Quality Evaluation of Traditional Chinese Medicine Guidelines based on AGREE Ⅱ Instrument_Chinese Journal of Evidence-Based Medicine

Authors：

 CHENYao-long ¹ ^# ,  ZHOUQi ² ^# , CUIRong-rong ³ , YANGNan ⁴ , XIAOShu-jun ² ,  SHANGHong-cai ¹

1. Key Laboratory of Chinese Internal Medicine, Ministry of Education, Beijing University of Chinese Medicine, Beijing 100700, China;
2. School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China;
3. The Second Clinical Medical College of Lanzhou University, Lanzhou 730000, China;
4. The First Clinical Medical College of Lanzhou University, Lanzhou 730000, China;

Corresponding author：

SHANGHong-cai, Email: shanghongcai@126.com

Keywords：

Quality assessment; Traditional Chinese medicine guidelines; AGREE Ⅱ

DOI：

10.7507/1672-2531.20160201

Video：

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Objective To evaluate the quality of traditional Chinese medicine (TCM) guidelines, so as to provide evidence for developing similar guidelines. Methods We systematically searched TCM guidelines published in domestic medical journals from WanFang Data, VIP, CNKI and CBM. We also searched Google, Amazon.cn and dangdang.com by hand in order to obtain TCM guidelines published in monographs. And we used AGREE II instrument to assess the methodological quality of included guidelines. Results A total of 115 guidelines (87 published in domestic medical journals and 28 published in monographs) were included. Scaled domain percentages from highest to lowest were:scope and purpose (41%), stakeholder involvement (28%), clarity of presentation (33%), rigour of development (20%), editorial independence (9%) and applicability (7%). Conclusion There is still a large gap about methodological quality between TCM guidelines and international guidelines. So the guideline developers should systematically search, evaluate and synthesize the evidence based on structured problems. At the same time, they also need to consider the costs of recommendations, the implementation environment and the patients' preference and values. On this basis, the developer could further increase the transparency and independence during developing TCM guidelines.

Citation： CHENYao-long, ZHOUQi, CUIRong-rong, YANGNan, XIAOShu-jun, SHANGHong-cai. Quality Evaluation of Traditional Chinese Medicine Guidelines based on AGREE Ⅱ Instrument. Chinese Journal of Evidence-Based Medicine, 2016, 16(11): 1331-1337. doi: 10.7507/1672-2531.20160201 Copy

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2.	Woolf SH, Grol R, Hutchinson A, et al. Potential benefits, limitations, and harms of clinical guidelines. BMJ, 1999, 318(7182):527-530.
3.	Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice:a systematic review of rigorous evaluations. Lancet, 1993, 342(8883):1317-1322.
4.	WHO. Guidelines for Methodologies on Research and Evaluation of Traditional Medicine. General:WHO, 2000.
5.	WHO. WHO traditional medicine strategy 2002-2005. General:WHO, 2002.
6.	中华人民共和国国民经济和社会发展第十一个五年规划纲要.[2016-1-26]. Available at:http://news.xinhuanet.com/misc/2006-03/16/content_4309517.htm.
7.	李楠, 姚亮, 吴琼芳, 等. 2012-2013年中国大陆期刊发表临床实践指南质量评价.中国循证医学杂志, 2015, 15(3):259-263.
8.	Consortium ANS. The AGREE Ⅱ Instrument. The AGREE Research Trust. 2009:1.
9.	Brouwers MC, Kho ME, Browman GP, et al. AGREE II:advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18):E839-E842.
10.	Zadvinskis IM, Grudell BA. Clinical practice guideline appraisal using the AGREE instrument:renal screening. Clin Nurse Spec, 2010, 24(4):209-214.
11.	Field MJ, Lohr KN. Guidelines for Clinical Practice:From Development to Use:National Academies Press, 1992.
12.	Field MJ. Setting priorities for clinical practice guidelines:National Academies Press, 1995.
13.	Chen YL, Yao L, Xiao XX, et al. Quality assessment of clinical guidelines in China:1993-2010. Chin Med J (Engl), 2012, 125(20):3660-3664.
14.	潘晓平, 倪宗瓒.组内相关系数在信度评价中的应用.华西医科大学学报, 1999, 30(1):62-63.
15.	余红梅, 罗艳虹, 萨建, 等.组内相关系数及其软件实现.中国卫生统计, 2011, 28(5):497-500.
16.	AGREE History.[2016-01-23]. Available at:http://www.agreetrust.org/about-agree/agree-history/.
17.	Alonso-Coello P, Irfan A, Solà I, et al. The quality of clinical practice guidelines over the last two decades:a systematic review of guideline appraisal studies. Qual Saf Health Care, 2010, 19(6):e58.
18.	陈敏, 何佳, 肖飏, 等.国内期刊发表的中医药系统评价/Meta分析的现状分析.中国循证医学杂志, 2012, 119(12):1526-1530.
19.	李廷谦, 刘雪梅, 张鸣明, 等.中文期刊发表的中医药系统评价/Meta分析现状调查.中国循证医学杂志, 2007, 50(3):180-188.
20.	刘建平, 夏芸.中文期刊发表的中医药系统综述或Meta分析文章的质量评价.中国中西医结合杂志, 2007, 27(4):306-311.
21.	卫茂玲, 刘鸣.中国临床指南循证制定的方法学现状分析.中国循证医学杂志, 2013, 3(8):927-932.
22.	吕爱平, 谢雁鸣, 韩学杰.基于循证医学的中医临床实践指南编制方法与范例.中国中医药出版社, 2013.
23.	刘筱敏.中国科学引文数据库来源期刊出版规模浅析.中国科技期刊研究, 2008, 19(6):935-937.
24.	刘筱敏.中国科学引文数据库与期刊网络化.中国科技期刊研究, 2003, 14(z1):810-813.
25.	Norris SL, Holmer HK, Ogden LA, et al. Conflict of Interest Disclosures for Clinical Practice Guidelines in the National Guideline Clearinghouse. PLoS ONE, 2012, 7(11):e47343.
26.	Norris SL, Holmer HK, Ogden LA, et al. Conflict of Interest in Clinical Practice Guideline Development:A Systematic Review. PLoS ONE, 2011, 6(10):e25153.
27.	陈耀龙, 杨克虎, 田金徽, 等.循证实践指南的制定:国际经验与中国实践.兰州大学学报(医学版), 2016, 42(1):29-35.
28.	李幼平, 李静, 孙鑫, 等.循证医学在中国的发展:回顾与展望.兰州大学学报(医学版), 2016, 42(1):25-28.

1. IOM (Institute of Medicine). 2011. Clinical Practice Guidelines We Can Trust. Washington, DC:The National Academies Press.
2. Woolf SH, Grol R, Hutchinson A, et al. Potential benefits, limitations, and harms of clinical guidelines. BMJ, 1999, 318(7182):527-530.
3. Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice:a systematic review of rigorous evaluations. Lancet, 1993, 342(8883):1317-1322.
4. WHO. Guidelines for Methodologies on Research and Evaluation of Traditional Medicine. General:WHO, 2000.
5. WHO. WHO traditional medicine strategy 2002-2005. General:WHO, 2002.
6. 中华人民共和国国民经济和社会发展第十一个五年规划纲要.[2016-1-26]. Available at:http://news.xinhuanet.com/misc/2006-03/16/content_4309517.htm.
7. 李楠, 姚亮, 吴琼芳, 等. 2012-2013年中国大陆期刊发表临床实践指南质量评价.中国循证医学杂志, 2015, 15(3):259-263.
8. Consortium ANS. The AGREE Ⅱ Instrument. The AGREE Research Trust. 2009:1.
9. Brouwers MC, Kho ME, Browman GP, et al. AGREE II:advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18):E839-E842.
10. Zadvinskis IM, Grudell BA. Clinical practice guideline appraisal using the AGREE instrument:renal screening. Clin Nurse Spec, 2010, 24(4):209-214.
11. Field MJ, Lohr KN. Guidelines for Clinical Practice:From Development to Use:National Academies Press, 1992.
12. Field MJ. Setting priorities for clinical practice guidelines:National Academies Press, 1995.
13. Chen YL, Yao L, Xiao XX, et al. Quality assessment of clinical guidelines in China:1993-2010. Chin Med J (Engl), 2012, 125(20):3660-3664.
14. 潘晓平, 倪宗瓒.组内相关系数在信度评价中的应用.华西医科大学学报, 1999, 30(1):62-63.
15. 余红梅, 罗艳虹, 萨建, 等.组内相关系数及其软件实现.中国卫生统计, 2011, 28(5):497-500.
16. AGREE History.[2016-01-23]. Available at:http://www.agreetrust.org/about-agree/agree-history/.
17. Alonso-Coello P, Irfan A, Solà I, et al. The quality of clinical practice guidelines over the last two decades:a systematic review of guideline appraisal studies. Qual Saf Health Care, 2010, 19(6):e58.
18. 陈敏, 何佳, 肖飏, 等.国内期刊发表的中医药系统评价/Meta分析的现状分析.中国循证医学杂志, 2012, 119(12):1526-1530.
19. 李廷谦, 刘雪梅, 张鸣明, 等.中文期刊发表的中医药系统评价/Meta分析现状调查.中国循证医学杂志, 2007, 50(3):180-188.
20. 刘建平, 夏芸.中文期刊发表的中医药系统综述或Meta分析文章的质量评价.中国中西医结合杂志, 2007, 27(4):306-311.
21. 卫茂玲, 刘鸣.中国临床指南循证制定的方法学现状分析.中国循证医学杂志, 2013, 3(8):927-932.
22. 吕爱平, 谢雁鸣, 韩学杰.基于循证医学的中医临床实践指南编制方法与范例.中国中医药出版社, 2013.
23. 刘筱敏.中国科学引文数据库来源期刊出版规模浅析.中国科技期刊研究, 2008, 19(6):935-937.
24. 刘筱敏.中国科学引文数据库与期刊网络化.中国科技期刊研究, 2003, 14(z1):810-813.
25. Norris SL, Holmer HK, Ogden LA, et al. Conflict of Interest Disclosures for Clinical Practice Guidelines in the National Guideline Clearinghouse. PLoS ONE, 2012, 7(11):e47343.
26. Norris SL, Holmer HK, Ogden LA, et al. Conflict of Interest in Clinical Practice Guideline Development:A Systematic Review. PLoS ONE, 2011, 6(10):e25153.
27. 陈耀龙, 杨克虎, 田金徽, 等.循证实践指南的制定:国际经验与中国实践.兰州大学学报(医学版), 2016, 42(1):29-35.
28. 李幼平, 李静, 孙鑫, 等.循证医学在中国的发展:回顾与展望.兰州大学学报(医学版), 2016, 42(1):25-28.

Chinese Journal of Evidence-Based Medicine

Quality Evaluation of Traditional Chinese Medicine Guidelines based on AGREE Ⅱ Instrument

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