Every country has its own clinical guideline to standardize medical care, and China is developing guidehnes too. Viewing the guidehne＇s usage in the world over many years, we find that it hasn＇t achieved good effect. The development of evidence-based medicine brings a primal change to guideline development. The evidence-based clinical guidehnes are arising in the world. We summarized the principle of developing evidence-based guideline according to the experience of Scotland to provide reference for domestic peers.
To identify the best evidence in the management of indicator, short and long term of prophylactic platelet transfusion in patient with myelodysplastic syndrome (MDS). We searched the latest evidence-based guidelines in PubMed,reviewed and appraised these guidelines. Clinical decision was made based on the guidelines and the actual patient with MDS. Perfect treatment effect was obtained through evidence-based clinical decision.
ObjectiveTo evaluate the quality, status of clinical practice guidelines on stomatology in China and discuss existing problems, so as to provide references for developing evidence-based guidelines. MethodsComprehensive search was conducted up to January 2014 for relevant clinical practice guidelines on stomatology, and the retrieval date was January 30th, 2014. After data extraction from eligibility guidelines, the quality was evaluated using the AGREE Ⅱ instrument and then descriptive analysis was performed. ResultsFinally a total of 18 guidelines were included, of which, 13 were for oral and maxillofacial surgery diseases. Based on the AGREE Ⅱ instrument, the average scores on the six domains were as follows:71.1% for scope and purpose, 40.1% for stakeholder involvement, 28.8% for rigor of development, 71.5% for clarity of presentation, 42.6% for applicability, and 8.6% for editorial independence. ConclusionThe overall quality of clinical practice guidelines on stomatology in China is relatively poor, only a few diseases are concerned, and no evidence-based guideline has been developed so far. However, considered the limitations of this study, the results of this study is only for a reference.
This article discussed the development and current situation about both national and international diagnostic practice guidelines, as well as the role of evidence based medicine and systematic reviews in the development of such guidelines. Authors also analyzed the opportunities and challenges developers faced, and the methods and processes of development. Finally, authors proposed several strategic suggestions about how to improve the quality of diagnostic practice guideline in China.
Objective To investigate and analyze the status of clinical guidelines of children in China, so as to regulate the development of children’s evidence-based clinical guidelines and provide recommendations for children’s clinical guidelines. Methods Names of guidelines, year and institution of publication, methodology of development and reference number were descriptively analyzed. Years of publication and diseases of guidelines were analyzed with statistical graphs. AGREE instrument was used to evaluate the evidence-based guidelines of children. Results a) Of 91 clinical guidelines of children, 62 were translations. Of 29 guidelines ourselves, nine were traditional Chinese medicine guidelines and five (17%) were evidence-based guidelines; b) Guideline on Rational Use of Antibiotics in Acute Respiratory Infections (Probation), the first guideline of children, was published in 1999. Guidelines of children was not published until 2005. Then, the number of guidelines was increasing each year and reached a peak in 2008. Of 13 guidelines in 2008, seven were traditional Chinese medicine guidelines. Guidelines on respiratory diseases were 14 ranked as the top; c) Guidelines on congenital deformity and chromosomal abnormalities, tumor, circulatory system disease, blood disease and western guideline on communicable disease were not formulated in China; and d) Average scores on six domain of five evidence-based guidelines were 84.4%, 37.5%, 74.3%, 90.0%, 22.2%, 46.6%, respectively. Guide on Diagnosis and Treatment of Children Aged 0 to 5 with Acute Fever of Unknown Etiology was bly recommended, Guide on Management of Children with Community-Acquired Pneumonia, Evidence-Based Guide on Diagnosis and Treatment of Children with Common Kidney Disease, Guide on Nutrition Support of Newborn, Guide on Diagnosis and Treatment of Children with Chronic Cough were recommended. Conclusion Clinical guidelines of children in China begin late, develop slowly and are lack of update. A standard on development of guidelines is needed. The government should increase the fund of development, implementation and promotion of guidelines. Recommendations for high-quality guidelines should be included in procedure of medical quality assurance. Compliance of guidelines should be provided by organization which formulatesd the guideline, so as to promote the application of high-quality guidelines.
ObjectiveTo systematically review the quality of evidence-based guidelines (EBGs) on medication therapy for children with vitamin D deficiency, and to compare differences and similarities of the drugs recommended, in order to provide guidance for clinical practice. MethodsDatabases such as the TRIP, PubMed, EMbase, CNKI, VIP, WanFang Data, CBM, National Guideline Clearinghouse and Guidelines International Network were searched to collect EBGs on medication therapy for children with vitamin D deficiency. The methodological quality of the guideline was evaluated according to the AGREE Ⅱ instrument, and the differences between recommendations were compared. ResultsA total of 9 EBGs were included. Among them, 3 guidelines were developed by America, 1 by Europe, 1 by France, 1 by China, 1 by Poland, 1 by Canadian and 1 guideline was by Australia and New Zealand. Seven guidelines were developed specially for children, while others were for people of different ages. According to the AGREE Ⅱ instrument, only "Scope and purpose" and "clarity and presentation" were scored more than 60%. The recommendations of different guidelines were of large different. ConclusionThe quality of included guidelines concerning children with vitamin D deficiency is vary. Although only the America 2011 guideline is of high quality, the strength of recommendation is not high. Thus, the development of national guidelines is urgently needed.
ObjectiveTo systematically assess the quality of evidence-based clinical guidelines and to compare the differences and similarities between recommendations, so as to provide references for clinical application. MethodsDatabases such as the TRIP, PubMed, CNKI, VIP, WanFang Data, CBM, National Guideline Clearinghouse and Guidelines International Network were searched to collect evidence-based guidelines on medication therapy for children with rheumatic fever. Methodological quality of included guidelines was assessed according to the AGREE Ⅱ instrument, and differences and similarities among recommendations were compared. ResultsOnly one evidence-based clinical guideline from Australia was included. Among 6 domains which were rated using the AGREE Ⅱ instrument, "scope and purpose", "stakeholder involvement", "rigor of development", "clarity and presentation" and "applicability" were scored more than 50%; while "editorial independence" was scored less than 50%. ConclusionThe included guideline is of relatively high quality; however, its application among Chinese population still has limitations. Thus, the development of national guidelines is urgently needed.
ObjectiveTo systematically review the quality of evidence-based guidelines (EBGs) on medication therapy for neonatal bacterial meningitis, and compare differences and similarities of the drugs recommended, in order to provide references for clinical application. MethodsDatabases such as the TRIP, PubMed, CNKI, VIP, WanFang, CBM, National Guideline Clearinghouse and Guidelines International Network were searched to collect evidence-based guidelines on medication therapy for neonatal bacterial meningitis. Methodological quality of included studies was assessed according to the AGREE Ⅱ instrument, and the differences and similarities among recommendations were compared. ResultsA total of 4 EBGs were included. Among them, one guideline was developed by the America and three guidelines were by the UK. Only one guideline was developed specially for neonates, while the rest were for neonates and children of different ages. According to the AGREE Ⅱ instrument, "scope and purpose", "stakeholder involvement", "rigor of development", "clarity and presentation", "applicability" and "editorial independence" were scored more than 60%. The recommendations of different guidelines were basically the same, only with conflicts in some areas. ConclusionAlthough most guidelines concerning neonatal bacterial meningitis are of high quality, grading levels of evidence and strength of recommendation should be unified.
Evidence grading and recommendation strength assessment are key steps in the development of evidence-based guidelines, and have made significant progress in recent years. This article systematically reviews the development and evolution of evidence grading and recommendation strength in the past 30 years, and introduces the main representative standards. At the same time, a brief introduction is given to the guidelines and consensus evaluation results published in the field of neurological diseases in China, and future improvements are proposed. This article aims to help readers understand the development patterns of evidence grading and recommendation strength, in order to better understand the guidelines, and to develop more standardized guidelines.
In this article, three research cases are introduced to show the rationale of analysis of papers cited in evidence-based guidelines and the implementation steps. The ultimate goal of medical research is to promote health; evidence-based guidelines are of most importance to medical practice, which can be directly used in clinical practice and health prevention. One of the ways in which research can influence practice is through its contribution to being references of guidelines, and it’s a new way to evaluate biomedical research’s “payback” on health.