Chronic obstructive pulmonary disease (COPD), with high prevalence rate, mortality, and disability rate, and heavy burden caused by the disease, has become a major chronic disease seriously threatening public health worldwide. Chinese medicine and Western medicine both have advantages in diagnosing and treating COPD, which have been widely used in clinic. In order to improve the diagnostic and treatment level for COPD with integrated traditional Chinese and Western medicine, Chinese Medicine of internal Medicine Committee of World federation of Chinese Medicine Societies organized and established a multidisciplinary background working group, the document was formulated by referring to the formulating method and process of international guidelines in clinical practice, current evidence with the best quality, and characteristics of integrated traditional Chinese and Western medicine in treating COPD and weighing pros and cons of interventions, 13 recommendations were established, physicians can refer to this guideline to formulate individualized treatment plans in combination with the specific conditions of patients.
Kangaroo mother care has reduced mortality and morbidity in preterm and low birth weight infants and has many benefits, such as promoting breastfeeding. Based on the current evidence in China and internationally, we developed clinical practice guidelines for kangaroo mother care in preterm and low birth weight infants using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE), and proposed 34 recommendations for 20 key questions. Our goal is to promote the appropriate implementation of kangaroo mother care in clinical practice.
ObjectiveTo analyze the current status of children's clinical practice guidelines from 2010 to 2021, and to evaluate the quality of evidence-based guidelines for children. MethodsPubMed, EMbase, CNKI, WanFang Data, and VIP databases and relevant domestic and foreign guideline websites were searched to collect Chinese pediatric clinical guidelines from January 1st 2010 to September 13th 2021. Two reviewers independently screened literature, extracted data; 4 reviewers used AGREE Ⅱ to evaluate the quality of the included evidence-based guidelines. ResultsA total of 164 guidelines were included, which involved 65 evidence-based guidelines and 99 non-evidence-based guidelines, 113 western medicine guidelines and 51 traditional Chinese medicine guidelines. The majority of the diseases with high hospitalization burden were covered by those guidelines, including 35 guidelines for respiratory diseases, ranking first among all diseases. However, there was no guideline for pediatric cardiovascular disease in China. The average scores for 65 evidence-based guidelines in 6 individual domains were 65.2%, 49.6%, 59.3%, 68.5%, 23.9% and 83.6%. ConclusionsThe scores for applicability, stakeholder involvement, and rigor of development are low for Chinese guideline for children. There is a lack of pediatric clinical guidelines for circulatory disorders.
Objective To review main obstacles to health care professionals' adherence to clinical practice guidelines (CPGs) by employing the scoping review method and a determinants framework, and to explore the effect of implementation strategies in intervention researches on guideline adherence. Methods The articles published from January 1, 2011 to June 10, 2023 were retrieved from the PubMed, CINAHL, MEDLINE, Embase, Scopus, Cochrane Library, SinoMed, CNKI, WanFang Data and VIP databases. The original literature on the CPGs implementation obstacles and strategies was included, and the primary and secondary screening of the literature were completed by four researchers according to the inclusion and exclusion criteria. The basic characteristics of the literature, the factors affecting the implementation of the CPGs, and the strategies used were extracted. The results were analyzed and summarized using qualitative and quantitative methods. Results A total of 61 articles were included in the scoping review. The factors affecting the implementation of CPGs could be divided into five categories: guidelines themselves, external factors, internal factors, individual factors, and implementation process. The most common implementation obstacles were insufficient knowledge or skills of professionals regarding guidelines (n=21, 34.4%), insufficient necessity of using guidelines according to doctors (n=17, 27.9%), and unreasonable factors within hospital (n=16, 26.2%). The factors that promoted the implementation of CPGs included guidelines based on high-quality evidence (n=5, 8.2%), good department or hospital culture (n=4, 6.6%), convenient accessibility of guideline knowledge and information (n=4, 6.6%), and doctors’ excellent professional ability (n=4, 6.6%). The overall effectiveness of the guideline implementation strategy was 50%. Clinical decision support system (CDSS) could improve the adherence of CPGs. Guideline education or training was one of the most commonly used methods, but the effect of improving guideline compliance was unstable. Conclusion The primary challenges in implementing guidelines include inadequate professional capacity and demand, suboptimal hospital infrastructure and limited resources. However, the obstacles are not absolute. It is recommended to use implementation strategies to improve the absorption and implementation of guidelines, among which CDSS is an effective measure for promoting guideline adherence.
Clinical pharmacy practice guidelines have developed rapidly in recent years. They provide a series of recommendations for optimizing drug treatment management and improving pharmaceutical care appropriateness and are widely employed in clinical practice. Based on literature review and the experience of guideline development, this paper summarized the meaning, formulation methods, formulation status, and registration of clinical pharmacy practice guidelines, and provided suggestions for the development of guidelines.
ObjectiveTo develop a transparency evaluation tool 2.0 of clinical practice guidelines (CPGs) oriented by public trust. MethodsThe Delphi method was employed to score and select the importance and operability of evaluation indicators. The analytic hierarchy process was used to determine the weights of the indicators. And the final evaluation indicator system was determined through expert consensus meeting. ResultsIt constructed two first-level indicators including conflict of interest and formulation process, and six second-level indicators, including guideline developers, reviewers, protocol and registration, evidence production, recommendation formation, and external review. Based on the second-level indicators, a total of 21 third-level indicators were constructed from the perspectives of disclosure and management. The logical structure of the tool is rigorous and harmonious. ConclusionThe CPGs transparency assessment tool 2.0 developed in this study provides measurement standards and an evaluation framework for assessing transparency in CPGs.
Community-acquired pneumonia refers to infectious pulmonary parenchyma inflammation that occurs outside the hospital, including pneumonia that occurs during the incubation period after admission of pathogens with a clear incubation period. Community-acquired pneumonia has a high incidence and mortality rate, imposing a heavy medical burden and posing a serious threat to social public health. In the diagnosis and treatment of community-acquired pneumonia, traditional Chinese medicine and Western medicine each have their own advantages. In order to strengthen the diagnosis and treatment of community-acquired pneumonia through the integration of traditional Chinese and Western medicine, and improve the prevention and treatment level of community-acquired lung disease, this guideline was developed by the Internal Medicine Professional Committee of the World Federation of Chinese Medicine Societies, led by Henan University of Chinese Medicine and the First Affiliated Hospital of Henan University of Chinese Medicine. This guideline refers to the development methods and processes of international clinical practice guidelines, based on the best existing evidence, combined with the characteristics of integrated traditional Chinese and Western medicine in the treatment of community-acquired pneumonia, weighing the pros and cons of intervention measures, and finally forming six recommended opinions, in order to provide references for the clinical practice of integrated traditional Chinese and Western medicine in the treatment of community-acquired pneumonia.
World Federation of Acupuncture-Moxibustion Societies (WFAS) standard Norms for Formulation and Evaluation of the Clinical Practice Guidelines of Acupuncture and Moxibustion (Hereinafter referred to as Norms) is the first methodological specification for the development of guidelines of acupuncture and moxibustion (Acup-Mox) issued by an international academic organization. The Norms stipulates the principles, procedures, review process and requirements of the development of WFAS guidelines of Acup-Mox. It also proposes the development method, evaluation method, and reporting standards of WFAS guidelines of Acup-Mox. This article introduces the development process of the Norms and provides an interpretation of the methodological supplementary requirements for key links such as "formulation of clinical questions", "evidence retrieval, evaluation and synthesis", and "consensus decision-making", as well as the "framework and contents of recommendation" to provide relevant references for users in learning and using the Guidelines.