The development of clinical guidelines in China: insights from a national survey.
China
Evidence-based practice
Practice guideline
Surveys and questionnaires
Journal
Health research policy and systems
ISSN: 1478-4505
Titre abrégé: Health Res Policy Syst
Pays: England
ID NLM: 101170481
Informations de publication
Date de publication:
23 Dec 2021
23 Dec 2021
Historique:
received:
13
09
2021
accepted:
03
12
2021
entrez:
24
12
2021
pubmed:
25
12
2021
medline:
28
12
2021
Statut:
epublish
Résumé
Previous research suggests that the quality of clinical guidelines (CGs) in China is suboptimal. However, little is known about the methodology that CGs follow. We conducted a national survey of methods used by Chinese CG developers for CG development, adaptation, and updating. We used a previously piloted questionnaire based on methodologies of CG development, adaptation, and updating, which was distributed during September-November 2020 to 114 organizations identified from published Chinese CGs (searched 2017-2020), recommended by Chinese CG developers, and recommended by clinical discipline experts. We collected 48 completed questionnaires (42.1% response). Most organizations developed CGs based on scientific evidence (89.6%), existing CGs (75%), or expert experience and opinion (64.6%). Only a few organizations had a specific CG development division (6.3%), a CG monitoring plan (on clinicians 33.3%; on patients 18.8%), funding (33.3%), or a conflict-of-interest (COI) management policy (23.4%). Thirty (62.5%) organizations reported using a CG development methodology handbook, from international organizations (14/30, 46.7%), methodology or evaluation resources (3/30, 10.0%), expert experience and opinion (3/30, 10.0%), or in-house handbooks (3/30, 10.0%). One organization followed a published adaptation methodology. Thirty-eight organizations (88.4%) reported de novo CG development: 21 (55.3%) formed a CG working group, and 29 (76.3%) evaluated the quality of evidence (21 [72.4%] using a methodological tool). Nineteen organizations (52.8%) reported CG adaptation: three (31.6%) had an adaptation working group, and 12 (63.2%) evaluated the quality of source CGs (2 (16.7%) using the AGREE II instrument). Thirty-three organizations (68.8%) updated their CGs, seven (17.5%) using a formal updating process. Our study describes how CGs are developed in a middle-income country like China. To ensure better healthcare, there is still an important need for improvement in the development, adaptation, and updating of CG in China.
Sections du résumé
BACKGROUND
BACKGROUND
Previous research suggests that the quality of clinical guidelines (CGs) in China is suboptimal. However, little is known about the methodology that CGs follow. We conducted a national survey of methods used by Chinese CG developers for CG development, adaptation, and updating.
METHODS
METHODS
We used a previously piloted questionnaire based on methodologies of CG development, adaptation, and updating, which was distributed during September-November 2020 to 114 organizations identified from published Chinese CGs (searched 2017-2020), recommended by Chinese CG developers, and recommended by clinical discipline experts.
RESULTS
RESULTS
We collected 48 completed questionnaires (42.1% response). Most organizations developed CGs based on scientific evidence (89.6%), existing CGs (75%), or expert experience and opinion (64.6%). Only a few organizations had a specific CG development division (6.3%), a CG monitoring plan (on clinicians 33.3%; on patients 18.8%), funding (33.3%), or a conflict-of-interest (COI) management policy (23.4%). Thirty (62.5%) organizations reported using a CG development methodology handbook, from international organizations (14/30, 46.7%), methodology or evaluation resources (3/30, 10.0%), expert experience and opinion (3/30, 10.0%), or in-house handbooks (3/30, 10.0%). One organization followed a published adaptation methodology. Thirty-eight organizations (88.4%) reported de novo CG development: 21 (55.3%) formed a CG working group, and 29 (76.3%) evaluated the quality of evidence (21 [72.4%] using a methodological tool). Nineteen organizations (52.8%) reported CG adaptation: three (31.6%) had an adaptation working group, and 12 (63.2%) evaluated the quality of source CGs (2 (16.7%) using the AGREE II instrument). Thirty-three organizations (68.8%) updated their CGs, seven (17.5%) using a formal updating process.
CONCLUSIONS
CONCLUSIONS
Our study describes how CGs are developed in a middle-income country like China. To ensure better healthcare, there is still an important need for improvement in the development, adaptation, and updating of CG in China.
Identifiants
pubmed: 34949195
doi: 10.1186/s12961-021-00799-7
pii: 10.1186/s12961-021-00799-7
pmc: PMC8705156
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
151Subventions
Organisme : Zhengzhou University Overseas Virtual Research Institute and the Chinese Scholarship Council
ID : No 201707040103
Informations de copyright
© 2021. The Author(s).
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