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Kataoka Y, Anan K, Taito S, Tsujimoto Y, Kurata Y, Wada Y, Maruta M, Kanaoka K, Oide S, Takahashi S, Nango E. Quality of clinical practice guidelines in Japan remains low: A cross-sectional meta-epidemiological study. J Clin Epidemiol 2021; 138:22-31. [PMID: 34217818 DOI: 10.1016/j.jclinepi.2021.06.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/13/2021] [Accepted: 06/25/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES We aimed to evaluate the characteristics, quality, and related factors of the Japanese Clinical Practice Guidelines (CPGs) published in recent years. STUDY DESIGN AND SETTING In this cross-sectional, meta-epidemiological study, we conducted a Google search for CPGs published by 30 Japanese medical societies that are the basis for training specialties between 2018 and 2019. We used the Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool and the Reporting Items for practice Guidelines in HealThcare (RIGHT) statement to evaluate the quality. RESULTS We included 53 systematic review-based CPGs. The median score was 0.54 (IQR, 0.38-0.62) for Stakeholder involvement, 0.57 (IQR, 0.51-0.66) in Rigor of development, 0.33 (IQR 0.21-0.46) in Applicability, and 0.63 (IQR 0.46-0.73) in Editorial independence. The number of guideline developers/clinical question ratio (odds ratio [OR]: 4.14, 95% confidence interval [CI]: 1.97, 8.70) and the adopted guideline development methods (OR: 3.69, 95% CI: 1.14, 12.0) were significantly related to the Rigor of development. CONCLUSION The quality of Japanese CPGs published in recent years remains low. Our study suggests that increasing contributors and adopting the latest guideline development methods at the beginning of the project may improve the quality of the Japanese CPGs.
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Affiliation(s)
- Yuki Kataoka
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Tanaka Asukai-cho 89, Sakyo-ku, Kyoto, 606-8226, Japan; Department of Community Medicine in the Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan; Systematic Review Workshop Peer Support Group (SRWS-PSG), Japan; Department of Healthcare Epidemiology, Graduate School of Medicine / Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Keisuke Anan
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Japan; Department of Healthcare Epidemiology, Graduate School of Medicine / Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Shunsuke Taito
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Japan; Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yasushi Tsujimoto
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Japan; Department of Nephrology and Dialysis, Kyoritsu Hospital, 16-5 Chuo-cho, Kawanishi, Hyogo, 666-0016, Japan; Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, JAPAN
| | - Yasuko Kurata
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Japan; Department of Pharmacy, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yoshitaka Wada
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Japan; Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, 470-1192, Japan
| | - Masaki Maruta
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Japan; Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Hospital, Shitsukawa, Toon, 791-0295, Japan
| | - Koshiro Kanaoka
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Japan; Department of Cardiovascular Medicine, Nara Medical University, 840, Shijo-cho, Kashihara-city, Nara, 634-8522, Japan
| | - Shiho Oide
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Japan; Department of Gynecology, Women's center, Yotsuya Medical Cube, 7-7, Nibancho, Chiyoda-ku, Tokyo, 102-0084, Japan
| | - Sei Takahashi
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Japan; Department of General Internal Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Eishu Nango
- Department of Family Medicine, Seibo International Catholic Hospital, 2-5-1 Naka-Ochiai, Shinjyuku-ku, Tokyo, 161-8521, Japan
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Kim C, Berta WB, Gagliardi AR. Exploring approaches to identify, incorporate and report patient preferences in clinical guidelines: Qualitative interviews with guideline developers. Patient Educ Couns 2021; 104:703-708. [PMID: 33059950 DOI: 10.1016/j.pec.2020.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Clinical guidelines informed by patient preferences are more likely to be used and widely advocated, yet research shows that few guidelines reflect patient preferences. OBJECTIVE Explore how developers generate guidelines informed by patient preferences. PATIENT INVOLVEMENT Seventeen patients were involved as interview participants. METHODS Using a basic descriptive approach, we conducted and analyzed semi-structured telephone interviews with 50 participants who were involved in developing guidelines on various topics. The sample included 17 patients, 16 clinicians and 17 managers from a total of 7 countries. RESULTS Participants used one or more approaches to identify preferences, patient panelists, focus groups, surveys and review of published research, despite acknowledging they identified similar preferences. Participants said they incorporated preferences in all guideline development steps, but provided little detail of specific processes. Few participants said their guidelines explicitly reported how patients were engaged, preferences identified, or how preferences influenced development processes or the guideline. Enablers were patient and clinician training, supportive coordinators and chairs, involving experienced patients, and assistance from qualitative and review experts. Barriers were finding and preparing patients, clinician skepticism about benefits, and token patient involvement. Participants recommended research on how to generate preference-informed guidelines. DISCUSSION Ideal approaches to identify, incorporate and report patient preferences in guidelines are unclear and unproven. PRACTICAL VALUE Findings revealed specific ways that developers can enhance their processes (e.g. patient training, supportive coordinators and chairs, involve experts in qualitative researcher and systematic reviews) and key issues that warrant ongoing research (e.g. how best to incorporate and report preferences).
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Affiliation(s)
- Claire Kim
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - Whitney B Berta
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada
| | - Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
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Dai Z, Kroeger CM, Lawrence M, Scrinis G, Bero L. Comparison of methodological quality between the 2007 and 2019 Canadian dietary guidelines. Public Health Nutr 2020; 23:2879-85. [PMID: 32552917 DOI: 10.1017/S1368980020000956] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE With significant shifts in the dietary recommendations between the 2007 and 2019 Canadian dietary guidelines, such as promoting plant-based food intake, reducing highly processed food intake and advocating the practice of food skills, we compared their differences in guideline development methods. DESIGN Two reviewers used twenty-five guided criteria to appraise the methods used to develop the most recent dietary guidelines against those outlined in the 2014 WHO Handbook for Guideline Development. SETTING Canada. PARTICIPANTS 2007 and 2019 dietary guidelines. RESULTS We found that the 2019 guidelines were more evidence-based and met 80 % (20/25) of the WHO criteria. For example, systematic reviews and health organisation authoritative reports, but not industry reports, constituted the evidence base for the dietary recommendations. However, recommendations on food sustainability and food skill practice were driven primarily by stakeholders' interests. By contrast, less information was recorded about the process used to develop the 2007 guidelines, resulting in 24 % (6/25) consistency with the WHO standards. CONCLUSIONS Our analysis suggests that a more transparent and evidence-based approach is used to develop the 2019 Canadian dietary guidelines and that method criteria should support further incorporation of nutrition priorities (food sustainability and food skills) in future dietary guideline development.
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