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.
ObjectivesTo investigate Chinese health practitioners’ usage and demand for clinical practice guidelines in general so as to improve the development and implementation of guidelines.MethodsWe conducted a cross-sectional questionnaire survey that covered health practitioners from different levels of medical institutions in 17 provinces in China. Attitudes, adherence, usage barriers and demands for clinical practice guidelines were investigated.ResultsA total of 953 health practitioners were involved in the survey in which 931 completed the questionnaires. Respondents generally held positive attitudes toward guidelines and agreed that they improved quality of care and standardized diagnosis and treatment. More than 80% of the respondents reported a fine adherence to guidelines. The most reported barriers to follow the guidelines were " several guidelines are competing” and " lack of facilities and medical resources”. Most respondents agreed that it was necessary to establish a national guideline database, appraise implementation effect of guidelines, develop evaluation tools for guidelines that are applicable for Chinese clinical practice, and provide guidelines training.ConclusionsThis study finds favorable attitudes and fine adherence towards clinical guidelines in general in China. However, internal barriers, such as authority of guidelines, and external barriers, such as supplying system and patients’ preference, can affect guideline dissemination and implementation. It is suggested that establishing a national guidelines database, developing evaluation tools for guidelines that fit for Chinese clinical practice, and provision of guideline training, would facilitate the use of guidelines.
The protocol of rational use of oral H1 receptor antagonists in children: a clinical practice guideline primarily introduces key methods, processes and precautions of the guideline to standardize and guarantee the formulation of this evidence-based guideline. Referring to the World Health Organization Guidelines Development Manual, the guideline will be conducted according to the following steps, which involves the establishment of project group; registration (IPGRP-2020CN110); declaration of interest and funding support; identification of the clinical issues and outcomes; evidence retrieval, assessment, synthesis and utilization; investigation of patients’ preferences and values; development, external review and revision of recommendations; guideline release, dissemination and update.
The clinical practice guideline on traditional Chinese medicine alone or combined with antibiotics for patients with acute upper respiratory infection in children was issued by China Association of Chinese Medicine in June 2017. Base on the evidence, consensus and experience, five manage groups, steering committee, consensus expert group, systematic review group, drafting group and secretary group, have promoted the project. The main work process refers to up-to-date clinical practice guideline definitions of institute of medicine and quick recommendations guide of guidelines international network and WHO. In order to provide readers with a better understanding of the guideline, the drafting process of guideline principle, main work process, and basis policy were described in detail in this paper. The guidelines’ scientific characteristics, accuracy and practicability were better exhibited in attempt to enhance its promotion and application.
ObjectiveTo analyze the current status of children's clinical practice guidelines from 2010 to 2021, and to evaluate the quality of evidence-based guidelines for children. MethodsPubMed, EMbase, CNKI, WanFang Data, and VIP databases and relevant domestic and foreign guideline websites were searched to collect Chinese pediatric clinical guidelines from January 1st 2010 to September 13th 2021. Two reviewers independently screened literature, extracted data; 4 reviewers used AGREE Ⅱ to evaluate the quality of the included evidence-based guidelines. ResultsA total of 164 guidelines were included, which involved 65 evidence-based guidelines and 99 non-evidence-based guidelines, 113 western medicine guidelines and 51 traditional Chinese medicine guidelines. The majority of the diseases with high hospitalization burden were covered by those guidelines, including 35 guidelines for respiratory diseases, ranking first among all diseases. However, there was no guideline for pediatric cardiovascular disease in China. The average scores for 65 evidence-based guidelines in 6 individual domains were 65.2%, 49.6%, 59.3%, 68.5%, 23.9% and 83.6%. ConclusionsThe scores for applicability, stakeholder involvement, and rigor of development are low for Chinese guideline for children. There is a lack of pediatric clinical guidelines for circulatory disorders.
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”.
China Association of Chinese Medicine officially issued the clinical guidelines for diagnosis and treatment of frozen shoulder in traditional Chinese medicine (T/CACM 1416-2022) on November 14th, 2022. The guideline covers clinical diagnosis, treatment, prevention and care of frozen shoulder. This paper introduces the background of this guideline and interprets its contents of clinical diagnosis, treatment and prevention. It helps the applicable population deepen their understanding and standardization of traditional Chinese medicine in the prevention and treatment of frozen shoulder, and provides references for the development of relevant guidelines in traditional Chinese medicine orthopedics in the future.