Recommendations on Imaging Diagnosis in Chinese Clinical Practice Guidelines: A Cross-sectional Study_Chinese Journal of Evidence-Based Medicine

Authors：

 PEICai-xia ¹ ^# ,  WANGMeng-shu ² ^# , LILe ¹ , ZHANGHong-xia ³ , LIRui ³ , CHANGXiao-nan ¹ , WANGYin-zhong ² , DULiang ⁴ , YANGKe-hu ^5,6,7 ,  LEIJun-qiang ² , CHENYao-long ^5,6,7

1. The First Clinical Medical College of Lanzhou University, Lanzhou 730000, China;
2. The First Hospital of Lanzhou University, Lanzhou 730000, China;
3. The Second Clinical Medical College of Lanzhou University, Lanzhou 730000, China;
4. Chinese Evidence-based Center, West China Hospital, Sichuan University, Chengdu 610041, China;
5. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China;
6. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China;
7. Chinese GRADE Center, Lanzhou University, Lanzhou 730000, China;

Corresponding author：

LEIJun-qiang, Email: leijq1990@163.com

Keywords：

Clinical practice guideline; Imaging diagnosis; Recommendation; Quality of evidence

DOI：

10.7507/1672-2531.20160023

Video：

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Objective To investigate the recommendations on imaging diagnosis in Chinese clinical practice guidelines (CPGs). Methods We electronically searched WanFang Data, VIP, CNKI and CBM databases from inception to December 31, 2014. Two reviewers independently screened literature and extracted data. The method of bibliometrics was used to analyze the data (including basic characteristics, strength of recommendation, quality of evidence, etc.). Results A total of 341 CPGs formulating the recommendations on diagnosis were included. 48.7% (166/341) guidelines developed the recommendations on imaging diagnosis (a total of 534). 25.7% (137/534) recommendations were with the symbols of quality of evidence and strength of recommendation, and 18.9% (101/534) with special words such as recommend, suggest. 22.3% (119/534) recommendations reported the strength of recommendation. Of which, 38.7% (46/119) were strong and 16.0% (19/119) were weak. However, 23.9% (11/46) strong recommendations were based on low quality of evidence. And 42.1% (8/19) weak recommendations were based on high quality of evidence. Conclusion Among Chinese CPGs formulating the recommendations on diagnosis, the number of CPGs with recommendations on imaging is about 50%. And the quantity increases by years. The proportions of recommendations on imaging which report the strength of recommendation and/or quality of evidence are low. Meanwhile, the rating systems are uniform. Then the developers do not report the explanation for the strong recommendations based on low quality of evidence or the weak recommendations based on high quality of evidence in guideline.

Citation： PEICai-xia, WANGMeng-shu, LILe, ZHANGHong-xia, LIRui, CHANGXiao-nan, WANGYin-zhong, DULiang, YANGKe-hu, LEIJun-qiang, CHENYao-long. Recommendations on Imaging Diagnosis in Chinese Clinical Practice Guidelines: A Cross-sectional Study. Chinese Journal of Evidence-Based Medicine, 2016, 16(2): 130-134. doi: 10.7507/1672-2531.20160023 Copy

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3.	IOM (Institute of Medicine). Setting priorities for clinical practice guidelines. Washington, DC:National Academy Press, 1995.
4.	IOM (Institute of Medicine). Clinical Practice Guidelines We Can Trust. Washington, DC:The National Academies Press, 2011.
5.	Chen YL, Yao L, Xiao XJ, et al. Quality assessment of clinical guidelines in China:1993-2010. Chin Med J (Engl), 2012, 125(20): 3660-3664.
6.	韦当, 王小琴, 吴琼芳, 等. 2011年中国临床实践指南质量评价. 中国循证医学杂志, 2013, 13(6):760-763.
7.	陈耀龙,元博,孙丽娜, 等. 中国大陆临床实践指南引文分析. 中国循证儿科杂志, 2013, 8(6):467-470.
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12.	中华医学会外科学分会胃肠外科学组, 中华医学会外科学分会结直肠肛门外科学组, 中国抗癌协会大肠癌专业委员会, 等. 结直肠癌肝转移诊断和综合治疗指南(V 2010). 中华胃肠外科杂志, 2010, 13(6):457-470.
13.	中华医学会外科学分会胃肠外科学组, 中华医学会外科学分会结直肠肛门外科学组, 中国抗癌协会大肠癌专业委员会, 等. 结直肠癌肝转移诊断和综合治疗指南(V 2013). 中华胃肠外科杂志, 2013, 16(8):780-788.
14.	中国儿科肠内肠外营养支持临床应用指南. 中国儿科肠内肠外营养支持临床应用指南. 中华儿科杂志, 2010, 48(6):436-441.
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16.	Available at:http://www.agreetrust.org/agree-research-projects/current-research-projects/agree-rex-recommendation-excellence/.
17.	Alexander PE, Bero L, Montori VM, et al. World Health Organization recommendations are often strong based on low confidence in effect estimates. J Clin Epidemiol, 2014, 67(6):629-634.

1. IOM (Institute of Medicine). Clinical practice guidelines:directions for a new program. Washington, DC:National Academy Press, 1990.
2. IOM (Institute of Medicine). Guidelines for clinical practice:From development to use. Washington, DC:National Academy Press, 1992.
3. IOM (Institute of Medicine). Setting priorities for clinical practice guidelines. Washington, DC:National Academy Press, 1995.
4. IOM (Institute of Medicine). Clinical Practice Guidelines We Can Trust. Washington, DC:The National Academies Press, 2011.
5. Chen YL, Yao L, Xiao XJ, et al. Quality assessment of clinical guidelines in China:1993-2010. Chin Med J (Engl), 2012, 125(20): 3660-3664.
6. 韦当, 王小琴, 吴琼芳, 等. 2011年中国临床实践指南质量评价. 中国循证医学杂志, 2013, 13(6):760-763.
7. 陈耀龙,元博,孙丽娜, 等. 中国大陆临床实践指南引文分析. 中国循证儿科杂志, 2013, 8(6):467-470.
8. 李楠, 姚亮, 王琪, 等. 中国临床实践指南证据检索策略报告情况调查. 中国循证医学杂志, 2014, 14(12):1510-1513.
9. 李楠, 姚亮, 吴琼芳, 等. 2012~2013年中国大陆期刊发表临床实践指南质量评价. 中国循证医学杂志, 2015, 15(3):259-263.
10. 中华医学会重症医学分会. 呼吸机相关性肺炎诊断、预防和治疗指南(2013). 中华内科杂志, 2013, 52(6):524-543.
11. 郝纯毅, 沈琳, 顾晋, 等. 北京大学临床肿瘤学院大肠癌肝转移诊疗指南(2007). 中国实用外科杂志, 2008, 28(7):517-522.
12. 中华医学会外科学分会胃肠外科学组, 中华医学会外科学分会结直肠肛门外科学组, 中国抗癌协会大肠癌专业委员会, 等. 结直肠癌肝转移诊断和综合治疗指南(V 2010). 中华胃肠外科杂志, 2010, 13(6):457-470.
13. 中华医学会外科学分会胃肠外科学组, 中华医学会外科学分会结直肠肛门外科学组, 中国抗癌协会大肠癌专业委员会, 等. 结直肠癌肝转移诊断和综合治疗指南(V 2013). 中华胃肠外科杂志, 2013, 16(8):780-788.
14. 中国儿科肠内肠外营养支持临床应用指南. 中国儿科肠内肠外营养支持临床应用指南. 中华儿科杂志, 2010, 48(6):436-441.
15. AGREE Next Steps Consortium. The AGREE II Instrument (Electronic version). 2009. Available at:http://www.Agreetrust.org.
16. Available at:http://www.agreetrust.org/agree-research-projects/current-research-projects/agree-rex-recommendation-excellence/.
17. Alexander PE, Bero L, Montori VM, et al. World Health Organization recommendations are often strong based on low confidence in effect estimates. J Clin Epidemiol, 2014, 67(6):629-634.

Chinese Journal of Evidence-Based Medicine

Recommendations on Imaging Diagnosis in Chinese Clinical Practice Guidelines: A Cross-sectional Study

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