Objective To study and analyze both merits and demerits of 4 famous foreign evidence-based medicine databases, so as to provide references for the development of Chinese evidence-based medicine databases. Methods By means of document analysis and web search, the databases including UpToDate, MD Consult, Clinical Evidence and DynaMed were comprehensively analyzed from the following aspects: management ideas, editing process, personalized services and so on. Results a) Time of foundation: UpToDate founded in 1992 is the earliest-established evidence-based medicine database; b) Management ideas: All 4 databases aim to integrate all the high quality evidences about some clinical topics and help doctors to make the most reasonable decisions at present; c) Editing process: The inclusive criteria of Clinical Evidence is more strict than other databases, for the evidence needs to go through 18 steps before it is included; and d) Update rate: DynaMed updates every day as the fastest than other databases. Conclusion A mature evidence-based medicine database needs a powerful methodology team, b financial support and a large number of literature services. Besides learning good foreign experiences, it is also very important to assemble a methodology team, and particularly to integrate domestic characteristics for the establishment of domestic evidence-based medicine database.
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.
ObjectivesTo investigate sources of evidence of the clinical pathways approved by the Chinese government.MethodsThe approved clinical pathways were obtained from the website of the National Health and Family Planning Commission. Two reviewers independently extracted the basic information, approval date, types of evidence of the clinical pathways and time of evidence. The variance analysis was performed for the diagnosis and treatment parts of clinical pathways and the LSD method was further used for comparison.ResultsThe main types of evidence were guidelines, textbooks, standard indicators and consensus views. Approximately 80% of the pathways cited clinical practice guidelines and 36% cited the textbooks. The median number of evidence for each clinical pathway was 2. Approximately 85% of the evidence could be obtained the time when the evidence published. The average time interval (between the time when the pathways released and the time when the evidence published) was 5.2 years. Specifically, textbooks constituted the largest proportion in all evidence that was over 15 years of time interval. In addition to the textbook comparison standard indicators, there were significant differences in time interval between guidelines or consensus and textbooks or standard indicators.Conclusions The evidence types selection is based on the concept of evidence-based medicine, yet the time span of the referred evidence is larger. Therefore, developing clinical pathways not only need to refer to the latest research evidence comprehensively and enhance transparency of clinical pathways, but also use evidence quality evaluation standards to evaluate and select the referred evidences.