How to identify clinical questions for practice guideline: A case analysis of a Chinese perioperative blood-glucose management guideline

Article type
Authors
wang J1, Chen Y2, Chen K3, Li X4, Mu Y3
1Affiliated Hospital of Academy of Military Medical Sciences (PLA 307 Hospital) Beijing,100071
2Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000
3Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853
4Department of Gerontology, First Affiliated Hospital of Kunming Medical University, Kunming 650031
Abstract
Background: There is no universally international standard on how to choose and determine the clinical questions for practice guideline.

Objectives: To determine the number and priorities of clinical questions for a Chinese perioperative blood glucose management guideline.

Methods: Referring to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method and consensus process, we designed a questionnaire, and conducted three rounds of e-mail survey for clinical practitioners. We refined and circulated the questions from the first and second surveys to the second and third surveys respectively, and clinicians scored and gave their comments to each question. We then included questions according to the scores.

Results: We collected 18 questions from 9 physicians in three hospitals in the first survey, and refined them into 31 questions. In the second round, we received 13 questionnaires from three hospitals, selected 20 high scored questions and deconstructed them into 84 questions. In the last survey, 84 questions were scored by 17 respondents in 3 hospitals, and the top 20 questions were included.

Conclusions: Different clinicians have different concerns, and they can provide the information of real need in practice. In our study, clinicians scored the questions raised by themselves can ensure the consistency. Whereas the three-rounds survey could, to a great extent, benefit the accuracy and pertinence.