Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Implementation Science
Published in: Implementation Science 1/2015

Open Access 01-12-2015 | Research

The quality of clinical practice guidelines in traditional medicine in Korea: appraisal using the AGREE II instrument

Authors: Tae-Young Choi, Jiae Choi, Ju Ah Lee, Ji Hee Jun, Bongki Park, Myeong Soo Lee

Published in: Implementation Science | Issue 1/2015

Login to get access

Abstract

Background

This study aimed to evaluate the quality of the current clinical practice guidelines (CPGs) in traditional medicine (TM) in South Korea using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument to further enhance the CPG development.

Methods

A search was performed for guidelines in Korea from inception until March 2014 in the major Korean guideline websites [the Korean Medical Guideline Information Centre (KoMGI), the Korean Guideline Clearing House (KGC)], PubMed and seven Korean electronic databases; the Association of Korean Oriental Medicine (AKOM) was also consulted. Five independent assessors rated the quality of each CPG using the AGREE II instrument and calculated the mean score of each AGREE item. The overall agreement amongst reviewers was evaluated using the intra-class correlation coefficient (ICC).

Results

Initially, 17 CPGs were examined for TM in Korea, and only 8 CPGs satisfied the inclusion criteria. The mean scores for each AGREE II domain were as follows: (1) scope and purpose, 60.0 % (CIs, 45.05-74.94 %); (2) stakeholder involvement, 56.11 % (41.28-70.94 %); (3) rigour of development, 42.7 % (23.48-61.92 %); (4) clarity and presentation, 62.50 % (50.89-74.10 %); (5) applicability, 20.31 % (13.96-26.66 %); and (6) editorial independence, 44.58 % (10.78-78.38 %). All of the CPGs were rated as “recommended with provisos or modifications”. The ICC values for CPG appraisal using the AGREE II ranged from 0.230 to 0.993.

Conclusions

To improve clinical practice and health outcomes, well-developed CPGs are needed. The quality of CPGs for TM in Korea has remained suboptimal according to the AGREE II instrument evaluation. Therefore, guideline developers in Korea should make more of an effort to ensure high-quality CPGs.
Appendix
Available only for authorised users
Literature
1.
Field MJ, Lohr KN, Committee to advise the public health service on clinical practice guidelines, Institute of Medicine. Clinical practice guidelines: directions for a new program. Washington, DC: National Academy Press; 1990.
2.
Institute of Medicine. Clinical practice guidelines we can trust. Washington, DC: The National Academies Press; 2011.
3.
Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. Clinical guidelines: potential benefits, limitations, and harms of clinical guidelines. BMJ. 1999;318:527–30.PubMedPubMedCentral
4.
Lugtenberg M, Burgers J, Westert G. Effects of evidence-based clinical practice guidelines on quality of care: a systematic review. Qual Saf Health Care. 2009;18(5):385–92.PubMed
5.
Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G, et al. AGREE II: advancing guideline development, reporting and evaluation in healthcare. CMAJ. 2010;182(18):E839–42.PubMedPubMedCentral
6.
7.
Yu WY, Xu JL, Shi NN, Wang LY, Han XJ, Wang YY, et al. Assessing the quality of the first batch of evidence-based clinical practice guidelines in traditional Chinese medicine. J Tradit Chin Med. 2011;31(4):376–81.PubMed
8.
Holmer HK, Ogden LA, Burda BU, Norris SL. Quality of clinical practice guidelines for glycemic control in type 2 diabetes mellitus. PLoS One. 2013;8(4), e58625.PubMedPubMedCentral
9.
Brosseau L, Rahman P, Toupin-April K, Poitras S, King J, De Angelis G, et al. A systematic critical appraisal for non-pharmacological management of osteoarthritis using the appraisal of guidelines research and evaluation ii instrument. PLoS One. 2014;9(1), e82986.PubMedPubMedCentral
10.
Yu WY, Han XJ, Shi NN, Wang LY, Liao X, Zhong LD, et al. Appraisal of clinical practice guidelines for the management of rheumatoid arthritis in traditional Chinese medicine using the AGREE II instrument: a systematic review. Eur J Integr Med. 2014;6(2):176–85.
11.
Ahn HS, Kim HJ. Development and implementation of clinical practice guideline: current status in Korea. J Korean Med Sci. 2012;27:S55–60.PubMedPubMedCentral
12.
13.
Jo MW, Lee JY, Kim NS, Kim SY, Sheen S, Kim SH, et al. Assessment of the quality of clinical practice guidelines in Korea using the AGREE instrument. J Korean Med Sci. 2013;28(3):357–65.PubMedPubMedCentral
14.
Choi J, Choi TY, Lee JA, Yun KJ, Lim HJ, Lee MS. Perceptions on developing clinical practice guidelines for traditional medicine in Korea: results of a web-based survey. Eur J Integr Med. 2014;6(2):156–63.
15.
Robinson N, Liu J, Lee MS. Clinical guidelines: the way for best practice. Eur J Integr Med. 2014;6(2):133–4.
16.
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7), e1000097.PubMedPubMedCentral
17.
Steering Committee for Clinical Practice Guideline. Korean appraisal of guidelines for research and evaluation. South Korea: Ministry of Health & Welfare. Korea Academy of Medical Science; 2009.
18.
Oh MK, Jo H, Lee YK. Improving the reliability of clinical practice guideline appraisals: effects of the Korean AGREE II scoring guide. J Korean Med Sci. 2014;29(6):771–5.PubMedPubMedCentral
19.
The Association of Korean Oriental Medicine. Clinical guideline for low fertility. Seoul: Korea; 2010.
20.
Kim JW, Jung IC, Kang HW, Lee SK, Jung SY. Clinical guideline for Hwa-Byung. Clinical Research Center for Hwa-Byung. Seoul: Korea; 2013.
21.
The Korean Society for Meridian and Acupoint. Clinical guideline on acupuncture treatment for knee pain. Seoul: Korea; 2013.
22.
The Korean Society for Meridian and Acupoint. Clinical guideline on acupuncture treatment for low back pain. Seoul: Korea; 2013.
23.
The Korean Society for Meridian and Acupoint. Clinical guideline on acupuncture treatment for neck pain. Seoul: Korea; 2013.
24.
Evidence Based Korean Medicine Clinical Practice Guideline Development Committee for atopic dermatitis (Korea Institute of Oriental Medicine and The Society of Korean Medical Ophthalmology Otolaryngology & Dermatology). Korean Medicine Clinical Practice Guideline for atopic dermatitis. Daejeon: Korea; 2014.
25.
Evidence Based Korean Medicine Clinical Practice Guideline Development Committee for Bell’s palsy (Korea Institute of Oriental Medicine and Korean Acupuncture and Moxibustion Medicine Society). Korean Medicine Clinical Practice Guideline for Bell’s palsy. Daejeon: Korea; 2014.
26.
Evidence Based Korean Medicine Clinical Practice Guideline Development Committee for Lumbar Herniated Intervertebral Disc (Korea Institute of Oriental Medicine and The Korean Academy of Oriental Rehabilitation). Korean Medicine Clinical Practice Guideline for Lumbar Herniated Intervertebral Disc in adults. Daejeon: Korea; 2014.
27.
Min SK, Suh SY, Song KJ. Symptoms to use for diagnostic criteria of Hwa-byung, an anger syndrome. Psychiatry investigation. 2009;6(1):7–12.PubMedPubMedCentral
28.
Chao HX, Wang YY. Evidence-based guideline of clinical practice in Chinese medicine internal China. Beijing: China Press of TCM; 2011.
29.
Chao HX, Wang YY. Evidence-based guideline of clinical practice in Chinese medicine specific disease. Beijing: China Press of TCM; 2011.
30.
Chao HX, Wang YY. Evidence-based guideline of clinical practice in Chinese medicine acupuncture. Beijing: China Press of TCM; 2011.
31.
Atkins D, Eccles M, Flottorp S, Guyatt GH, Henry D, Hill S, et al. Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The GRADE Working Group. BMC Health Serv Res. 2004;22(4):38–44.
32.
Eccles M, Clapp Z, Grimshaw J, Adams PC, Higgins B, Purves I, et al. North of England evidence based guidelines development project: methods of guideline development. BMJ. 1996;312(7033):760–2.PubMedPubMedCentral
33.
Atkins D, Best D, Briss P, Eccles M, Falck-Ytter Y, Flottorp S, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328(7454):1490–4.PubMed
34.
Boutron I, Guittet L, Estellat C, Moher D, Hróbjartsson A, Ravaud P. Reporting methods of blinding in randomized trials assessing nonpharmacological treatments. PLoS Med. 2007;4(2), e61.PubMedPubMedCentral
35.
Julliard KN, Citkovitz C, McDaniel D. Towards a model for planning clinical research in oriental medicine. Explore. 2007;3(2):118–28.PubMed
36.
Liu JP. The composition of evidence body of traditional medicine and recommendations for its evidence grading. Chin J Integrated Tradit West Med (Zhongguo Zhong Xi Yi Jie He Za Zhi). 2007;27(12):1061–5.
37.
Chen KJ, Jiang YR. Current status and problems in developing clinical guidelines for Chinese medicine and integrative medicine. JCIM (Zhong Xi Yi Jie He Xue Bao). 2009;7(4):301–5.
38.
Grimshaw J, Thomas R, MacLennan G, Fraser C, Ramsay CR, Vale L, et al. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess. 2004;8(6):1–72.
39.
Turner T, Misso M, Harris C, Green S. Development of evidence-based clinical practice guidelines (CPGs): comparing approaches. Implement Sci. 2008;27(3):45–52.
40.
41.
Rycroft-Malone J. Formal consensus: the development of a national clinical guideline. Qual Health Care. 2001;10(4):238–44.PubMedPubMedCentral
42.
Nair R, Aggarwal R, Khanna D. Methods of formal consensus in classification/diagnostic criteria and guideline development. Semin Arthritis Rheum. 2011;41(2):95–105.PubMedPubMedCentral
43.
44.
Brosseau L, Wells GA, Finestone HM, Egan M, Dubouloz CJ, Graham I, et al. Clinical practice guidelines for acupuncture. Top Stroke Rehabil 2006;13(2):65–67.
Metadata
Title
The quality of clinical practice guidelines in traditional medicine in Korea: appraisal using the AGREE II instrument
Authors
Tae-Young Choi
Jiae Choi
Ju Ah Lee
Ji Hee Jun
Bongki Park
Myeong Soo Lee
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2015
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-015-0294-1

Other articles of this Issue 1/2015

Implementation Science 1/2015 Go to the issue

Research

The Guideline Implementability Decision Excellence Model (GUIDE-M): a mixed methods approach to create an international resource to advance the practice guideline field

Study protocol

Development and preliminary evaluation of a rehabilitation consult for survivors of head and neck cancer: an intervention mapping protocol

Research

Co-production in practice: how people with assisted living needs can help design and evolve technologies and services

Study protocol

Effectiveness and cost-effectiveness of knowledge transfer and behavior modification interventions in type 2 diabetes mellitus patients—the INDICA study: a cluster randomized controlled trial

Editorial

Implementation science: a reappraisal of our journal mission and scope

Research

A multifaceted feedback strategy alone does not improve the adherence to organizational guideline-based standards: a cluster randomized trial in intensive care