Analysis of quality of clinical practice guidelines for otorhinolaryngology in China.
OBJECTIVE
To evaluate the quality of clinical practice guidelines (CPGs) for otorhinolaryngology in China.


METHODS
A systematic search of relevant literature databases (CBM, WANFANG, VIP, CNKI, China Guideline Clearinghouse) published between 1978 and March 2012 was undertaken to identify and select CPGs related to otorhinolaryngology. Four independent reviewers assessed the eligible guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Their degree of agreement was evaluated using the intraclass correlation coefficient (ICC).


RESULTS
From 170 citations, 21 relevant guidelines were included. The overall agreement among reviewers was moderate (ICC = 0.87; 95% confidence interval [CI], 0.78-0.91). The scores for each of the AGREE domains were the following: "scope and purpose" (mean ± standard error [SE] = 45.4±4.4; ICC = 0.92), "stakeholder involvement" (mean ± SE = 30.4±3.1; ICC = 0.81), "rigor of development" (mean ± SE = 20.9±2.8; ICC = 0.87), "clarity of presentation" (mean ± SE = 48.8±3.7; ICC = 0.80), "applicability" (mean ± SE = 12.6±1.7; ICC = 0.72), and "editorial independence" (mean ± SE = 6.2±0.8; ICC = 0.76). Three guidelines (14%) mentioned updates, and the average update frequency was 7 years. None used the GRADE system.


CONCLUSIONS
The quality of otorhinolaryngology guidelines in China is low. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision-making in this field.
School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
Zhe-wen
ZW
Zhang
Xiao-wen
XW
Liu
Bai-cheng
BC
Xu
Su-yang
SY
Wang
Li
L
Li
Ying-ying
YY
Kang
Yu-fen
YF
Guo
D002681:China; D006801:Humans; D010036:Otolaryngology / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D011786:Quality Control