Quality Assessment of Clinical Practice Guidelines for Integrative Medicine in China: A Systematic Review
【摘要】：Objective: To assess the quality of integrative medicine clinical practice guidelines(CPGs) published before 2014. Methods: A systematic search of the scientific literature published before 2014 was conducted to select integrative medicine CPGs. Four major Chinese integrated databases and one guideline database were searched: the Chinese Biomedical Literature Database(CBM), the China National Knowledge Infrastructure(CNKI), China Science and Technology Journal Database(VIP), Wanfang Data, and the China Guideline Clearinghouse(CGC). Four reviewers independently assessed the quality of the included guidelines using the Appraisal of Guidelines for Research and Evaluation(AGREE) Ⅱ Instrument. Overall consensus among the reviewers was assessed using the intra-class correlation coefficient(ICC). Results: A total of 41 guidelines published from 2003 to 2014 were included. The overall consensus among the reviewers was good [ICC: 0.928; 95% confidence interval(CI): 0.920 to 0.935]. The scores on the 6 AGREE domains were: 17% for scope and purpose(range: 6% to 32%), 11% for stakeholder involvement(range: 0 to 24%), 10% for rigor of development(range: 3% to 22%), 39% for clarity and presentation(range: 25% to 64%), 11% for applicability(range: 4% to 24%), and 1% for editorial independence(range: 0 to 15%). Conclusions: The quality of integrative medicine CPGs was low, the development of integrative medicine CPGs should be guided by systematic methodology. More emphasis should be placed on multi-disciplinary guideline development groups, quality of evidence, management of funding and conflicts of interest, and guideline updates in the process of developing integrative medicine CPGs in China.