Updates to and quality of clinical practice guidelines for high-priority diseases in Japan

Int J Qual Health Care. 2019 Dec 31;31(10):G139-G145. doi: 10.1093/intqhc/mzz095.

Abstract

Purpose: To examine the update status of clinical practice guidelines (CPGs) for 24 main diseases in Japan, and to clarify the quality of and issues pertaining to the most recent versions of CPGs for each disease.

Data sources: CPGs were searched in two Japanese guideline databases.

Study selection: All relevant Japanese CPGs published between January 1999 and July 2016 were selected.

Data extraction: The developer and issue date were extracted for all target CPGs. The most recent CPGs were assessed using the Appraisal of Guidelines for Research and Evaluation-II (AGREE II) instrument.

Results of data synthesis: Among 106 target CPGs, 24 most recent CPGs were subjected to assessment using the AGREE II instrument. CPGs for 11 diseases (46%) had a mean time interval for update of ≥5 years. Among the 24 CPGs subjected to AGREE II assessment, median domain scores were 74% for "Domain 1: Scope and Purpose," 43% for "Domain 2: Stakeholder Involvement," 46% for "Domain 3: Rigor of Development," 69% for "Domain 4: Clarity of Presentation," 24% for "Domain 5: Applicability" and 27% for "Domain 6: Editorial Independence."

Conclusions: The systematic assessment of CPGs for 24 major diseases in Japan revealed a trend for a delay in timing of update for many CPGs. Moreover, the 24 most recent CPGs had low domain scores for domains 2, 3, 5 and 6. In the future, concrete measures will need to be considered in order to improve the quality of CPGs.

Keywords: AGREE II; appropriate health care; evidence-based medicine; guidelines < appropriate health care; practice guideline.

MeSH terms

  • Evidence-Based Medicine*
  • Guidelines as Topic / standards*
  • Humans
  • Japan
  • Quality Assurance, Health Care / methods