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.
Objective To undertake a preliminary study of the concept and approach of patient value and preference and to learn how to understand and elicit patient preference in the light of evidence-based medicine so as to promote evidence-based practice and improve the relationship between clinicians and patients. Methods The searching key words were developed and pertinent data were retrospectively retrieved for the years of 1992-2002. MEDLINE and CBMdisc were searched along with handsearching 9 Chinese medical journals and 4 evidence-based medicine books. Data were scanned and analyzed. Results A total of 2 646 related articles were identified, most of which were found in MEDLINE (2 403), followed by CBMdisc (185) and the journals (58). Currently there is no original article to study in this field from a point of view of evidence-based medicine in China. Conclusion Patient value and preference have been emphasized in the approach of evidence-based medicine and it is a worthwhile topic for us to explore.
Patient values and preferences is one of the elements of evidence-based medicine research, which is also an important part that should be considered in the development of evidence-based guidelines in the present and future. However, the research in this field in China has just begun. This article gives a brief introduction of its concepts, methods, influence factors based on the international researches of patient values and preferences and a brief description of the development in China, in order to provide references for the development of evidence-based guidelines based on the consideration of patient values and preferences in the future.
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.
When prioritizing clinical questions in the development of the clinical practice guidelines, clinical questions with high recognition and low variability, or high score and less disagreement among experts were often prioritized, while questions with high recognition but high variability were excluded. By this approach, clinical questions with practical value but also showed high variability due to different causes were not accepted as priorities. There were some methodological and clinical limitations by doing so. By summarizing the causes and connotations of expert opinion variability in terms of clinical experience, expertise and values, this paper analyzed the advantages of the variability quantification application, and proposed corresponding methodological recommendations, so as to provide references for guideline developers in the priority selection of clinical questions.
This article illustrates the development, current status and future prospects of knowledge translation. Its importance and necessity are introduced and some measurements or approaches to promote knowledge translation are discussed.
Chinese guideline for diagnosis and treatment of osteoarthritis (2021 edition) was published in the Chinese Journal of Orthopaedics, providing abundant recommendations on osteoarthritis (OA) issues. In this paper, the methodological and reporting qualities of the guideline were explained and assessed by using quality appraisal tools, such as appraisal of guidelines research and evaluation-China (AGREE-China), Institute of Medicine Committee (IOM), and reporting items for practice guidelines in healthcare (RIGHT). It also aimed to provide personalized treatments for specific patients, support readers in understanding the principle of OA treatment, and standardize OA treatment strategies. In addition, this study would contribute to the clinical promotion of the current guidelines and provide the necessary references for clinical practice guidelines in treating OA in the future.
National Center for Medical Service Administration of National Health and Family Planning Commission of China was established at the beginning of 2015. It is mainly in charge of developing and managing standards of medical technology and organizing their implementation, and giving technical guidance and consulting for evaluation of medical institutions. The foundation of the center fills in the blank of lacking central administrative department of the guideline development and evaluation. This paper introduces the definition and the function of clinical practice guideline, and analyzes the current situation, problems and challenges of domestic guidelines, and proposes some potential suggestions on improving the quality of Chinese guidelines from national level for promoting the standardization, scientification and transparency of clinical practice guidelines in China.