Abstract

Background: Clinical practice guidelines (CPGs) are intended to improve quality of care based on the best available evidence. A credible CPG is an essential tool for knowledge translation. A quality CPG can facilitate clinical decision making. Therefor it is imperative to evaluate the quality of CPGs for promoting healthcare. Objectives: The aim of this research was to systematically review the quality of evidence-based CPGs developed in Taiwan. Methods: (1) Systematic search: Using "Guideline" [Publication Type], "Guidelines as Topic"[Mesh] as keywords, search for Cochrane, PubMed, EMBASE, CINAHL, NGC, SIGN, NICE, NZGG, G-I-N Library, JBI, National Digital Library of Theses and Dissertations in Taiwan, Airiti Library (Chinese database), Government Research Bulletin, and Google Scholar, limited to Chinese or English. (2) Quality assessment: Each CPG was evaluated independently by 2 researchers with Appraisal of Guidelines for REsearch & Evaluation (AGREE II) Instrument. In case of ≧ 3 points difference in score between 2 reviewers, a third expert was invited as tiebreaker. Results: A total of 96 CPGs published between 1999 and 2018 were included after screening. Majority of CPGs were published in Traditional Chinese (n=78, 81.3%), the others in English (n=18, 18.7%). Three quarters (n=72) CPGs development was based on systematic reviews, and one fourth (n=24) CPGs by experts’ consensus. Four (4.2%) CPGs adapted Grading of Recommendation Assessment, Development and Evaluation (GRADE) methodology. Only 13 (14%) CPGs provided updated version. For funding, a total of 35 (36.5%) CPGs received grants from government, while others were developed independently by professional societies. The statements of conflicts of interest and related documents were rarely mentioned. The standardized score of AGREE II in the 6 domain were 81%, 55%, 47%, 63%, 31%, and 22%, and the overall quality was 4.5 points. The domains with lower score were: “editorial independence”, “application”, and “rigour of development”. Conclusions: There is room for quality improvement in Taiwan’s CPGs from our survey. For the future development, the use of a standardized international grading system, such as GRADE, is essential to ensure a high quality of methodology. In addition, the tools such as AGREE II for evaluation of the new CPGs will substantially improve the developed and updated CPGs through rigorous evaluation. It is difficult to obtain the necessary or complete information of developed CPGs in Taiwan without a credible agency, therefore hinders the research efforts and completeness of the data search. It would be most desirable to develop a CPGs integration platform in Taiwan, either governmental or NGO based, for better coordinating the development and quality assurance of CPGs and the indexing of the database for CPGs. In addition, the agency can play a role in dissemination of the CPGs information for healthcare quality.
Original languageEnglish
Pages (from-to)214
Number of pages1
JournalCochrane Database of Systematic Reviews
Issue number9 suppl 1
DOIs
Publication statusPublished - Sep 30 2020

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