1.Reporting Status of Clinical Practice Guideline Protocols: A Systematic Analysis
Huayu ZHANG ; Xufei LUO ; Hui LIU ; Qi ZHOU ; Yishan QIN ; Ye WANG ; Yuanyuan YAO ; Haodong LI ; Xiaohui WANG ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2026;17(1):255-262
To systematically analyzed the reporting status of core elements in publicly available clinical practice guideline(hereafter referred to as "guideline") protocols published domestically and internationally over the past decade, identified existing problems, and provided evidence to inform the standardized writing and publication of future guideline protocols. A systematic search was conducted in Chinese and English databases for clinical practice guideline protocols published during the past ten years. The basic characteristics and reporting of core elements—including registration information, conflict of interest management, evidence grading, development process and timeline planning, as well as dissemination and implementation—were extracted and analyzed. Chi-square tests were performed to explore associations between protocol characteristics and the reporting of core elements. A total of 94 guideline protocols were included, of which 67 were in Chinese(71.28%) and 27 were in English(28.72%). Overall, 82.98% of the guideline protocols were registered, 92.55% reported management of conflicts of interest, 97.87% reported evidence searching, 88.30% reported evidence grading, and 89.36% described dissemination and implementation strategies. However, only 55.32% reported the guideline development process, and merely 23.40% reported timeline planning. Further analysis indicated that the reporting of registration, evidence searching, development process, and timeline planning was associated with year of publication. Differences were observed between domestic and international guidelines in reporting registration, conflict of interest management, development process, time planning, and dissemination and implementation. Guidelines intended for development exhibited higher reporting rates for registration, development process, and dissemination and implementation compared to those planned for updating or adaptation. Although current guideline protocols demonstrate relatively adequate reporting of methodological elements, deficiencies remain in development process and timeline planning. Future efforts should focus on promoting the publication and standardized reporting of guideline protocols, enhancing the international recognition of registration platforms, and strengthening the development process and timeline planning to advance the scientific rigor and transparency of guideline development.
2.STAR Guideline Terminology (I): Planning and Launching
Zhewei LI ; Qianling SHI ; Hui LIU ; Xufei LUO ; Zijun WANG ; Jinhui TIAN ; Long GE ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2025;16(1):216-223
To develop a guideline terminology system and promote its standardization, thereby enhancing medical staff's accurate understanding and correct application of guidelines. A systematic search was conducted for guideline development manuals and method ological literature (as of October 25, 2024). After screening, relevant terms from the guideline planning and launching stages were extracted and standardized. The term list and definitions were finalized through discussion and evaluation at a consensus conference. A total of 36 guideline manuals and 14 method ological articles were included, and 27 core terms were identified. The standardization of guideline terminology is essential for improving guideline quality, facilitating interdisciplinary communication, and enhancing other related aspects. It is recommended that efforts to advance the standardization and continuous updating of the terminology system should be prioritized in the future to support the high-quality development of guidelines.
3.Analysis of the efficacy of traditional Chinese medicine for diabetic retinopathy based on evidence body quality assessment
Juan LING ; Zhuolin XIE ; Xiangxia LUO ; Wanying GUO ; Jiajin LI ; Jun ZHOU ; Xufei LUO
China Pharmacy 2025;36(7):863-866
OBJECTIVE To evaluate the quality of evidence in the systematic evaluation/meta-analysis of traditional Chinese medicine (TCM) for diabetes retinopathy (DR) based on the GRADE system. METHODS Chinese and English databases were searched to obtain the relevant studies of systematic evaluation/meta-analysis of traditional Chinese medicine in the treatment of DR. The search time was from the establishment of each database to January 13th, 2024. According to the inclusion and exclusion criteria, literature screening was conducted. After extracting relevant information from the included literature, the GRADE system was used to evaluate the quality level of the evidence body in the included studies, and the evidence of the outcome indicators was integrated and summarized. RESULTS A total of 51 studies were ultimately included, encompassing 135 outcome indexes. Among these, 19 indicators (14.1%) were of high quality, 87 (64.4%) were of medium quality, 26 (19.3%) were of low quality, and 3 (2.2%) were of very low quality. Overall, the evidence quality of the outcome indicators in the included studies was medium to low quality. The integrated results of evidence on the efficacy of outcome indexes showed that compared with conventional Western medicine, calcium dobesilate or placebo, TCM had significant advantages in improving overall efficacy, reducing bleeding spot area, reducing macular foveal thickness, and increasing visual improvement rate. In addition,the combination of TCM and conventional Western medicine or calcium dobesilate was significantly more effective than using conventional Western medicine or calcium dobesilate alone. CONCLUSIONS The overall quality of the evidence in the systematic evaluation/meta-analysis study on the treatment of DR with TCM is medium to low quality. Based on existing research findings, TCM demonstrates good clinical efficacy in the treatment of DR.
4.Analysis of the Current Status of China's Adaptation Guidelines
Ling WANG ; Yaxuan REN ; Xufei LUO ; Di ZHU ; Zhewei LI ; Ye WANG ; Bingyi WANG ; Huayu ZHANG ; Shu YANG ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2024;15(1):192-201
5.Methodology of Scientific, Transparent and Applicable Rankings for Chinese Guidelines and Consensus Related Literature Published in the Medical Journals: ample Identification and Speciality Assignment
Hui LIU ; Nan YANG ; Qianling SHI ; Xufei LUO ; Hairong ZHANG ; Jinhui TIAN ; Yinghui JIN ; Yaolong CHEN ; METHODOLOGY AND TECHNOLOGY SPECIALISATION COMMITTEE OF THE STAR WORKING GROUP
Medical Journal of Peking Union Medical College Hospital 2024;15(2):429-434
With the development of the Scientific, Transparent and Applicable Rankings tool for clinical practice guidelines(STAR), the publication of evaluation and ranking for scientificity, transparency and applicability of Chinese guidelines and consensus published in the medical journals in 2021and 2022, as well as the publication of the STAR evaluation and ranking for some specialities, the STAR evaluation and ranking has received widespread attention in the medical community. In order to further enhance its scientificity and transparency, Methodology and Technology Specialization Committee of the STAR Working Group presents this article to introduce sample identification and speciality assignment in the evaluation and ranking process.
6.Reflections on Developing Health Standards Based on Evidence-based Concept
Renfeng SU ; Hui LIU ; Qianling SHI ; Xufei LUO ; Nan YANG ; Junxian ZHAO ; Qiannan TIAN ; Juanjuan ZHANG ; Liqun WU ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2024;15(2):435-441
National health standards involve all kinds of technical requirements formulated and numbered in accordance with the procedures and formats stipulated in the standardisation system for the implementation of national health and hygiene laws, regulations and policies, and the protection of human health. The establishment of health standards in China should align with our legal framework, including laws, regulations, departmental rules, and health and hygiene policies. During the development of these standards, a comprehensive approach is advocated, encompassing in-depth investigations, rigorous demonstrations, and extensive stakeholder engagement. However, the process of standard formulation may suffer from insufficient research evidence. The evidence-based concept emphasizes the significance of evidence. Therefore, integrating evidence-based concept into the process of developing health standards can enhance the quality and scientific basis of these standards. This article systematically elucidates the current status and development process of health standards in China, explores the necessity and feasibility of incorporating evidence-based concept into the development of these standards, analyzes the challenges and opportunities, and presents reflections and suggestions.
7.How to Correctly Understand and Use the Low-quality Evidence to Formulate Recommendations in Guidelines
Qianling SHI ; Hui LIU ; Zijun WANG ; Xufei LUO ; Bingyi WANG ; Nan YANG ; Wenbo MENG ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2024;15(3):676-685
The essence of clinical practice guidelines lies in their recommendations. It is common to find strong recommendations supported by low-quality evidence in current published guidelines. There is a typical misunderstanding among medical professionals that without high-quality evidence, it is impossible to develop high-quality guidelines or only expert consensus can be developed. Based on the GRADE approach, this paper explains the concept and clinical significance of low-quality evidence, and introduces the methods for formulating recommendations based on low-quality evidence in guidelines, with the aim to provide reference for guideline developers and users in China.
8.The Differences and Connections Among Expert Evidence, Expert Opinion and Expert Consensus in the Development of Guidelines
Di ZHU ; Xufei LUO ; Zijun WANG ; Qianling SHI ; Haodong LI ; Ye WANG ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2024;15(4):936-941
Expert evidence, expert opinion, and expert consensus are frequently mentioned and used in the process of guideline development. However, due to the lack of clear definitions and standards, there is confusion and misuse among the three in practice. This paper clarifies the meanings, current status, differences, and connections of expert evidence, expert opinion, and expert consensus in the development of guidelines, aiming to provide a reference for guideline developers in China.
9.The Impact of Generative Artificial Intelligence on the Development, Evaluation, and Application of Clinical Practice Guidelines
Xufei LUO ; Han LYU ; Zaiwei SONG ; Hui LIU ; Zhixiang WANG ; Haodong LI ; Ye WANG ; Di ZHU ; Lu ZHANG ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1173-1181
Generative artificial intelligence (GAI) refers to AI technology capable of generating new content such as text, images, or audio from training data. GAI tools not only demonstrate rapid and efficient potential in literature screening, data extraction, and literature appraisal in systematic reviews, but can also be used for guideline evaluation and dissemination, enhancing the readability and promotion efficiency of guidelines. However, the accuracy of content generated by GAI tools, the rationality of cited evidence, the level of evidence, and the reliability of data still need verification. Additionally, data privacy protection and ethical issues are challenges that need to be addressed. This article aims to overview the current status of GAI tools in the formulation, evaluation, dissemination, and implementation of guidelines, explore the feasibility and new models of GAI tools in the field of guidelines, and improve the efficiency and quality of guideline formulation to better serve guideline developers and users.
10.Research progress of ferroptosis and ischemia-reperfusion injury
Longcan YANG ; Yongxia CHEN ; Hao LUO ; Yuyou HUANG ; Xiaobin REN ; Bo LIU ; Zhaoming HU ; Xufei TIAN ; Feng ZHANG
Chinese Journal of Hepatobiliary Surgery 2024;30(7):556-560
Ferroptosis is a kind of programmed cell death, involves multi-molecular and multi-signaling pathways, and the core processes is iron overload and lipid peroxidation. It affects cancer, neurological disease, cardiovascular disease, digestive system disease, and many other diseases. While, ischemia-reperfusion injury is an extremely complex pathological process, including ischemia-reperfusion injury of the heart, brain, liver and kidney, etc., which often occurs in shock, organ surgery and organ transplantation, seriously affecting human health, and there is no effective radical treatment. However, ferroptosis is closely related to ischemia-reperfusion injury so that it is possible to find the prevention and treatment measures of ischemia-reperfusion injury by exploring the internal relationship between them. Therefore, the author tries to summarize the signaling pathways of ferroptosis, and explores the relationship between ferroptosis and ischemia-reperfusion injury of heart, brain, liver and kidney by moderating the ferroptosis targets properly to find the effective ways to treat cancer, improve inflammation and relieve other diseases.

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