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.
ObjectiveTo explore impact factors related to the clinical applicability of guidelines, and provide suggestions for better development and implementation of guidelines. MethodsThe CNKI database was electronically searched to collect clinical guidelines issued by the Chinese Medical Association and the Chinese Medical Doctor Association from 2015 to 2020. Sixty-one guidelines were randomly selected from included guidelines and each guideline was evaluated by medical staff from three regions using the instrument for evaluating clinical applicability of guidelines (version 2.0). Statistical data were described, and t-test or rank sum test or chi-square test were used for comparison between groups. The impact factors were screened by stepwise logistic regression analysis. ResultsA total of 6 904 valid questionnaires were collected from 119 medical institutions in 26 provinces of China. The more familiar with the guidelines and the more consistent with the wishes of patients or their families, the overall standardized score of the clinical applicability of guidelines would be higher. In addition, the more familiar with the guidelines, the standardized scores in each field would be higher. The higher emphasis on guidelines compliance, the higher the feasibility standardized score. ConclusionIn order to improve the clinical applicability of guidelines, developers should pay attention to whether the recommendations are consistent with the wishes of patients or their families. Then, medical institutions should pay attention to the compliance of guidelines. Finally, medical personnel should be familiar with the recommendations.
To promote the accessibility and application of guidelines, it is necessary to establish a professional guideline database to adapt to the rapid growth of TCM clinical practice guidelines. This study described the framework design, technology module, information management, and quality control of the clinical practice guideline database of traditional Chinese medicine (G-TCM). G-TCM had included 658 TCM clinical practice guidelines, which would provide a platform for clinicians, researchers, guideline makers (revision), and evaluators to quickly query and obtain clinical guideline information, and play a supporting role in promoting the standardization and accessibility of TCM clinical practice guidelines and better guiding clinical practice.
Objective To improve care and outcomes for all migraine suffers, the USHC created these evidence-based guidelines for migraine headache. Methods Firstly, 5 relative Technical reviews were done according to the Methods used in the AHCPR Technical Reviews. Secondly, based on the results of the 5 technical reviews, the 4 treatment guidelines were developed in direction of the USHC’S Methods used in developing clinical guidelines. Results Evidence supporting the acute treatment and preventive treatment were exclusively Class 1 studies, evidence supporting the diagnostic testing were either Class 2 or Class 3 studies , only very few expert judgment was given on some compelling issues without evidence. The recommendations they supporting were high-qualified, middle-qualified, and poor-qualified respectively. Conclusion This Evidence-Based Guidelines is one of the first and most extensive cooperative projects available for creating guidelines. The guideline was developed with systematical and scientific methods and stroven to base all of its recommendations on evidence.
In October 2020, the American Heart Association issued the 2020 edition of guidelines for cardiopulmonary resuscitation and cardiovascular first aid, which comprehensively revised cardiopulmonary resuscitation and emergency cardiovascular care guidelines related to adults, children, newborns, resuscitation education science and treatment system. According to the latest edition of International Liaison Committee on Resuscitation’s classes of recommendation and levels of evidence, relevant suggestions are put forward. This article interprets the main updated and revised content, including children’s basic and advanced life support and neonatal resuscitation, in order to better guide emergency personnel and improve the quality of cardiopulmonary resuscitation and cardiovascular first aid.
Surgical site infections are the common healthcare-associated infections. This article introduced the guidelines on the prevention and control of surgical site infection in using from background, making progress, and recommendations, to give directions for clinicians and infection prevention and control professionals choosing appropriately for decreasing surgical site infection risks.
In November 2017, the American Heart Association updated the pediatric basic life support and cardiopulmonary resuscitation (CPR) quality. The new guidelines focused on the clinical value of chest compression-only CPR versus CPR using chest compressions with rescue breaths in children, rather than a comprehensive revision of the 2015 edition guidelines. The Pediatric Task Force of the International Liaison Committee on Resuscitation updated part content of the guidelines according to the continuous evidence review process. Guidelines recommend CPR using chest compressions with rescue breaths should be provided for infants and children with cardiac arrest. Bystanders provide chest compressions if they are unwilling or unable to deliver rescue breaths. This article mainly interprets the updated content.
Objective To systematically review published methodological guidelines for health technology assessment (HTA) at home and abroad. Methods Common electronic databases, guideline databases, international networks of HTA agencies/organizations, representative national HTA networks and official websites of governmental health departments were extensively searched and screened to identify guidelines for conducting or reporting HTA from inception to April 24, 2023. Basic information on guidelines, HTA processes, assessment indicators, reporting checklists and other information was extracted, analyzed and described using a systematic review methodology. Results A total of 41 guidelines were included in this study, published from January 2002 to January 2023; the publishing institutions involved 23 countries/international organizations, and 6 languages; the assessments were mainly for all health technologies (n=23), pharmaceuticals (n=4), diagnostic/testing technologies (n=4), non-pharmaceutical health technologies (n=3), medical devices/equipment (n=3), hospital health technologies (n=2), medical and surgical interventions (n=1), and screening technologies (n=1); the assessment perspectives were mainly health system perspectives (n=16), societal perspectives (n=12), and hospital perspectives (n=3), while the rest did not provide information on the perspectives; 28 guidelines described the detailed HTA assessment process, involving 11 steps; there were 39 guidelines described the assessment domains and related assessment indicators in detail, ranging from 2 to 9 assessment domains and involving 10 first-level assessment indicators; a checklist for HTA reports listed in 10 guidelines, involving 18 report entries; 17 guidelines reported conflicts of interest, mostly no conflicts of interest (n=10), and 3 of the remaining 7 guidelines did not indicate a specific conflict of interest, while 4 guidelines in which possible sources of conflict of interest were indicated. Conclusion The development of HTA has formed a relatively perfect assessment system, but there is a need to unify the criteria for classification of health technologies and reporting checklist, improve the specificity indicators for different types of health technologies, and clarify the assessment perspectives. Combined with the current situation of HTA development in China, contextualized guidelines for HTA implementation and reporting should be formulated to provide scientific information and methodological basis for decision-making on rational allocation of health resources.
ObjectiveTo adapt existing clinical practice guidelines to the management of medication adherence to highly active antiretroviral therapy (HAART) in China, so as to provide evidence to support the development of practice guidelines that meet China's actual conditions.
MethodsAccording to ADAPTE methodology and status of HAART in China, we searched, appraised, selected and adapted current clinical practice guidelines on the management of medication adherence to HAART.
ResultsA total of 10 guidelines were included, and the final clinical practice guidelines for the management of medication adherence to HAART involved 3 aspects, including influential factors, assessment methods, and interventions. High quality evidence resources had been formed, and the quality of final clinical practice guidelines was higher.
ConclusionIt is feasible to develop clinical practice guidelines according to the ADAPTE method, and reliable evidence support has been provided for the development of clinical practice guidelines based on guideline adaption.
Adapting the existing guidelines in the context of specific regions can improve the efficiency of guidelines development, and reduce cost and time for developing guidelines. ADOLOPMENT is a methodological tool for guidelines adaptation, which was developed by the GRADE Working Group based on the standardized international guidelines making process. With ADOLOPMENT, developers can effectively use existing guidelines and evidence, avoid duplication of the evidence evaluation, and record the process from evidence to recommendations, which will ensure the transparency of adaptation, help users to understand the process, and improve the acceptability and credibility of guideline adaptation. This paper aims to introduce the ADOLOPMENT and its application.
