Objective To evaluate the quality of Chinese clinical practice guidelines published in domestic medical journals in 2011. Methods The following 4 Chinese databases including WanFang Data, VIP, CNKI and CBM were searched from January 2011 to December 2011. The quality of included guidelines was assessed by using AGREE II. Results A total of 75 guidelines published in 2011 were included. Among them, 10 guidelines (13%) stated the conflict of interest, 10 guidelines (13%) mentioned evidence-based developing, 5 guidelines (7%) performed evidence grading system, 8 guidelines (11%) performed recommendation strength grading system, and 4 guidelines (5%) performed both evidence and recommendation strength grading systems. The ratio of the 6 domains’ scores of AGREEⅡ were as follows: scope and purpose (18%), stakeholder involvement (11%), rigour of development (8%), clarity of presentation (34%), applicability (5%), and editorial independence (14%). Conclusion Compared with the guidelines published before, the guidelines of 2011 have a higher quality and some of them are progressively standardized in developing methodology.
GRADE（Grades of Recommendation, Assessment, Development，and Evaluation）方法为卫生保健中的证据质量评价与推荐强度评级提供指导。对那些为系统评价、卫生技术评估及临床实践指南总结证据的人而言，GRADE具有重要意义。GRADE提供了一个系统而透明的框架用以明确问题，确定所关注的结局，总结针对某问题的证据，以及从证据到形成推荐或作出决策。GRADE方法的广泛传播与应用，获全球50余个组织认可，这些组织大多有很强的影响力（http://www.gradeworkinggroup.org/），足以证明该工作的重要性。本文介绍临床流行病学杂志将刊出的20篇系列文章，为如何使用GRADE方法提供指导。
本文是GRADE（Grading of Recommendations Assessment，Development，and Evaluation）系列文章的导论。该系列文章为使用GRADE系统提供指导，介绍如何将该系统用于系统评价、卫生技术评估（HTAs）及临床实践指南中备选方案的证据质量评价和推荐强度评级。GRADE方法始于提出一个明晰的问题，包括对所有重要结果的详细说明。证据被收集和汇总后，GRADE提供了明确的标准来评价其质量，包括研究设计、偏倚风险、不精确性、不一致性、间接性及效应量大小。
Objective To explore the methods used for developing evidence-based clinical practice guidelines for acupuncture. Methods Based on the characteristics of acupuncture in traditional Chinese medicine,and principles of evidence-based medicine, this article introduces and summarizes the processes and methods for developing an evidence-based clinical practice guideline for acupuncture. We analyzed similarities and differences between clinical practice guidelines for acupuncture and for other interventions. We used an evidence-based clinical practice guideline of acupuncture for depression as an example to illustrate the methods of literature search, grading of evidence and recommendations, evidence evaluation and consensus formation. Results Preliminary recommendations on the methods for developing evidence-based clinical practice guidelines for acupuncture were made. Conclusion Based on the optimized rational methodology for developing clinical guidelines, evidence-based high-quality clinical practice guidelines for acupuncture could be established.
Based-on retrieval and reviewing information of evidence-based clinical practice guidelines from the literature, this paper introduced the key components of assessment guideline quality, including the process of development and reporting of guideline.
ObjectiveTo analyze the content of international clinical practice guidelines related to endotracheal suctioning of adults with an artificial airway, and to provide reference for developing corresponding domestic clinical practice guidelines. MethodsContent analysis method was used to analyze clinical practice guidelines searched from the Internet between January 2000 and December 2012. ResultsThree clinical practice guidelines were included and 21 items related to endotracheal suctioning of adults with an artificial airway were identified. ConclusionAlthough the existing clinical practice guidelines can help to guide endotracheal suctioning of adults with an artificial airway, there are some differences between guidelines and domestic operation standards. Researchers and clinical nurses should develop local clinical practice guidelines on endotracheal suctioning of adults with an artificial airway with consideration of the actual medical situations in China and the best evidences.
ObjectiveTo investigate the updating period, methods and procedures of Clinical Practice Guidelines (CPGs) in China. MethodsWe searched WanFang Data, VIP, CNKI using the term "guideline" in the title, and Chinese Biomedical Literature Database (CBM) using "guideline" as the topic word up to December 2012. Then we screened and analyzed all included papers. ResultsA total of 380 Chinese CPGs were included. Thirty-eight (10%) guidelines have been updated, among which the longest update period was 10 years and the shortest was 1 year, and the average update period was 5.1 years. Eight (2%) of the updated guidelines had been updated more than once, and the average update time of them was 3, average update period was 4.9 years. There were 42 (12%) of the rest 342 guidelines which have never been updated mentioned that they would be updated. The detailed information of the updated guidelines according to their clinical objectives were as follow:1 (0.3%) was prevention guideline, of which the update period was 4 years; 8 (2%) were treatment guidelines and the average update period was 4.3 years; 5 (1%) were prevention and treatment guidelines, and the average update period was 6.8 years; 18 (5%) were diagnosis and treatment guidelines, and the average update period was 5.3 years; 4 (1%) were technology guidelines and the average update period was 5.5 years; and the average update period of the 2 (0.5%) integrative guidelines was 2.5 years. Forty (10%) of the total 380 guidelines had described their updating methods. ConclusionAccording the analysis of international studies and domestic guidelines, the update rate of Chinese CPGs is low, the update period is comparatively long, with differences found among them. The reporting of the updated CPGs' methods and procedures is insufficient, with less normalization. Big differences have been found in their updating condition among CPGs of different types and institutional developers.
ObjectiveTo investigate the reporting of search strategies of clinical practice guidelines (CPGs) in China. MethodsWe electronically searched WanFang Data, VIP, CNKI and CBM for clinical practice guidelines developed in China from inception to December 2012. Two reviewers independently screened guidelines, extracted data, and analyzed search strategies in these guidelines. ResultsA total of 380 Chinese CPGs were included, of which, only 13 reported search strategies of evidence, 9 in China reported search terms, 5 reported retrieval time of Chinese CPGs, and only 3 completely reported search terms, retrieval time and search databases. ConclusionThe reporting rate of search strategies of evidence in Chinese CPGs is fairly low and Chinese CPGs lack unified reporting criteria. We suggest that the developers of Chinese guideline should apply the reporting items of AGREE Ⅱ and the criteria of Conference on Guideline Standardization (COGS) to report CPGs.