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.
ObjectivesTo investigate the citation status of systematic reviews (SRs)/meta-analyses in clinical practice guidelines and consensuses of traditional Chinese medicine (TCM).MethodsWe electronically searched PubMed, CBM, WanFang Data and CNKI databases to collect TCM guidelines and consensus from January 1st, 2009 to December 31st, 2018. Two reviewers independently screened literature and extracted data. Citation analysis method was used to analyze the citation status of SRs/meta-analysis in TCM guidelines and consensuses.ResultsA total of 142 TCM guidelines and consensuses were included, of which 39 (26.5%) failed to provide relevant citations. Of the 103 (72.5%) TCM guidelines and consensuses providing citations, 48 (34.3%) cited SRs/meta-analyses, and 43 cited outdated SRs/ meta-analyses. Four TCM guidelines and consensuses cited Cochrane reviews. In terms of citations, the average citations of guidelines and consensuses were 35.1 and 42.2, respectively; and the average SRs/meta-analyses citations of guidelines and consensuses were 3.8 and 5.5, respectively.ConclusionsTCM guidelines and consensuses citation report rates and the proportion of citation SRs/meta-analyses still require increase. TCM guidelines developers should strengthen the role and significance of SRs, especially Cochrane reviews, in supporting recommendations.
This article aims to explore the application of health economics evidence in the development of clinical practice guidelines and evidence recommendations, and to provide better references for clinical decision-making. By reviewing the use of health economics evidence in domestic and international clinical practice guidelines, the difficulties in the application of health economics evidence in the development of clinical practice guidelines and evidence recommendations were summarized. It was found that there were significant differences in the use of health economics evidence in clinical practice guidelines in different countries, and these differences were affected by the goals of clinical practice guidelines and limitations of health economics evidence itself, lacking standardized methodological guidance, resulting in limited use of health economics evidence in clinical practice guidelines. Therefore, further research is needed to optimize the integration of health economics and clinical practice guidelines, and develop standardized methodological guidance.
Objective To review and evaluate the basic contents and development of the current global clinical guidelines for lung cancer practice so as to provide useful information for domestic study. Methods Six databases including PubMed (to June 2008) and relevant websites (both in Chinese and English) were searched. Articles were screened according to the predefined inclusion and exclusion criteria. The number of clinical guidelines was counted and the quality of guidelines was also assessed. Results A total of 208 articles were found to be clinical guideline-related and 133 were finally included. Of those, 78 were original versions and 55 were updated versions. And 86 articles mentioned guideline development methodology. The guidelines were issued by 14 countries/regions, mainly by USA (39.85%), Canada (24.81%) and France (8.27%). The earliest one was published by USA in 1984. 125 guidelines were issued by oncological or thoracic institutions, and the other 8 were not issued by specialized institutions or not specified. The 133 articles were classified into 3 major clinical categories: synthesis (24), multi-subject (21) and single-subject (88). As for quality evaluation, the average score of all guidelines was 72.09 (full score 100). The highest average score was found in 1996 which was 83.50, and the lowest in 1997 (66.80). The guidelines issued by France had the highest average score (79.80), and Japan, with the lowest average score (48.00). The average score of 4 categories of lung cancer were 73.54 (non-smallcell lung cancer), 65.74 (lung cancer), 74.72 (small-cell lung cancer), and 76.00 (bronchogenic lung cancer), respectively. Conclusion The number of clinical guidelines showed an increasing trend. Most guidelines were issued by developed countries. The subjects included in the synthetic guidelines showed an expanding trend covering about 20 subjects from prevention to palliative care. A trend of multi-country contribution to the guidelines development and revision was noted. Researches became more focused on different types and stages. Evidence-based methodology was accepted globally in the clinical guideline development, but unfortunately very few applied the method of health technology assessment. China issued only 2 original guidelines, which were based on literature review and expert opinions, respectively. Due to the limitation of language restriction, inaccessibility of full-text articles and unavailability of authorized and specific quality evaluation protocols, the conclusions of this study should be interpreted with caution.
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.
ObjectivesTo assess the methodological quality of Chinese clinical practice guidelines (CPGs) for diagnosis and management of atrial fibrillation, and to provide methodological advice for developing and updating CPGs for atrial fibrillation in future. MethodsCBM, CNKI, WanFang Data and VIP databases were electronically searched to collect filter relevant CPGs from inception to Feburary, 2018. Two reviewers independently screened literature, extracted data and evaluated the quality of eligible CPGs by using the appraisal of guidelines for research and evaluation (AGREE Ⅱ) instrument. ResultsA total of 10 CPGs were included. The standardized mean scores for AGREE Ⅱ were: 54.17% for scope and purpose, 18.89% for stakeholder involvement, 15.89% for rigor of development, 66.39% for clarity and presentation, 34.9% for applicability, and 0 for editorial independence. ConclusionsThe quality of Chinese CPGs for atrial fibrillation is low. More efforts should be made to enhance the quality of CPGs for atrial fibrillation using methodological rigorous frameworks and strengthen guideline reporting.
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.
Rapid, living evidence-based points, as a new model promoting the rapid translation of evidence, aim to integrate the current best evidence, clinical status, public/patient preferences and values, and provide concise and practical guidance rapidly to important questions concerned in clinical medicine and public health. This paper introduces the methodological framework for the development of "Rapid, Living Evidence-Based Points" from 4 aspects: initiation and planning, evidence search and review, development, update, publication and dissemination of evidence-based points, in order to provide a reference for domestic scholars in developing rapid, living evidence-based points.