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Development of local clinical practice guidelines in the real world: an evolving scene in China
  1. Joey SW Kwong,
  2. Xin Sun
  1. Chinese Evidence-Based Medicine Center and Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
  1. Correspondence to Dr Joey SW Kwong, Chinese Evidence-Based Medicine Center and Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; jswkwong{at}hotmail.com

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Introduction

Clinical practice guidelines play a vital and indispensable role in every healthcare system. In China, the comprehensive reform of the healthcare system was initiated in 2009 with the ultimate goal of universal health coverage.1 The approach to boost government funding to subsidise health expenditures in the form of government health insurance schemes inevitably led to higher demands for healthcare services and a sharp rise in health expenditures.2–4 This dramatic transformation of healthcare delivery and utilisation highlights the important consideration of ensuring that the health system in China is able to meet the increased demands and provide universal access to effective and consistent healthcare with optimised resource management. At the heart of a sustainable and effective health system is the use of robust and relevant research evidence to inform clinical practice at local and national levels. Successful translation of evidence into practice is achieved by trustworthy clinical practice guidelines, defined by the US Institute of Medicine as ‘statements that include recommendations intended to optimise patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options’.5 China is emerging as a new hub for guideline development with the production of Chinese clinical practice guidelines increasing by nearly fourfold over the past few years.6 However, unlike their Western counterparts, China lacks a central infrastructure (eg, National Institute for Health and Care Excellence in the UK) to coordinate and monitor guideline development process. Most Chinese clinical practice guidelines are developed by professional societies, such as the Chinese Medical Association. Ideally, guideline recommendations should be formulated de novo with reference to primary research data from Chinese populations due to known ethnic differences in drug responses and diagnostic reference values as well as country-specific health expenditure trends.7 However, enrolment …

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