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@#Objective To evaluate the methodological quality of clinical practice guidelines of rehabilitation using Appraisal of Guidelines for Research and Evaluation (AGREE) II.Methods Clinical practice guidelines of rehabilitation were searched in databases such as PubMed, EMBASE, Wanfang database, CNKI, China Biology Medicine disc and related websites from medlive.cn, National Institute for Health and Care Excellence, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, World Health Organization, and Guidelines International Network from establishment to January 11, 2020. Two researchers reviewed literatures and assessed the methodological quality of the guidelines independently by using AGREE II; any disagreements needed to be discussed in a consensus meeting.Results A total of 84 guidelines were included in the study, with 67 foreign guidelines and 17 domestic guidelines. The average score rate for all the guidelines was 48.1%, in which 49.9% for the foreign guidelines and 40.7% for the domestic guidelines. In the six areas of AGREE II, the average score rate of the foreign guidelines was higher than that of domestic ones (|Z| > 2.034, P < 0.05), expect applicability; the average score rate of clarity and independence improved with the launch of AGREE Ⅱ ( Z > 2.130, P < 0.05). The average scores rate ranged from high to low followed as range and purpose (41.6%), clarity (39.9%), participants (24.5%), rigor (23.2%), independence (15.5%) and applicability (12.9%). Conclusion Clinical practice guidelines of rehabilitation is mainly of low quality by AGREE II. Guideline developers need to work after AGREE Ⅱ standard in the future.
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OBJECTIVE: To systematically review the related guidelines of nutrition support therapy (hereinafter referred to as nutrition support) in acute respiratory disease, and to provide evidence-based evidences for clinical nutrition in coronavirus disease 2019 (COVID-19). METHODS: Retrieved from PubMed, EMBase, CNKI, etc., websites of association in nutrition and global guideline databases. The guidelines in nutrition support for related diseases were collected. Recommendations were summarized after data extraction and quality evaluation. RESULTS: A total of 10 guidelines were enrolled, with development time ranging from 2006 to 2019. There were 6 guidelines with quality of level A, 3 with level B, and 1 with level C. “scope and purpose”, “clarity” and “independence” showed the higher scores in AGREE Ⅱ, and “applicability” showed generally low scores. There were differences among emphases of guidelines, however, supplements for each other, and the recommendations for the same questions showed substantial agreement. CONCLUSION: The recommendations, in high quality guidelines of critical illness, acute respiratory distress syndrome, pneumonia, etc., could be applied to nutrition support in COVID-19.
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Objective@#To evaluate Chinese clinical practice guideline/consensus for digestive diseases published in the past five years in order to recommend the high-quality guidelines and help with the promotion and implementation of them.@*Methods@#From January 2013 to June 2018, the officially published Chinese practice guideline/consensus for digestive diseases were selected. The inclusion and exclusion criteria of the guideline/consensus was evaluated by "Evaluation Criteria for Chinese Clinical Practice Guidelines 2017(AGREE-China 2017)" . The guideline/consensus were independently scored by three evaluators and then calculated the average value. Descriptive analysis methods were used to analyze the Chinese clinical practice guideline/consensus for digestive diseases. Those with the total score more than 40.0 points were included in the recommended list.@*Results@#A total of 119 officially published clinical practice guideline/consensus of digestive diseases were retrieved, and 74 clinical practice guideline/consensus for digestive diseases were included in the evaluation. Among them, 18 (24.3%, 18/74) scored over 60.0 points, 31 (41.9%, 31/74) scored between 40.0 and 59.9 points. Finally 48 guideline or consesus were selected for the recommended list 19 cases of esophagus and gastrointestinal diseases, 18 cases of liver diseases, five cases of biliary and pancreafic diseases, and six cases of digestive endoscopy. The three guideline/consensus with the high scores (> 80.0 points) were The Fifth Chinese National Consensus Report on the Maragement of Helicobacter pylori Infection, Consensus on the Diagnosis and Treatmeat of Cholestatic Liver Disease (2015) and Guidelines for the Prevention and Treatment of Chroaic Hepatitis B (2015 Update). The higher the score of the guideline/consensus, the more scientific and rigorous the method, and the clearer the evaluation of evidence grade and the description of the formation of recommendations. Compared with international standards of guideline/consensus development, there are still some problems in Chinese guidelines or consensus such as no explanation of retrieval strategy, no basis of evidence classification and no description of the formation process from evidence to recommendation.@*Conclusions@#The quality of Chinese clinical practice guideline/consensus for digestive diseases has been improved year by year. However the scientific aspects need to be further improved. AGREE-China which demonstrates good validity, realiability and practicability is easy and clear to use.
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Objective To evaluate Chinese clinical practice guideline/consensus for digestive diseases published in the past five years in order to recommend the high-quality guidelines and help with the promotion and implementation of them.Methods From January 2013 to June 2018,the officially published Chinese practice guideline/consensus for digestive diseases were selected.The inclusion and exclusion criteria of the guideline/consensus was evaluated by " Evaluation Criteria for Chinese Clinical Practice Guidelines 2017 (AGREE-China 2017)".The guideline/consensus were independently scored by three evaluators and then calculated the average value.Descriptive analysis methods were used to analyze the Chinese clinical practice guideline/consensus for digestive diseases.Those with the total score more than 40.0 points were included in the recommended list.Results A total of 119 officially published clinical practice guideline/consensus of digestive diseases were retrieved,and 74 clinical practice guideline/consensus for digestive diseases were included in the evaluation.Among them,18 (24.3％,18/74) scored over 60.0 points,31 (41.9％,31/74) scored between 40.0 and 59.9 points.Finally 48 guideline or consesus were selected for the recommended list 19 cases of esophagus and gastrointestinal diseases,18 cases of liver diseases,five cases of biliary and pancreafic diseases,and six cases of digestive endoscopy.The three guideline/consensus with the high scores (＞ 80.0 points) were The Fifth Chinese National Consensus Report on the Maragement of Helicobacter pylori Infection,Consensus on the Diagnosis and Treatmeat of Cholestatic Liver Disease (2015) and Guidelines for the Prevention and Treatment of Chroaic Hepatitis B (2015 Update).The higher the score of the guideline/consensus,the more scientific and rigorous the method,and the clearer the evaluation of evidence grade and the description of the formation of recommendations.Compared with international standards of guideline/consensus development,there are still some problems in Chinese guidelines or consensus such as no explanation of retrieval strategy,no basis of evidence classification and no description of the formation process from evidence to recommendation.Conclusions The quality of Chinese clinical practice guideline/consensus for digestive diseases has been improved year by year.However the scientific aspects need to be further improved.AGREE-China which demonstrates good validity,realiability and practicability is easy and clear to use.
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Questionnaires and case investigation methods were taken in this paper, taking the clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for upper respiratory tract infection in children published by the Chinese Medicine Association as the research object. Doctors from 187 hospitals in 29 regions across the country were invited to evaluate the applicability of the Guideline and clinical application effects, so as to collect the opinions on revising the Guideline. Clinicians about 508 accepted the applicability survey of the Guideline, and considered that the structure and content of the Guideline were reasonable, with the proportions being as high as 98.23% and 98.03%, respectively. In the content of syndrome differentiation-based treatment, the factors with higher rationality included therapeutic principle and method (99.41%), diagnosis elements (98.82%), and syndrome differentiation classification (98.03%); while the factors with lower rationality included the rehabilitation and health preserving (97.05%) and complication prevention (97.24%). 98.03% of the clinicians considered theat the Guideline was to be fully applicable and basically applicable, and 1.97% of the clinicians considered it to be applicable after revision. By observing 491 cases, the Guide was applied for evaluation and analysis. The factors with higher compliance included diagnosis of Western medicine disease (100%) and the diagnosis of TCM disease (99.18%); while the factors with lower compliance included the treatment measures, with a compliance rate of 77.18% and 83.05% respectively for simple preparations and other treatment method. The safety and economy of the Guideline were good, 97.35%, 93.89%, respectively. The comprehensive evaluation was good, and 99.41% of the respondents were willing to follow the treatment schemes recommended in the Guideline, suitable for clinical application. The opinions on revision were mainly focused on dialectical treatment, complication prevention and rehabilitation. It indicates that only by actively and extensively soliciting opinions to revise the Guideline, can we improve the quality of the Guideline for clinical practice, so as to raise the level of clinical efficacy.