Open Access Open Badges Correspondence

Analysis of the Status of Chinese clinical practice guidelines development

Zhi-hong Zheng1, Shu-qi Cui2*, Xiao-qin Lu2*, David Zakus36, Wan-nian Liang24, Fang Huang2, Xiao-na Cao2, Ya-li Zhao2, Xiao-xia Peng2, Ke-qin Rao5 and Jing Wu5

Author Affiliations

1 Department of Educational Management, Friendship Hospital, Capital Medical University, Beijing 100050, China

2 Department of Family Medicine, School of Public Health and Family Medicine, Capital Medical University, Beijing 100069, China

3 Global Health Program, Canadian Public Health Association, Ottawa, Canada

4 Office of Health Emergency, Ministry of Health, People’s Republic of China, No.1, Xi Zhi Men Wai Nan Road, Beijing 100044, China

5 Statistical Information Center of Chinese Ministry of Health, Beijing 100044, China

6 Adjunct Professor, Faculty of Medicine, University of Toronto, Toronto, Canada

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BMC Health Services Research 2012, 12:218  doi:10.1186/1472-6963-12-218

Published: 25 July 2012



The work of developing clinical practice guidelines began just a little more than ten years ago in China. Up to now, there have been few studies about them.


To review and analyze the status of Chinese clinical practice guidelines in 1997–2007.


All Chinese guidelines from 1997–2007 were collected, and made a regression analysis, and a citation analysis for evaluating the impact of guidelines. To analyze the developing quality, the most influential guidelines were evaluated with AGREE instrument, and each guideline was evaluated to check for any updating. In order to analyze the objective and target population, all guidelines were classified and counted separately according to disease/symptom center, and whether towards specialists or general practitioners.


143 guidelines were collected. An exponential function equation was established for the trend in the number of guidelines. The immediacy index in every year was very low while the average citation rate was not. Both the percentages of highly cited and never cited were high. For the evaluation with AGREE, only the average score of clarity and presentation was high (89.9%); the remaining were much lower. Editorial independence scored 0. Only 27 (18.9%) of 143 guidelines, were found to be evidence-based. Only a few had ever been updated, with an average updating interval of 5.2 years. Only 2.1% were symptom-centered, and only 4.2% were aimed at general practitioners.


Much progress has been obtained for Chinese guidelines development. However, there were still defects, and greater efforts should be made in the future.

Clinical practice guidelines; Status; AGREE appraisal; Citation; Update