Jiang Mei, Liao Li-Yue, Liu Xiao-Qing, He Wei-Qun, Guan Wei-Jie, Chen Hao, Li Yi-Min
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical University, Guangzhou.
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical University, Guangzhou; State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical University, Guangzhou.
Chest. 2015 Sep;148(3):759-766. doi: 10.1378/chest.14-3201.
There has been a significant increase in the publication of clinical practice guidelines (CPGs) for respiratory diseases in China. However, little is known about the quality and potential impacts of these CPGs. Our objective was to critically evaluate the quality of Chinese CPGs for respiratory diseases that were published in peer-reviewed medical journals.
A systematic search of scientific literature published between 1979 and 2013 was undertaken to identify and select CPGs that were related to respiratory diseases. Four Chinese databases (the Chinese Biomedical Literature database [CBM], the China National Knowledge Infrastructure [CNKI], the VIP database, and the WANFANG database) were used. The quality of eligible guidelines was assessed independently by four reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. The overall agreement among reviewers was evaluated using an intraclass correlation coefficient.
A total of 109 guidelines published in 27 medical journals from 1979 to 2013 were evaluated. The overall agreement among reviewers was considered good (intraclass correlation coefficient, 0.838; 95% CI, 0.812-0.862). The scores of the six AGREE domains were low: 57.3% for scope and purpose (range, 4.2%-80.5%), 23.8% for stakeholder involvement (range, 2.8%-54.2%), 7.7% for rigor of development (range, 0%-27.1%), 59.8% for clarity and presentation (range, 22.2%-80.6%), 10.9% for applicability (range, 0%-22.9%), and 0.6% for editorial independence (range, 0%-16.7%). Scores for all guidelines were below 60%, and only three guidelines (2.8%) were recommended for clinical practice with modifications.
The quality of the guidelines was low, and stakeholder involvement, rigor of development, applicability, and editorial independence should be considered in the future development of CPGs for respiratory diseases in China.
中国呼吸系统疾病临床实践指南（CPG）的发表数量显著增加。然而，对于这些CPG的质量和潜在影响知之甚少。我们的目的是严格评估发表在同行评审医学期刊上的中国呼吸系统疾病CPG的质量。
对1979年至2013年间发表的科学文献进行系统检索，以识别和选择与呼吸系统疾病相关的CPG。使用了四个中文数据库（中国生物医学文献数据库[CBM]、中国知网[CNKI]、维普数据库和万方数据库）。由四名评审员使用《研究与评价指南评估》（AGREE）II工具独立评估符合条件的指南的质量。使用组内相关系数评估评审员之间的总体一致性。
对1979年至2013年间在27种医学期刊上发表的共109份指南进行了评估。评审员之间的总体一致性被认为良好（组内相关系数，0.838；95%CI，0.812 - 0.862）。AGREE六个领域的得分较低：范围和目的为57.3%（范围，4.2% - 80.5%），利益相关者参与为23.8%（范围，2.8% - 54.2%），制定的严谨性为7.7%（范围，0% - 27.1%），清晰度和呈现为59.8%（范围，22.2% - 80.6%），适用性为10.9%（范围，0% - 22.9%），编辑独立性为0.6%（范围，0% - 16.7%）。所有指南的得分均低于60%，只有三份指南（2.8%）被推荐经修改后用于临床实践。结论：这些指南的质量较低，在中国未来制定呼吸系统疾病CPG时应考虑利益相关者参与、制定的严谨性、适用性和编辑独立性。
