Chinese Clinical Practice Guidelines For General Practice:the Current Situation And Reporting Guideline

Background: Primary health care plays an important role in the health care system,and at present,the quality of primary health care in China needs to be further improved.Clinical practice guidelines(CPGs)for general practice are an important tool to guide clinical practice and improve the medical quality in primary health care.Existing studies showed that Chinese CPGs for general practice had poor methodological quality and lacked methodological parts.However,no studies have investigated the reporting quality and the involvement of primary health care workers in the development process.At the same time,there is a lack of reporting guidelines for CPGs for general practice.Objective: 1)To investigate the current status and factors influencing the quality of the CPGs;2)To develop a reporting guideline suitable for CPGs in general practice.Methods: Five methods were mainly adopted,including 1)current situation investigation: current situation analysis and quality evaluation of the included CPGs.2)Content analysis method: analyze the contents of the included CPGs’ content to form the initial items.3)Brainstorming: put forward potential initial items to supplement the deficiency caused by the incomplete coverage of the CPGs.4)thematic analysis method:integration of the initial items and identification of the corresponding topics.5)Modified Delphi method: Delphi consensus of the reporting items for the CPGs for general practice.Results: 1)A total of 150 CPGs were included,most published between 2019 and2021.Most included CPGs(108,72.0%)focused on the diagnosis and treatment of diseases.The top three specialties were cardiovascular diseases(40,26.7%),gastroenterology(31,20.7%),and clinical pharmacy(27,18.0%).The Chinese Medical Association and its branches(123,82.0%),the editorial board of the Chinese Journal of General Practitioners(119,79.3%),and the Chinese Medical Journals Publishing House(116,77.3%)were involved in the development of most guidelines.The mean compliance to the RIGHT checklist was 23.6%(11.4%-42.9%);among the domains,the compliance rate for basic information(59.8%)was the highest,and for evidence(0.3%)lowest.The mean AGREE-China score was 23.4(12.0-40.0);the domain-specific scores were highest for conflicts of interest(63.0%)and usability/feasibility(53.0%),and lowest for economic efficiency(7.0%).2)A total of 13 initial items were collected,of which five items were adapted from the RIGHT checklist and eight were new items.The items covered five topics: the title/subtitle,health problem(s),end users and settings,recommendations,and suggestions for future research.We conducted two rounds of Delphi survey between December 2 and 26,2022.All 22 invited experts participated in both rounds.Finally,we formed a final checklist consisting of 15 items.Conclusion: 1)The number of Chinese CPGs in general practice has increased rapidly in the past five years,which has played an important role in promoting the quality of primary health care.2)Currently,the number of CPGs is small,the variety of diseases is limited,the methodological and reporting quality is poor.In the future,it is necessary to further develop CPGs in different specialties and diseases,and to accelerate the methodology of guideline development and reporting.3)We developed a definition and reporting guideline for CPGs for general practice,which will provide a guide for the developers of CPGs for general practice,which can improve the reporting quality of the CPGs for general practice,especially in China.