, aiming to meet the diagnosis and treatment needs of most patients. When applying this consensus to guide practice, clinicians should take into account the specific disease characteristics of patients, combined with various factors such as available treatment means and patients' economic status, and implement individualized comprehensive treatment plans, so as to meet the diversified diagnosis and treatment needs of the majority of RVO patients.
Families are important venues for nutritional management of the elderly, and there is an increasing demand for continuous nutritional management services from hospital to home. It has been 7 years since the publication of the "Chinese expert consensus on home nutrition administration for the elderly (2017 edition)", and with the publication of more research evidence and the practice of home nutrition administration, there is an urgent need to update the 2017 edition of the consensus. A total of 35 recommendations or consensus opinions have been proposed in this consensus update, aiming to guide grassroots related professionals to provide scientific, reasonable and standardized home nutrition management services for the elderly population at home or in the community.
Expert consensus, as an important supplement to clinical practice guidelines, supports clinical decision-making when evidence is lacking or controversial. Compared to clinical practice guidelines, the presentation of expert consensus is more diverse. Currently, there are no reporting guidelines for expert consensus in clinical and public health decision-making. The RIGHT (Reporting Items for Practice Guidelines in Healthcare) checklist is the most commonly used international guideline reporting standard, and is often referred to when writing expert consensus. However, the RIGHT checklist does not include a section on consensus formation methods; while the ACCORD (ACcurate COnsensus Reporting Document) checklist includes reporting requirements for consensus formation methods, but not for reporting recommendations. Therefore, this article integrates the RIGHT and ACCORD reporting checklists and proposes an integrated reporting framework (TIMER-DO) to help authors combine these two commonly used international reporting standards and complete the standardized reporting of expert consensus.