ObjectivesTo assess the methodological quality of clinical practice guidelines of cervical cancer in China published from 2014 to 2018.MethodsCNKI, WanFang Data, CBM, VIP, Medlive.cn, the National Guideline Clearinghouse, PubMed, The Cochrane Library and EMbase were searched for cervical cancer clinical practice guidelines published in China from January 1st, 2014 to December 31st, 2018. Four reviewers searched and selected the literature independently according to the inclusion and exclusion criteria and assessed the methodological quality of the included guidelines by using AGREE Ⅱ.ResultsA total of 9 guidelines were included. The average score for each area was: scope and purpose 75.47%, stakeholders’ involvement 35.09%, the rigor of development 43.70%, clarity of presentation 87.74%, applicability 80.76%, and editorial independence 0%.ConclusionsThe quality of cervical cancer clinical practice guidelines in China requires further improvement.
ObjectivesTo evaluate the methodological and reporting quality of clinical guidelines and consensus for esophageal cancer.MethodsDatabases including PubMed, EMbase, Web of Science, CBM, WanFang Data and CNKI were electronically searched and major guideline websites such as GIN, NICE, NGC and Yimaitong were also searched to collect guidelines and consensus for esophageal cancer from inception to August 2018. Two reviewers independently screened the literatures and extracted data according to the inclusion and exclusion criteria and then evaluated the quality of the included guidelines using the AGREE II and RIGHT instruments.ResultsA total of 26 esophageal cancer guidelines and consensus were included. The mean scores for each domain of AGREE II was 49.63% for scope and purpose, 25.16% for stakeholder involvement, 23.42% for rigor of development, 49.25% for clarity of presentation, 16.91% for applicability, and 21.07% for editorial independence. The item with the highest reporting rate among the RIGHT evaluation items was 5 (84.62%), followed by 1a (80.77%), 1c (65.38%), 13a (65.38%), and 4 (61.54%), and the remaining items were all reported below 50%. Results of subgroup analysis showed that the guidelines and consensus developed based on the evidence-based medicine method had higher average scores in the six domains of AGREE II and the RIGHT score than the guidelines and consensus developed based on expert opinions or reviews. The foreign guidelines and consensus had higher average scores in the three domains of AGREE II (formulation rigor, clarity, editorial independence) and the RIGHT score than the domestic guidelines.ConclusionsThe methodological and reporting quality of the guidelines and consensus on esophageal cancer is low, with the guidelines and consensus in China even lower, requiring further improvement. It is suggested that the guideline developers should refer to the standards such as AGREE II and RIGHT to develop high-quality guidelines and promote their application, so as to better guide the standardized diagnosis and treatment of esophageal cancer.
ObjectiveTo systematically assess the quality of evidence-based clinical guidelines and to compare the differences and similarities between recommendations, so as to provide references for clinical application. MethodsDatabases such as the TRIP, PubMed, CNKI, VIP, WanFang Data, CBM, National Guideline Clearinghouse and Guidelines International Network were searched to collect evidence-based guidelines on medication therapy for children with rheumatic fever. Methodological quality of included guidelines was assessed according to the AGREE Ⅱ instrument, and differences and similarities among recommendations were compared. ResultsOnly one evidence-based clinical guideline from Australia was included. Among 6 domains which were rated using the AGREE Ⅱ instrument, "scope and purpose", "stakeholder involvement", "rigor of development", "clarity and presentation" and "applicability" were scored more than 50%; while "editorial independence" was scored less than 50%. ConclusionThe included guideline is of relatively high quality; however, its application among Chinese population still has limitations. Thus, the development of national guidelines is urgently needed.
ObjectivesTo evaluate the methodological quality of guidelines for pharmacological intervention of migraine in adults, to compare and analyze the differences in first-line drug recommendations in different regions and quality levels, so as to explore the evidence of drug recommendations, and provide a basis for clinical decision-making.MethodsPubMed, The Cochrane Library, EMbase, SinoMed, CNKI, VIP, and WanFang Data databases, Up To Date, as well as the related books, Yimaitong, Guideline Central, Guidelines International Network (GIN) and National Institute for Health and Clinical Excellence (NICE) were systematically searched to collect pharmacological intervention guidelines of migraine in adults from inception to January 12th, 2020. The methodological quality of the guidelines was evaluated by Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ).ResultsA total of 25 guidelines were included (including 22 evidence-based guidelines), covering 10 countries on 4 continents and World Health Organization (WHO) with a time span of 1997 to 2019. According to AGREE Ⅱ, 5 were A-level guidelines, 18 were B-level guidelines, and 2 were C-level guidelines. Scope and purpose, rigour of development, clarity of presentations and editorial independence obtained high average scores (more than 60%) among all 25 guidelines. The average scores of guidelines in different domains of AGREE Ⅱ varied with regions and countries. Triptans and NSAIDs were the most frequently recommended as first-line drugs for the acute management; beta-blockers and antiepileptic drugs were recommended for the first-line prevention drugs of migraine in adults. There were 2 guidelines that recommended complementary treatments, one recommended traditional Chinese medicine and another recommended herbal butterbur.ConclusionsThe methodological quality of the pharmacological intervention guidelines of migraine in adults is suboptimal among different regions or countries. The quality of evidence-based guidelines is superior to that established by consensus. The consistency of first-line drug recommendations is strong, but there are still regional differences. The therapeutic effect of traditional Chinese medicine requires further verification.
ObjectivesTo investigate the current situation of clinical practice guidelines (CPGs) of gastric cancer in China, and to assess the quality of these CPGs, so as to provide reference for developing the CPGs of gastric cancer normatively in the future.MethodsCNKI, WanFang Data, CBM and VIP databases were electronically searched to collect the CPGs of gastric cancer in China from inception to January 31st, 2018. Four reviewers independently screened literature, extracted data and assessed the quality of these CPGs using the Appraisal of Guidelines for Research and Evaluation Ⅱ(AGREE Ⅱ).ResultsA total of 12 guidelines published from 2007 to 2017 were included. Only 1 guideline was evidence-based guideline. The average scores of guidelines in six domains of AGREE Ⅱ were 83.3%, 42.2%, 16.3%, 80.2%, 37.3% and 0% respectively.ConclusionsThe overall quality of included CPGs is insufficient. There is a lack of evidence-based guidelines in China. More attention should be paid to rigor of development and applicability during the development of CPGs in the future, and a timely upgrade is also required.
Objective To verify the applicability of AGREE-China and select high-quality clinical practice guidelines (CPGs) or consensus for the management of fragility fractures (FF) in China by evaluating their methodological quality. Methods CBM, CNKI, WanFang Data, VIP databases and related CPGs websites were electronically searched. Two reviewers independently screened literature, extracted data, and checked each other. Quality appraisal of CPGs or consensus were evaluated by AGREE Ⅱ and AGREE-China, and weighted Kappa value and intraclass correlation coefficients (ICC) were calculated to illustrate the consistency of the two tools. Results Nine CPGs and sixteen consensuses were included. Among the six domains in AGREE Ⅱ, "scope and purpose" domain (62.22%) scored higher than "clarity of presentation" domain (45.67%). The "stakeholder involvement" domain (34.89%) and "applicability" domain (38.17%) both exceeded 30%, while "rigor of development" domain (18.79%) and "editorial independence" domain (13.33%) were lower. Among the five domains in AGREE-China, "conflict of interest" domain (72.80%) was higher, followed by "usability/feasibility" domain (49.87%), while "scientificity/preciseness" domain (20.36%), "effectiveness/safety" domain (25.20%) and "economic efficiency" domain (14.40%) were lower. The weighted Kappa value of recommendations from the two tools was 0.694 (P<0.001), showing moderate consistency. ICC values of the same items and two evaluators were all greater than 0.85 (P<0.001) with high consistency. Three high-quality CPGs were consistently selected by the two tools. Conclusion AGREE Ⅱ holds high consistency with AGREE-China; however, AGREE-China is more suitable for the quality appraisal of Chinese CPGs or consensus. The methodological quality of CPGs or consensus for the management of FF in China needs to be further improved.
Objectives To assess the quality of clinical practice guidelines for primary hepatic carcinoma published in 2016 and 2017 in China. Methods CNKI, WanFang Data, CBM and VIP databases were searched for clinical practice guidelines for primary hepatic carcinoma in China. The search date was from Jan. 1st, 2016 to Jan. 1st, 2018. Four researchers independently selected literatures and extracted data according to the inclusion and exclusion criteria. The Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) was utilized to assess the methodological quality of the guidelines. Results A total of 7 guidelines were included. The average scores of six domains for these guidelines were: 65.1% for scope and purpose, 39.4% for stakeholders’ involvement, 64.3% for rigor of development, 55.6% for clarity of presentation, 61.8% for applicability and 6.1% for editorial independence. Conclusions The quality of clinical practice guidelines for primary hepatic carcinoma in China is relative high, of which the recommendations are of great value in clinical practice, yet still required to be improved in some ways.
ObjectiveTo systematically evaluate the methodological quality of traditional Chinese medicine (TCM) guidelines and expert consensuses for the diagnosis and treatment of coronary heart diseases (CHD).MethodsDatabases including PubMed, CNKI, CBM, WanFang Data and the official websites of the China Association of Traditional Chinese Medicine, and the Chinese Association of Integrated Traditional and Western Medicine were electronically searched to collect guidelines (or expert consensus) of TCM for CHD from January 1st, 2010 to January 1st, 2021. Methodological evaluation of the included guidelines was conducted by 3 researchers independently using the AGREE Ⅱ instrument.ResultsA total of 16 guidelines were included. The AGREE Ⅱ scores for each domain were: clarity and presentation (63.89%), followed by scope and purpose (55.90%), stakeholder involvement (42.13%), the rigor of development (41.42%), editorial independence (32.12%), and applicability (21.99%). Nine guidelines were rated as level B (recommended after being revised), and 7 were rated as level C (not recommended).ConclusionsGuidelines and expert consensuses of TCM for CHD provide a standard for clinical practice, however, the methodological quality remains to be improved. It is suggested that future guidelines be formulated in accordance with international standards and using the methods of evidence-based medicine to improve the quality of guidelines further and promote international acceptability.
ObjectiveTo systematically review the methodological quality of guidelines on the management of bronchiolitis in children, then to compare the recommendations and to provide a reference for clinical use. MethodsGuidelines concerning bronchiolitis were electronically retrieved in CNKI, VIP, WanFang Data, CBM, PubMed, EMbase, Medlive, GIN (Guidelines International Network), CGC (China Guideline Chearinghouse), NGC (National Guideline Clearinghouse), AAP (American Academy of Pediatrics), NICE (National Institute for Health and Clinical Excellence) and WHO (World Health Organization) from inception to December 2015. The methodological quality of included guidelines were evaluated according to the AGREE II instrument, and the differences between recommendations were compared. ResultsEight guidelines on bronchiolitis were included, Among them, one guideline was developed by UK, two by US, one by Spain, two by Australia, one by Scottish and one by South Africa. Five of them were evidence-based (EB) guidelines, and 3 were non-EB guidelines. Domain 4 (clarity of presentation) showed the highest scores (81%), then scope and purpose (74%), stakeholder involvement (56%), rigor of development (52%), editorial independence (43%), and scores (42%) were the lowest in domain 3 (applicability). The recommendations of managements and medicines for bronchiolitis were basically consistent, but there were individual differences suggested. ConclusionIn these guidelines, the domain score better is "clarity of presentation" and "scope and purpose ", but the other areas should need to improve. Current our country only has an expert consensus of bronchiolitis, which should be further improved. It's urgent to develop evidence-based guidelines which conforms to the situation of our country, in order to make evidence-based medicine implementation in clinical practice.
ObjectiveTo systematically review the methodological quality of Chinese clinical practice guidelines (CPGs) for diagnosis and management of diabetic foot.MethodsCNKI, WanFang Data, VIP, CBM, Yimaitong databases, website of Diabetes Branch of Chinese Medical Association, website of Chinese Integrative Medicine Association and website of Peripheral Vascular Disease Professional Committee of Chinese Society of Microcirculation were electronically searched to collect relevant CPGs from inception to May, 2020. Four researchers independently evaluated the CPGs methodological quality by using AGREEⅡ tool.ResultsA total of 10 Chinese CPGs for diabetes foot were included. The standardized mean scores for various fields were 75.74% for scope and purpose, 36.58% for stakeholder involvement, 28.61% for rigor of development, 86.30% for clarity and presentation, 43.47% for applicability, and 9.44% for editorial independence. ConclusionsThere are merely a small quantity of diabetic foot guidelines in China, and the methodological quality is insufficient. Therefore, more attention should be focused on the establishment of guidelines in the future, so as to further improve the quality of Chinese diabetic foot guidelines.