Article type
Year
Abstract
Background:
To consider equity issues in clinical practice guidelines (CPGs) development and implementation has become increasingly important, although incorporating equity into guidelines remains a challenge. The number of Chinese CPGs is rising quickly every year, but no study has examined how these considered health equity when forming their recommendations.
Objectives:
To investigate how health equity issues were reported in recommendations from Chinese CPGs.
Methods:
Using the terms “指南” and “指引”, we searched CNKI, WanFang Data and CBM from 1 January 2016 to 1 February 2018, and collected Chinese CPGs published in 2016 and 2017. After completing the screening, two independent reviewers assessed and abstracted all the guidelines with a predefined data form and according to preset criteria. The two reviewers reached consensus on results from screening, assessment, and data abstraction process. We investigated for information about the PROGRESS-Plus factors reported in recommendations, and summarized the data of the reporting characteristics as frequencies and percentages.
Results:
We identified a total of 17096 records, from which 108 (73 in 2016 and 35 in 2017) CPGs were included after screening. A total of 65 (60.2%) CPGs reported one or more (one in 54 guidelines, two in seven, and three in four) PROGRESS-Plus factors in their recommendations. The reporting of PROGRESS Plus factors was: place of residence (2, 1.9%), which included economically underdeveloped regions and locations with limited access to the intervention; race/ethnicity/culture/language (2, 1.9%), both CPGs only mentioned language; occupation (2, 1.9%); gender/sex (9, 8.3%); religion (0); education (2, 1.9%); socioeconomic position (2, 1.9%); and social capital (0). For Plus factors, only personal characteristics associated with discrimination, like age (60, 56%), and disability (1, 0.9%) were noted.
Conclusions:
More than half of Chinese CPGs published in the 2016 and 2017 reported some factors according to PROGRESS-Plus, but only 11.1% mentioned two or three factors. Age was the most commonly reported factor in recommendations (56%); all other factors were mentioned in less than 10% of recommendations. These could to some degree, reflect the gaps concerning the reporting and awareness of equity issues and the PROGRESS-Plus framework among Chinese guideline developers.
Patient or healthcare consumer involvement:
None.
To consider equity issues in clinical practice guidelines (CPGs) development and implementation has become increasingly important, although incorporating equity into guidelines remains a challenge. The number of Chinese CPGs is rising quickly every year, but no study has examined how these considered health equity when forming their recommendations.
Objectives:
To investigate how health equity issues were reported in recommendations from Chinese CPGs.
Methods:
Using the terms “指南” and “指引”, we searched CNKI, WanFang Data and CBM from 1 January 2016 to 1 February 2018, and collected Chinese CPGs published in 2016 and 2017. After completing the screening, two independent reviewers assessed and abstracted all the guidelines with a predefined data form and according to preset criteria. The two reviewers reached consensus on results from screening, assessment, and data abstraction process. We investigated for information about the PROGRESS-Plus factors reported in recommendations, and summarized the data of the reporting characteristics as frequencies and percentages.
Results:
We identified a total of 17096 records, from which 108 (73 in 2016 and 35 in 2017) CPGs were included after screening. A total of 65 (60.2%) CPGs reported one or more (one in 54 guidelines, two in seven, and three in four) PROGRESS-Plus factors in their recommendations. The reporting of PROGRESS Plus factors was: place of residence (2, 1.9%), which included economically underdeveloped regions and locations with limited access to the intervention; race/ethnicity/culture/language (2, 1.9%), both CPGs only mentioned language; occupation (2, 1.9%); gender/sex (9, 8.3%); religion (0); education (2, 1.9%); socioeconomic position (2, 1.9%); and social capital (0). For Plus factors, only personal characteristics associated with discrimination, like age (60, 56%), and disability (1, 0.9%) were noted.
Conclusions:
More than half of Chinese CPGs published in the 2016 and 2017 reported some factors according to PROGRESS-Plus, but only 11.1% mentioned two or three factors. Age was the most commonly reported factor in recommendations (56%); all other factors were mentioned in less than 10% of recommendations. These could to some degree, reflect the gaps concerning the reporting and awareness of equity issues and the PROGRESS-Plus framework among Chinese guideline developers.
Patient or healthcare consumer involvement:
None.