Quality assessment of Chinese clinical practice guidelines for diagnosis and management of atrial fibrillation_Chinese Journal of Evidence-Based Medicine

Authors：

XIAO Zhenghua ¹ , LU Chen ¹ , XIANG Mengmeng ² , ZHANG Yu ² , GUO Xinli ² , YANG Peng ¹ , HUANG yao ¹ ,  HU Jia ¹

1. Department of Cardiovascular Surgery, West China Hospital of Sichuan University, Chengdu, 610041, P.R.China;
2. West China School of Medicine, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding?author：

HU Jia, Email: humanjia@msn.com

Keywords：

Atrial fibrillation; Clinical practice guideline; Quality assessment; AGREE Ⅱ

DOI：

10.7507/1672-2531.201807083

Video：

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Objectives To assess the methodological quality of Chinese clinical practice guidelines (CPGs) for diagnosis and management of atrial fibrillation, and to provide methodological advice for developing and updating CPGs for atrial fibrillation in future. Methods CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect filter relevant CPGs from inception to Feburary, 2018. Two reviewers independently screened literature, extracted data and evaluated the quality of eligible CPGs by using the appraisal of guidelines for research and evaluation (AGREE Ⅱ) instrument. Results A total of 10 CPGs were included. The standardized mean scores for AGREE Ⅱ were: 54.17% for scope and purpose, 18.89% for stakeholder involvement, 15.89% for rigor of development, 66.39% for clarity and presentation, 34.9% for applicability, and 0 for editorial independence. Conclusions The quality of Chinese CPGs for atrial fibrillation is low. More efforts should be made to enhance the quality of CPGs for atrial fibrillation using methodological rigorous frameworks and strengthen guideline reporting.

Citation： XIAO Zhenghua, LU Chen, XIANG Mengmeng, ZHANG Yu, GUO Xinli, YANG Peng, HUANG yao, HU Jia. Quality assessment of Chinese clinical practice guidelines for diagnosis and management of atrial fibrillation. Chinese Journal of Evidence-Based Medicine, 2019, 19(2): 199-204. doi: 10.7507/1672-2531.201807083 Copy

1.	Benjamin EJ, Levy D, Vaziri SM, et al. Independent risk factors for atrial fibrillation in a population-based cohort: the framingham heart study. JAMA, 1994, 271(11): 840.
2.	周自強, 胡大一, 陳捷, 等. 中國心房顫動現狀的流行病學研究. 中華內科雜志, 2004, 43(7): 491-494.
3.	Wang X, Fu Q, Song F, et al. Prevalence of atrial fibrillation in different socioeconomic regions of China and its association with stroke: results from a national stroke screening survey. Int J Cardiol, 2018, 271: 92-97.
4.	梅舉, 姜兆磊, 湯敏, 等. 微創心臟瓣膜手術同期雙房冷凍消融治療合并心房顫動. 中國胸心血管外科臨床雜志, 2017, 24(1): 25-29.
5.	Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham study. Stroke, 1991, 22(8): 983.
6.	Guo Y, Tian Y, Wang H, et al. Prevalencmne, incidence, and lifetime risk of atrial fibrillation in China: new insights into the global burden of atrial fibrillation. Chest, 2015, 147(1): 109-119.
7.	陳新, 張澍, 胡大一, 等. 心房顫動: 目前認識和治療建議. 中華心律失常學雜志, 2001, 5(2): 69-94.
8.	AGREE Next Steps Consortium. The AGREE Ⅱ instrument, 2009. Available at: http://www.agreetrust.org.
9.	Sabharwal S, Patel V, Nijjer SS, et al. Guidelines in cardiac clinical practice: evaluation of their methodological quality using the AGREE Ⅱ instrument. J R Soc Med, 2013, 106(8): 315-322.
10.	Galvez-Olortegui JK, ?lvarez-Vargas ML, Galvez-Olortegui TV, et al. Current clinical practice guidelines in atrial fibrillation: a review. Medwave, 2016, 16(1): 6365.
11.	Institute of Medicine (US) Committee to advise the public health service on clinical practice guidelines. Clinical practice guidelines: directions for a new program. Ann Oncol, 1990, 60(9): 343-348.
12.	黃從新, 馬長生, 楊延宗, 等. 代表中華醫學會心電生理和起搏分會心房顫動治療專家工作組. 心房顫動: 目前的認識和治療建議 (二). 中華心律失常學雜志, 2006, 19(3): 167-197.
13.	黃從新, 馬長生, 張澍, 等. 經導管消融心房顫動中國專家共識. 中華心律失常學雜志, 2008, 12(4): 248-258.
14.	佚名. 慢性心力衰竭合并心房顫動診斷與治療中國專家共識. 中國醫刊, 2011, 46(1): 78-84.
15.	黃從新, 張澍, 馬長生, 等. 心房顫動: 目前的認識和治療建議-2012. 中國心律失常學雜志, 2012, 16(4): 246-289.
16.	中華醫學會心血管病學分會, 心律失常聯盟. 心房顫動抗凝治療中國專家共識. 中華內科雜志, 2012, 51(11): 916-921.
17.	利伐沙班臨床應用中國專家組. 利伐沙班臨床應用中國專家建議-非瓣膜病心房顫動卒中預防分冊. 中華內科雜志, 2013, 52(10): 897-902.
18.	中華醫學會心血管病學分會. 非瓣膜病心房顫動患者新型口服抗凝藥的應用中國專家共識. 中華心律失常學雜志, 2014, 18(5): 321-329.
19.	黃從新, 張澍, 黃德嘉, 等. 心房顫動: 目前的認識和治療建議-2015. 中國心臟起搏與心電生理雜志, 2015, 19(5): 328-369.
20.	張澍, 楊艷敏, 黃從新, 等. 中國心房顫動患者卒中預防規范. 中華心律失常學雜志, 2015, 19(3): 162-173.
21.	Graham R, Mancher M. Institute of Medicine (US) Committee on standards for developing trustworthy clinical practice guidelines, clinical practice guidelines we can trust. Washington (DC): National Academies Press (US), 2011.
22.	Chen YL, Yao L, Xiao XJ, et al. Quality assessment of clinical guidelines in China: 1993–2010. 中華醫學雜志 (英文版), 2012, 125(20): 3660-3664.
23.	韋當, 王小琴, 吳瓊芳, 等. 2011 年中國臨床實踐指南質量評價. 中國循證醫學雜志, 2013, 13(6): 760-763.
24.	李楠, 姚亮, 吳瓊芳, 等. 2012–2013 年中國大陸期刊發表臨床實踐指南質量評價. 中國循證醫學雜志, 2015, 15(3): 259-263.
25.	álvarez-Vargas ML, Galvez-Olortegui JK, Galvez-Olortegui TV, et al. Clinical practice guidelines in hypertension: a review. Medwave, 2015, 15(9): e6290.
26.	Chen Y, Wang C, Shang H, et al. Clinical practice guidelines in China. BMJ, 2018, 360: j5158.
27.	Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650): 924-926.
28.	Avaliable at: http://www.gradeworkinggroup.org.
29.	Gordon G, Andrew DO, Elie A, et al. GRADE 指南: Ⅰ.導論-GRADE 證據概要表和結果總結表. 中國循證醫學雜志, 2011, 11(4): 437-445.
30.	Zheng ZH, Cui SQ, Lu XQ, et al. Analysis of the status of Chinese clinical practice guidelines development. Bmc Health Serv Res, 2012, 12(1): 218.
31.	Detsky AS. Sources of bias for authors of clinical practice guidelines. CMAJ, 2006, 175(9): 1033, 1035.

1. Benjamin EJ, Levy D, Vaziri SM, et al. Independent risk factors for atrial fibrillation in a population-based cohort: the framingham heart study. JAMA, 1994, 271(11): 840.
2. 周自強, 胡大一, 陳捷, 等. 中國心房顫動現狀的流行病學研究. 中華內科雜志, 2004, 43(7): 491-494.
3. Wang X, Fu Q, Song F, et al. Prevalence of atrial fibrillation in different socioeconomic regions of China and its association with stroke: results from a national stroke screening survey. Int J Cardiol, 2018, 271: 92-97.
4. 梅舉, 姜兆磊, 湯敏, 等. 微創心臟瓣膜手術同期雙房冷凍消融治療合并心房顫動. 中國胸心血管外科臨床雜志, 2017, 24(1): 25-29.
5. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham study. Stroke, 1991, 22(8): 983.
6. Guo Y, Tian Y, Wang H, et al. Prevalencmne, incidence, and lifetime risk of atrial fibrillation in China: new insights into the global burden of atrial fibrillation. Chest, 2015, 147(1): 109-119.
7. 陳新, 張澍, 胡大一, 等. 心房顫動: 目前認識和治療建議. 中華心律失常學雜志, 2001, 5(2): 69-94.
8. AGREE Next Steps Consortium. The AGREE Ⅱ instrument, 2009. Available at: http://www.agreetrust.org.
9. Sabharwal S, Patel V, Nijjer SS, et al. Guidelines in cardiac clinical practice: evaluation of their methodological quality using the AGREE Ⅱ instrument. J R Soc Med, 2013, 106(8): 315-322.
10. Galvez-Olortegui JK, ?lvarez-Vargas ML, Galvez-Olortegui TV, et al. Current clinical practice guidelines in atrial fibrillation: a review. Medwave, 2016, 16(1): 6365.
11. Institute of Medicine (US) Committee to advise the public health service on clinical practice guidelines. Clinical practice guidelines: directions for a new program. Ann Oncol, 1990, 60(9): 343-348.
12. 黃從新, 馬長生, 楊延宗, 等. 代表中華醫學會心電生理和起搏分會心房顫動治療專家工作組. 心房顫動: 目前的認識和治療建議 (二). 中華心律失常學雜志, 2006, 19(3): 167-197.
13. 黃從新, 馬長生, 張澍, 等. 經導管消融心房顫動中國專家共識. 中華心律失常學雜志, 2008, 12(4): 248-258.
14. 佚名. 慢性心力衰竭合并心房顫動診斷與治療中國專家共識. 中國醫刊, 2011, 46(1): 78-84.
15. 黃從新, 張澍, 馬長生, 等. 心房顫動: 目前的認識和治療建議-2012. 中國心律失常學雜志, 2012, 16(4): 246-289.
16. 中華醫學會心血管病學分會, 心律失常聯盟. 心房顫動抗凝治療中國專家共識. 中華內科雜志, 2012, 51(11): 916-921.
17. 利伐沙班臨床應用中國專家組. 利伐沙班臨床應用中國專家建議-非瓣膜病心房顫動卒中預防分冊. 中華內科雜志, 2013, 52(10): 897-902.
18. 中華醫學會心血管病學分會. 非瓣膜病心房顫動患者新型口服抗凝藥的應用中國專家共識. 中華心律失常學雜志, 2014, 18(5): 321-329.
19. 黃從新, 張澍, 黃德嘉, 等. 心房顫動: 目前的認識和治療建議-2015. 中國心臟起搏與心電生理雜志, 2015, 19(5): 328-369.
20. 張澍, 楊艷敏, 黃從新, 等. 中國心房顫動患者卒中預防規范. 中華心律失常學雜志, 2015, 19(3): 162-173.
21. Graham R, Mancher M. Institute of Medicine (US) Committee on standards for developing trustworthy clinical practice guidelines, clinical practice guidelines we can trust. Washington (DC): National Academies Press (US), 2011.
22. Chen YL, Yao L, Xiao XJ, et al. Quality assessment of clinical guidelines in China: 1993–2010. 中華醫學雜志 (英文版), 2012, 125(20): 3660-3664.
23. 韋當, 王小琴, 吳瓊芳, 等. 2011 年中國臨床實踐指南質量評價. 中國循證醫學雜志, 2013, 13(6): 760-763.
24. 李楠, 姚亮, 吳瓊芳, 等. 2012–2013 年中國大陸期刊發表臨床實踐指南質量評價. 中國循證醫學雜志, 2015, 15(3): 259-263.
25. álvarez-Vargas ML, Galvez-Olortegui JK, Galvez-Olortegui TV, et al. Clinical practice guidelines in hypertension: a review. Medwave, 2015, 15(9): e6290.
26. Chen Y, Wang C, Shang H, et al. Clinical practice guidelines in China. BMJ, 2018, 360: j5158.
27. Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650): 924-926.
28. Avaliable at: http://www.gradeworkinggroup.org.
29. Gordon G, Andrew DO, Elie A, et al. GRADE 指南: Ⅰ.導論-GRADE 證據概要表和結果總結表. 中國循證醫學雜志, 2011, 11(4): 437-445.
30. Zheng ZH, Cui SQ, Lu XQ, et al. Analysis of the status of Chinese clinical practice guidelines development. Bmc Health Serv Res, 2012, 12(1): 218.
31. Detsky AS. Sources of bias for authors of clinical practice guidelines. CMAJ, 2006, 175(9): 1033, 1035.

Chinese Journal of Evidence-Based Medicine

Quality assessment of Chinese clinical practice guidelines for diagnosis and management of atrial fibrillation

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