Objective To explore the methodological characteristics of Chinese clinical practice guidelines/expert consensus based on usage of GRADE. MethodsCNKI, PubMed, WanFang Data databases, and Medlive.cn were electronically searched to collect Chinese clinical practice guidelines/expert consensus over the past 11 years from January 1st 2010 to December 31st 2020. Four reviewers independently extracted data according to the content of appraisal of guidelines quality evaluation tool AGREE Ⅱ. The clinical practice guidelines/expert consensus were divided into two groups based on whether GRADE was used or not. The changes and development of methodological quality in the past 11 years were explored between the two groups. ResultsIn recent years, the number of clinical practice guidelines/expert consensus which used the GRADE in China had increased annually. The practice guidelines/expert consensus which did not use GRADE had lower methodology quality (P<0.01). ConclusionsThe use of GRADE in clinical practice guidelines/expert consensus requires improvement, and mastering GRADE methodology can effectively improve the methodological quality of the clinical practice guidelines/expert consensus.
Clinical practice guidelines serve as a critical tool for bridging evidence and clinical practice, with the quality and clarity of their recommendations directly influencing implementation outcomes. Based on the classification framework of guideline actionable statements proposed by Lotfi, this article systematically interprets the definitions, characteristics, and applicable conditions of six types of guideline statements: formal recommendations, research only recommendations, good practice statements, implementation considerations, tools and tips, remarks, and informal recommendations. A comparative analysis with mainstream international guideline development manuals is also provided. The article emphasizes the importance of standardizing statement classification to enhance the methodological quality and implement ability of guidelines, offering practical insights for both guideline developers and users.