ZHANG Chuan 1,2 # , LI Hailong 1,2 # , HUANG Chao 3 , ZENG Linan 1,2 , HUANG Zongyao 1,2,4 , YI Qiusha 1,2,5 , CHEN Xiao 1,2,4 , KANG Deying 6 , LIU Guanjian 6 , LIU Qiaolan 7 , ZHAO Rongsheng 8,9 , ZHANG Junhua 10 , LI Youping 6 , WANG Qiang 3 , ZHANG Lingli 1,2,9
  • 1. Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu 610041, P.R.China;
  • 2. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, P.R.China;
  • 3. Medical Management Service Guidance Center, National Health Commission of the People’s Republic of China, Beijing 10004, P.R.China;
  • 4. West China School of Pharmacy, Sichuan University, Chengdu 610041, P.R.China;
  • 5. West China School of Medicine, Sichuan University, Chengdu 610041, P.R.China;
  • 6. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;
  • 7. West China School of Public Health, Sichuan University, Chengdu 610041, P.R.China;
  • 8. Department Pharmacy, Peking University Third Hospital, Beijing 100191, P.R.China;
  • 9. Evidence-based Pharmacy Committee, Chinese Pharmaceutical Association, Beijing 100044, P.R.China;
  • 10. Centre for Evidence-Based Medicine, Tianjin University of TCM, Tianjin 301617, P.R.China;
WANG Qiang, Email: jason2019@sina.cn; ZHANG Lingli, Email: zhanglingli@scu.edu.cn
Kidney transplantation guideline; Applicability of guideline; Scale analysis; Influencing factor
10.7507/1672-2531.201909125
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Objectives To establish statistical analysis and result reporting model for evaluation of the applicability of the clinical guidelines. We conducted empirical study for clinical guidelines for diagnosis and treatment of renal transplantation rejection in China.Methods A cross-sectional survey was conducted to select 16 medical institutions in China which had carried out kidney transplantations. In each medical institution, 6 to 8 clinicians from the kidney transplantation department or related departments were selected to complete the questionnaire. Descriptive analysis was carried out for characteristics of evaluators, scores of each dimension, access to guidelines and factors affecting implementation. The Kruskal-Wallis rank sum test and Nemenyi test were used for multi-group comparison and pairwise comparison. Multiple linear regression with stepwise strategy were used to screen out the association factors.Results In this survey, 128 questionnaires were distributed, in which 105 valid questionnaires were collected, and the recovery rate was 82.03%. The subjects of this survey were all kidney transplant clinicians from public tertiary hospitals, with an average 10.95 years of working time. The results showed the accessibility score was lowest and the acceptability score was highest. The results of multi-group comparison and multiple linear regression analysis showed that familiarity with the guidelines was the influencing factor of each score (P<0.05). The guidelines were primarily obtained from biomedical literature database (73.3%), academic journals (55.2%) and academic conferences (55.2%). Among the evaluators, 44 (41.9%) believed that there were implementation obstacles in the guidelines, among which 40 (38.1%) believed that implementation obstacles were environmental factors.Conclusions The applicability of clinical guidelines for diagnosis and treatment of renal transplantation rejection in China is adequate. However, the publicity of the guideline requires improvement. As the guideline is updated, consideration should be given to including access to the guideline, adding free public information promotion, and familiarizing clinicians with the guidelines through training programs to promote application of the guideline.

Citation： ZHANG Chuan, LI Hailong, HUANG Chao, ZENG Linan, HUANG Zongyao, YI Qiusha, CHEN Xiao, KANG Deying, LIU Guanjian, LIU Qiaolan, ZHAO Rongsheng, ZHANG Junhua, LI Youping, WANG Qiang, ZHANG Lingli. An empirical study on evaluation of clinical applicability of kidney transplantation guideline. Chinese Journal of Evidence-Based Medicine, 2020, 20(5): 543-550. doi: 10.7507/1672-2531.201909125 Copy

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