Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China; Evidence-Based Medicine Center, Peking University, Beijing, China.
J Eval Clin Pract. 2013 Oct;19(5):961-7. doi: 10.1111/j.1365-2753.2012.01893.x. Epub 2012 Jul 29.
Clinical guidelines are an important tool for improving service quality, the benefits of guidelines depend on their quality. In China, there has been a great increase in production of guidelines. However, little is known about their quality.
We identified Chinese guidelines published between 2006 and 2010 by searching three Chinese full-text databases, major Chinese guidelines websites and Google. Three appraisers independently evaluated each guideline by using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Subgroup analyses were performed according to source, title, version, aspect of care and developer of guidelines.
A total of 327 guidelines were eligible and 57 were excluded for their lacking of any account of the guideline development methodology. Of the 270 guidelines, 77 (28.5%) can be recommended, 6 (2.2%) were evidence-based guidelines. Sixteen (5.9%) guidelines described the methods used to search for evidence, 61 (22.6%) appraised the quality of evidence and 53 (19.6%) graded the strength of recommendations. Two guidelines declared the involvement of methodological experts and none reported considering patients' values. 29 (10.7%) guidelines received drug company sponsorship but only two declared the views of the funding bodies did not influence the recommendations, 259 (95.9%) didn't declare the interest conflicts of guideline developers. Guidelines downloaded from Internet and with updated versions yielded higher quality than the rest.
Although numerous guidelines were produced in China, the quality was generally low. Focusing on improving the quality of Chinese guidelines, rather than continuing to produce them in great quantity, is urgently needed.
临床指南是提高服务质量的重要工具，指南的效益取决于其质量。在中国，指南的数量大幅增加。然而，其质量却鲜为人知。
我们通过检索三个中文全文数据库、主要的中文指南网站和 Google，确定了 2006 年至 2010 年期间发表的中国指南。三名评估员使用评估研究和评估指南（AGREE）工具，独立评估每个指南。根据指南的来源、标题、版本、护理方面和开发者进行了亚组分析。
共有 327 条指南符合条件，57 条指南因缺乏指南制定方法的任何说明而被排除在外。在这 270 条指南中，有 77 条（28.5%）可推荐，6 条（2.2%）为基于证据的指南。有 16 条（5.9%）指南描述了搜索证据所使用的方法，61 条（22.6%）评估了证据的质量，53 条（19.6%）对推荐的强度进行了分级。有两条指南声明了方法学专家的参与，没有一条指南报告考虑了患者的价值观。29 条（10.7%）指南接受了制药公司的赞助，但只有两条声明资助机构的观点不会影响建议，259 条（95.9%）指南没有声明指南开发者的利益冲突。从互联网下载的和有更新版本的指南质量高于其他指南。
尽管中国制定了大量的指南，但总体质量较低。迫切需要关注提高中国指南的质量，而不是继续大量生产。
