Guidelines as Topic ; Pharmacoepidemiology ; Reference Standards

Guidelines as Topic ; Humans ; Medical Oncology ; standards ; Neoplasms

Child ; Documentation ; standards ; Humans ; Pediatrics ; standards ; Practice Guidelines as Topic

Carcinoma, Intraductal, Noninfiltrating ; therapy ; Humans ; Lymphoma ; therapy ; Periodicals as Topic ; standards ; Practice Guidelines as Topic ; standards ; Publishing ; standards

Acupuncture Therapy ; methods ; standards ; Guidelines as Topic ; Humans ; Randomized Controlled Trials as Topic ; methods ; standards ; Research Design ; standards

China ; Humans ; Lymphoma ; diagnosis ; Practice Guidelines as Topic ; standards

China ; Humans ; Lung Neoplasms ; diagnosis ; therapy ; Practice Guidelines as Topic ; standards

BACKGROUNDClinical practice guidelines (CPGs) play an important role in healthcare in China as well as in the world. However, the current status and trends of Chinese CPGs are unknown. The aim of this study was to systematically review the present situation and the quality of Chinese CPGs published in the peer-reviewed medical literature.

METHODSTo identify Chinese CPGs, a systematic search of relevant literature databases (CBM, WANFANG, VIP, and CNKI) was performed for the period January 1978 to December 2010. We used the AGREE II instrument to assess the quality of the included guidelines.

RESULTSWe evaluated 269 guidelines published in 115 medical journals from 1993 to 2010 and produced by 256 different developers. Only four guidelines (1%) described the systematic methods for searching and selecting the evidence, 14 (5%) guidelines indicated an explicit link between the supporting evidence and the recommendations, only one guideline used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Thirty-one guidelines (12%) mentioned updates and the average frequency of update was 5.5 years; none described a procedure for updating the guideline. From the assessment with the Appraisal of Guidelines for Research and Ecaluation II (AGREE II), the mean scores were low for the domains "scope and purpose" (19%) and "clarity of presentation" (26%) and very low for the other domains ("rigour of development" 7%, "stakeholder involvement" 8%, "applicability" 6% and "editorial independence" 2%).

CONCLUSIONSCompared with other studies on the quality of guidelines assessed with the AGREE instrument in other countries, Chinese CPGs received lower scores, which indicates a relatively poor quality of the guidelines. However, there was some increase over time.

Asthma ; diagnosis ; therapy ; China ; Humans ; Practice Guidelines as Topic ; standards

Harmonization of clinical laboratory results means that results are comparable irrespective of the measurement procedure used and where or when a measurement was made. Harmonization of test results includes consideration of pre-analytical, analytical, and post-analytical aspects. Progress has been made in each of these aspects, but there is currently poor coordination of the effort among different professional organizations in different countries. Pre-analytical considerations include terminology for the order, instructions for preparation of the patient, collection of the samples, and handling and transportation of the samples to the laboratory. Key analytical considerations include calibration traceability to a reference system, commutability of reference materials used in a traceability scheme, and specificity of the measurement of the biomolecule of interest. International organizations addressing harmonization include the International Federation for Clinical Chemistry and Laboratory Medicine, the World Health Organization, and the recently formed International Consortium for Harmonization of Clinical Laboratory Results (ICHCLR). The ICHCLR will provide a prioritization process for measurands and a service to coordinate global harmonization activities to avoid duplication of effort. Post-analytical considerations include nomenclature, units, significant figures, and reference intervals or decision values for results. Harmonization in all of these areas is necessary for optimal laboratory service. This review summarizes the status of harmonization in each of these areas and describes activities underway to achieve the goal of fully harmonized clinical laboratory testing.
Chemistry, Clinical ; Documentation ; Guidelines as Topic ; Laboratories/*standards ; Reference Values