Clinical Epidemiology in China series. Paper 4: The reporting and methodological quality of Chinese clinical practice guidelines published between 2014 and 2018: A systematic review

Qi Zhou; Zijun Wang; Qianling Shi; Siya Zhao; Yangqin Xun; Hui Liu; Hairong Zhang; Xiao Liu; Xiaoqin Wang; Liang Yao; Qi Wang; Qinyuan Li; Janne Estill; Kehu Yang; Yaolong Chen

doi:10.1016/j.jclinepi.2021.08.013

Clinical Epidemiology in China series. Paper 4: The reporting and methodological quality of Chinese clinical practice guidelines published between 2014 and 2018: A systematic review

J Clin Epidemiol. 2021 Dec:140:189-199. doi: 10.1016/j.jclinepi.2021.08.013. Epub 2021 Aug 18.

Authors

Qi Zhou¹, Zijun Wang², Qianling Shi³, Siya Zhao⁴, Yangqin Xun², Hui Liu⁴, Hairong Zhang², Xiao Liu⁴, Xiaoqin Wang⁵, Liang Yao⁶, Qi Wang⁷, Qinyuan Li⁸, Janne Estill⁹, Kehu Yang¹⁰, Yaolong Chen¹¹

Affiliations

¹ Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Lanzhou University Institute of Health Data Science, Lanzhou, China.
² Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
³ The First School of Clinical Medicine, Lanzhou University, Lanzhou, China.
⁴ School of Public Health, Lanzhou University, Lanzhou, China.
⁵ The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, L8S 4L8, Canada.
⁶ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, L8S 4L8, Canada.
⁷ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, L8S 4L8, Canada; McMaster Health Forum, McMaster University, Hamilton, Ontario, L8S 4L8, Canada.
⁸ Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China.
⁹ Institute of Global Health, University of Geneva, Geneva, Switzerland; Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland.
¹⁰ Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China; Lanzhou University GRADE Centre, Lanzhou, China. Electronic address: yangkh-ebm@lzu.edu.cn.
¹¹ Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Lanzhou University Institute of Health Data Science, Lanzhou, China; Lanzhou University GRADE Centre, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China. Electronic address: chevidence@lzu.edu.cn.

PMID: 34416326
DOI: 10.1016/j.jclinepi.2021.08.013

Abstract

Objective: This study aimed to systematically review the methodological and reporting quality of clinical practice guidelines (CPGs) developed in China and published in medical journals between 2014 and 2018.

Study design and setting: We conducted a comprehensive search in multiple databases: MEDLINE (via PubMed), Embase, CBM (China Biology Medicine), CNKI (China National Knowledge Infrastructure) and Wanfang Data. We included all clinical practice guidelines developed in China between 2014 and 2018. The AGREE II tool and the RIGHT checklist were used to appraise the methodological quality and reporting quality of the included guidelines, respectively.

Results: We identified 17,188 records, and included finally 573 CPGs. Most (n=507, 88.5%) were published in Chinese, and 508 (88.7%) were about Western medicine. Only 62 (10.8%) of the guidelines used the GRADE approach. The mean overall score of methodological quality over all guidelines was 19.4%, and the mean scores for the AGREE II domains were 28.6% (Scope and purpose), 17.0% (Stakeholder involvement), 11.7% (Rigor of development), 32.2% (Clarity of presentation), 14.2% (Applicability) and 12.8% (Editorial independence). The mean overall score for reporting quality over all guidelines was 30.2%, with the following mean scores for each RIGHT domain: 55.6% (Basic information), 43.8% (Background), 14.5% (Evidence), 29.2% (Recommendations), 10.7% (Review and quality assurance), 12.6% (Funding and declaration of interest) and 8.4% (Other information). Subgroup analyses found that both the methodological and reporting quality were generally higher among CPGs that used evidence grading systems or reported receiving funding.

Conclusion: Both the methodological quality and the reporting quality of CPGs developed in China have improved over time, but are still below the international average.

Keywords: AGREE II; Clinical practice guideline; Methodological quality; RIGHT; Reporting quality; Systematic review.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

China
Humans
Periodicals as Topic / standards*
Practice Guidelines as Topic / standards*