Systematic analysis of levels of evidence supporting Chinese clinical practice guidelines for gastrointestinal disease.

IF 12.8 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Med Pub Date : 2024-09-13 Epub Date: 2024-06-17 DOI:10.1016/j.medj.2024.05.006
Ke Han, Pengyue Zhao, Shimin Chen, Yinghui Bao, Boyan Li, Jiajun Du, Junwei Wu, Huikai Li, Ningli Chai, Xiaohui Du, Enqiang Linghu, Miao Liu
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Abstract

Background: Clinical practice guidelines (CPGs) inform healthcare decisions and improve patient care. However, an evaluation of guidelines on gastrointestinal diseases (GIDs) is lacking. This study aimed to systematically analyze the level of evidence (LOE) supporting Chinese CPGs for GIDs.

Methods: CPGs for GIDs were identified by systematically searching major databases. Data on LOEs and classes of recommendations (CORs) were extracted. According to the Grades of Recommendation, Assessment, Development, and Evaluation system, LOEs were categorized as high, moderate, low, or very low, whereas CORs were classified as strong or weak. Statistical analyses were conducted to determine the distribution of LOEs and CORs across different subtopics and assess changes in evidence quality over time.

Findings: Only 27.9% of these recommendations were supported by a high LOE, whereas approximately 70% were strong recommendations. There was a significant disparity among different subtopics in the proportion of strong recommendations supported by a high LOE. The number of guidelines has increased in the past 5 years, but there has been a concomitant decline in the proportion of recommendations supported by a high LOE.

Conclusions: There is a general lack of high-quality evidence supporting Chinese CPGs for GIDs, and there are inconsistencies in strong recommendations that have not improved. This study identified areas requiring further research, emphasizing the need to bridge these gaps and promote the conduct of high-quality clinical trials.

Funding: This study was supported by the National Key R&D Program of China (2022YFC2503604 and 2022YFC2503605) and Special Topics in Military Health Care (22BJZ25).

系统分析支持中国胃肠疾病临床实践指南的证据水平。
背景:临床实践指南(CPG)为医疗保健决策提供依据并改善患者护理。然而,目前尚缺乏对胃肠道疾病(GIDs)指南的评估。本研究旨在系统分析支持中国胃肠道疾病临床实践指南的证据水平(LOE):方法:通过系统检索主要数据库,确定了针对 GID 的 CPGs。方法:通过系统检索主要数据库,确定了 GID 的 CPGs,并提取了 LOE 和推荐等级(CORs)数据。根据推荐等级、评估、发展和评价系统,LOEs 被分为高、中、低或极低,而 CORs 被分为强或弱。我们进行了统计分析,以确定LOE和COR在不同子课题中的分布情况,并评估证据质量随时间的变化:只有 27.9% 的建议得到了高 LOE 的支持,而约 70% 的建议属于强建议。在不同的子主题中,得到高LOE支持的强力建议的比例存在明显差异。在过去的5年中,指南的数量有所增加,但得到高LOE支持的建议比例却随之下降:结论:中国的 GID CPGs 指南普遍缺乏高质量的证据支持,在有说服力的建议中也存在不一致的情况,而且没有得到改善。本研究确定了需要进一步研究的领域,强调了弥合这些差距和促进开展高质量临床试验的必要性:本研究得到了国家重点研发计划(2022YFC2503604和2022YFC2503605)和军队医疗卫生专项课题(22BJZ25)的资助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Med
Med MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
17.70
自引率
0.60%
发文量
102
期刊介绍: Med is a flagship medical journal published monthly by Cell Press, the global publisher of trusted and authoritative science journals including Cell, Cancer Cell, and Cell Reports Medicine. Our mission is to advance clinical research and practice by providing a communication forum for the publication of clinical trial results, innovative observations from longitudinal cohorts, and pioneering discoveries about disease mechanisms. The journal also encourages thought-leadership discussions among biomedical researchers, physicians, and other health scientists and stakeholders. Our goal is to improve health worldwide sustainably and ethically. Med publishes rigorously vetted original research and cutting-edge review and perspective articles on critical health issues globally and regionally. Our research section covers clinical case reports, first-in-human studies, large-scale clinical trials, population-based studies, as well as translational research work with the potential to change the course of medical research and improve clinical practice.
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