ObjectivesTo assess the methodological quality of clinical practice guidelines of cervical cancer in China published from 2014 to 2018.MethodsCNKI, WanFang Data, CBM, VIP, Medlive.cn, the National Guideline Clearinghouse, PubMed, The Cochrane Library and EMbase were searched for cervical cancer clinical practice guidelines published in China from January 1st, 2014 to December 31st, 2018. Four reviewers searched and selected the literature independently according to the inclusion and exclusion criteria and assessed the methodological quality of the included guidelines by using AGREE Ⅱ.ResultsA total of 9 guidelines were included. The average score for each area was: scope and purpose 75.47%, stakeholders’ involvement 35.09%, the rigor of development 43.70%, clarity of presentation 87.74%, applicability 80.76%, and editorial independence 0%.ConclusionsThe quality of cervical cancer clinical practice guidelines in China requires further improvement.
1992年,循证医学(evidence-based medicine,EBM)倡导者提出新"范式",即卫生研究证据是对个体病人及卫生系统决策的最好基础.该方法原意是拟除去传统医学知识体系仅关注疾病本身的病理生理过程及临床经验的积累,因此在2001年被lt;纽约时代杂志gt;评为最具影响力的理论之一.本文回顾了循证医学的产生、发展、哲学局限性和临床实践的挑战.指出EBM的演变、发展早已超出它原来(误解的)概念,即EBM有可能替代传统医学.EBM现正力求去增强而不是替代个人的临床经验及了解疾病的机制.并且EBM一定要继续发展、并探讨一系列的问题包括加强科学基础,伦理道德的重要性及其有关传播及应用的实际事务.例如,为了促进科学研究成果用于临床,证据往往都是从经选择过的人群的不完整证据而来,这些人群仅能从那些贵重技术中得到一些边缘性的好处.而证据的应用就会把这些有限的好处普遍化,由此引发出一系列问题即有多少人和谁能用得起这些新的疗法.因此循证医学的倡导者希望医生及用户关注那些来自临床研究、有效且适于临床应用的好证据.而要达到此目标还需做很多的工作.
Objective To explore the methods used for developing evidence-based clinical practice guidelines for acupuncture. Methods Based on the characteristics of acupuncture in traditional Chinese medicine,and principles of evidence-based medicine, this article introduces and summarizes the processes and methods for developing an evidence-based clinical practice guideline for acupuncture. We analyzed similarities and differences between clinical practice guidelines for acupuncture and for other interventions. We used an evidence-based clinical practice guideline of acupuncture for depression as an example to illustrate the methods of literature search, grading of evidence and recommendations, evidence evaluation and consensus formation. Results Preliminary recommendations on the methods for developing evidence-based clinical practice guidelines for acupuncture were made. Conclusion Based on the optimized rational methodology for developing clinical guidelines, evidence-based high-quality clinical practice guidelines for acupuncture could be established.
Chinese guideline for diagnosis and treatment of osteoarthritis (2021 edition) was published in the Chinese Journal of Orthopaedics, providing abundant recommendations on osteoarthritis (OA) issues. In this paper, the methodological and reporting qualities of the guideline were explained and assessed by using quality appraisal tools, such as appraisal of guidelines research and evaluation-China (AGREE-China), Institute of Medicine Committee (IOM), and reporting items for practice guidelines in healthcare (RIGHT). It also aimed to provide personalized treatments for specific patients, support readers in understanding the principle of OA treatment, and standardize OA treatment strategies. In addition, this study would contribute to the clinical promotion of the current guidelines and provide the necessary references for clinical practice guidelines in treating OA in the future.
Chinese medicine (CM) has significant clinical effects in the treatment of tracheal-bronchitis. It is of important clinical significance to formulate guidelines for the diagnosis and treatment of tracheal-bronchitis based on the characteristics of TCM syndrome differentiation. The Respiratory Disease Branch of China Association of Chinese Medicine and Respiratory Disease Branch of China Medical Association of Minorities organized and established a multi-disciplinary background working group, based on the World Health Organization Handbook for Guideline Development and the Guideline Development Handbook for Diagnosis and Therapy of Integrative Medicine to develop this guideline. It was developed through technical links such as clinical problem investigation, evidence collection and evaluation, Delphi consultation, and expert consensus meetings. Based on the current best evidence, CM intervention costs and expert experience, 25 recommendations were established to standardize the etiology and pathogenesis of tracheal-bronchitis, syndrome differentiation and treatment, prevention, and care, etc., which can be used by physicians at different levels of medical institutions.
Neuromuscular disease (NMD) encompasses a group of disorders that affect motor neurons, peripheral nerves, neuromuscular junctions, and skeletal muscles, potentially leading to respiratory muscle impairment and decline in respiratory function, significantly impacting patients' quality of life. In March 2023, clinical practice guideline titled Respiratory Management of Patients with Neuromuscular Weakness was released by the American College of Chest Physicians. This article summarizes, categorizes, and interprets the contents and key points of the guideline, aiming to provide more targeted guidance for clinical healthcare professionals and ultimately enhance the effectiveness of respiratory management for patients with NMD.