Clinical practice guidelines in primary care are important tools to guide primary care practice, but they are found with relatively low quality and unstandardized reporting on the whole.
To develop the reporting guideline for clinical practice guidelines in primary care based on the Reporting Items for practice Guidelines in HealThcare (RIGHT) .
According to the reporting methods recommended by EQUATOR Network, an item development group and an expert consensus group were established to develop reporting guideline for clinical practice guidelines in primary care. Content analysis, brainstorming, and topic analysis were used in developing the initial items. The Delphi survey was conducted to determine the final items.
Thirteen items (five were modified and eight were added) were developed initially, covering five domains: guideline title, health issues, intended setting, recommendations and suggestions for future research. Then the initial item checklist was revised to a final version consisting of 15 items according to the results of two rounds of Delphi survey (with 100% response rates from 22 experts) conducted from December 2 to December 26, 2022.
This reporting checklist will provide a detailed guide for developers of guidelines in primary care, which will further improve the reporting quality of guidelines in primary care, especially that of those in China.
The clinical practice guidelines in general practice can improve healthcare quality in primary health care, however, no study has yet systematically investigated the current status and quality of the guidelines in China.
To investigate the current status and influencing factors of quality of the guidelines in China.
We searched China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, Chinese biomedical literature database, and CQVIP website, and included the published guidelines in China. We analyzed the basic characteristics and used RIGHT to evaluate the reporting quality and AGREE-China for methodological quality.
A total of 150 guidelines were included, mainly published from 2019 to 2021. Most of the guidelines〔108 (72.0%) 〕focused on the diagnosis and treatment of diseases. The top three specialties were cardiovascular disease〔40 (26.7%) 〕, gastroenterology〔31 (20.7%) 〕, and clinical pharmacy〔27 (18.0%) 〕. The main development institutions were the Chinese Medical Association and its branches〔123 (82.0%) 〕, the editorial committee of the Chinese Journal of General Practitioners〔119 (79.3%) 〕, and the Chinese Medical Journals Publishing House〔116 (77.3%) 〕. In terms of reporting quality, the average reporting rate of RIGHT was 23.6% (11.4%-42.9%) ; the reporting rate of basic information (59.8%) was higher, and that of evidence (0.3%) was the lowest. As for methodological quality, the average AGREE-China score was 23.4 (12.0-40.0) ; the reporting rates of conflicts of interest (63.0%) and availability/feasibility (53.0%) were higher, and that of economics (7.0%) was the lowest.
The number of Chinese clinical practice guidelines in general practice has increased rapidly in the past five years, which has played an important role in promoting the quality of primary health care. In the future, it is necessary to further develop the guidelines in different specialties and diseases and accelerate the methodology of development and reporting of the guidelines.
Evidence-based medicine has greatly contributed to the improvement of the level of medical services and health regulation. However, the critical use of the published medical literature and medical databases by Chinese clinical practitioners is insufficient, and the achievements of cutting-edge research methods of evidence-based medicine are not used by every Chinese clinical practitioner for benefit. This article provided a concise and well understood methodological illustration of the development of evidence-based medicine practice guidelines, to help Chinese clinical practitioners better understand the philosophy of guideline development by presenting the definitions of clinical practice guidelines and sorting out the standard development process of the guidelines. This paper analyzes from three parts, "Formulation of Clinical Practice Guidelines""Problems Existing in the Formulation of Clinical Practice Guidelines" and "How Clinicians Apply Clinical Guidelines". In this paper, the two guideline development standards, published by World Health Organization (WHO) and together with Guideline International Network (GIN) and McMaster University, were simplified, combined and summarized into were more concise. The problems existing in the formulation of clinical practice guidelines are analyzed with cases, in order to guide clinicians to apply the guidelines.
