ObjectiveTo understand the current national status of the rating of published orthopedic guidelines and consensus in China, to help users select the appropriate use of these clinical guidelines, to guide clinical practice, and to promote the targeted improvement of the quality of Chinese orthopedic guidelines and consensus. MethodsChinese biomedical databases, including CNKI, WanFang Data, and SinoMed were searched electronically from January 2016 to October 2023, and relevant Chinese orthopedic clinical practice guidelines and consensus documents were collected. Two evaluators independently screened the retrieved literature and extracted data. The scientificity, transparency, and applicability rankings (STAR) tool was used to comprehensively rate Chinese orthopedic guidelines and consensus documents published in medical journals since 2016. Any dispute between the two evaluators was resolved by consulting a third evaluator. Kappa values were used to evaluate the consistency of the results between the two evaluators. ResultsA total of 191 orthopedic-related guidelines and consensus documents were obtained, including 74 guidelines and 117 consensus documents. The average score of the guidelines included in the evaluation was 34.4 points, while the average score of consensus documents included in the evaluation was 21.7 points. Guidelines scored higher than consensus documents in areas such as registration, planning, workgroups, clinical issues, evidence, consensus methods, recommendations, accessibility, and other fields. The Kappa value test result was 0.684. ConclusionThere has been a progressive increase in methodological scores of Chinese orthopedic clinical practice guidelines and consensus documents published in recent years, but the overall quality is not high. Future guidelines development needs to improve methodology further, especially in terms of transparent funding, formation of recommendations, guidelines release, and dissemination.
Clinical pharmacy practice guidelines have developed rapidly in recent years. They provide a series of recommendations for optimizing drug treatment management and improving pharmaceutical care appropriateness and are widely employed in clinical practice. Based on literature review and the experience of guideline development, this paper summarized the meaning, formulation methods, formulation status, and registration of clinical pharmacy practice guidelines, and provided suggestions for the development of guidelines.
ObjectivesTo assess the quality of clinical practice guidelines for transplantation in 2017. MethodsPubMed, NICE, NGC, NCCN, SIGN, CMA Infobase and GIN databases were searched online to collect guidelines for transplantation published in 2017. Guidelines were then assessed by using the AGREE Ⅱ instrument. ResultsA total of 10 guidelines were included. The result of assessments by the AGREE Ⅱ instrument showed a clear discrepancy among domains (P=0.001). Satisfactory scores were found in domains of " scope and purpose”, " clarity of presentation” and " overall score”, where the average scores were 90.8% (95%CI 83.5% to 98.1%), 82.5% (95%CI 72.7% to 92.3%) and 75.6% (95%CI 66.6% to 84.6%), respectively. Low scores were found in domains of " stakeholder involvement” and " applicability”, in which a score of 40.0% (95%CI 32.4% to 47.6%) and a score of 27.8% (95%CI 11.2% to 44.5%) were achieved, respectively. ConclusionsThere is a clear discrepancy among domains of global clinical practice guidelines for transplantation in 2017. Guidelines in this field should be improved in " stakeholder involvement” and " applicability”.
ObjectivesTo evaluate the reporting status of conflict of interest and economic evidence in Chinese clinical practice guidelines published in 2017 and to provide implications for the guideline development in China.MethodsCNKI, WanFang Data and Google Scholar were electronically searched to collect clinical practice guidelines published in 2017 from January 1st to December 31st, 2017. Two authors independently screened literature, extracted information of interest, such as conflict of interest disclosure and economic evidences, then, the analysis was performed by using the Microsoft Excel 20013 software.ResultsA total of 53 guidelines were included; in which, 14 (26.42%) disclosed conflict of interest, 10 (18.87%) stated sources of funding, and 6 (11.32%) mentioned economics evidence.ConclusionIn China, inadequate attention is addressed to the conflict of interest disclosure and economics evidence during the development of clinical practice guidelines. We propose the inclusion of conflict of interest and economics evidence disclosure in clinical practice guidelines, which will improve their objectivity, independence, and transparency.
ObjectivesTo investigate and analyze the status of pediatric internal medicine clinical practice guidelines published in journals of mainland China from 2010 to 2017.MethodsCBM, CNKI, VIP and WanFang Data databases were electronically searched to collect pediatric internal medicine clinical practice guidelines published in Chinese journals of mainland China from January 2010 to December 2017. Two reviewers independently screened literature, extracted data. The author's information was organized and co-word matrixes were produced using BICOMS 2 software. The visualization diagram was plotted using Ucinet 6.0 software to analysze the societal relationship of authors.ResultsA total of 135 pediatric clinical guidelines were included, involving 109 western medical guidelines, 24 Chinese traditional medicine guidelines and 2 guidelines on integrated traditional Chinese and western medicine. The main types of clinical practice guidelines for children were diagnosis and treatment (45.19%), followed by technical guidelines (15.56%). Most of the guidelines were on respiratory diseases (23.70%). 54.81% of the guidelines for children were formulated by seminars and consensus, and 28.89% of the guidelines mentioned the application of evidence-based methods to develop guidelines. The institutes (40.00%) were participated in the development of the guidelines, in which 11 research groups were participated in the development of the guidelines.ConclusionsThe quantity of pediatric internal medicine clinical practice guidelines in mainland China has increased from 2010 to 2017. The scope of the guidelines is limited, and cooperation is required to further improve the quality of children’s guidelines.
ObjectivesTo summarize and compare the operative mechanisms of the most representative comprehensive clinical practice guideline (CPG) databases worldwide, so as to provide references for establishing and managing Chinese CPG database.MethodsCPG databases were collected worldwide by discussing with experts in the guideline and database fields. Studies on guideline databases were searched in PubMed and CNKI to further collect CPG databases mentioned in these studies. Representative comprehensive guideline databases were finally selected by consulting relevant guideline experts. The institutions’ names of establishing and managing CPG databases, funding sources, human resources, aims, quality control measures (including CPG inclusion and updating criteria) were extracted and summarized. Databases were divided into government-led, society-led, and enterprise-led models. A descriptive analysis was conducted.ResultsThere were four government-led databases, four society-led databases and merely one enterprise-led database. The institutions of establishing CPG databases were same as the institutions of managing databases in the seven databases. All CPG databases had set up offices, seven of which were located in the capital. Most databases’ funds came from the government. Four databases implemented board management. According to the division of functions, members involved in establishing and managing CPG databases mainly included leaders, expert teams, managerial personnel, secretaries, web developers, and patient representatives. Criteria for inclusion of CPG were relevant to the purpose of establishing databases. Most databases required guidelines that had be updated within three to five years.ConclusionsThis study provides comprehensive information on operative mechanism of different CPG databases which can assist guideline database builders to optimize their operative mechanism.
ObjectiveTo adapt existing clinical practice guidelines to the management of medication adherence to highly active antiretroviral therapy (HAART) in China, so as to provide evidence to support the development of practice guidelines that meet China's actual conditions. MethodsAccording to ADAPTE methodology and status of HAART in China, we searched, appraised, selected and adapted current clinical practice guidelines on the management of medication adherence to HAART. ResultsA total of 10 guidelines were included, and the final clinical practice guidelines for the management of medication adherence to HAART involved 3 aspects, including influential factors, assessment methods, and interventions. High quality evidence resources had been formed, and the quality of final clinical practice guidelines was higher. ConclusionIt is feasible to develop clinical practice guidelines according to the ADAPTE method, and reliable evidence support has been provided for the development of clinical practice guidelines based on guideline adaption.
ObjectiveTo evaluate the quality of guidelines for the management of delirium in adult patients in the last ten years, so as to provide references for updating, selection, implementation guidelines and delirium management optimization.MethodsWe searched guidelines from databases including PubMed, EMbase, WanFang Data and CNKI, and websites of guidelines from January 1st 2010 to September 1st 2019. Guidelines were comprehensively screened, evaluated based on AGREE Ⅱ and data was independently extracted by two researchers.ResultsGuidelines of NICE, RNAO and SIGN had higher scores, while CSCCM’s and IPS’s gained lower. Among domains of AGREE Ⅱ, Domain I (scope and purpose) and IV (clarity of presentation) scored the highest, with a minimum of Domain Ⅱ (stakeholder involvement) and V (applicability). Delirium management focused on screening, prediction, prevention and treatment both pharmacologically and non-pharmacologically, and information support.ConclusionsFuture development of delirium guidelines should follow the methodology of guideline development, update or adjustment, and dedicate to every domain, especially domain of application. Medical staffs can establish our own domestic guidelines based on high quality guidelines, to promote knowledge translation and delirium management.
With the development of evidence-based medicine, an increasing amount of clinical care experts are paying attention to recommendations in the guidelines and the application of guidelines in clinical nursing practice. The demand for clinical practice guidelines is becoming increasingly important. Based on characteristics of nursing, this paper focuses on primary steps in the formulation of nursing-clinical practice guideline, such as clinical problems, outcomes, nursing evidence retrieval and selection, evidence and recommendations classification, methods from evidence to recommendations, patients' preference and value, and provides suggestions for development of nursing-clinical practice guidelines.
This paper interprets 2017 European Society of Cardiology (ESC) peripheral arterial disease diagnosis and treatment guidelines on lower extremity arterial disease, and in order to provide reference for clinical practice.