The development of clinical guidelines in China: insights from a national survey

Table 2 De novo clinical guideline (CG) development (n = 38)

Methods (yes responses)	n (%)
The institution has a formal CG working group	21 (55.3)
Evidence is retrieved using systematic searching	35 (92.1)
Eligibility criteria are used to select evidence	37 (97.4)
Evidence limitations are assessed	29 (76.3)
Evidence quality/certainty is rated	36 (94.7)
Strength of recommendations is rated	35 (92.1)
A formal decision-making process is followed	29 (76.3)
The balance between benefits and harms is considered	31 (81.6)
Patient values and preferences are considered	33 (86.8)
Cost and resources needed are considered	33 (86.8)
Other factors are considered	31 (81.6)
An external review is conducted	34 (89.5)

Specific methods (open-ended responses)		n (%)
Stakeholder involvement^a
Stakeholders	Working group (n = 21)	External review (n = 34)
Clinicians	20 (95.2)	34 (100.0)
Methodologists	18 (85.7)	30 (88.2)
Policy-makers	7 (33.3)	18 (52.9)
Patient representatives	9 (42.9)	9 (26.5)
Other	1 (4.8)	4 (11.8)
Systematic search^a (n = 35)
Search is conducted in at least two databases		27 (77.1)
Formal/rigorous search strategy is used		26 (74.3)
Other		1 (2.9)
Evidence limitations (n = 29)
Methodological tools (e.g., Cochrane RoB, ROBINS I)		21 (72.4)
Expert opinion		8 (27.6)
Formal decision-making^a (n = 29)
Voting system		16 (55.2)
Delphi consensus		15 (51.7)
Informal consensus or expert opinion		8 (27.6)
Cost/resources^a (n = 33)
Based on expert opinion		26 (78.8)
Based on evidence synthesis		19 (57.6)
Based on studies (e.g., cost-effectiveness, cost–utility, budgetary impact)		14 (42.4)
Other factors^a (n = 31)
Based on expert opinion		26 (83.9)
Based on evidence synthesis (e.g., local data)		16 (51.6)
Based on studies (e.g., interviews)		9 (29.0)
Patient values/preferences^a (n = 33)
Based on expert opinion		21 (63.6)
Based on consultation with patient representatives		14 (42.4)
Based on evidence synthesis		12 (36.4)
Based on studies (e.g., reviews, surveys)		9 (27.3)

RoB risk of bias; ROBINS I Risk of Bias in Non-randomised Studies of Interventions
^aMore than one response possible

ISSN: 1478-4505