Objective To assess the methodological quality of clinical guidelines and consensus of lupus nephritis, to collect the recommendations of each guideline, and to provide references for clinical decision-making. Methods PubMed, CNKI, and CBM databases and related websites such as NGC, NICE, GIN, SIGN, and Medive were electronically searched from January 2012 to December 2020 to collect the clinical guidelines and expert consensus for lupus nephritis. After consistency evaluation by four evaluators, the methodological quality of the included guidelines or expert consensus was evaluated using AGREE Ⅱ. The relevant recommendations, evidence level, and recommended strength of each guideline in treating lupus nephritis were summarized. Results A total of eight guidelines and two consensus statements were included. Among them, eight guidelines or consensus statements were level B (generally recommended guidelines), and two were level C (non-recommended guidelines). Relevant recommendations mainly gave the corresponding treatment scheme according to the pathological type of lupus nephritis. Conclusion The methodological quality of lupus nephritis guideline formulation in China needs to be improved. The included guidelines and consensus can provide reference for clinical decision-makers. However, higher-quality clinical practice guidelines for the Chinese population are needed to be developed in the future.
ObjectiveTo evaluate the quality of pancreatic cancer guidelines using evidence-based methods based on the global burden of pancreatic cancer, so as to explore its status, region distribution, characteristics of coverage themes, and difference of therapies recommended by the guidelines of various quality, and to provide references for clinical decisionmaking. MethodsPubMed, The Cochrane Library (Issue 11, 2013), CBM, CNKI, and VIP, as well as the website of National Guidelines Clearinghouse (NGC), Guidelines International Network (GIN), and National Institute for Clinical Excellence (NICE) were systematically searched for pancreatic cancer treatment guidelines. The Appraisal of Guidelines for Research and Evaluation (AGREE Ⅲ) was applied to assess methodological quality of included guidelines. ResultsA total of 14 relevant guidelines (including five evidence-based guidelines) were included involving seven countries of four continents (Asia, Europe, North America and Oceania) and four international academic organizations. There were only two domains, namely "scope and purpose" and "clarity of presentations" which got high average scores (more than 60%) among all 14 guidelines. The mean AGREE domain scores in guidelines varied with areas, and the quality of five evidence-based guidelines was superior to that established by consensus. According to the outcomes of AGREE Ⅲ, 11 guidelines were weakly recommended, while 3 were not recommended due to poor methodological quality. The subjects of 14 guidelines covered six treatment categories, including chemotherapy, surgery, radiotherapy, support therapy, radiotherapy, and interventional therapy. ConclusionThe overall methodological quality of pancreatic cancer guidelines is not high among different countries or regions. The quality of evidence-based guidelines is superior to that established by consensus. Chemotherapy, surgery, radiotherapy and support therapy were reccommended as predominant choice by these guidelines.
Objective To evaluate the methodological quality and reporting quality of clinical guidelines and consensus on central venous catheters. Methods The PubMed, EMbase, Web of Science, CBM, WanFang Data, CNKI databases and Guidelines International Network, National Institute for Health and Clinical Excellence, National Guideline Clearinghouse, Medive.cn websites were searched to collect clinical guidelines and consensus related to central venous catheters. The retrieval time was from the establishment of the database to October 2022. Two researchers independently screened the literature, extracted data and used evaluation tools AGREE Ⅱ and RIGHT to evaluate the quality of the included studies. Results A total of 34 central venous catheter guidelines and consensus were included. The average score for each field of AGREE II was 53.73% for scope and purpose, 39.26% for participants, 39.57% for rigor, 46.76% for clarity, 30.23% for application and 49.18% for editorial independence. Items 1a, 1b, 3, and 4 (100.00%) had the highest reporting rate in the RIGHT evaluation items, followed by items 19a (97.05%), 2/19b (94.11%), 20 (91.17%), 7b/11a (88.23%), and 7a (85.29%). The reporting rate of the remaining items was below 60%. Subgroup analysis results showed that the average score and RIGHT score of the guidance class in the four fields of AGREE Ⅱ (rigor, clarity, application and editorial independence) were higher than those of the consensus class. Guidelines and consensus formulated based on evidence-based medicine methods were higher than those formulated based on expert opinions or reviews in the three fields of AGREE II (rigor, application and editorial independence). The average scores of foreign guidelines and consensus in 6 fields and RIGHT scores of AGREE Ⅱ were higher than those of domestic guidelines and consensus. Conclusion The AGREE Ⅱ of 6 fields average score and RIGHT score in foreign guidelines are higher than those in domestic guidelines.
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.
ObjectiveTo assess the methodological quality of guidelines for bronchoscopic alveolar lavage. MethodsCNKI, VIP, WanFang Data, CBM, Web of Science, PubMed, EMbase databases and medlive.cn, the National Guideline Clearinghouse (NGC), the National Guideline International Network (GIN), the Scottish Intercollegiate Guidelines Network (SIGN), the National Institute for Clinical Excellence (NICE), and the World Health Organization (WHO) websites were electronically searched to collect guidelines of bronchoscopic alveolar lavage from inception to December 2020. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of the guidelines by using AGREE Ⅱ tool. ResultsA total of 19 guidelines were included, with 5 from China, 5 from the USA, 3 from Europe, 2 from the UK, 1 from Australia, 1 from Israel, 1 from Spain, and 1 from India. The average standard score rates of the 19 guidelines in the six fields were 50.73% for scope and purpose, 20.02% for participants, 15.13% for formulation rigor, 36.40% for clarity of presentation, 3.51% for applicability, and 22.37% for editorial independence.ConclusionsThe quality of bronchoalveolar lavage guidelines remains relatively low.
ObjectiveTo evaluate the quality, status of clinical practice guidelines on stomatology in China and discuss existing problems, so as to provide references for developing evidence-based guidelines. MethodsComprehensive search was conducted up to January 2014 for relevant clinical practice guidelines on stomatology, and the retrieval date was January 30th, 2014. After data extraction from eligibility guidelines, the quality was evaluated using the AGREE Ⅱ instrument and then descriptive analysis was performed. ResultsFinally a total of 18 guidelines were included, of which, 13 were for oral and maxillofacial surgery diseases. Based on the AGREE Ⅱ instrument, the average scores on the six domains were as follows:71.1% for scope and purpose, 40.1% for stakeholder involvement, 28.8% for rigor of development, 71.5% for clarity of presentation, 42.6% for applicability, and 8.6% for editorial independence. ConclusionThe overall quality of clinical practice guidelines on stomatology in China is relatively poor, only a few diseases are concerned, and no evidence-based guideline has been developed so far. However, considered the limitations of this study, the results of this study is only for a reference.
Objectives To evaluate the methodological quality of published clinical practice guidelines for benign prostatic hyperplasia. Methods PubMed, EMbase, CNKI, WanFang Data, VIP and CBM databases, website of Yimaitong, and international authoritative guide platforms were electronically searched to collect the relevant clinical practice guidelines or consensus for benign prostate hyperplasia. The retrieval covered the time up to December 13th, 2016. Literatures were independently screened by 2 reviewers. After data extraction, the methodological quality of included guidelines was evaluated by 4 reviewers using the AGREE Ⅱ. Each domain score was calculated and the intraclass correlation coefficient was used to evaluate the consistency among the reviewers. Results A total of 15 clinical practice guidelines were included. The mean scores for the six domains in AGREE Ⅱ were: 72%, 38%, 30%, 58%, 16%, and 40%, respectively. The intraclass correlation coefficient was larger than 0.87, which indicated the total consistency was well. Conclusions The quality of clinical practice guidelines for benign prostatic hyperplasia is not satisfactory as expected. They are heterogeneous in quality and some requires improvement. Guidelines are required to be further developed in methodology in future, especially in three domains, including participants, preciseness and applicability of the design.
ObjectiveTo evaluate the quality of Chinese clinical practice guidelines published in domestic medical journals from 2012 to 2013 and compare with the quality of guidelines published before. MethodsCNKI, CBM and WanFang Data were searched to collect guidelines from January 1st, 2012 to December 31st, 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria and extracted data. The AGREE Ⅱ instrument was applied to assess methodological quality of included guidelines. ResultsA total of 78 guidelines were identified. Among them, 37 guidelines were published in 2012, and 41 in 2013. The scores of 6 domains' scores of AGREE Ⅱ were as follows:scope and purpose (24%), stakeholder involvement (11%), rigour of development (7%), clarity of presentation (32%), applicability (7%), and editorial independence (4%). The results of subgroup analysis indicated that, the scores in 5 domains (except applicability) of the guidelines published in CSCD journals were higher than those of non CSCD journals; the scores in 4 domains (except stakeholder involvement and applicability) of the guidelines received funds were higher than those of guidelines with no funds; and the scores in 5 domains (except editorial independence) of the guidelines published in 2013 were higher than those in 2012. ConclusionThe guidelines published from 2012 to 2013 have higher quality than guidelines published before 2012, but great discrepancies exist when comparing with international guidelines of average level. Chinese guidelines developers should attach importance to international methodology to develop guidelines, and use the AGREE Ⅱ instrument to develop and report guidelines.
ObjectivesTo investigate the current situation of clinical practice guidelines (CPGs) of gastric cancer in China, and to assess the quality of these CPGs, so as to provide reference for developing the CPGs of gastric cancer normatively in the future.MethodsCNKI, WanFang Data, CBM and VIP databases were electronically searched to collect the CPGs of gastric cancer in China from inception to January 31st, 2018. Four reviewers independently screened literature, extracted data and assessed the quality of these CPGs using the Appraisal of Guidelines for Research and Evaluation Ⅱ(AGREE Ⅱ).ResultsA total of 12 guidelines published from 2007 to 2017 were included. Only 1 guideline was evidence-based guideline. The average scores of guidelines in six domains of AGREE Ⅱ were 83.3%, 42.2%, 16.3%, 80.2%, 37.3% and 0% respectively.ConclusionsThe overall quality of included CPGs is insufficient. There is a lack of evidence-based guidelines in China. More attention should be paid to rigor of development and applicability during the development of CPGs in the future, and a timely upgrade is also required.
ObjectivesTo evaluate the methodological quality of clinical practice guidelines (CPGs) of Chinese rehabilitation medicine.MethodsCBM, VIP, CNKI, WanFang Data and Medlive databases were electronically searched to collect CPGs of Chinese rehabilitation medicine from January 1979 to May 2018. Four reviewers evaluated the methodological quality of the CPGs by AGREE Ⅱ.ResultsA total of 11 CPGs were included, which involved 5 CPGs on nervous system rehabilitation, 1 CPG on bone and joint system rehabilitation, 1 CPG each on pediatric rehabilitation, internal medicine system rehabilitation, burn rehabilitation, earthquake rehabilitation and rehabilitation diagnosis and treatment criteria respectively. The results of AGREE Ⅱ score showed that the average scores on six domains were 65.3%, 28.0%, 9.3%, 42.1%, 6.3% and 4.0%. There were not any level A (recommended) guidelines. Two guidelines were level B (recommended after being revised). The other nine guidelines were level C (not recommended).ConclusionsThere are a few rehabilitation CPGs in China and the quality of methodology is low. AGREE's methods and concepts have not been fully used for formulation. The rigor of development, clarity of presentation, applicability and editorial independence of guidelines should be emphasized, so as to produce high level CPGs and improve clinical practice quality in rehabilitation medicine.