中国临床实践指南更新情况调查

Survey on Update Condition of Clinical Practice Guidelines in China

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。

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.