Application of GRADE in Chinese clinical practice guidelines/expert consensus_Chinese Journal of Evidence-Based Medicine

Authors：

HUANG Qiao ^1,2 , REN Xiangying ³ , ZHANG Rong ^4,5 , LI Jiang ⁶ , YAN Siyu ^1,2 , WANG Yunyun ^1,2 ,  JIN Yinghui ^1,2

1. Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, P.R.China;
2. Department of Evidence-Based Medicine and Clinical Epidemiology, The Second Clinical College, Wuhan University, Wuhan 430071, P.R.China;
3. School of Nursing and Health, Henan University, Kaifeng 475000, P.R.China;
4. Department of Neurotumor Disease Diagnosis and Treatment Center, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, P.R.China;
5. School of Health Sciences, Wuhan University, Wuhan 430071, P.R.China;
6. Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R.China;

Corresponding?author：

JIN Yinghui, Email: jinyinghuiebm@163.com

Keywords：

Clinical practice guideline; Expert consensus; GRADE; Level of evidence; Strength of recommendation

DOI：

10.7507/1672-2531.202108187

Video：

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Objective To explore the methodological characteristics of Chinese clinical practice guidelines/expert consensus based on usage of GRADE. Methods CNKI, PubMed, WanFang Data databases, and Medlive.cn were electronically searched to collect Chinese clinical practice guidelines/expert consensus over the past 11 years from January 1^st 2010 to December 31^st 2020. Four reviewers independently extracted data according to the content of appraisal of guidelines quality evaluation tool AGREE Ⅱ. The clinical practice guidelines/expert consensus were divided into two groups based on whether GRADE was used or not. The changes and development of methodological quality in the past 11 years were explored between the two groups. Results In recent years, the number of clinical practice guidelines/expert consensus which used the GRADE in China had increased annually. The practice guidelines/expert consensus which did not use GRADE had lower methodology quality (P<0.01). Conclusions The use of GRADE in clinical practice guidelines/expert consensus requires improvement, and mastering GRADE methodology can effectively improve the methodological quality of the clinical practice guidelines/expert consensus.

Citation： HUANG Qiao, REN Xiangying, ZHANG Rong, LI Jiang, YAN Siyu, WANG Yunyun, JIN Yinghui. Application of GRADE in Chinese clinical practice guidelines/expert consensus. Chinese Journal of Evidence-Based Medicine, 2021, 21(12): 1457-1462. doi: 10.7507/1672-2531.202108187 Copy

1.	王小欽, 王吉耀. 循證臨床實踐指南的制定和實施. 北京: 人民衛生出版社, 2015.
2.	趙世華. 科學認知臨床實踐指南和專家共識. 中華放射學雜志, 2021, 55(4): 340-342.
3.	Rosenfeld RM, Shiffman RN. Clinical practice guidelines: a manual for developing evidence-based guidelines to facilitate performance measurement and quality improvement. Otolaryngol Head Neck Surg, 2006, 135(4 Suppl): S1-S28.
4.	鄧通, 汪洋, 黃笛, 等. 臨床實踐指南制訂方法—GRADE方法理論篇. 中國循證心血管醫學雜志, 2018, 10(12): 1441-1445.
5.	Djulbegovic B, Guyatt GH. Progress in evidence-based medicine: a quarter century on. Lancet, 2017, 390(10092): 415-423.
6.	陳昊, 王艷, 陳耀龍, 等. 從GRADE系統方法學看中醫藥臨床證據體系的構建. 中華中醫藥雜志, 2017, 32(1): 25-28.
7.	王春青, 胡雁. JBI證據預分級及證據推薦級別系統(2014版). 護士進修雜志, 2015, 30(11): 964-967.
8.	GRADE Working Group. GRADE home, 2021-03-01. Available at: http://www.gradeworkinggroup.org.
9.	Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4): 383-394.
10.	陳耀龍, 姚亮, Susan Norris, 等. GRADE在系統評價中應用的必要性及注意事項. 中國循證醫學雜志, 2013, 13(12): 1401-1404.
11.	Werner SS, Binder N, Toews I, et al. Use of GRADE in evidence syntheses published in high-impact-factor nutrition journals: A methodological survey. J Clin Epidemiol, 2021, 135: 54-69.
12.	Barker TH, Dias M, Stern C, et al. Guidelines rarely used GRADE and applied methods inconsistently: A methodological study of Australian guidelines. J Clin Epidemiol, 2021, 130: 125-134.
13.	Wang X, Zhou Q, Chen Y, et al. Using RIGHT (Reporting Items for Practice Guidelines in Healthcare) to evaluate the reporting quality of WHO guidelines. Health Res Policy Syst, 2020, 18(1): 75.
14.	Antoniou SA, Tsokani S, Mavridis D, et al. Guideline assessment project: filling the gap in surgical guidelines: quality improvement initiative by an international working group. Ann Surg, 2019, 269(4): 642-651.
15.	黃笛, 黃瑞秀, 郭晨煜, 等. 臨床實踐指南制定方法—證據分級與推薦強度. 中國循證心血管醫學雜志, 2018, 10(7): 769-776.
16.	靳英輝, 韓斐, 王明輝, 等. 臨床實踐指南制訂方法—證據向推薦意見轉化. 中國循證心血管醫學雜志, 2018, 10(9): 1031-1038.
17.	Zhang Y, Coello PA, Bro?ek J, et al. Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach. Health Qual Life Outcomes, 2017, 15(1): 52.
18.	王子君, 王小琴, 姚亮, 等. GRADE對健康公平性的考慮. 中國循證醫學雜志, 2018, 18(7): 746-752.
19.	Welch VA, Akl EA, Guyatt G, et al. GRADE equity guidelines 1: considering health equity in GRADE guideline development: introduction and rationale. J Clin Epidemiol, 2017, 90: 59-67.
20.	Welch VA, Akl EA, Pottie K, et al. GRADE equity guidelines 3: considering health equity in GRADE guideline development: rating the certainty of synthesized evidence. J Clin Epidemiol, 2017, 90: 76-83.
21.	陳耀龍, 楊克虎, 姚亮, 等. GRADE系統方法學進展. 中國循證兒科雜志, 2013, 8(1): 64-65.
22.	周奇, 王玲, 楊楠, 等. 基于GRADE康復臨床實踐指南證據質量與推薦強度研究. 中國康復理論與實踐, 2020, 26(2): 156-160.
23.	Agoritsas T, Merglen A, Heen AF, et al. UpToDate adherence to GRADE criteria for strong recommendations: an analytical survey. BMJ Open, 2017, 7(11): e018593.
24.	Alexander PE, Brito JP, Neumann I, et al. World Health Organization strong recommendations based on low-quality evidence (study quality) are frequent and often inconsistent with GRADE guidance. J Clin Epidemiol, 2016, 72: 98-106.
25.	王子君, 姚亮, 劉練, 等. 推薦分級的評估, 制訂與評價(GRADE)方法學家的培訓與認證. 中國循證兒科雜志, 2017, 12(5): 388-391.

1. 王小欽, 王吉耀. 循證臨床實踐指南的制定和實施. 北京: 人民衛生出版社, 2015.
2. 趙世華. 科學認知臨床實踐指南和專家共識. 中華放射學雜志, 2021, 55(4): 340-342.
3. Rosenfeld RM, Shiffman RN. Clinical practice guidelines: a manual for developing evidence-based guidelines to facilitate performance measurement and quality improvement. Otolaryngol Head Neck Surg, 2006, 135(4 Suppl): S1-S28.
4. 鄧通, 汪洋, 黃笛, 等. 臨床實踐指南制訂方法—GRADE方法理論篇. 中國循證心血管醫學雜志, 2018, 10(12): 1441-1445.
5. Djulbegovic B, Guyatt GH. Progress in evidence-based medicine: a quarter century on. Lancet, 2017, 390(10092): 415-423.
6. 陳昊, 王艷, 陳耀龍, 等. 從GRADE系統方法學看中醫藥臨床證據體系的構建. 中華中醫藥雜志, 2017, 32(1): 25-28.
7. 王春青, 胡雁. JBI證據預分級及證據推薦級別系統(2014版). 護士進修雜志, 2015, 30(11): 964-967.
8. GRADE Working Group. GRADE home, 2021-03-01. Available at: http://www.gradeworkinggroup.org.
9. Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4): 383-394.
10. 陳耀龍, 姚亮, Susan Norris, 等. GRADE在系統評價中應用的必要性及注意事項. 中國循證醫學雜志, 2013, 13(12): 1401-1404.
11. Werner SS, Binder N, Toews I, et al. Use of GRADE in evidence syntheses published in high-impact-factor nutrition journals: A methodological survey. J Clin Epidemiol, 2021, 135: 54-69.
12. Barker TH, Dias M, Stern C, et al. Guidelines rarely used GRADE and applied methods inconsistently: A methodological study of Australian guidelines. J Clin Epidemiol, 2021, 130: 125-134.
13. Wang X, Zhou Q, Chen Y, et al. Using RIGHT (Reporting Items for Practice Guidelines in Healthcare) to evaluate the reporting quality of WHO guidelines. Health Res Policy Syst, 2020, 18(1): 75.
14. Antoniou SA, Tsokani S, Mavridis D, et al. Guideline assessment project: filling the gap in surgical guidelines: quality improvement initiative by an international working group. Ann Surg, 2019, 269(4): 642-651.
15. 黃笛, 黃瑞秀, 郭晨煜, 等. 臨床實踐指南制定方法—證據分級與推薦強度. 中國循證心血管醫學雜志, 2018, 10(7): 769-776.
16. 靳英輝, 韓斐, 王明輝, 等. 臨床實踐指南制訂方法—證據向推薦意見轉化. 中國循證心血管醫學雜志, 2018, 10(9): 1031-1038.
17. Zhang Y, Coello PA, Bro?ek J, et al. Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach. Health Qual Life Outcomes, 2017, 15(1): 52.
18. 王子君, 王小琴, 姚亮, 等. GRADE對健康公平性的考慮. 中國循證醫學雜志, 2018, 18(7): 746-752.
19. Welch VA, Akl EA, Guyatt G, et al. GRADE equity guidelines 1: considering health equity in GRADE guideline development: introduction and rationale. J Clin Epidemiol, 2017, 90: 59-67.
20. Welch VA, Akl EA, Pottie K, et al. GRADE equity guidelines 3: considering health equity in GRADE guideline development: rating the certainty of synthesized evidence. J Clin Epidemiol, 2017, 90: 76-83.
21. 陳耀龍, 楊克虎, 姚亮, 等. GRADE系統方法學進展. 中國循證兒科雜志, 2013, 8(1): 64-65.
22. 周奇, 王玲, 楊楠, 等. 基于GRADE康復臨床實踐指南證據質量與推薦強度研究. 中國康復理論與實踐, 2020, 26(2): 156-160.
23. Agoritsas T, Merglen A, Heen AF, et al. UpToDate adherence to GRADE criteria for strong recommendations: an analytical survey. BMJ Open, 2017, 7(11): e018593.
24. Alexander PE, Brito JP, Neumann I, et al. World Health Organization strong recommendations based on low-quality evidence (study quality) are frequent and often inconsistent with GRADE guidance. J Clin Epidemiol, 2016, 72: 98-106.
25. 王子君, 姚亮, 劉練, 等. 推薦分級的評估, 制訂與評價(GRADE)方法學家的培訓與認證. 中國循證兒科雜志, 2017, 12(5): 388-391.

Chinese Journal of Evidence-Based Medicine

Application of GRADE in Chinese clinical practice guidelines/expert consensus

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