2019年期刊公开发表的中国临床实践指南文献调查与评价——方法学质量和报告质量

刘云兰; 张静怡; 史乾灵; 杨楠; 王子君; 罗旭飞; 任梦娟; 荀杨芹; 周奇; 刘辉; 吕萌; 陈耀龙

doi:10.12290/xhyxzz.2022-0027

2019年期刊公开发表的中国临床实践指南文献调查与评价——方法学质量和报告质量

doi: 10.12290/xhyxzz.2022-0027

刘云兰¹,
张静怡²,
史乾灵³,
杨楠⁴,
王子君⁴,
罗旭飞¹,
任梦娟¹,
荀杨芹⁴,
周奇⁴,
刘辉¹,
吕萌¹,
陈耀龙^{1, 4, 5, 6, 7, 8, 9, ,}

1.
兰州大学公共卫生学院，兰州 730000
2.
广东省第二人民医院临床流行病与方法学中心，广州 510317
3.
兰州大学第一临床医学院，兰州 730000
4.
兰州大学基础医学院循证医学中心，兰州 730000
5.
兰州大学健康数据科学研究院，兰州 730000
6.
中国医学科学院循证评价与指南研究创新单元，兰州大学基础医学院，兰州 730000
7.
世界卫生组织指南实施与知识转化合作中心，兰州 730000
8.
Cochrane中国协作网兰州大学分中心，兰州 730000
9.
兰州大学GRADE中心，兰州 730000

基金项目:

国家社会科学基金重大项目 19ZDA142

国家重点研发计划 2018YFC1705500

中央高校基本科研业务费专项资金资助 lzujbky-2021-ey13

详细信息

通讯作者:
陈耀龙，E-mail：chevidence@lzu.edu.cn

中图分类号: R181.2
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- 被引次数: 0
出版历程
- 收稿日期: 2022-01-16
- 录用日期: 2022-02-14
- 网络出版日期: 2022-03-14
- 刊出日期: 2022-03-30

Investigation and Evaluation of Chinese Clinical Practice Guidelines Published in Medical Journals in 2019:Methodological and Reporting Quality

LIU Yunlan¹,
ZHANG Jingyi²,
SHI Qianling³,
YANG Nan⁴,
WANG Zijun⁴,
LUO Xufei¹,
REN Mengjuan¹,
XUN Yangqin⁴,
ZHOU Qi⁴,
LIU Hui¹,
LYU Meng¹,
CHEN Yaolong^{1, 4, 5, 6, 7, 8, 9
, ,}

1.
School of Public Health, Lanzhou University, Lanzhou 730000, China
2.
Center for Clinical Epidemiology and Methodology, Guangdong Second Provincial General Hospital, Guangzhou 510317, China
3.
The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
4.
Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
5.
Institute of Health Data Science, Lanzhou University, Lanzhou 730000, China
6.
Research Unit of Evidence-based Evaluation and Guidelines, Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
7.
WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China
8.
Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou 730000, China
9.
Lanzhou University GRADE Center, Lanzhou 730000, China

Funds:

National Social Science Fund of China 19ZDA142

National Key Research and Development Program of China 2018YFC1705500

Fundamental Research Funds for the Central Universities lzujbky-2021-ey13

More Information

Corresponding author: CHEN Yaolong, E-mail: chevidence@lzu.edu.cn

摘要

摘要: 目的评价2019年期刊公开发表的中国临床实践指南的方法学质量和报告质量, 以了解我国指南的质量现状, 为未来指南制订提供改进方向和建议。方法采用AGREEⅡ和RIGHT工具分别评价指南的方法学质量和报告质量, 计算AGREE Ⅱ和RIGHT各领域及总体平均得分或平均报告率, 以60%作为合格阈值。结果共纳入符合要求的指南226篇。评价结果显示, 2019年期刊公开发表的中国临床实践指南AGREEⅡ平均得分为25.3%;各领域得分依次为: 范围和目的37.9%, 参与人员23.2%, 制订严谨性14.9%, 表达清晰性39.1%, 应用性14.6%, 编辑独立性22.5%。RIGHT平均报告率为33.9%, 各领域报告率依次为: 基本信息59.2%, 背景51.9%, 证据10.8%, 推荐意见31.5%, 评审与质控4.4%, 资助与利益冲突的声明和管理22.3%, 其他方面14.5%。12篇注册指南相较于未注册指南的AGREEⅡ平均得分高24.3%(48.3% 比24.0%), RIGHT平均报告率高21.2%(54.0% 比32.8%)。结论 2019年期刊公开发表的中国临床实践指南的方法学质量和报告质量整体较低, 注册指南的整体得分高于未注册指南。
- 临床实践指南 /
- 方法学质量 /
- 报告质量 /
- 评价
Abstract: Objective To evaluate the methodological and reporting quality of Chinese clinical practice guidelines published in medical journals in 2019, so as to understand their current quality and provide suggestions for the improvement of guideline development. Methods We used the AGREE Ⅱ tool and the RIGHT checkilist to assess the methodological and reporting quality of Chinese clinical practice guidelines respectively. The average score or average reporting rate was calculated for each domain and the overall. We used 60% as the qualified threshold. Results A total of 226 guidelines meeting the criteria were included. The average score of AGREE Ⅱ was 22.3%, and the scores of six domains were as follows: 37.9% (scope and purpose), 23.2% (stakeholder involvement), 14.9% (rigour of development), 39.1% (clarity of presentation), 14.6% (applicability), and 22.5%(editorial independence). The average reporting rate of RIGHT was 33.9%, and the reporting rates of seven domains were as follows: 59.2% (basic information), 51.9% (background), 10.8% (evidence), 31.5% (recommendation), 4.4% (review and quality assurance), 22.3%(funding and declaration and management of interests), and 14.5% (other information). Compared to unregistered guidelines, 12 registered guidelines had a 24.3% higher mean score (48.3% vs. 24.0%) in AGREE Ⅱ and a 21.2% higher mean reporting rate (54.0% vs. 32.8%) in RIGHT. Conclusions The overall methodological and reporting quality of Chinese clinical practice guidelines published in medical journals in 2019 were relatively low. Registered guidelines had higher overall scores than unregistered guidelines.
- clinical practice guidelines /
- methodological quality /
- reporting quality /
- evaluation
注释:

作者贡献：刘云兰、张静怡、史乾灵、杨楠、王子君、罗旭飞、任梦娟、荀杨芹、周奇、刘辉、吕萌负责指南的评价；刘云兰、张静怡负责统计数据并撰写文章；史乾灵、杨楠、王子君、罗旭飞、任梦娟、荀杨芹、周奇、刘辉、吕萌负责修改初稿；陈耀龙负责文章选题、结构设计、团队组建、数据核查及文章修订。

利益冲突：所有作者均声明不存在利益冲突

HTML全文

图 1 2019年期刊公开发表的中国临床实践指南AGREEⅡ各领域得分

注：D1：范围和目的；D2：参与人员；D3：制订严谨性；D4：表达清晰性；D5：应用性；D6：编辑独立性

下载: 全尺寸图片幻灯片

图 2 2019年期刊公开发表的中国临床实践指南RIGHT各领域报告率

注：D1：基本信息；D2：背景；D3：证据；D4：推荐意见；D5：评审与质控；D6：资助与利益冲突的声明和管理；D7：其他方面

下载: 全尺寸图片幻灯片

图 3 2019年期刊公开发表的中国临床实践指南RIGHT各条目报告率

下载: 全尺寸图片幻灯片

图 4 期刊公开发表的中国临床实践指南与国际或WHO指南比较^{[7-8, 14-17]}

A.AGREE Ⅱ评价各领域得分，D1~D6：同图 1；B.RIGHT评价各领域得分，D1~D7：同图 2

下载: 全尺寸图片幻灯片

表 1 2019年期刊公开发表的中国临床实践指南AGREEⅡ得分亚组分析(x±s, %)

分组	数量(篇)	范围和目的	参与人员	制订严谨性	表达清晰性	应用性	编辑独立性	平均得分
发表语种
中文	187	38.1±13.1	24.2±10.6	14.8±12.6	38.3±20.8	13.9±8.9	22.5±20.3	25.3±10.0
英文	39	37.1±12.5	17.4±14.2	15.3±14.0	42.7±18.8	17.8±7.0	22.2±22.4	25.4±11.2
注册状态
是	12	58.6±8.0	51.0±13.5	45.3±18.3	68.3±8.1	19.8±8.8	46.7±17.2	48.3±8.8
否	214	36.7±12.2	21.6±9.3	13.2±10.0	37.4±19.7	14.3±8.6	21.1±20.0	24.0±8.6
制订机构
卫生管理部门	20	30.8±11.1	10.2±9.6	6.8±2.5	21.5±10.6	16.9±8.6	12.5±17.9	16.4±5.3
学会/协会	161	38.0±12.7	24.5±10.8	15.5±12.6	41.0±20.4	15.1±8.9	25.0±20.7	26.5±10.1
医院	22	43.9±10.7	23.5±12.2	14.3±13.6	40.0±18.2	10.7±6.7	15.5±20.2	24.7±8.3
其他^*	23	37.1±16.2	24.7±12.2	18.4±17.2	39.8±24.2	11.8±7.8	19.3±18.9	25.2±12.8
期刊收录情况^#
CSCD收录	114	41.1±11.7	25.0±11.0	14.9±12.2	41.5±20.6	13.4±8.4	21.5±20.8	26.2±10.0
非CSCD收录	73	33.3±13.8	23.4±10.1	14.6±13.3	33.3±20.2	14.6±9.7	24.1±19.5	23.9±9.9
SCI收录	34	35.7±12.1	14.5±11.7	13.6±12.8	40.0±18.6	17.7±7.1	20.0±22.7	23.6±10.3
非SCI收录	5	47.2±10.9	36.7±15.3	27.2±17.3	60.8±7.2	19.0±6.3	36.7±14.9	37.9±9.3
AGREEⅡ：指南研究与评价工具；^*包括学校、科研机构和专家组；^#中文期刊按照是否被CSCD收录进行分类，英文期刊按照是否被SCI收录进行分类；CSCD：中国科学引文数据库；SCI：科学引文索引

下载: 导出CSV

表 2 2019年期刊公开发表的中国临床实践指南RIGHT报告率亚组分析(x±s，%)

分组	数量(篇)	基本信息	背景	证据	推荐意见	评审与质控	资助与利益冲突	其他方面	平均报告率
发表语种
中文	187	60.8±14.1	54.5±16.2	11.2±18.9	30.5±23.0	3.5±13.8	21.8±19.5	11.8±20.0	34.2±11.0
英文	39	51.7±13.1	39.4±20.4	8.7±13.6	37.4±26.3	9.0±19.4	25.0±25.0	27.4±21.5	32.3±13.8
是否注册
是	12	52.8±13.9	64.6±18.3	45.0±24.3	71.4±14.9	16.7±24.6	58.3±22.2	22.2±21.7	54.0±12.2
否	214	59.6±14.3	51.2±17.7	8.9±15.7	29.2±22.1	3.7±14.0	20.3±18.5	14.0±21.0	32.8±10.4
制订机构
卫生管理部门	20	52.5±6.1	30.6±18.8	1.0±4.5	18.6±10.5	2.5±11.2	12.5±19.0	23.3±15.7	23.4±6.1
学会/协会	161	60.7±15.1	54.6±16.2	11.6±18.0	33.1±24.1	4.2±15.0	23.5±20.8	13.1±19.7	35.2±11.3
医院	22	58.3±13.4	50.6±18.7	10.0±21.2	29.9±21.1	9.1±19.7	22.7±18.8	16.7±22.4	33.5±10.2
其他^*	23	54.4±12.2	52.6±15.9	14.7±22.0	35.3±29.5	2.6±11.5	22.4±20.2	14.0±32.0	34.4±14.1
期刊收录类型^#
CSCD收录	114	60.2±13.4	54.8±16.0	11.2±17.3	33.2±22.5	3.5±12.8	22.8±20.1	9.4±17.5	34.7±10.6
非CSCD收录	73	61.6±15.1	54.1±16.7	11.2±21.3	26.2±23.3	3.4±15.2	20.2±18.5	15.5±23.0	33.6±11.6
SCI收录	34	52.0±13.5	36.0±18.4	7.1±12.9	33.2±23.5	7.4±18.0	22.8±24.9	25.5±16.5	30.0±11.8
非SCI收录	5	50.0±11.8	62.5±19.8	20.0±14.1	65.7±29.6	20.0±27.4	40.0±22.4	40.0±43.5	48.0±17.5
RIGHT：卫生保健实践指南的报告条目；^*同表 1；^#同表 1；CSCD、SCI：同表 1

下载: 导出CSV

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2019年期刊公开发表的中国临床实践指南文献调查与评价——方法学质量和报告质量

doi: 10.12290/xhyxzz.2022-0027

通讯作者:
陈耀龙，E-mail：chevidence@lzu.edu.cn

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Investigation and Evaluation of Chinese Clinical Practice Guidelines Published in Medical Journals in 2019:Methodological and Reporting Quality

Corresponding author: CHEN Yaolong, E-mail: chevidence@lzu.edu.cn

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2019年期刊公开发表的中国临床实践指南文献调查与评价——方法学质量和报告质量

doi: 10.12290/xhyxzz.2022-0027

通讯作者: 陈耀龙，E-mail：chevidence@lzu.edu.cn

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Investigation and Evaluation of Chinese Clinical Practice Guidelines Published in Medical Journals in 2019:Methodological and Reporting Quality

Corresponding author: CHEN Yaolong, E-mail: chevidence@lzu.edu.cn

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出版历程

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通讯作者:
陈耀龙，E-mail：chevidence@lzu.edu.cn