GRADE要求明确说明相关的背景、人群、干预措施和对照，同时要求不论研究结果能否形成证据，均需详述所有重要结果。对某一特定管理问题，人群、干预措施及结果应在不同研究间足够类似，才能认为得到相似的效应量合乎情理。指南制定者在收集证据前应先详细说明各结局的相对重要性，同样地，证据总结完成时也需要详细说明这一点。考虑到替代结局的重要性，对采用替代指标描述且对患者很重要的结局，作者应评估其重要性，并进而降低这种间接结果的证据质量等级。
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.
This article introduces development methods and notices about evidence-based clinical practice guidelines of ventilator-associated pneumonia (VAP) and discuss the similarities and differences between GRADE system and the methodological studies of other clinical guidelines, focusing on the analysis of literature retrieval, quality of evidence, formation of recommendation strength, and detailed measures on how to ensure correct understanding and rationally using the GRADE system. Applying the GRADE system to develop evidence-based clinical practice guidelines of VAP could clearly present the quality of evidence and make recommendations.
Patient values and preferences is one of the elements of evidence-based medicine research, which is also an important part that should be considered in the development of evidence-based guidelines in the present and future. However, the research in this field in China has just begun. This article gives a brief introduction of its concepts, methods, influence factors based on the international researches of patient values and preferences and a brief description of the development in China, in order to provide references for the development of evidence-based guidelines based on the consideration of patient values and preferences in the future.
In order to help Chinese guideline developers, clinicians, health policy makers and other relevant researchers fully understand and make appropriate use of the World Health Organization (WHO) guidelines, Chinese GRADE Center and Guidelines Review Committee of WHO (WHO-GRC) have written a series of papers about development methods, review principles and the structure and content of WHO guidelines. This is the first paper of this series introducing the basic principles and methods of development based on the WHO Handbook of Guideline Development and WHO Handbook of Guideline Development 2nd edition. We aim to provide guidance for Chinese guideline developers, and promote the development of high-quality guideline.