Inherited retinal diseases (IRDs) are a group of severe retinal degenerative diseases leading to permanent visual impairment. IRDs are the major cause of irreversible blindness in children and working age groups. Gene therapy is a new clinical treatment method and currently the only clear and effective treatment for IRDs, while, there are still risks in clinical research and application. How to standardize perioperative management and reduce the potential risks of treatment is one of the keys to ensure the safety and effectiveness of treatment. However, there is no systematic and standardized guidance on the perioperative management for IRDs gene therapy. Therefore, in order to standardize the perioperative management, the Fundus Disease Group of Ophthalmology Society of Chinese Medical Association and Chinese Medical Doctor Association organized domestic experts to put forward standardized opinions on the perioperative management of IRDs gene therapy in China after repeated discussion and combined with domestic and foreign research experience, so as to provide clinicians with reference and application in clinical research and practice.
The number of clinical guidelines developed and published in different countries is increasing worldwide. Too many guidelines do not remain in regular use, even though the aim is to implement them in clinical practice. The scientific validity and reliability of the guidelines need to be reviewed. Here is a case presented to show how to optimally use the evidence-based guideline to improve clinical decision making.
ObjectivesTo assess the methodological quality of Chinese clinical practice guidelines (CPGs) for respiratory diseases published in 2017, so as to provide evidence for developing and updating CPGs of this field in the future.MethodsWanFang Data, CNKI, VIP, CBM databases, Medlive and other related websites were electronically searched to collect Chinese CPGs for respiratory diseases published from January 2017 to December 2017. Four reviewers independently evaluated the quality of eligible guidelines by using Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) instrument.ResultsA total of 37 guidelines were included. The mean scores of the six AGREE Ⅱ domains (scope and purpose, stakeholder involvement, rigor of development, clarity and presentation, applicability, editorial independence) were 59.3%, 25.1%, 10.8%, 59.1%, 25.8%, and 7.3%, respectively. Only 1 guideline (2.7%) was recommended for clinical use, and 2 guidelines (5.4%) were recommended with modification.ConclusionsThe CPGs for respiratory diseases published in China in 2017 have higher quality than CPGs published prior to 2017, however great discrepancies exist when comparing with international guidelines of average level. More attention should be paid on the rigorousness of methodology and the practicality of content in the future development of CPGs.
The "2022 AHA/ACC/HFSA guideline for the management of heart failure" replaces the "2013 ACCF/AHA guideline for the management of heart failure" and the "2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure". The 2022 guideline is intended to provide patient-centric recommendations for clinicians to prevent, diagnose and manage patients with heart failure. Heart failure remains a leading cause of morbidity and mortality globally. The 2022 heart failure guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to manage patients with heart failure, with the intent to improve quality of care and align with patients’ interests. New recommendations have been created when supported by published data. Value statements are provided for certain treatments with high-quality published economic analyses. This article summarized and interpreted the new concept of heart failure in 2022 guidelines, especially the new evidence and suggestions related to cardiac surgery.
Objectives To investigate the participation of magazines or journals' editors in the clinical practice guidelines in China. Methods WanFang Data, VIP, CNKI, CBM databases, as well as Baidu, Google and www.medlive.cn were searched online to collect incorporated guidelines in which magazines or journal editors participated in. Data was then analyzed. Results In total, 68 guidelines were selected, with 51 (75.00%) led by magazines and 17 (25.00%) edited by editors. 55 guidelines (80.88%) were the same in published and participated journals. Circulatory diseases (27.94%), diagnosis and treatment (54.41%) were the most concerned. 15 guidelines (22.06%) were updated. 17 guidelines reported the roles of the editors who were mostly expert group members (13.24%). 7 guidelines, 3 of which affirmed no relevant conflicts of interest, reported the sponsorship. The quality was higher than the domestic average while lower than the international guidelines. Conclusions The number of clinical practice guidelines magazines or editors participating in China is relatively small, while the quality was higher. The primary form of the participation is journal-led, however, the process, methods, roles, and conflicts of interest in the guidelines require further definition.
ObjectivesTo investigate the awareness and knowledge of Chinese guideline developers on the patient version of guidelines (PVG).MethodsA questionnaire was developed and distributed to participants of the guideline development workshop on the " 2017 Chinese Medical Doctor Association Annual Conference on Evidence-Based Medicine & Gansu Medical Doctor Association/ Gansu Medical Association Annual Conference on Evidence-Based Medicine”, and guideline developers in Shenzhen, Guangzhou, Xi’an, Beijing and other places were investigated through field surveys. The questionnaire included ten questions centred on respondents’ awareness and their views on the development of PVG. After the invalid questionnaire was excluded, Excel 2013 software was used for data entry, and SPSS 19.0 software was used for data analysis.Results150 questionnaires were distributed and 107 (71.3%) were collected, from which 90 (60.0%) questionnaires with complete response were analyzed. For the awareness of PVG: 30.0% of respondents chose " just know it without more knowledge”, 34.4% chose " never heard of”. The awareness was not associated with educational or departmental background, majors and regions (P>0.05). For opinions on PVG and its development process: 86.7% of the respondents thought PVG is necessary, 90% thought the presentation of PVG needs to follow reporting standards, and 45.6% thought the primary barrier of the development of PVG is lack of cognition.ConclusionsResearch work on PVGs is at an initial stage in China. The awareness among Chinese guideline developers and relevant researchers is lacking and the development methodology requires further exploration. Carrying out research relevant to PVG can promote its development and application in China, so as to improve the clinical practice.
The National Comprehensive Cancer Network (NCCN) released the latest version 1, 2022 of "NCCN guidelines for the clinical diagnosis and treatment of small cell lung cancer" (hereinafter referred to as "guideline"). Based on high-quality evidence-based medicine, this guideline provides references of clinical diagnosis and treatment for clinicians around the world. Compared with the version 3, 2021 of the "guideline", updates and revisions mainly focused on the progress of radiotherapy and systemic treatment. This article will interpret the updated therapy content in this new version of the "guideline".
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.
CONSORT Group members update the CONSORT (Consolidated Standards of Reporting Trials) statement by collecting relevant literatures to improve the reporting quality of randomised controlled trials. Recently, they have outlined CONSORT-Equity reporting standards, an extension to the CONSORT statement, which had been developed to improve the reporting of intervention effects in randomised trials where health equity is relevant. It will be helpful to improve social health equity or reduce social health inequities. This paper aims to introduce CONSORT-Equity and interprets its usage by a series of randomised trials where health equity is relevant.