An analysis of impact factors related to the clinical applicability of guidelines: a cross-sectional study_Chinese Journal of Evidence-Based Medicine

Authors：

DIAO Sha ^1,2,3,4 , LIU Zheng ^1,2,3,4,5 , SHI Yuqing ^1,2,3,4,6 , LI Siyu ^1,2,3,4,5 , ZENG Linan ^1,2,3,4 , YI Qiusha ^1,2,3,4 , LI Hailong ^1,2,3,4 , XU Huizhong ⁷ , WANG Xixiong ⁸ , HUANG Xiusen ⁸ , YANG Xice ⁹ , HUANG Chao ¹⁰ ,  WANG Qiang ¹⁰ , ZHANG Lingli ^1,2,3,4,11

1. Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Evidence-based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu 610041, P. R. China;
4. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu 610041, P. R. China;
5. West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China;
6. West China School of Pharmacy, Sichuan University, Chengdu 610041, P. R. China;
7. Dongtai People's Hospital, Yancheng 224200, P. R. China;
8. The First People's Hospital of Qinzhou, Qinzhou 535099, P. R. China;
9. West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
10. Medical Management Service Guidance Center, National Health Commission of the People’s Republic of China, Beijing 100044, P. R. China;
11. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WANG Qiang, Email: jason2019@sina.cn

Keywords：

Guidelines; Clinical applicability; Impact factors; Cross-sectional study

DOI：

10.7507/1672-2531.202306025

Video：

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Objective To explore impact factors related to the clinical applicability of guidelines, and provide suggestions for better development and implementation of guidelines. Methods The 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. Results A 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. Conclusion In 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.

Citation： DIAO Sha, LIU Zheng, SHI Yuqing, LI Siyu, ZENG Linan, YI Qiusha, LI Hailong, XU Huizhong, WANG Xixiong, HUANG Xiusen, YANG Xice, HUANG Chao, WANG Qiang, ZHANG Lingli. An analysis of impact factors related to the clinical applicability of guidelines: a cross-sectional study. Chinese Journal of Evidence-Based Medicine, 2024, 24(1): 29-35. doi: 10.7507/1672-2531.202306025 Copy

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2.	Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med, 2011, 104(12): 510-520.
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11.	李思雨, 刁莎, 石雨晴, 等. 指南临床适用性评价工具(2. 0版). 中国循证医学杂志, 2023, 23(5): 597-605.
12.	张淼, 刁莎, 曾力楠, 等. 指南临床适用性评价工具(2. 0版)信效度分析. 中国循证医学杂志, 2023, 23(1): 80-84.
13.	刁莎, 万杰, 石雨晴, 等. 中国近五年临床实践指南的临床适用性: 一项横断面研究. 中国循证医学杂志, 2023, 23(6): 632-637.
14.	刁莎, 杨梦婷, 曾力楠, 等. 医学评估量表用户手册撰写框架的定性系统评价. 医学新知, 2022, 32(1): 10-22.
15.	孙振球, 徐勇勇. 医学统计学. 北京: 人民卫生出版社, 2014.
16.	王芳, 杨洋, 刘孟宇, 等. 基于指南熟悉和使用程度探索中医诊疗指南实施推广策略. 中华中医药杂志, 2016, 31(8): 3162-3165.
17.	Vander Weigden T, Francel L, Antoine B, et al. How to integrate individual patient values and preferences in clinical practice guideline. A research protocol. Implement Sci, 2010, 5(1): 1-10.
18.	Institute of Medicine. Clinical practice guidelines we can trust. Washington DC: National Academies Press, 2011.
19.	World Health Organization. WHO handbook for guideline development (2nd edition). 2014.

1. Institute of Medicine (US) Committee on standards for developing trustworthy clinical practice guidelines. Clinical practice guidelines we can trust. Washington: National Academies Press, 2011: 4.
2. Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med, 2011, 104(12): 510-520.
3. 曾力楠, 李幼平, 张伶俐, 等. 国内外制订临床指南的指南的循证评价. 中国循证医学杂志, 2016, 16(11): 1322-1330.
4. The ADAPTE Collaboration. The apapte process: resource toolkit for guideline adaptation, version 2.0.
5. 林茂, 曾力楠, 李佳莲, 等. 全球指南临床适用性评价工具现状的系统评价. 中国循证医学杂志, 2020, 20(4): 437-443.
6. 曾力楠, 易秋莎, 张川, 等. 制订指南临床适用性评价工具. 中国循证医学杂志, 2020, 20(4): 466-475.
7. Linan Z, Qiusha Y, Chuan Z, et al. An instrument for evaluating the clinical applicability of guidelines. J Evid Based Med, 2020, 14(1): 75-81.
8. 李海龙, 张川, 黄超, 等. 指南临床适用性评价工具信效度分析. 中国循证医学杂志, 2020, 20(4): 378-382.
9. 黄超, 李海龙, 张川, 等. 指南临床适用性评价实证研究: 以糖尿病指南临床适用性评价为例. 中国循证医学杂志, 2020, 20(5): 536-542.
10. 张川, 李海龙, 黄超, 等. 指南临床适用性评价实证研究: 以肾移植指南临床适用性评价为例. 中国循证医学杂志, 2020, 20(5): 543-550.
11. 李思雨, 刁莎, 石雨晴, 等. 指南临床适用性评价工具(2. 0版). 中国循证医学杂志, 2023, 23(5): 597-605.
12. 张淼, 刁莎, 曾力楠, 等. 指南临床适用性评价工具(2. 0版)信效度分析. 中国循证医学杂志, 2023, 23(1): 80-84.
13. 刁莎, 万杰, 石雨晴, 等. 中国近五年临床实践指南的临床适用性: 一项横断面研究. 中国循证医学杂志, 2023, 23(6): 632-637.
14. 刁莎, 杨梦婷, 曾力楠, 等. 医学评估量表用户手册撰写框架的定性系统评价. 医学新知, 2022, 32(1): 10-22.
15. 孙振球, 徐勇勇. 医学统计学. 北京: 人民卫生出版社, 2014.
16. 王芳, 杨洋, 刘孟宇, 等. 基于指南熟悉和使用程度探索中医诊疗指南实施推广策略. 中华中医药杂志, 2016, 31(8): 3162-3165.
17. Vander Weigden T, Francel L, Antoine B, et al. How to integrate individual patient values and preferences in clinical practice guideline. A research protocol. Implement Sci, 2010, 5(1): 1-10.
18. Institute of Medicine. Clinical practice guidelines we can trust. Washington DC: National Academies Press, 2011.
19. World Health Organization. WHO handbook for guideline development (2nd edition). 2014.

Chinese Journal of Evidence-Based Medicine

An analysis of impact factors related to the clinical applicability of guidelines: a cross-sectional study

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