Methodological tasks of clinical practice guidelines developed in Japan




Poster session 3 Friday: Evidence Tools / Evidence synthesis - creation, publication and updating in the digital age


Friday 15 September 2017 - 12:30 to 14:00


All authors in correct order:

Fukuoka T1, Okumura A2, Nakayama T3, Kiyohara K4, Yamaguchi N2, Minds G2
1 Kurashiki Central Hospital, Japan
2 Japan Council for Quality Health Care, Japan
3 Department of Health Informatics, Kyoto University, School of Public Health, Japan
4 Department of Public Health, Tokyo Women’s Medical University, Japan
Presenting author and contact person

Presenting author:

Toshio Fukuoka

Contact person:

Abstract text
Background: The Japan Council for Quality Health Care (JQ) has managed evidence-based medicine promoting project which works on the evaluation, certification and dissemination of clinical practice guidelines (CPGs) developed in Japan as a guideline clearinghouse.

Objectives: To clarify the methodological tasks of CPGs developed in Japan.

Methods: After searching and screening with exclusion criteria, we evaluated identified CPGs from the aspect of methodological quality using Appraisal of Guidelines for Research & Evaluation II Instrument (AGREE II) by guideline evaluation expert committee. Each guideline was evaluated by 4 expert members, and CPG evaluation conferences were held to facilitate consensus-building among members. We adopted the second scoring after the conferences and calculated the mean scores of domains and items of AGREE II. In this study, we focused on the domain 3 (Rigour of Development).

Results: A total of 441 guidelines were evaluated by the AGREE II from September 2011 to January 2017. The mean scores of each AGREE II domain (0-100%) were as follows: Scope and Purpose, 63.0%; Stakeholder Involvement, 47.8%; Rigour of Development, 40.8%; Clarity of Presentation, 59.8%; Applicability, 44.5%; Editorial Independence, 38.7% and Overall Guideline Assessment, 50.4%. The low-scoring items in the mean scores of Rigour of Development (<3.5, range 1-7) were as follows: item 7 (search methods), 3.3; item 8 (evidence selection criteria), 2.8; item 9 (strengths and limitations of the evidence), 3.2; item 10 (formulation of recommendation), 3.3; item 13 (external review), 2.8; and item 14 (updating procedure), 3.2.

Conclusions: This study indicates that Japanese CPGs have some tasks regarding description of evidence selection criteria and external review. As evaluation report leaves much to be desired in other items, it is necessary to utilise the evaluation results effectively for quality improvement. We are preparing to hold the meeting with guideline development group (GDG), and to support GDG individually.