The Essential of ACC/AHA Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction was introduced, including epidemology, initial management in the emergency department and hospital management.
The focus of health equity is to enable the public to have fair access to health services and achieve satisfactory health outcomes. With research developments, guideline developers increasingly pay more attention to the fairness in the practice guidelines and have carried out exploration and practice in the relevant guidelines. The GRADE working group has begun to investigate how to use GRADE to assess health equity in practice guidelines since 2014. In 2017, the series of methodological guidelines of health equity in guideline development was officially published. It proposed 5 approaches to evaluate health equity and pointed out current methodological challenges of applying GRADE to assess health equity. This paper aims to introduce the GRADE equity guidelines, so as to provide a reference for Chinese researchers in their practice.
The first edition of “The Chinese expert consensus on the diagnosis and treatment of optic neuritis” have been published in Chinese Journal of Ophthalmology in 2014. Seven years later, more evidence-based medicine has been accumulated in the treatment of optic neuritis. It is necessary to update or formulate guidelines to guide clinical practice. Based on the methods and procedures for developing evidence -based guidelines, Neuro-Ophthalmology Group of Ophthalmology Branch of Chinese Medical Association and Evidence-based Medicine Centre of Lanzhou University/World Health Organization Collaborating Centre for Guideline Implementation and Knowledge Translation created the first “An evidence-based guideline for the diagnosis and treatment of demyelinating optic neuritis in China (2021)”, which aimed to improve the level of clinical diagnosis and treatments of demyelinating optic neuritis. This guideline proposes a new subtype classification of demyelinating optic neuritis to guide precision treatment. It also gives new suggestions about clinical treatment hotspots in the acute and chronic phases, including the application of immunosuppressants and rituximab and other biological agents.
Objective To assess the methodological quality of pediatric COVID-19 guidelines using the AGREE Ⅱ. Methods Domestic and foreign pediatric COVID-19 guidelines from inception to 1st Oct 2021 were electronically searched in PubMed, CBM, CNKI, VIP, WanFang Data, Medlive, NGC, GIN, and NICE databases and relevant websites. Two researchers independently assessed the methodological quality of the guidelines by using AGREE Ⅱ. Results A total of 21 guidelines were included. The AGREE Ⅱ results revealed that the average scores of included guidelines in 6 domains (scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence) were 62.70%, 36.24%, 20.34%, 50.42%, 22.12% and 53.17%, respectively. ConclusionThe methodological quality of pediatric COVID-19 guidelines is poor. Guideline developers should follow the requirements of AGREE Ⅱ in guideline development.
Infiltrative optic neuropathy (ION) is characterized by the infiltration of tumor cells or inflammatory cells in the optic nerve and its sheath. ION is rare in clinic practice, and ION caused by direct infiltration or metastasis of malignant tumors is easily misdiagnosed as optic perineuritis or optic neuritis, which means delayed proper treatment and makes patients risking possible side effects of steroid therapy. Currently, ophthalmologists are lack of sufficient knowledge about ION, which contributes to the high rate of misdiagnosis and missed diagnosis of ION in clinical practice. The diagnosis and treatment of ION have not yet formed systematic standardized guidelines. Therefore, Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association organized experts to propose consenus of opinions on definition, diagnosis and treatment of ION, which helps to guide clinical diagnosis and treatment of ION, as well as basic researches about ION.
The Evidence-based guidelines for diagnosis and treatment of age-related macular degeneration in China (2023) is the first evidence-based clinical practice guidelines for the diagnosis and treatment of age-related macular degeneration (AMD) in China that strictly follows the WHO guideline formulation and international guideline standards. Based on the latest evidence-based medical evidence and the rapid development of ocular fundus imaging technology, the new version of the guidelines has been updated in the diagnosis, treatment and follow-up of AMD. Based on the origin and presence of neovascularization in retinal tissue, the macular neovascularizations are divided into type 1, type 2 and type 3 macular neovascularization (MNV). Optical coherence tomography (OCT) plus OCT angiography is recommended as the useful diagnostic method in neovascular AMD patients. Antioxidant vitamins, zinc, lutein, zeaxanthin, or a mix of antioxidant vitamins and minerals are recommended to prevent the progression of early to intermediate AMD. Intravitreal administration of anti-vascular endothelial growth factor (VEGF) agents is the first-line treatment for neovascular AMD, and once a month for the first 3 months plus treatment and prolonged administration regimen shows benefit to a certain extent. For poor response and non-response neovascular AMD patients, the clinician should decide the next treatment plan based on comprehensive consideration. Close observation is recommended for non-exudative MNV, and anti-VEGF therapy should be used promptly once non-exudative MNV transfer to exudative MNV. It is hoped that this guideline will improve the diagnosis, treatment, prevention and follow-up of AMD in China.