ArticleFrontiers in medicine2026
An external peer review instrument for Korean Medicine clinical practice guideline drafts (KM-EPRI): development and content validation.
Article in Frontiers in medicine, 2026. 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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Abstract
Background: Korean Medicine clinical practice guidelines (KM-CPGs) undergo mandatory external peer review of their drafts during development, yet reviewers lack a standardized, validated instrument to guide this task. Widely used appraisal tools assess the quality of completed guidelines rather than support the section-level review of a draft. We aimed to develop an external peer review instrument for KM-CPG drafts (KM-EPRI) and to assess its content validity. Methods: In this two-phase methodological study, a draft instrument was first derived by directed qualitative content analysis of the external review comments produced for previously published KM-CPGs, with each comment coded into one of four predefined review modules: the clinical questions (CQ), the introductory components (CPG-I), the development methods (CPG-M), and the recommendations (CPG-R). The content validity and acceptability of the items were then assessed through a modified Delphi study with a multidisciplinary panel of KM clinicians and evidence-based medicine methodologists. Consensus was defined a priori as an item-level content validity index (I-CVI) Results: From 3,630 external review comments, 2,073 content-related comments were consolidated and refined into a finalized instrument of 117 review items across 4 modules and 33 subdomains. All 10 invited experts participated (response rate 100%, no attrition), and every item reached the consensus threshold in a single round under a pre-defined early-stopping rule. All 117 items had an I-CVI Conclusion: KM-EPRI can serve as a consensus-based, structured reference for the external peer review of KM-CPG drafts during development. Its effect on review quality and inter-rater reliability remains to be evaluated in practice.
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