Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China.
Chin Med J (Engl). 2012 Oct;125(20):3660-4.
Clinical practice guidelines (CPGs) play an important role in healthcare in China as well as in the world. However, the current status and trends of Chinese CPGs are unknown. The aim of this study was to systematically review the present situation and the quality of Chinese CPGs published in the peer-reviewed medical literature.
To identify Chinese CPGs, a systematic search of relevant literature databases (CBM, WANFANG, VIP, and CNKI) was performed for the period January 1978 to December 2010. We used the AGREE II instrument to assess the quality of the included guidelines.
We evaluated 269 guidelines published in 115 medical journals from 1993 to 2010 and produced by 256 different developers. Only four guidelines (1%) described the systematic methods for searching and selecting the evidence, 14 (5%) guidelines indicated an explicit link between the supporting evidence and the recommendations, only one guideline used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Thirty-one guidelines (12%) mentioned updates and the average frequency of update was 5.5 years; none described a procedure for updating the guideline. From the assessment with the Appraisal of Guidelines for Research and Ecaluation II (AGREE II), the mean scores were low for the domains "scope and purpose" (19%) and "clarity of presentation" (26%) and very low for the other domains ("rigour of development" 7%, "stakeholder involvement" 8%, "applicability" 6% and "editorial independence" 2%).
Compared with other studies on the quality of guidelines assessed with the AGREE instrument in other countries, Chinese CPGs received lower scores, which indicates a relatively poor quality of the guidelines. However, there was some increase over time.
临床实践指南（CPGs）在中国乃至世界的医疗保健中都发挥着重要作用。然而，目前中国 CPG 的现状和趋势尚不清楚。本研究旨在系统地回顾已发表的同行评议医学文献中中国 CPG 的现状和质量。
为了确定中国 CPG，我们对相关文献数据库（CBM、WANFANG、VIP 和 CNKI）进行了系统检索，检索时间为 1978 年 1 月至 2010 年 12 月。我们使用 AGREE II 工具评估纳入指南的质量。
我们评估了 1993 年至 2010 年发表在 115 种医学期刊上的 269 条指南，这些指南由 256 个不同的开发者编写。只有 4 条指南（1%）描述了系统地搜索和选择证据的方法，14 条指南（5%）明确指出了支持证据与建议之间的联系，只有 1 条指南使用了推荐评估、制定和评估分级（GRADE）系统。31 条指南（12%）提到了更新，平均更新频率为 5.5 年；没有描述更新指南的程序。从评估指南研究和评估 II（AGREE II）来看，“范围和目的”（19%）和“表述清晰度”（26%）这两个领域的平均得分较低，其他领域的得分则非常低，包括“制定严谨性”（7%）、“利益相关者参与”（8%）、“适用性”（6%）和“编辑独立性”（2%）。
与使用 AGREE 工具评估其他国家指南质量的其他研究相比，中国 CPG 的得分较低，这表明指南的质量相对较差。然而，随着时间的推移，这种情况有所改善。
