Investigation and Evaluation of Chinese Clinical Practice Guidelines Published in Medical Journals in 2019： Analysis of the Evidence

Objective The aim of this studty is to investigate the current status of evidence of recommendations contained in Chinese clinical practice guidelines published in journals in 2019, so as to provide reference for the use of evidencefor Chinese guidelines in the future. Methods We searched and analyzed information on Chinese guidelines published in 2019 with clear recommendations, grading of evidence quality and corresponding instructions of grading, as well as information on citations supporting the recommendations. Results A total of 31 guidelines (29 Chinese guidelines and 2 English guidelines) containing 568 recommendations and 3126 references were included. Each guideline included an average of 18 recommendations. Of these, 2541 references were presented as evidence in the statements of guideline recommendation (such references are referred to as "evidence" hereafter). The average number of evidence was 82 in each guideline and every recommendation has 4 pieces of evidence. The top three countries where the evidence was from were China (28.8%), the United States (25.9%), and the United Kingdom (7.0%). Only 39.2% (995/2541) of the evidence was published in the last 5 years. The most common type of evidence for the guidelines was randomized controlled trials (26.9%). The citation of systematic review was only 12.0%. Conclusion Most of the Chinese guidelines published in 2019 did not have clear and unambiguous recommendations. Some guidelines with clear recommendations had incomplete and untimely evidence citations. Guideline developers should strengthen the rational use of currently available research evidence.