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中国临床实践指南更新情况调查
引用本文:陈耀龙,王小琴,吴琼芳,韦当,姚亮,王琪,元博,王新,杨克虎.中国临床实践指南更新情况调查[J].中国循证医学杂志,2014(2):178-183.
作者姓名:陈耀龙  王小琴  吴琼芳  韦当  姚亮  王琪  元博  王新  杨克虎
作者单位:[1]甘肃省循证医学与临床转化重点实验室,兰州730000 [2]兰州大学循证医学中心/中国GRADE中心,兰州大学基础医学院,兰州730000 [3]兰州大学第一临床医学院,兰州730000 [4]兰州大学口腔医学院,兰州730000 [5]西安交通大学医学院第一附属医院,西安710061
基金项目:甘肃省循证医学与临床转化重点实验室开放基金
摘    要:目的调查中国临床实践指南的更新周期、方法和步骤。方法在WanFang Data、VIP、CNKI中,以"指南、指引"为检索词在题名中进行检索,在CBM数据库中以"指南"为主题词进行检索,纳入符合标准的文献,统计分析其更新情况。结果共纳入指南380个,报道已更新的指南仅有38个(10%),平均更新周期为5.1年,更新周期最长为10年,最短为1年;38个已更新指南中有8个(2%)进行过多次更新,其平均更新次数为3次,平均更新周期为4.9年。在342个未更新过的指南中,提及未来会更新的指南有42个(12%)。将已更新指南按临床用途分:预防类指南1个(0.3%),更新周期为4年;治疗类指南8个(2%),平均更新周期为4.3年;防治指南5个(1%),平均更新周期6.8年;诊疗类指南18个(5%),平均更新周期5.3年;技术类指南4个(1%),平均更新周期为5.5年;综合指南2个(0.5%),平均更新周期为2.5年。所有指南中,有40个(10%)在文中描述了更新方法。结论分析国际与国内指南更新情况发现,中国临床实践指南更新比例低,更新周期长,且参差不齐;更新方法和步骤报道不规范,描述不充分;不同类别的指南和不同机构制定的指南更新情况差异大。

关 键 词:临床实践指南  循证医学  更新  中国

Survey on Update Condition of Clinical Practice Guidelines in China
CHEN Yao-long,WANG Xiao-qin,WU Qiong-fang,WEI Dang,YAO Liang,WANG Qi,YUAN Bo,WANG Xin,YANG Ke-hu.Survey on Update Condition of Clinical Practice Guidelines in China[J].Chinese Journal of Evidence-based Medicine,2014(2):178-183.
Authors:CHEN Yao-long  WANG Xiao-qin  WU Qiong-fang  WEI Dang  YAO Liang  WANG Qi  YUAN Bo  WANG Xin  YANG Ke-hu
Institution:1. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China; 2. Evidence-Based Medicine Center/Chinese GRADE Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China, 3. The First Clinical Medical School Lanzhou University, Lanzhou 730000, China; 4. School of Stomatology, Lanzhou University, Lanzhou 730000, China; 5. The First Affiliated Hospital Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
Abstract:Objective To investigate the updating period, methods and procedures of Clinical Practice Guidelines (CPGs) in China. Methods We 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. Results A 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. Condusion According 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.
Keywords:Clinical practice guideline (CPG)  Evidence-based Medicine (EBM)  Update  China
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