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Analysis Medical Research in China

Clinical practice guidelines in China

BMJ 2018; 360 doi: (Published 05 February 2018) Cite this as: BMJ 2018;360:j5158

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  1. Yaolong Chen, researcher1 2,
  2. Chen Wang, professor3,
  3. Hongcai Shang, professor2,
  4. Kehu Yang, professor1,
  5. Susan L Norris, scientist4
  1. 1Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
  2. 2Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
  3. 3National Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
  4. 4Secretary, Guidelines Review Committee, World Health Organization, Geneva, Switzerland
  1. Correspondence to: Yaolong Chen chenyaolong{at}

Yaolong Chen and coworkers analyse the situation and challenges for clinical practice guidelines in China and provide recommendations for their development and implementation.

Clinical practice guidelines are statements that include recommendations for the optimisation of patient care. They are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative options.1 Such guidelines are an extremely important tool for healthcare delivery in China. Firstly, implementation of cost effective treatment and care will help to optimise resource use and patient outcomes for the country with the largest population in the world. Secondly, substantial variability in clinical practice exists among hospitals and in different districts across China, which can be minimised by the use of guidelines. Thirdly, China is the only country where Western medicine and traditional Chinese medicine are practised alongside each other at every level of the healthcare system; traditional Chinese treatments account for about 40% of the total.2 Healthcare providers can use guidelines to identify and apply evidence based recommendations across both types of medicine in a complementary and safe manner. We analyse the situation and challenges for clinical practice guidelines in China and provide recommendations for their development and implementation.

Status of clinical practice guidelines developed in China

Between 1993 and 2010, 269 guidelines were produced by 256 Chinese developers and published in 115 Chinese medical journals,3 and the number of guidelines is increasing annually (fig 1). Most were developed by the Chinese Medical Association and its branches, and one third focused on traditional Chinese medicine.3 Chinese medical societies have released an even larger number of expert based consensus statements: one study identified 186 expert consensus statements but only 14 guidelines for managing cardiovascular disease.4 These expert consensus statements were usually developed without any formal approach, did not use evidence systematically, and seldom dealt with …

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