Evidence map›Paper›PMID 40086883›Full record

ArticleBMJ evidence-based medicine2025

Identifying actionable statements in Chinese health guidelines: a cross-sectional study.

Xiangying Ren, Tamara Lotfi, Jiyu Chen, Yuling Lei, Chenyibei Zhou, Wei Zhang, Qiao Huang, Yongbo Wang, Siyu Yan, Shichun Wang and 6 more

Abstract read
In one paragraph

Article in BMJ evidence-based medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Xiangying RenCenter for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
Tamara LotfiDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Jiyu ChenSchool of Nursing, Wuhan University, Wuhan, Hubei, China.
Yuling LeiSchool of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China.
Chenyibei ZhouSchool of Nursing, Wuhan University, Wuhan, Hubei, China.
Wei ZhangSchool of Nursing, Wuhan University, Wuhan, Hubei, China.
Qiao HuangCenter for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
Yongbo WangCenter for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
Siyu YanCenter for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
Shichun WangCenter for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
Siyuan RuanCenter for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
Wanru WangCenter for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
Qiyi ZhangCenter for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
Xiaomei YaoDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada jinyinghuiebm@163.com yaoxia@mcmaster.ca.
Yinghui JinCenter for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China jinyinghuiebm@163.com yaoxia@mcmaster.ca.ORCID 0000-0003-4725-9581
Holger J SchuenemannDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0003-3211-8479

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe purpose of this study is to validate the taxonomy and framework using Chinese guidelines and identify actionable statements. DESIGN AND

settingWe searched five databases, to identify the health guidelines from 1 January 2020 to 1 May 2023. Five researchers categorised statements into six types: formal recommendations (Type I) with clear direction and strength, with explicit and direct evidence; good practice statements (GPS) (Type II), actionable in isolation with a significant benefit; remarks (Type III), an inseparable unit belonging to a formal recommendation or GPS that provides additional clarification; research only recommendations (Type IV) for specific populations; implementation considerations, tools and tips (Type V), that describe the how, who, where, what and when, in relation to implementing a recommendation and lacking a direct evidence link; and informal recommendations (Type VI), unrelated to evidence and not meeting GPS criteria.

resultsWe included 116 guidelines, including 74 Western medicine guidelines, 12 traditional Chinese medicine guidelines and 30 integrated Chinese and Western medicine guidelines. 99 guidelines (85.3%) used the Grading of Recommendations Assessment, Development and Evaluation criteria. Medical specialty societies developed the highest number of guidelines (53.4%). Of all the statements, 4422 statements were extracted from the guidelines. Among them, 2154 (48.7%) were formal recommendations, 197 (4.4%) were GPS, 394 (8.9%) were remarks, 16 (0.4%) were research only recommendations, 1106 (25.0%) were implementation considerations, tools and tips, and 555 (12.6%) were informal recommendations.

conclusionsUp to date, the Chinese guideline developers tend to overestimate the number of formal recommendations and underestimate the number of GPS, remarks, research only recommendations, implementation considerations, tools and tips, and informal recommendations. Thus the current quality of actionable statements in Chinese health guidelines requires further enhancement.

Indexed as

Practice Guidelines as TopicChinaCross-Sectional StudiesEvidence-Based MedicineHumansMethods

Identifiers

PMID40086883
PMCPMC12505086

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.