A comparative study on operative mechanism of the global clinical guideline databases_Chinese Journal of Evidence-Based Medicine

Authors：

LONG Youlin ¹ , ZHANG Yonggang ^1,2 , LI Youping ¹ , HU Chuan ² , CHEN Yaolong ^3,4 , YAO Xun ⁵ ,  WANG Qiang ⁶ ,  HUANG Jin ⁷ ,  DU Liang ^1,2

1. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. West China Medical Publishers, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
3. Evidence-Based Medicine Center, Lanzhou University, Lanzhou, 730000, P.R.China;
4. Chinese GRADE Center, Lanzhou University, Lanzhou, 730000, P.R.China;
5. West China School of Medicine, Sichuan University, Chengdu, 610041, P.R.China;
6. Department of Standardization, National Center for Medical Service Administration, National Health Commission of the People’s Republic of China, Beijing, 100000, P.R.China;
7. West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding?author：

WANG Qiang, Email: jason2019@sina.cn; HUANG Jin, Email: michael.huangjin@gmail.com; DU Liang, Email: duliang0606@vip.sina.com

Keywords：

Clinical practice guideline; Guideline database; Web resource; Operating mechanism

DOI：

10.7507/1672-2531.201805128

Video：

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Objectives To summarize and compare the operative mechanisms of the most representative comprehensive clinical practice guideline (CPG) databases worldwide, so as to provide references for establishing and managing Chinese CPG database.Methods CPG databases were collected worldwide by discussing with experts in the guideline and database fields. Studies on guideline databases were searched in PubMed and CNKI to further collect CPG databases mentioned in these studies. Representative comprehensive guideline databases were finally selected by consulting relevant guideline experts. The institutions’ names of establishing and managing CPG databases, funding sources, human resources, aims, quality control measures (including CPG inclusion and updating criteria) were extracted and summarized. Databases were divided into government-led, society-led, and enterprise-led models. A descriptive analysis was conducted.Results There were four government-led databases, four society-led databases and merely one enterprise-led database. The institutions of establishing CPG databases were same as the institutions of managing databases in the seven databases. All CPG databases had set up offices, seven of which were located in the capital. Most databases’ funds came from the government. Four databases implemented board management. According to the division of functions, members involved in establishing and managing CPG databases mainly included leaders, expert teams, managerial personnel, secretaries, web developers, and patient representatives. Criteria for inclusion of CPG were relevant to the purpose of establishing databases. Most databases required guidelines that had be updated within three to five years.Conclusions This study provides comprehensive information on operative mechanism of different CPG databases which can assist guideline database builders to optimize their operative mechanism.

Citation： LONG Youlin, ZHANG Yonggang, LI Youping, HU Chuan, CHEN Yaolong, YAO Xun, WANG Qiang, HUANG Jin, DU Liang. A comparative study on operative mechanism of the global clinical guideline databases. Chinese Journal of Evidence-Based Medicine, 2018, 18(10): 1045-1052. doi: 10.7507/1672-2531.201805128 Copy

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2.	Field MJ, Lohr KN. Clinical practice guidelines: Directions for a new program. Washington (DC): National Academies Press (US), 1990.
3.	Sobczak D. Clinical practice guidelines resources on the Web. Med Ref Serv Q, 2000, 19(2): 73-79.
4.	Shaughnessy AF, Cosgrove L, Lexchin JR. The need to systematically evaluate clinical practice guidelines. J Am Board Fam Med, 2016, 29(6): 644-648.
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6.	龍囿霖, 張永剛, 李幼平, 等. 全球臨床指南數據庫功能特點及技術參數的比較研究. 中國循證醫學雜志, 2018, 18(3): 254-262.
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13.	Duda S, Fahim C, Szatmari P, et al. is the national guideline clearinghouse a trustworthy source of practice guidelines for child and youth anxiety and depression. J Can Acad Child Adolesc Psychiatry, 2017, 26(2): 86-97.
14.	Hurwitz B. Clinical guidelines and the law. BMJ, 1995, 311(7019): 1517-1518.
15.	Hurwitz B. Legal and political considerations of clinical practice guidelines. BMJ, 1999, 318(7184): 661-664.
16.	趙琨, 肖月, 池延花, 等. 英國NICE技術評估和臨床指南的實施對我們的啟示. 中國衛生資源, 2011, 14(3): 193-195.
17.	About the nhmrc. Available at: https://www.nhmrc.gov.au/about.
18.	周巍, 張新平. 澳大利亞制訂臨床實踐指南對中國的啟示. 中國全科醫學, 2012, 15(31): 3568-3569.
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21.	Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet, 1993, 342(8883): 1317-1322.
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24.	Available at: https://www.nice.org.uk/about.
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28.	汪宏, 包旭. 美國國立臨床診療指南數據庫介紹. 中國執業藥師, 2013, 10(1): 42-45.
29.	Kost GJ. National guideline clearinghouse. Clin Chem, 2000, 46(1): 141-142.
30.	何林, 杜小麗. 循證醫學臨床實踐指南檢索. 中國組織工程研究與臨床康復, 2007, 11(40): 8173-8177.
31.	Fitzpatrick RB. CMA Infobase: clinical practice guidelines. Med Ref Serv Q, 2008, 27(4): 419-429.
32.	李曉婷, 詹思延. 最佳證據網上資源介紹. 中國循證心血管醫學雜志, 2009, 1(1): 123-126.
33.	曾佩瑜. 循證醫學的網絡資源. 醫學信息(中旬刊), 2010, 5(9): 2556-2557.
34.	陳波, 傅鷹. 循證性臨床指南主要英文網站的搜集和簡介. 藥物流行病學雜志, 2002, 11(2): 90-93.
35.	孫文茜, 趙晨, 高維潔, 等. 循證護理實踐中的證據檢索方法及資源. 中國循證心血管醫學雜志, 2016, 8(3): 263-266, 272.
36.	鐘麗萍. 臨床實踐指南網絡資源及元數據分析. 現代情報, 2009, 29(2): 105-108.
37.	鐘麗萍. 臨床實踐指南網絡資源分布及利用. 循證醫學, 2008, 8(6): 356-359.

1. Woolf SH, Grol R, Hutchinson A, et al. Clinical guidelines: potential benefits, limitations, and harms of clinical guidelines. BMJ, 1999, 318(7182): 527-530.
2. Field MJ, Lohr KN. Clinical practice guidelines: Directions for a new program. Washington (DC): National Academies Press (US), 1990.
3. Sobczak D. Clinical practice guidelines resources on the Web. Med Ref Serv Q, 2000, 19(2): 73-79.
4. Shaughnessy AF, Cosgrove L, Lexchin JR. The need to systematically evaluate clinical practice guidelines. J Am Board Fam Med, 2016, 29(6): 644-648.
5. Alper BS, Malone-Moses M, McLellan JS, et al. Thrombolysis in acute ischaemic stroke: time for a rethink? BMJ, 2015, 350: h1075.
6. 龍囿霖, 張永剛, 李幼平, 等. 全球臨床指南數據庫功能特點及技術參數的比較研究. 中國循證醫學雜志, 2018, 18(3): 254-262.
7. New Zealand guidelines group. Available at: http://www.health.govt.nz/about-ministry/ministry-health-websites/new-zealand-guidelines-group.
8. 隋賓艷, 齊雪然. 英國NICE衛生技術評估研究決策轉化機制及對我國的啟示. 中國衛生政策研究, 2015, 8(7): 74-78.
9. 王方. 規范的董事會運行管理機制成就企業可持續發展研究. 納稅, 2018, (4): 124.
10. The clinical practice guidelines portal. Available at: https://www.clinicalguidelines.gov.au/about.
11. Field MJ, Lohr KN. Guidelines for clinical practice: From development to use. Washington (DC): National Academies Press (US), 1992.
12. El-Khayat YM, Forbes CS, Coghill JG. Guideline.gov: A Database of Clinical Specialty Guidelines. Med Ref Serv Q, 2017, 36(1): 62-72.
13. Duda S, Fahim C, Szatmari P, et al. is the national guideline clearinghouse a trustworthy source of practice guidelines for child and youth anxiety and depression. J Can Acad Child Adolesc Psychiatry, 2017, 26(2): 86-97.
14. Hurwitz B. Clinical guidelines and the law. BMJ, 1995, 311(7019): 1517-1518.
15. Hurwitz B. Legal and political considerations of clinical practice guidelines. BMJ, 1999, 318(7184): 661-664.
16. 趙琨, 肖月, 池延花, 等. 英國NICE技術評估和臨床指南的實施對我們的啟示. 中國衛生資源, 2011, 14(3): 193-195.
17. About the nhmrc. Available at: https://www.nhmrc.gov.au/about.
18. 周巍, 張新平. 澳大利亞制訂臨床實踐指南對中國的啟示. 中國全科醫學, 2012, 15(31): 3568-3569.
19. Durieux P, Chaix-Couturier C, Durand-Zaleski I, et al. From clinical recommendations to mandatory practice. The introduction of regulatory practice guidelines in the French healthcare system. Int J Technol Assess Health Care, , 2000, 16(4): 969-975.
20. Durieux P, Gaillac B, Giraudeau B, et al. Despite financial penalties, French physicians' knowledge of regulatory practice guidelines is poor. Arch Fam Med, 2000, 9(5): 414-418.
21. Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet, 1993, 342(8883): 1317-1322.
22. Grimshaw JM, Russell IT. Achieving health gain through clinical guidelines II: Ensuring guidelines change medical practice. Qual Health Care, 1994, 3(1): 45-52.
23. Hunt DL, Haynes RB, Hanna SE, et al. Effects of computer-based clinical decision support systems on physician performance and patient outcomes: a systematic review. JAMA, 1998, 280(15): 1339-1346.
24. Available at: https://www.nice.org.uk/about.
25. Available at: https://www.guideline.gov/help-and-about.
26. 熊天壽. 怎樣完善醫院運行機制. 現代預防醫學, 2006, 33(12): 2390-2391.
27. 吳紅梅, 李峻. 病因證據的評價與應用. 李幼平, 主編. 循證醫學. 北京: 人民衛生出版社, 2014.
28. 汪宏, 包旭. 美國國立臨床診療指南數據庫介紹. 中國執業藥師, 2013, 10(1): 42-45.
29. Kost GJ. National guideline clearinghouse. Clin Chem, 2000, 46(1): 141-142.
30. 何林, 杜小麗. 循證醫學臨床實踐指南檢索. 中國組織工程研究與臨床康復, 2007, 11(40): 8173-8177.
31. Fitzpatrick RB. CMA Infobase: clinical practice guidelines. Med Ref Serv Q, 2008, 27(4): 419-429.
32. 李曉婷, 詹思延. 最佳證據網上資源介紹. 中國循證心血管醫學雜志, 2009, 1(1): 123-126.
33. 曾佩瑜. 循證醫學的網絡資源. 醫學信息(中旬刊), 2010, 5(9): 2556-2557.
34. 陳波, 傅鷹. 循證性臨床指南主要英文網站的搜集和簡介. 藥物流行病學雜志, 2002, 11(2): 90-93.
35. 孫文茜, 趙晨, 高維潔, 等. 循證護理實踐中的證據檢索方法及資源. 中國循證心血管醫學雜志, 2016, 8(3): 263-266, 272.
36. 鐘麗萍. 臨床實踐指南網絡資源及元數據分析. 現代情報, 2009, 29(2): 105-108.
37. 鐘麗萍. 臨床實踐指南網絡資源分布及利用. 循證醫學, 2008, 8(6): 356-359.

Chinese Journal of Evidence-Based Medicine

A comparative study on operative mechanism of the global clinical guideline databases

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