An analysis of impact factors related to the clinical applicability of guidelines: a cross-sectional study_Chinese Journal of Evidence-Based Medicine

Authors：

DIAO Sha ^1,2,3,4 , LIU Zheng ^1,2,3,4,5 , SHI Yuqing ^1,2,3,4,6 , LI Siyu ^1,2,3,4,5 , ZENG Linan ^1,2,3,4 , YI Qiusha ^1,2,3,4 , LI Hailong ^1,2,3,4 , XU Huizhong ⁷ , WANG Xixiong ⁸ , HUANG Xiusen ⁸ , YANG Xice ⁹ , HUANG Chao ¹⁰ ,  WANG Qiang ¹⁰ , ZHANG Lingli ^1,2,3,4,11

1. Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Evidence-based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu 610041, P. R. China;
4. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu 610041, P. R. China;
5. West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China;
6. West China School of Pharmacy, Sichuan University, Chengdu 610041, P. R. China;
7. Dongtai People's Hospital, Yancheng 224200, P. R. China;
8. The First People's Hospital of Qinzhou, Qinzhou 535099, P. R. China;
9. West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
10. Medical Management Service Guidance Center, National Health Commission of the People’s Republic of China, Beijing 100044, P. R. China;
11. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

WANG Qiang, Email: jason2019@sina.cn

Keywords：

Guidelines; Clinical applicability; Impact factors; Cross-sectional study

DOI：

10.7507/1672-2531.202306025

Video：

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Objective To explore impact factors related to the clinical applicability of guidelines, and provide suggestions for better development and implementation of guidelines. Methods The CNKI database was electronically searched to collect clinical guidelines issued by the Chinese Medical Association and the Chinese Medical Doctor Association from 2015 to 2020. Sixty-one guidelines were randomly selected from included guidelines and each guideline was evaluated by medical staff from three regions using the instrument for evaluating clinical applicability of guidelines (version 2.0). Statistical data were described, and t-test or rank sum test or chi-square test were used for comparison between groups. The impact factors were screened by stepwise logistic regression analysis. Results A total of 6 904 valid questionnaires were collected from 119 medical institutions in 26 provinces of China. The more familiar with the guidelines and the more consistent with the wishes of patients or their families, the overall standardized score of the clinical applicability of guidelines would be higher. In addition, the more familiar with the guidelines, the standardized scores in each field would be higher. The higher emphasis on guidelines compliance, the higher the feasibility standardized score. Conclusion In order to improve the clinical applicability of guidelines, developers should pay attention to whether the recommendations are consistent with the wishes of patients or their families. Then, medical institutions should pay attention to the compliance of guidelines. Finally, medical personnel should be familiar with the recommendations.

Citation： DIAO Sha, LIU Zheng, SHI Yuqing, LI Siyu, ZENG Linan, YI Qiusha, LI Hailong, XU Huizhong, WANG Xixiong, HUANG Xiusen, YANG Xice, HUANG Chao, WANG Qiang, ZHANG Lingli. An analysis of impact factors related to the clinical applicability of guidelines: a cross-sectional study. Chinese Journal of Evidence-Based Medicine, 2024, 24(1): 29-35. doi: 10.7507/1672-2531.202306025 Copy

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2.	Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med, 2011, 104(12): 510-520.
3.	曾力楠, 李幼平, 張伶俐, 等. 國內外制訂臨床指南的指南的循證評價. 中國循證醫學雜志, 2016, 16(11): 1322-1330.
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9.	黃超, 李海龍, 張川, 等. 指南臨床適用性評價實證研究: 以糖尿病指南臨床適用性評價為例. 中國循證醫學雜志, 2020, 20(5): 536-542.
10.	張川, 李海龍, 黃超, 等. 指南臨床適用性評價實證研究: 以腎移植指南臨床適用性評價為例. 中國循證醫學雜志, 2020, 20(5): 543-550.
11.	李思雨, 刁莎, 石雨晴, 等. 指南臨床適用性評價工具(2. 0版). 中國循證醫學雜志, 2023, 23(5): 597-605.
12.	張淼, 刁莎, 曾力楠, 等. 指南臨床適用性評價工具(2. 0版)信效度分析. 中國循證醫學雜志, 2023, 23(1): 80-84.
13.	刁莎, 萬杰, 石雨晴, 等. 中國近五年臨床實踐指南的臨床適用性: 一項橫斷面研究. 中國循證醫學雜志, 2023, 23(6): 632-637.
14.	刁莎, 楊夢婷, 曾力楠, 等. 醫學評估量表用戶手冊撰寫框架的定性系統評價. 醫學新知, 2022, 32(1): 10-22.
15.	孫振球, 徐勇勇. 醫學統計學. 北京: 人民衛生出版社, 2014.
16.	王芳, 楊洋, 劉孟宇, 等. 基于指南熟悉和使用程度探索中醫診療指南實施推廣策略. 中華中醫藥雜志, 2016, 31(8): 3162-3165.
17.	Vander Weigden T, Francel L, Antoine B, et al. How to integrate individual patient values and preferences in clinical practice guideline. A research protocol. Implement Sci, 2010, 5(1): 1-10.
18.	Institute of Medicine. Clinical practice guidelines we can trust. Washington DC: National Academies Press, 2011.
19.	World Health Organization. WHO handbook for guideline development (2nd edition). 2014.

1. Institute of Medicine (US) Committee on standards for developing trustworthy clinical practice guidelines. Clinical practice guidelines we can trust. Washington: National Academies Press, 2011: 4.
2. Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med, 2011, 104(12): 510-520.
3. 曾力楠, 李幼平, 張伶俐, 等. 國內外制訂臨床指南的指南的循證評價. 中國循證醫學雜志, 2016, 16(11): 1322-1330.
4. The ADAPTE Collaboration. The apapte process: resource toolkit for guideline adaptation, version 2.0.
5. 林茂, 曾力楠, 李佳蓮, 等. 全球指南臨床適用性評價工具現狀的系統評價. 中國循證醫學雜志, 2020, 20(4): 437-443.
6. 曾力楠, 易秋莎, 張川, 等. 制訂指南臨床適用性評價工具. 中國循證醫學雜志, 2020, 20(4): 466-475.
7. Linan Z, Qiusha Y, Chuan Z, et al. An instrument for evaluating the clinical applicability of guidelines. J Evid Based Med, 2020, 14(1): 75-81.
8. 李海龍, 張川, 黃超, 等. 指南臨床適用性評價工具信效度分析. 中國循證醫學雜志, 2020, 20(4): 378-382.
9. 黃超, 李海龍, 張川, 等. 指南臨床適用性評價實證研究: 以糖尿病指南臨床適用性評價為例. 中國循證醫學雜志, 2020, 20(5): 536-542.
10. 張川, 李海龍, 黃超, 等. 指南臨床適用性評價實證研究: 以腎移植指南臨床適用性評價為例. 中國循證醫學雜志, 2020, 20(5): 543-550.
11. 李思雨, 刁莎, 石雨晴, 等. 指南臨床適用性評價工具(2. 0版). 中國循證醫學雜志, 2023, 23(5): 597-605.
12. 張淼, 刁莎, 曾力楠, 等. 指南臨床適用性評價工具(2. 0版)信效度分析. 中國循證醫學雜志, 2023, 23(1): 80-84.
13. 刁莎, 萬杰, 石雨晴, 等. 中國近五年臨床實踐指南的臨床適用性: 一項橫斷面研究. 中國循證醫學雜志, 2023, 23(6): 632-637.
14. 刁莎, 楊夢婷, 曾力楠, 等. 醫學評估量表用戶手冊撰寫框架的定性系統評價. 醫學新知, 2022, 32(1): 10-22.
15. 孫振球, 徐勇勇. 醫學統計學. 北京: 人民衛生出版社, 2014.
16. 王芳, 楊洋, 劉孟宇, 等. 基于指南熟悉和使用程度探索中醫診療指南實施推廣策略. 中華中醫藥雜志, 2016, 31(8): 3162-3165.
17. Vander Weigden T, Francel L, Antoine B, et al. How to integrate individual patient values and preferences in clinical practice guideline. A research protocol. Implement Sci, 2010, 5(1): 1-10.
18. Institute of Medicine. Clinical practice guidelines we can trust. Washington DC: National Academies Press, 2011.
19. World Health Organization. WHO handbook for guideline development (2nd edition). 2014.

Chinese Journal of Evidence-Based Medicine

An analysis of impact factors related to the clinical applicability of guidelines: a cross-sectional study

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