The quality of clinical practice guidelines in <scp>C</scp>hina: a systematic assessment

Hu, Jing; Chen, Ru; Wu, Shanshan; Tang, Jin‐Ling; Kunnamo, Ilkka; Yang, Zhirong; Wang, Weiwei; Hua, Xinyang; Zhang, Yuelun; Xie, Yan-Ming; Zhan, Siyan

doi:10.1111/j.1365-2753.2012.01893.x

Cited by 22 publications

(22 citation statements)

References 28 publications

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“…Given the deficiencies within this metric, we can conclude poor quality of our selected CPGs. Similar to our findings, Chinese CPGs have been evaluated for poor quality, particularly presenting low scores on the “rigor of development” domain [74–77]. …”

Section: Discussionsupporting

confidence: 85%

Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency

et al. 2016

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BackgroundAnnually, non-communicable diseases (NCDs) kill 38 million people worldwide, with low and middle-income countries accounting for three-quarters of these deaths. High-quality clinical practice guidelines (CPGs) are fundamental to improving NCD management. The present study evaluated the methodological rigor and transparency of Brazilian CPGs that recommend pharmacological treatment for the most prevalent NCDs.MethodsWe conducted a systematic search for CPGs of the following NCDs: asthma, atrial fibrillation, benign prostatic hyperplasia, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease and/or stable angina, dementia, depression, diabetes, gastroesophageal reflux disease, hypercholesterolemia, hypertension, osteoarthritis, and osteoporosis. CPGs comprising pharmacological treatment recommendations were included. No language or year restrictions were applied. CPGs were excluded if they were merely for local use and referred to NCDs not listed above. CPG quality was independently assessed by two reviewers using the Appraisal of Guidelines Research and Evaluation instrument, version II (AGREE II).Main Findings“Scope and purpose” and “clarity and presentation” domains received the highest scores. Sixteen of 26 CPGs were classified as low quality, and none were classified as high overall quality. No CPG was recommended without modification (77% were not recommended at all). After 2009, 2 domain scores (“rigor of development” and “clarity and presentation”) increased (61% and 73%, respectively). However, “rigor of development” was still rated < 30%.ConclusionBrazilian healthcare professionals should be concerned with CPG quality for the treatment of selected NCDs. Features that undermined AGREE II scores included the lack of a multidisciplinary team for the development group, no consideration of patients’ preferences, insufficient information regarding literature searches, lack of selection criteria, formulating recommendations, authors’ conflict of interest disclosures, and funding body influence.

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Section: Discussionsupporting

confidence: 85%

Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency

et al. 2016

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“…Clinical practice guideline (CPG) is integrated well into the thinking of practicing clinicians and professional clinical organizations [85][86][87]; and also make scientific evidence incorporated into clinical practice [88]. However, not all CPGs are evidence-based [89,90] and their qualities are uneven [91][92][93]. Until now there were more than 20 appraisal tools have been developed [94].…”

Section: Clinical Practice Guidelinesmentioning

confidence: 99%

Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: what are they and which is better?

et al. 2020

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Methodological quality (risk of bias) assessment is an important step before study initiation usage. Therefore, accurately judging study type is the first priority, and the choosing proper tool is also important. In this review, we introduced methodological quality assessment tools for randomized controlled trial (including individual and cluster), animal study, non-randomized interventional studies (including follow-up study, controlled before-and-after study, before-after/ pre-post study, uncontrolled longitudinal study, interrupted time series study), cohort study, case-control study, cross-sectional study (including analytical and descriptive), observational case series and case reports, comparative effectiveness research, diagnostic study, health economic evaluation, prediction study (including predictor finding study, prediction model impact study, prognostic prediction model study), qualitative study, outcome measurement instruments (including patient -reported outcome measure development, content validity, structural validity, internal consistency, cross-cultural validity/ measurement invariance, reliability, measurement error, criterion validity, hypotheses testing for construct validity, and responsiveness), systematic review and meta-analysis, and clinical practice guideline. The readers of our review can distinguish the types of medical studies and choose appropriate tools. In one word, comprehensively mastering relevant knowledge and implementing more practices are basic requirements for correctly assessing the methodological quality.

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“…Successful translation of evidence into practice is achieved by trustworthy clinical practice guidelines, defined by the US Institute of Medicine as ‘statements that include recommendations intended to optimise patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options’ 5. China is emerging as a new hub for guideline development with the production of Chinese clinical practice guidelines increasing by nearly fourfold over the past few years 6. However, unlike their Western counterparts, China lacks a central infrastructure (eg, National Institute for Health and Care Excellence in the UK) to coordinate and monitor guideline development process.…”

Section: Introductionmentioning

confidence: 99%

Development of local clinical practice guidelines in the real world: an evolving scene in China

Kwong

Sun

2017

Heart Asia

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The quality of clinical practice guidelines in China: a systematic assessment

Abstract: Although numerous guidelines were produced in China, the quality was generally low. Focusing on improving the quality of Chinese guidelines, rather than continuing to produce them in great quantity, is urgently needed.

Cited by 22 publications

References 28 publications

Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency

Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency

Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: what are they and which is better?

Development of local clinical practice guidelines in the real world: an evolving scene in China

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