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Original Research: Education, Research, and Quality Improvement |

Quality Assessment of Clinical Practice Guidelines for Respiratory Diseases in ChinaQuality Assessment Respiratory Disease Guidelines: A Systematic Appraisal

Mei Jiang, PhD; Li-yue Liao, MD; Xiao-qing Liu, MD; Wei-qun He, MD; Wei-jie Guan, PhD; Hao Chen, MD; Yi-min Li, MD
Author and Funding Information

From the State Key Laboratory of Respiratory Disease (Drs Jiang, Liao, Liu, He, Guan, and Li), National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical University, Guangzhou; and the Second Clinical College of Nanjing University of Chinese Medicine (Dr Chen), Nanjing, China.

CORRESPONDENCE TO: Yi-min Li, MD, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Rd, Guangzhou, Guangdong 510120, China; e-mail: dryiminli@vip.163.com


FUNDING/SUPPORT: This work was supported by the National Natural Science Foundation of China [Grants 81270125 and 81402772].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(3):759-766. doi:10.1378/chest.14-3201
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BACKGROUND:  There has been a significant increase in the publication of clinical practice guidelines (CPGs) for respiratory diseases in China. However, little is known about the quality and potential impacts of these CPGs. Our objective was to critically evaluate the quality of Chinese CPGs for respiratory diseases that were published in peer-reviewed medical journals.

METHODS:  A systematic search of scientific literature published between 1979 and 2013 was undertaken to identify and select CPGs that were related to respiratory diseases. Four Chinese databases (the Chinese Biomedical Literature database [CBM], the China National Knowledge Infrastructure [CNKI], the VIP database, and the WANFANG database) were used. The quality of eligible guidelines was assessed independently by four reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. The overall agreement among reviewers was evaluated using an intraclass correlation coefficient.

RESULTS:  A total of 109 guidelines published in 27 medical journals from 1979 to 2013 were evaluated. The overall agreement among reviewers was considered good (intraclass correlation coefficient, 0.838; 95% CI, 0.812-0.862). The scores of the six AGREE domains were low: 57.3% for scope and purpose (range, 4.2%-80.5%), 23.8% for stakeholder involvement (range, 2.8%-54.2%), 7.7% for rigor of development (range, 0%-27.1%), 59.8% for clarity and presentation (range, 22.2%-80.6%), 10.9% for applicability (range, 0%-22.9%), and 0.6% for editorial independence (range, 0%-16.7%). Scores for all guidelines were below 60%, and only three guidelines (2.8%) were recommended for clinical practice with modifications.

CONCLUSIONS:  The quality of the guidelines was low, and stakeholder involvement, rigor of development, applicability, and editorial independence should be considered in the future development of CPGs for respiratory diseases in China.

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