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 systematically review the methodological and reporting quality of the current global breast cancer screening guidelines so as to provide useful information for domestic study in the future.MethodsWe searched databases including PubMed, The Cochrane Library, Web of Science, EMbase, CNKI, CBM, WanFang Data and some cancer official websites to collect breast cancer screening guidelines from inception to February, 2018. Two reviewers independently screened literature, extracted data and assessed the quality of the guidelines by using AGREE II tool and RIGHT statement.ResultsA total of 11 guidelines were included, in which 5 guidelines (45%) were issued by the USA. The results of the quality assessment showed that: the average scores in the " scale and objective”, " participants”, " rigorism”, " clarity”, " application”, and " independence” of all guidelines were 83, 48, 60, 77, 53 and 79, respectively. 6 guidelines were evaluated as level A and 5 as level B. For the reporting quality, 3 guidelines were of high quality, including 2 in the USA and 1 in Canada.ConclusionsThe methodological and reporting quality of breast cancer screening guidelines are at present very satisfactory. The quantity of clinical guidelines shows an increasing trend. Multi-country contribution to one guideline is another trend. The evidence-based methodology has been accepted globally in the guideline development.
Objectives To assess the quality of clinical practice guidelines for primary hepatic carcinoma published in 2016 and 2017 in China. Methods CNKI, WanFang Data, CBM and VIP databases were searched for clinical practice guidelines for primary hepatic carcinoma in China. The search date was from Jan. 1st, 2016 to Jan. 1st, 2018. Four researchers independently selected literatures and extracted data according to the inclusion and exclusion criteria. The Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) was utilized to assess the methodological quality of the guidelines. Results A total of 7 guidelines were included. The average scores of six domains for these guidelines were: 65.1% for scope and purpose, 39.4% for stakeholders’ involvement, 64.3% for rigor of development, 55.6% for clarity of presentation, 61.8% for applicability and 6.1% for editorial independence. Conclusions The quality of clinical practice guidelines for primary hepatic carcinoma in China is relative high, of which the recommendations are of great value in clinical practice, yet still required to be improved in some ways.
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.
ObjectivesTo assess the methodological quality of clinical practice guidelines of cervical cancer in China published from 2014 to 2018.MethodsCNKI, WanFang Data, CBM, VIP, Medlive.cn, the National Guideline Clearinghouse, PubMed, The Cochrane Library and EMbase were searched for cervical cancer clinical practice guidelines published in China from January 1st, 2014 to December 31st, 2018. Four reviewers searched and selected the literature independently according to the inclusion and exclusion criteria and assessed the methodological quality of the included guidelines by using AGREE Ⅱ.ResultsA total of 9 guidelines were included. The average score for each area was: scope and purpose 75.47%, stakeholders’ involvement 35.09%, the rigor of development 43.70%, clarity of presentation 87.74%, applicability 80.76%, and editorial independence 0%.ConclusionsThe quality of cervical cancer clinical practice guidelines in China requires further improvement.
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.
ObjectiveTo evaluate the methodological quality of clinical practice guidelines and expert consensus of chronic heart failure domestically and abroad.MethodsPubMed, EMbase, SinoMed, CNKI, WanFang Data, and VIP databases, and related websites were searched to collect guidelines and expert consensus on chronic heart failure published from January 1st, 2011 to December 31st, 2020. Four reviewers evaluated the methodological quality of the guidelines and expert consensus with the AGREE Ⅱ tool after the consistency evaluation training.ResultsA total of 17 studies were included (consisting of 11 English and 6 Chinese studies). The recommended levels were B level (recommend after modification) for 10 studies and C level (not recommended) for 7 studies. The AGREE Ⅱ standardized mean scores for various fields were 69.61% (scope and purpose), 34.20% (stakeholder involvement), 33.13% (rigor of development), 84.53% (clarity and presentation), 42.40% (applicability), and 37.09% (editorial independence). The methodological quality of English guidelines was generally high (level B for 10 and level C for 1), while all scores of Chinese guidelines or consensus in the 6 fields were mostly lower than the average (level C for 6).ConclusionsThe guidelines for the diagnosis and treatment of chronic heart failure requires further improvement in terms of stakeholder involvement and rigor of development. It should develop standards and methods to improve the quality for Chinese guidelines and expert consensus to better serve clinical practice.
ObjectiveTo review guidelines on diet intervention for hypertension, compare the similarities/differences and the regularity of the guidelines, discuss the prevention and treatment effects of diet intervention for hypertension, promote the understanding of the guide, and to explore the best method of diet intervention for hypertension. MethodsDatabase such as CNKI, EMbase, PubMed, etc., as well as guideline websites were searched from inception to February 28th, 2014, for collecting guidelines on diet intervention in the prevention and treatment of hypertension. The Appraisal of Guidelines for Research and Evaluation (AGREE Ⅱ) were applied to assess methodological quality of the guidelines. Characteristics of diets recommended by the guidelines were analyzed through comparing the different regions and quality levels of the guidelines. ResultsA total of 27 guidelines on diet intervention for hypertension were included. They were formulated by 5 continents, 9 countries, 2 regions (Taiwan of China and Europe), and 1 international organization (WHO). According to the AGREE Ⅱ instrument, 13 guidelines were graded as Level A (recommendation) and 14 were graded as Level B (recommended after changes), respectively. The domains were more than 60% except for "rigor of development" (57.89±7.71)% and "applicability" (58.39±6.29)%. Each guideline recommended low sodium diet (usually:5 to 6 g/d; Oceania:4 g/d; North America:the amount of sodium intake should be decreased as age increases). The amount of alcohol intake was generally 30 mL/d for men and 20 mL/d for women. All included guidelines recommended to increase the intake of fruits, vegetables, and potassium. ConclusionCurrently, more than half of diet intervention recommendations for hypertension in different countries and regions are still needs to be improved and modified. Diet recommendations differ in regions, gender, and age.
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 systematically review the methodological quality of clinical practice guidelines (CPGs) on the management of acute gastroenteritis/diarrhea in children, then to compare differences and similarities of drug recommendations, in order to provide references for clinical practice. MethodsGuidelines concerning acute gastroenteritis/diarrhea in children were searched in CNKI, VIP, WanFang Data, CBM, PubMed and EMbase databases from inception to April 2015. The websites of GIN (Guidelines International Network), CGC (China Guideline Clearinghouse), NGC (National Guideline Clearinghouse), APP (American Academy of Pediatrics), NICE (National Institute for Health and Clinical Excellence) and the WHO (World Health Organization) were also searched for additional guidelines. The methodological quality of included guidelines were evaluated according to the AGREE Ⅱ instrument, and the differences between recommendations of included guidelines were compared. ResultsA total of 9 guidelines on acute gastroenteritis/diarrhea in children were included. Among them, 3 guidelines were developed by USA, 1 by Malaysia, 1 by EU, 1 by UK, 1 by South Wales, 1 by Australia and 1 by South Africa. Five guidelines were evidence-based guidelines, and the other 4 were non-evidence-based guidelines. The average scores of guidelines in six domains of AGREE Ⅱ were 79% (clarity of presentations), 74% (scope and purpose), 44% (stakeholder involvement), 35% (rigor of development), 32% (applicability), and 30% (editorial independence), respectively. The recommendations of management and treatment were almost consistent. ConclusionThe overall quality of included guidelines was not high. The domain scores of "clarity of presentations" and "scope and purpose" were higher, but the domain scores of "stakeholder involvement", "rigor of development", "applicability" and "editorial independence" needed to be improved. There is still no local guideline of acute gastroenteritis/diarrhea in children in China, so it's urgent to develop guideline that should be suite able for Chinese condition.