ObjectiveTo get known of the application of Preferred Items of Systematic Review and Meta Analysis (PRISMA). MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 10, 2013), CBM, WanFang Data and CNKI, to collect relevant literature about the application of PRISMA during 2009-2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and then bibliometric analysis was performed using Excel software. ResultsWe finally included 175 papers, including 26 conference abstracts and 149 full texts. The results of bibliometric analysis of full texts showed that, they were published in 118 journals, and PRISMA official website announced that 176 journals endorsed the application of PRISMA. According to study type, there were 111 systematic reviews and meta-analyses (SRs/MAs) for development and reporting, 20 overviews of SRs for reporting quality assessments, 7 versions of PRISMA interpretation, and 11 articles of other kinds. In 131 SRs/MAs as well as overviews, the studies about western medicine accounted for 77.8%, followed by public health (8.4%), and traditional Chinese medicine (4.6%). ConclusionThe application of PRISMA statement is still at the first phase and mainly confined to the field of western medicine, which needs more attention and understanding. Thus, it's necessary to interpret and disseminate the PRISMA statement.
In response to the public health emergency and other urgent needs, World Health Organization (WHO) developed the concept and methodology of rapid advice guidelines (RAGs) in 2006. Compared with the standard guideline, striving to minimize the risk of bias, the RAG shortens the time to 1-3 months from more than 2 years. This study introduces the background, definition, application condition and performing methods of RAGs, and uses an example to clarify it, thus to provide a reference for the guideline development of public health emergency and other urgent need in China.
The approaches of rating the quality of evidence of systematic reviews of diagnostic accuracy tests are different from systematic reviews of interventional studies. This article systematically introduces the application of GRADE in systematic reviews of diagnostic accuracy tests by a case interpretation and analysis. In this article we present rating workflow in systematic reviews of diagnostic accuracy tests and introduce how to use the GDT website to display the rating results, and interpret the conclusion of systematic reviews based on GRADE results.
Depending on different designs of original studies, systematic reviews of diagnostic studies could be categorized into two kinds:one is based on diagnostic randomized controlled trials, of which the GRADE rating approach is similar to that of interventional systematic reviews; and the other is based on diagnostic accuracy tests, of which the GRADE rating approach is introduced in this article. This article explains the application of GRADE in systematic reviews of diagnostic accuracy tests mainly from the angle of theoretical analysis, including rationales, methods, and challenges.
ObjectiveTo investigate the updating period, methods and procedures of Clinical Practice Guidelines (CPGs) in China. MethodsWe searched WanFang Data, VIP, CNKI using the term "guideline" in the title, and Chinese Biomedical Literature Database (CBM) using "guideline" as the topic word up to December 2012. Then we screened and analyzed all included papers. ResultsA total of 380 Chinese CPGs were included. Thirty-eight (10%) guidelines have been updated, among which the longest update period was 10 years and the shortest was 1 year, and the average update period was 5.1 years. Eight (2%) of the updated guidelines had been updated more than once, and the average update time of them was 3, average update period was 4.9 years. There were 42 (12%) of the rest 342 guidelines which have never been updated mentioned that they would be updated. The detailed information of the updated guidelines according to their clinical objectives were as follow:1 (0.3%) was prevention guideline, of which the update period was 4 years; 8 (2%) were treatment guidelines and the average update period was 4.3 years; 5 (1%) were prevention and treatment guidelines, and the average update period was 6.8 years; 18 (5%) were diagnosis and treatment guidelines, and the average update period was 5.3 years; 4 (1%) were technology guidelines and the average update period was 5.5 years; and the average update period of the 2 (0.5%) integrative guidelines was 2.5 years. Forty (10%) of the total 380 guidelines had described their updating methods. ConclusionAccording the analysis of international studies and domestic guidelines, the update rate of Chinese CPGs is low, the update period is comparatively long, with differences found among them. The reporting of the updated CPGs' methods and procedures is insufficient, with less normalization. Big differences have been found in their updating condition among CPGs of different types and institutional developers.
ObjectiveTo investigate the reporting of search strategies of clinical practice guidelines (CPGs) in China. MethodsWe electronically searched WanFang Data, VIP, CNKI and CBM for clinical practice guidelines developed in China from inception to December 2012. Two reviewers independently screened guidelines, extracted data, and analyzed search strategies in these guidelines. ResultsA total of 380 Chinese CPGs were included, of which, only 13 reported search strategies of evidence, 9 in China reported search terms, 5 reported retrieval time of Chinese CPGs, and only 3 completely reported search terms, retrieval time and search databases. ConclusionThe reporting rate of search strategies of evidence in Chinese CPGs is fairly low and Chinese CPGs lack unified reporting criteria. We suggest that the developers of Chinese guideline should apply the reporting items of AGREE Ⅱ and the criteria of Conference on Guideline Standardization (COGS) to report CPGs.
ObjectiveTo investigate primary healthcare workers' knowledge, attitude and behaviour, and explore the way of guidelines' popularization, application and surveillance mechanism in primary healthcare institutions. MethodsHealthcare workers in seven township hospitals in Gaolan county, Gansu province were given a questionnaire to test their knowledge, attitudes and behaviour regarding Clinical practice guidelines. ResultsAmong the 143 distributed questionnaires, 143 valid were retrieved. The results showed that 80% of respondents knew the guidelines and 51% had used guidelines in treatment, 32% obtained guidelines mainly through distribution by affiliations. The most popular type of guidelines was self-developed by native departments. Respondents (37%) considered difficult availability of guidelines major barriers to popularization, 74% failed to receive training about guidelines, 88% looked forward to special organizations in charge of disseminating guidelines and conducting related training on how to apply guidelines. ConclusionPrimary healthcare workers report low awareness of, attention to and compliance with clinical practice guidelines. The greatest challenge for guidelines' popularization in township hospitals is difficult availability and it is of vital importance for primary institutions to enhance guidelines' implementation and strengthen learning and conduct training.
Currently there is no tool designed specifically to assess the risk of bias in the design, conduct or analysis of systematic reviews. ROBIS (Risk Of Bias In Systematic reviews), which was developed lately, aims mainly to assess the risk of bias in the conduct and result interpretation of systematic reviews relating to interventions, etiology, diagnosis and prognosis, as well as the relevance of the systematic review questions and the practice questions that their users want to address. This paper aims to introduce the ROBIS tool to Chinese systematic review developers, guideline developers and other researchers to promote the comprehension of it and its application, so as to improve the quality of systematic reviews in China.
With the perspective of evidence-based medicine, this review aims to investigate the effectiveness and safety of off-label drug use of bevacizumab for eye disease, and explore the barriers to further study. And then, suggestions for the supported evidence and clinical use of off-label drug use will be provided based on this case.
ObjectiveTo evaluate the quality of Chinese clinical practice guidelines published in domestic medical journals from 2012 to 2013 and compare with the quality of guidelines published before. MethodsCNKI, CBM and WanFang Data were searched to collect guidelines from January 1st, 2012 to December 31st, 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria and extracted data. The AGREE Ⅱ instrument was applied to assess methodological quality of included guidelines. ResultsA total of 78 guidelines were identified. Among them, 37 guidelines were published in 2012, and 41 in 2013. The scores of 6 domains' scores of AGREE Ⅱ were as follows:scope and purpose (24%), stakeholder involvement (11%), rigour of development (7%), clarity of presentation (32%), applicability (7%), and editorial independence (4%). The results of subgroup analysis indicated that, the scores in 5 domains (except applicability) of the guidelines published in CSCD journals were higher than those of non CSCD journals; the scores in 4 domains (except stakeholder involvement and applicability) of the guidelines received funds were higher than those of guidelines with no funds; and the scores in 5 domains (except editorial independence) of the guidelines published in 2013 were higher than those in 2012. ConclusionThe guidelines published from 2012 to 2013 have higher quality than guidelines published before 2012, but great discrepancies exist when comparing with international guidelines of average level. Chinese guidelines developers should attach importance to international methodology to develop guidelines, and use the AGREE Ⅱ instrument to develop and report guidelines.