The development of clinical guidelines in China: insights from a national survey

Health Research Policy and Systems

Ruixia Guo¹  Yang Song²  Yuan Zhang³  Yaolong Chen⁴  Pablo Alonso-Coello⁵  Jing Li⁶ 

[1] Department of Gynaecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;Department of Gynaecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;Iberoamerican Cochrane Centre – Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain;Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Canada;Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China;WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China;Iberoamerican Cochrane Centre – Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain;Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;Vall d’Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain;

关键词: Practice guideline;    Surveys and questionnaires;    Evidence-based practice;    China;   

DOI  :  10.1186/s12961-021-00799-7

来源: Springer

【 摘 要 】

BackgroundPrevious research suggests that the quality of clinical guidelines (CGs) in China is suboptimal. However, little is known about the methodology that CGs follow. We conducted a national survey of methods used by Chinese CG developers for CG development, adaptation, and updating.MethodsWe used a previously piloted questionnaire based on methodologies of CG development, adaptation, and updating, which was distributed during September–November 2020 to 114 organizations identified from published Chinese CGs (searched 2017–2020), recommended by Chinese CG developers, and recommended by clinical discipline experts.ResultsWe collected 48 completed questionnaires (42.1% response). Most organizations developed CGs based on scientific evidence (89.6%), existing CGs (75%), or expert experience and opinion (64.6%). Only a few organizations had a specific CG development division (6.3%), a CG monitoring plan (on clinicians 33.3%; on patients 18.8%), funding (33.3%), or a conflict-of-interest (COI) management policy (23.4%). Thirty (62.5%) organizations reported using a CG development methodology handbook, from international organizations (14/30, 46.7%), methodology or evaluation resources (3/30, 10.0%), expert experience and opinion (3/30, 10.0%), or in-house handbooks (3/30, 10.0%). One organization followed a published adaptation methodology. Thirty-eight organizations (88.4%) reported de novo CG development: 21 (55.3%) formed a CG working group, and 29 (76.3%) evaluated the quality of evidence (21 [72.4%] using a methodological tool). Nineteen organizations (52.8%) reported CG adaptation: three (31.6%) had an adaptation working group, and 12 (63.2%) evaluated the quality of source CGs (2 (16.7%) using the AGREE II instrument). Thirty-three organizations (68.8%) updated their CGs, seven (17.5%) using a formal updating process.ConclusionsOur study describes how CGs are developed in a middle-income country like China. To ensure better healthcare, there is still an important need for improvement in the development, adaptation, and updating of CG in China.

【 授权许可】

CC BY