全球临床指南数据库运行机制的比较研究

A comparative study on operative mechanism of the global clinical guideline databases

目的比较全球最具代表性的综合性指南库运行机制及其特点,为我国临床实践指南库的运行与管理提供借鉴。方法首先,课题组成员通过讨论并咨询指南和数据库领域专家,收集国内外指南数据库;其次,检索PubMed和CNKI数据库中与指南库相关的研究,补充获取研究中提及的指南库;最后,进一步咨询指南专家,纳入最具代表性的综合性指南库。提取符合纳入标准的指南库建立及管理机构、资金来源、人力资源、建库目标及质控措施(指南入库标准、更新要求)资料,根据建立机构性质将指南库分为政府主导、学术组织主导、企业主导三类,采用描述性方法进行分析。结果共纳入9个指南库,其中政府主导、学术主导分别为4个,企业主导1个。7个指南库的建立机构与管理机构是同一机构。9个指南库均设立办事处,其中7个位于首都。多数指南库资金来自政府。4个指南库实行董事会管理。按职能分工,指南库建立、运行人员主要包括负责人、专家团队、管理人员、秘书、网站开发人员、患者代表6类。指南库入库标准与建库目的有相关性。多数指南库要求指南在3～5年内更新。结论本研究提供了不同国家指南库的运行管理机制信息,以帮助指南库构建者在顶层设计时能全面考虑不同运行机制的优缺点,从而建立本土化的科学的指南库运行机制。

Objectives To summarize and compare the operative mechanisms of the most representative comprehensive clinical practice guideline（CPG） databases worldwide, so as to provide references for establishing and managing Chinese CPG database. Methods CPG databases were collected worldwide by discussing with experts in the guideline and database fields. Studies on guideline databases were searched in PubMed and CNKI to further collect CPG databases mentioned in these studies. Representative comprehensive guideline databases were finally selected by c onsulting relevant guideline experts. The institutions＇ names of establishing and managing CPG databases,funding sources, human resources, aims, quality control measures（including CPG inclusion and updating criteria） were extracted and summarized. Databases were divided into government-led, society-led, and enterprise-led models. A descriptive analysis was conducted. Results There were four government-led databases, four society-led databases and merely one enterprise-led database. The institutions of establishing CPG databases were same as the institutions of managing databases in the seven databases. All CPG databases had set up offices, seven of which were located in the capital. Most databases＇ funds came from the government. Four databases implemented board management. According to the division of functions, members involved in establishing and managing CPG databases mainly included leaders,expert teams, managerial personnel, secretaries, web developers, and patient representatives. Criteria for inclusion of CPG were relevant to the purpose of establishing databases. Most databases required guidelines that had be updated within three to five years. Conclusions This study provides comprehensive information on operative mechanism of different CPG databases which can assist guideline database builders to optimize their operative mechanism.