Using RIGHT (Reporting Items for Practice Guidelines in Healthcare) to evaluate the reporting quality of WHO guidelines.

BACKGROUND: Without adequate reporting of research, valuable time and resources are wasted. In the same vein, adequate reporting of practice guidelines to optimise patient care is equally important. Our study examines the quality of reporting of published WHO guidelines, over time, using the RIGHT (Reporting Items for Practice Guidelines in HealThcare) reporting checklist. METHODS: We examined English-language guidelines approved by the WHO Guidelines Review Committee from inception of the committee in 2007 until 31 December 2017. Pairs of independent, trained reviewers assessed the reporting quality of these guidelines. Descriptive data were summarised with frequencies and percentages. RESULTS: We included 182 eligible guidelines. Overall, 25 out of the 34 RIGHT items were reported in 75% or more of the WHO guidelines. The reporting rates improved over time. Further, 90% of the guidelines reported document type in the title. The identification of evidence, the rationale for recommendations and the review process were reported in more than 80% of guidelines. The certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was assessed in 81% of the guidelines assessed. While 82% of guidelines reported funding sources, only 25% mentioned the role of funders. CONCLUSIONS: WHO guidelines provide adequate reporting of many of the RIGHT items and reporting has improved over time. WHO guidelines compare favourably to guidelines produced by other organisations. However, reporting can be further improved in a number of areas.

Evaluation of the quality of guidelines for assisted reproductive technology using the RIGHT checklist: A cross-sectional study.

INTRODUCTION: In recent years, assisted reproductive technology (ART) has developed rapidly, leading to an increasing number of clinical practice guidelines in this field. However, the reporting quality of current clinical practice guidelines in ART is still unknown. Objective To evaluate the reporting quality of clinical practice guidelines in the field of ART using the RIGHT checklist. METHOD: Relevant guidelines were identified by electronic search of PubMed, Chinese Biomedical Literature Database (CBM), Wan Fang Database and Chinese National Knowledge Infrastructure (CNKI) from the beginning of the database to October, 2017. We also searched the websites of the guideline development organizations, including Guidelines International Network (GIN), National Guideline Clearinghouse (NGC) and the National Institute for Health and Care Excellence (NICE), as well as from two medical associations, including the European Society of Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM). We used Google Scholar to find additional clinical practice guidelines (CPGs) as well. Two investigators searched the database, selected guidelines independently based on the inclusion criteria, and extracted the relevant information. RESULT: Fifteen guidelines (i.e. six developed by individual institutions and 9 by associations) were included. On average, 12.7 out of 35 items in the RIGHT standard (36.3%) were reported in each guideline. Five items were not reported by any of these guidelines. The reporting proportion of the seven domains (i.e. Basic information; Background; Evidence; Recommendations; Review and quality assurance; Funding and declaration and management of interests; Other information) were 46.7%, 40.8%, 45.3%, 29.5%, 53.3%, 10.0%, 26.7%, respectively. CONCLUSION: At present, the reporting quality of guidelines for ART is poor, especially regarding the funding. In the future guideline development, more consideration should be given to reporting, dissemination and implementation.

Therapeutic effect of angelica and its compound formulas for hypertension and the complications: Evidence mapping.

BACKGROUND: Hypertension is one of the common diseases, which brings heavy burden to human race. Currently, western medication is in absolutely dominant position in the treatment of hypertension, but it maintains for a short time and there are various side effects and drug tolerance. Therefore, Chinese medicine has attracted great attention in the treatment field of hypertension, and angelica is one of the most frequently used herbs. OBJECTIVES: In order to give some inspiration to researches in these fields, this article presents the current research status of angelica and its compound formulas treating hypertension and its complications with evidence mapping. METHODS: Main databases were systematically searched, and researches about angelica or its compound formulas containing angelica treating hypertension or its complications were included. EXCEL 2013 was used to integrate and process the data, and the result is showed intuitively with the bubble diagram. RESULTS: 49 RCTs were included after screening. The articles recruited were published with a rising trend along with time. Of the 49 RCTs, there is the outcome measure of general the efficacy in the result part in 34 RCTs (69.4%), and all the clinical effective rate in the angelica intervention group is significantly higher than the control group. There is the outcome measure of reduction of MAP in the result part in 28 RCTs, and 27 RCTs (96.4%) showed that the angelica intervention group is significantly improved than the control group while 1 (3.6%) showed no significant differences. There is the outcome measure of efficacy of target organ protection in the result part in 26 RCTs, and 25 RCTs (96.2%) showed that there is significant difference between the angelica intervention group and the control group. Of the 49 RCTs, there is the outcome measure of adverse effects in the result part in 17 RCTs. 14 RCTs (82.4%) reported no adverse effects, 2 RCTs (11.8%) reported adverse effects rate as lower than 10%, and 1 RCT (7.1%) reported adverse effects rate as higher than 40%. CONCLUSION: Current research with low quality has revealed that angelica is effective in reduction of MAP and target organ protection and the adverse effects rate is low, and the effectiveness and safety of angelica needs to be proved by further researches with high quality. Researches of high quality are needed to provide scientific evidence for angelica in treating hypertension and its complications.

[Treatment of anovulatory infertility by tonifying kidney and promoting blood circulation].

Infertility is a common disease in women of childbearing age and is also a refractory disease. Anovulatory dysfunction is one of the main causes of female infertility, and the incidence of anovulatory infertility has been increasing year by year. Traditional Chinese medicine has unique advantages and definite curative effect on the treatment of this disease. Kidney deficiency is the basic pathogenesis and blood stasis is an important factor that has been through. Flexible of tonifying the kidney and promoting blood circulation treatment of anovulatory infertility in clinic, has achieved remarkable curative effect. Kidney deficiency and blood stasis is a common form of gynecological disease. After years of clinical practice, we also found that patients with anovulatory infertility were more common with kidney deficiency and blood stasis. The kidneys and blood are not isolated from each other, but interact and influence each other. Kidney deficiency and blood stasis interact as both cause and effect, they have very close relationship. To achieve the purpose of urinary Tiangui, Chongren, ovulation and pregnancy miscarriage by tonifying the kidney and promoting blood circulation.

[Features of Professor Ma Kun's medication in treating ovulatory infertility].

In order to analyze Professor Ma Kun's medication in treating anovulatory infertility, her prescriptions for treating anovulatory infertility in 2012-2015 were collected. The medication features and the regularity of prescriptions were mined by using traditional Chinese medicine inheritance support system, association rules, complex system entropy clustering and other mining methods. Finally, a total of 684 prescriptions and 300 kinds of herbs were screened out, with a total frequency of 11 156 times; And 68 core combinations and 8 new prescriptions were mined. The top three frequently used herbs by effect were respectively tonic herb, blood circulation promoting herb, and Qi-circulation promoting herb. The top three tastes were sweetness, bitterness and pungent flavor. The results showed 28 herbs with a high frequency of ≥100.The top 10 frequently used herbs were respectively Angelica Sinensis Radix, Cyperi Rhizoma, Chuanxiong Rhizome, Paeoniae Radix Rubra, Cyathulae Radix, Taxilli Herba, Cuscutae Semen, Codonopsis Radix, Ligustri Lucidi Fructus, Paeoniae Albaand Paeoniae Radix Alba. The association rules analysis showed commonly used herbal pairs, including Rehmanniae Radix Preparata-Chuanxiong Rhizome, Rehmanniae Radix Preparata-Angelica Sinensis Radix, Cuscutae Semen-Dipsaci Radix. In conclusion, Professor Ma has treated anovulatory infertility by nourishing the kidney and activating blood throughout the treatment course, and attached the importance to the relationship between Qi and blood and there gulation of liver, spleen and kidney in treating anovulatory infertility.

[Systematic review on Bushen Huoxue ricipe in treating patients suffering from diminished ovarian reserve].

To systematically evaluate the efficacy and safety of Bushen Huoxue ricipe in treating patients suffering from diminished ovarian reserve. Databases such as CNKI, WanFang, VIP, CBM, PubMed, EMbase and Cochrane Library were searched on randomized controlled trial/quasi-randomized controlled trial about Bushen Huoxue ricipe in treating patients suffering from diminished ovarian reserve form the inception of the study until June 2017. The studies were screened according to inclusion and exclusion criteria. Risk of bias evaluation tools were adopted to conduct quality evaluation. Meta-analysis on outcome indicator was performed by RevMan Version 5.3 Software. Due to the different Bushen Huoxue recipe (observation group) and the different Western medicine(control group) of all included studies, the effect size was combined by the random effect model after the subgroup analysis or sensitivity analysis was performed. Eventually 11 trials were included, including 733 cases of patients. Results of Meta-analysis indicated that, Bushen Huoxue recipe had advantages over Western medicine on lowering FSH, increasing AMH and AFC, enhancing the Chinese medicine symptom curative effect; Bushen Huoxue recipe had no advantages over Western medicine on increasing E2; the advantages of Bushen Huoxue recipe were not clear on reducing FSH/LH and increasing total effective rate because of the different outcomes to compared with the different Western medicine; no serious adverse reaction appering from Bushen Huoxue recipe was reported in the including researches. Bushen Huoxue recipe has the clinical curative effect and high safety suffering from diminished ovarian reserve. However, limited by the poor quantity of studies, these conclusions remain to be examined by more center, more sample and high-quality studies.