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Volume 13 Issue 1
Jan.  2022
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LU Shuya, ZHAO Siya, WU Shouyuan, LUO Xufei, LIU Yunlan, LYU Meng, YANG Nan, WANG Xiaohui, CHEN Yaolong. Investigation and Evaluation of Chinese Clinical Practice Guidelines Published in Medical Journals in 2019:the Quality of Evidence and Strength of Recommendations[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(1): 130-137. DOI: 10.12290/xhyxzz.2021-0784
Citation: LU Shuya, ZHAO Siya, WU Shouyuan, LUO Xufei, LIU Yunlan, LYU Meng, YANG Nan, WANG Xiaohui, CHEN Yaolong. Investigation and Evaluation of Chinese Clinical Practice Guidelines Published in Medical Journals in 2019:the Quality of Evidence and Strength of Recommendations[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(1): 130-137. DOI: 10.12290/xhyxzz.2021-0784
shu

Investigation and Evaluation of Chinese Clinical Practice Guidelines Published in Medical Journals in 2019:the Quality of Evidence and Strength of Recommendations

  • 1.

    School of Public Health, Lanzhou University, Lanzhou 730000, China

  • 2.

    Institute of Health Data Science, Lanzhou University, Lanzhou 730000, China

  • 3.

    Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China

  • 4.

    WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China

  • 5.

    Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou 730000, China

  • 6.

    Lanzhou University GRADE Center, Lanzhou 730000, China

Funds: 

National Social Science Fund of China 19ZDA142

National Key Research and Development Program of China 2018YFC1705500

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

More Information
  • Corresponding author:

    WANG Xiaohui, E-mail: wangxiaohui@lzu.edu.cn

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

  • Received Date: December 11, 2021
  • Accepted Date: January 16, 2022
  • Available Online: January 23, 2022
  • Issue Publish Date: January 29, 2022
    Graphical Abstract
    • Abstract
  •   Objective  To investigate the methodological issues related to the quality of evidence and strength of recommendations of 2019 Chinese clinical practice guidelines (hereafter referred to as "guidelines") published in journals, so as to provide reference for standardization of recommendations.
      Methods  We searched and analyzed information on Chinese guidelines published in 2019, evaluated the quality of evidence, and graded the strength of recommendations. Information on grading methods, grading descriptions, phrases for the quality of evidence, and the strength of recommendation was extracted.
      Results  A total of 226 Chinese clinical practice guidelines were published in journals in 2019, of which 106 guidelines (87 Chinese guidelines, 19 English guidelines) were included in this study. There were 18 grading methods adopted, with the GRADE(Grading of Recommendations Assessment, Development and Evaluation) system being the most used(35.8%, 38/106). A total of 6 grading descriptions were used; the most frequently used symbol for grading the quality of evidence was letters (39.6%, 42/106); the most frequently used symbol for grading the strength of recommendations was text (34.9%, 37/106). The most common word used in the guidelines to describe the recommended strength was "may". Among the 38 guidelines that used the GRADE system, only 15 followed the presentation recommended by the GRADE working group. There were 250 clearly graded recommendations included, with 60.4% (151/250) being strong recommendations and 44.8% (112/250) citing low or very low-quality evidence. There were 96 recommendations(38.4%, 96/250) that were supported by systematic reviews.
      Conclusions  Chinese guidelines published in journals in 2019 that used the grading system accounts for a small proportion compared with those that did not use. And the quality of evidence and strength of recommendations used in guidelines remains incomplete, inconsistent and irregular. The GRADE system is underused. Very few guidelines present grading criteria and details in accordance with the requirements of the GRADE Working Group.We recommend the use of the GRADE system to promote the rigorous, transparent and rational development of guideline recommendations.
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    • References (22)
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