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.
Clinical practice guidelines (CPGs) serve as the cornerstone of medical decision-making, with evaluation tools such as AGREE and RIGHT designed to ensure that these guidelines are grounded in the best available evidence and contribute to enhancing healthcare quality. This article reviews the historical development and current status of CPG evaluation tools, examining their diversity, complexity, application challenges, and inconsistencies in evaluation outcomes. A thorough discussion is provided on the strengths and weaknesses of existing evaluation tools, along with proposed future developmental directions. It is recommended that future efforts prioritize the creation of more streamlined tool designs, foster enhanced international collaboration strategies, and incorporate artificial intelligence technologies. These initiatives aim to improve both the efficiency and accuracy of evaluative processes while facilitating advancements in healthcare practices towards elevated quality standards.
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.
Currently, there is a lack of clarity and standardization regarding the implementation details of interventions in traditional Chinese medicine clinical practice guidelines (CPGs). This in methodological guidance for standardizing the implementation prescription adversely impacts the quality of implementation and hinders the clinical application rate of recommendations. Through in-depth analysis of implementation prescription of evidence-based CPGs in traditional Chinese medicine, we identified the challenges associated with standardization. In response, we propose enhancing the technical specifications of implementation prescriptions, advocating for improved formulation processes, diverse reporting approaches, and standardizedological guidelines. These recommendations aim to serve as a methodological reference and guidance for clinical practice guideline developers.
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.
Neuromuscular disease (NMD) encompasses a group of disorders that affect motor neurons, peripheral nerves, neuromuscular junctions, and skeletal muscles, potentially leading to respiratory muscle impairment and decline in respiratory function, significantly impacting patients' quality of life. In March 2023, clinical practice guideline titled Respiratory Management of Patients with Neuromuscular Weakness was released by the American College of Chest Physicians. This article summarizes, categorizes, and interprets the contents and key points of the guideline, aiming to provide more targeted guidance for clinical healthcare professionals and ultimately enhance the effectiveness of respiratory management for patients with NMD.
This study was an interpretation study based on the standard of AGREEⅡ. It analyzed methodological perspective of the International Evidence-Based Recommendations for Focused Cardiac Ultrasound determined by the International Conference on Focused Cardiac UltraSound (IC-FoCUS).
Traditional Chinese Medicine (TCM) clinical practice guidelines play essential roles in the development of TCM. However, the existing TCM guidelines are not effectively used in clinic. Based on this phenomenon, this article addresses the characteristics of clinical practice guidelines of TCM, and analyzes its status, problems and resolutions, providing feasible suggestions for the development of high-quality clinical practice guidelines of TCM which are in accordance with clinical practice.
By employing the nominal group technique, as per the process standard of the EQUATOR Collaboration Network, experts were selected through purposeful sampling. Two rounds of nominal group discussions were conducted, and the essential information of the utilization of the consensus method was extracted from the literature. After comparison, discussion, evaluation, and optimization, a list of 3 fields, 11 themes, 63 necessary items, and 28 supplementary items was eventually constructed to upgrade the standardization and rigor of the application of the consensus method in the future, assisting guideline developers to plan the consensus process.