Abstract
Objective
To assess the quality of integrative medicine clinical practice guidelines (CPGs) published before 2014.
Methods
A systematic search of the scientific literature published before 2014 was conducted to select integrative medicine CPGs. Four major Chinese integrated databases and one guideline database were searched: the Chinese Biomedical Literature Database (CBM), the China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Data, and the China Guideline Clearinghouse (CGC). Four reviewers independently assessed the quality of the included guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument. Overall consensus among the reviewers was assessed using the intra-class correlation coefficient (ICC).
Results
A total of 41 guidelines published from 2003 to 2014 were included. The overall consensus among the reviewers was good [ICC: 0.928; 95% confifi dence interval (CI): 0.920 to 0.935]. The scores on the 6 AGREE domains were: 17% for scope and purpose (range: 6% to 32%), 11% for stakeholder involvement (range: 0 to 24%), 10% for rigor of development (range: 3% to 22%), 39% for clarity and presentation (range: 25% to 64%), 11% for applicability (range: 4% to 24%), and 1% for editorial independence (range: 0 to 15%).
Conclusions
The quality of integrative medicine CPGs was low, the development of integrative medicine CPGs should be guided by systematic methodology. More emphasis should be placed on multi-disciplinary guideline development groups, quality of evidence, management of funding and conflfl icts of interest, and guideline updates in the process of developing integrative medicine CPGs in China.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Wang J, Xu ZR. The concept and scope of integrative medicine. J Chin Integr Med (Chin) 1997;17:692.
Lyu AP, Liu MY, Zhang C, Yu WY, Lyu C. The review of integrative medicine in the last three decades. J Chin Integr Med (Chin) 2011;31:1445.
Grol R. Success and failures in the implementation of evidence-based guidelines for clinical practice. Med Care 2001;39(8 Suppl 2):46–54.
Davis DA, Taylor-Vaisey A. Translating guidelines into practice: a systematic review of theoretic concepts, practice experience and research evidence in the adoption of clinical practice guidelines. CMAJ 1997;157:408–416.
Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluation. Lancet 1993;342:1317–1322.
AGREE Collaboration. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care 2003;12:18–23.
Liu DS, Zhao XY, Yu WY. The quality assessment of clinical practice guidelines of traditional Chinese medicine for hypertension which based on AGREE VI instrument. China J Tradit Chin Med Pharm (Chin) 2014;29:1197.
Yu WY, Han XJ, Zhang H, Wang LY, Shi NN, Wang YY, et al. The quality assessment of evidence-based guidelines of traditional Chinese medicine which based on AGREE instrument. Modern Tradit Chin Med Mater Med World Sci Technol (Chin) 2011;13:596.
Institute of Medicine. Clinical practice guidelines: directions for a new program. Washington D.C.: National Academies Press; 1990.
Institute of Medicine. Guidelines for clinical practice: from development to use. Washington D.C.: National Academies Press; 1992.
Institute of Medicine. Setting priorities for clinical practice guidelines. Washington D.C.: National Academies Press; 1995.
Institute of Medicine, ed. Clinical practice guidelines we can trust. Washington D.C: The National Academies Press; 2011.
Chen YL, Yao L, Xiao XJ, Wang Q, Wang ZH, Liang FX, et al. Quality assessment of clinical guidelines in China: 1993–2010. Chin Med J (Engl) 2012;125:3660–3664.
Alonso-Coello P, Irfan A, Sola I, Gich I, Delgado-Noguera M, Rigau D, et al. The quality of clinical practice guidelines over the last two decades: a systematic review of guideline appraisal studies. Qual Saf Health Care 2010;19:e58.
World Health Organization. WHO handbook for guideline development. 2nd ed. Geneva: WHO Press; 2014.
Langer G, Meerpohl JJ, Perleth M, Gartlehner G, Kaminski-Hartenthaler A, Schünemann H. GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of fi ndings tables. J Clin Epidemiol 2011;64:383–394.
Sniderman AD, Furberg CD. Why guideline-making requires reform. JAMA 2009;301:429–431.
Williams MJ, Kevat DA, Loff B. Confl ict of interest guidelines for clinical guidelines. Med J Aust 2011;195:442–445.
Boyd EA, Bero LA. Improving the use of research evidence in guideline development: 4. Managing confl icts of interests. Health Res Policy Syst 2006;4:16.
Shekelle PG, Ortiz E, Rhodes S, Morton SC, Eccles MP, Grimshaw JM, et al. Validity of the agency for healthcare research and quality clinical practice guidelines: how quickly do guidelines become outdated? JAMA 2001;286:1461–1467.
Shekelle P, Eccles MP, Grimshaw JM, Woolf SH. When should clinical guidelines be updated? BMJ 2001;323:155–157.
Author information
Authors and Affiliations
Corresponding author
Additional information
Supported by the Special Program on Science and Technology of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine and Guangdong Province Fund for Nature (No. S2013010015427)
Electronic supplementary material
Rights and permissions
About this article
Cite this article
Yao, S., Wei, D., Chen, Yl. et al. Quality assessment of clinical practice guidelines for integrative medicine in China: A systematic review. Chin. J. Integr. Med. 23, 381–385 (2017). https://doi.org/10.1007/s11655-016-2739-z
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11655-016-2739-z