2018年中国发布临床实践指南利益冲突与经济学证据的调查分析

更新时间:2020年03月17日阅读量:1816下载量:731下载手机版

作者: 王彦博 1 王强 2* 赵明娟 3 贺大林 4 王云云 3

作者单位: 1.武警北京总队医院(北京 100027) 2.中华人民共和国国家卫生健康委员会医疗管理服务指导中心标准管理处(北京 100044) 3.武汉大学循证与转化医学中心(武汉 430071) 4.西安交通大学第一附属医院泌尿外科(西安 710061)

关键词: 临床实践指南 利益冲突 经费来源 经济学证据

DOI:10.12173/j.issn.1004-5511.2020.02.10

基金项目: 国家重点研发计划专项课题(2016YFC0106303);国家卫健委医管中心委托课题([2019]099号);陕西省重点研发计划项目(2017ZDCXL-SF-01-04-02)

引用格式:王彦博, 王强, 赵明娟, 贺大林, 王云云. 2018年中国发布临床实践指南利益冲突与经济学证据的调查分析[J]. 医学新知, 2020, 30(2): 139-158. DOI: 10.12173/j.issn.1004-5511.2020.02.10.

Wang YB, Wang Q, Zhao MJ, Wang YY. Conflict of interest and economic evidence in Chinese clinical practice guidelines published in 2018: A survey[J].Yixue Xinzhi Zazhi, 2020, 30(2): 139-158. DOI: 10.12173/j.issn.1004-5511.2020.02.10.[Article in Chinese]

摘要|Abstract

目的  评价2018年中国发布的临床实践指南中有关利益冲突和经济学证据的情况,并与2017年进行比较,以期了解指南制定变化情况,为完善我国临床实践指南的制定/修订提供参考。方法  计算机检索中国知网、万方数据库及中国生物医学文献数据库,检索2018年我国发布的临床实践指南,检索时间为2018年1月1日至2028年12月31日。由2名研究者独立筛选文献、提取纳入指南的利益冲突声明与是否关注经济学证据等相关信息后,使用Microsoft Excel 2019软件进行统计分析。结果  共纳入临床实践指南92部,其中23部指南(25.00%)声明了利益冲突,25部(27.17%)报告了资金来源,22部(23.91%)报道了经济学证据,且该报道的指南中有一半都有国家重大或重点专项支持(50.00%)。而2017年中国发布的53部临床实践指南中,有26.42%声明利益冲突,18.87%报告资金来源,11.32%提及经济学证据。结论  相较于2017年,2018年我国加大了对临床实践指南制定资金投入的力度,在指南经济学证据方面的关注也有所提高,但是对于指南中利益冲突的声明报告和确切的经济学证据仍然很低。因此,进一步推进和完善我国临床实践指南对利益冲突的声明与经济学证据的关注,使我国临床实践指南制定更加客观、透明和独立是必要的。

全文|Full-text

美国医学科学院(Institute of Medicine,IOM)于1990年首次提出实践指南定义:系统制定的针对特定临床情况,帮助医务人员和患者做出恰当处理的指导性建议(推荐意见)[1]。随着循证医学的发展及其对指南的影响,2011年IOM更新指南定义为:指南是基于系统评价的证据和平衡了不同干预措施的利弊,在此基础上形成的能够为患者提供最佳医疗服务的推荐意见[2]。我国临床实践指南数量近年来也不断增加,医学期刊在1995-2015年期间,已发表了超过500部指南[3]。但是指南整体质量还有待进一步提高,截至到2017年10月底,美国国立指南文库(National Guideline Clearinghouse,NGC)收录高质量的循证指南数量超过1 700部,我国由中国药理学会治疗药物监测委员会组织的《中国万古霉素治疗药物监测指南》[4]被首次收录进入NGC数据库;然而,运用指南评价工具(Appraisal of Guidelines Research and Evaluation II,AGREE II)分析国内外指南质量,发现我国在指南制定的严谨性和编辑的独立性与国际水平存在较大差距[5]。利益冲突的存在可直接影响临床实践指南制定的独立性,并可以直接降低整个指南的可信度及权威性,应高度重视。随着全球医疗负担的加重,治疗成本问题得到了越来越多决策者的关注,众多的临床实践指南都需将成本问题考虑至指南推荐中[6]。但是,目前我国临床实践指南制定对于经济学证据关注不足,王强等[7]调查分析了2017年中国发布的临床实践指南,发现仅有11.32%临床实践指南涉及到卫生经济学的内容,且无经济学证据存在。本研究进一步调查2018年我国发布的临床实践指南中利益冲突与经济学证据的情况,并与2017年发布的临床实践指南进行对比,以明确我国临床实践指南制定时这两方面的情况,为进一步完善我国临床实践指南制定/修订提供依据。

1 资料与方法

1.1 纳入与排除标准

纳入2018年1月1日至2018年12月31日发布的所有中国医药卫生领域临床实践指南,仅限中文。排除标准为:①无法获取全文;②不同刊物同步发表的同一部指南,选择其中最详细的纳入;③对指南的解读或者摘译;④专家共识、计划书及草案。

1.2 文献检索策略

计算机检索中国知网(CNKI)、万方数据库(WanFang Data)和中国生物医学文献数据库(CBM),搜索2018年我国发布的有关医药卫生领域的临床实践指南,检索时间为2018年1月1日-2018年12月31日。采用“主题词+自由词”方式检索,中文检索词包括:临床实践指南、指南、诊疗常规,限定领域为“医药卫生科技”或“医药、卫生”。

1.3 文献筛选与资料提取

由2名研究者独立筛选文献、提取资料并交叉核对,如遇分歧,则讨论解决或交由第三名研究者解决,缺乏相关资料尽量与原作者联系并予以补充。首先通过阅读标题进行文献筛选,在排除明确不相关的文献后,进一步阅读全文和摘要,最终确定是否纳入。预先设计好资料提取表,提取资料内容主要包括:指南的标题、制定组织、涉及专业领域、版本、关注领域、利益冲突声明、资金来源及是否关注经济学证据。

1.4 统计分析

使用Microsoft Excel 2019软件进行资料整理和数据分析。以描述性分析为主,对2017年与2018年指南的三个方面比较采用柱状图形式展示;对2018年指南的学科分布领域按照内科学、外科学、儿科学、口腔科学、妇产科学、麻醉学和护理学进行领域分类,并以柱状图展示结果。

2 结果

2.1 文献筛选流程及结果

初步检索共获取8 678部相关的指南文献,严格按照纳入与排除标准筛选后,最终纳入92部[8-99]临床实践指南。文献筛选的流程及结果详见图1。

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图1 2018年中国发布临床实践指南筛选的流程及结果

2.2 纳入研究的基本信息

2018年中国发布的临床实践指南有关利益冲突和经济学证据的基本信息详见表1。

表1 2018年中国临床实践指南发布的有关利益冲突声明和经济学证据的基本信息

b1.jpg
b2.jpg
b3.jpg

2.3 纳入2018年临床实践指南中关于利益冲突与经济学证据分析结果

纳入临床实践指南中,声明利益冲突的有23部[34,75,79-99](25.00%),其中有7部[79-85](7.61%)指南仅粗略报道无利益冲突,并未声明相关利益冲突的具体内容;报告资金来源有25部[8-10,12,24,38,42,47,53,65,69,73,75,84-85,87,89-95,97-98] (27.17%),多数资金来源于国家自然科学基金及国家重点研发计划专项基金;报道经济学证据有22部指南[14-15,30,33-35,42, 46-47,65,75,80,83,86-87,89,90-95](23.91%),其中11部[42,47, 65,75,87,89-94] (50.00%)指南均有国家重点或重大专项基金支持。在不同的学科领域,中国临床实践指南的利益冲突声明、资金来源与经济学证据分布有差异,在内科学中利益冲突声明有9部[34,79-85,98](22.00%),报告资金来源8部[8-9,42,53,65,84-85,98](20.00%)与提及经济学证据7部[15,33-34,42,65,80,83](17.00%);在外科学中三者分布分别为24.00%,30.00%与21.00%;而在儿科学中三者分布均为75.00%,妇产科中差异很大,具体详见图2。临床实践指南学科进一步细分,涵盖了26个专业,主要分布在骨科12部[10,17,25,36,48,51-52, 58-62,86-87,95](13.04%)和妇产科10部[13,16,20,30,38, 45-46,60-61,78](10.87%),其次是中医科和心血管科各8部[39,53,72,79-81,84,85](8.70%);指南类型涵盖6大领域,主要针对的是疾病的诊疗62部[7-13,16,17,19-20,22-29,41-42,44-68,72,79-80,82-87,89-93, 98-99](67.39%);基于循证医学方法制定指南有28部(30.43%),其他内容详见表1。相较于2018年中国发布的临床实践指南,2017年中国发布的指南中,利益冲突声明26.40%略高于2018年,而资金来源及指南对经济学证据关注低于2018年指南,详见图3。

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图2 2018年中国分布的临床实践指南中利益冲突及经济学证据在不同学科领域分布情况

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图3 2017-2018年中国发布临床实践指南有关利益冲突声明及经济学证据的对比结果

3 讨论

随着循证医学、转化医学和人工智能的兴起,作为医务人员临床诊疗工作最重要的决策依据,临床实践指南的发展已经从专家共识进入一个全新的时代。2011年IOM更新指南的定义,再次强调了循证医学在指南制定中的重要地位。本次研究纳入的92部指南中,有28部(30.43%)是基于循证方法制定的,其中占比最多的是儿科指南5部(5.43%),刘雅莉等人[100]调查2010-2017年针对儿内科临床实践指南发现39部(28.89%)指南提及应用循证方法制定指南,且2010-2013年占12部(31.00%),2014-2017年占27部(69.00%),间接证实我国基于循证方法制定指南在逐年增高,但是每个专业领域是有差异的。除此以外,我们还发现不同学科领域中临床实践指南对利益冲突声明、资金来源的报道及经济学证据的关注分布也是有差异的,内科学临床实践指南中三者的分布由高到低分别为利益冲突声明22.00%,资金来源报道20.00%及提及经济学证据17.00%;外科学指南中最高为资金来源的报道30.00%,而儿科学指南中三者分布一致,均为75.00%,妇产科学指南中有关利益冲突声明为0.00%,且学科领域的临床实践指南分布亦不均,此次调查分析中并未发现与口腔学科相关的临床实践指南的发布。故我们在倡导大家基于系统评价证据制定临床实践指南时,不能一概而论,应根据不同学科领域具体情况,针对性提倡和推广基于循证方法制定指南,全面提高我国临床实践指南制定的规范性。

利益冲突可直接影响临床实践指南制定的独立性,是临床实践指南制定的重要因素。利益冲突主要包括经济和非经济两类[101]。本研究纳入的指南中有23部(25.00%)声明利益冲突,其中7部指南仅以“无”来表述利益冲突,未描述是否填写利益冲突声明表及是否会影响最终推荐建议的形成等详尽的信息。2017年我国发布的临床实践指南有关利益冲突声明[7]是26.40%,相比之下,我国临床实践指南在利益冲突声明方面依然需要大力的提倡和改进。值得提及的是,相对于2017年我国对于临床实践指南制定资金的投入力度有所加强,由原来18.90%提高至27.17%,说明国家对临床实践指南制定的支持。

近年来科学证据逐渐增多,高新技术层出不穷,患者及家属知识水平和法律意识的增强,使得临床决策不仅仅考虑诊治问题,还要平衡治疗成本,效益及风险等。故临床实践指南作为指导文件,在其制定过程中涉及到证据向推荐意见转化时需要平衡利弊关系,这里面的弊主要包括成本,这里的成本主要是指与治疗有关的经济负担及随访管理中可能的成本消耗[102]。本次纳入的指南中有22部(23.91%)指南提及经济学证据,其中11部[42,47,65,75,87,89-94](50.00%)指南均有国家重点专项基金支持。相对于2017年中国发布的临床实践指南报道的经济学证据11.30%,2018年指南制定在经济学证据方面有所改善。这跟国家投入资金大力支持有关;但是,我们发现临床实践指南中有关经济学证据方面的报道,大部分只是在推荐意见中宽泛的提及,在治疗时除考虑患儿及其家属的观点及意愿,还需兼顾有效性,安全性和经济性,没有确切的经济学证据支持。为更好的制定/更新临床实践指南与科学化的临床决策,建议如下:其一,完善指南制定团队,在原来人员组成的基础上,增加卫生经济学专家,研究表明卫生经济学专家能帮助指南制定团队得出干预或服务可能的成本效果[103],以提供确切的经济学证据;其二,国家继续投入资金,支持临床实践指南的制定/更新;其三,提高我国有关卫生经济学的原始研究,积极培养具有临床实践指南制定和卫生经济学思维的交叉学科人才。

总之,本研究的结果显示,虽然国家提高了对于临床实践指南制定资金的投入,指南制定过程中对经济学证据方面关注也有所提高,但是我国临床实践指南制定在利益冲突声明和确切的经济学证据方面依然薄弱,而这些又影响到我国临床实践指南制定整体的客观性、独立性及透明性。因此,加强对利益冲突的声明及管理,加大对经济学证据关注及生产的落实,对未来我们制定更规范,更实用的临床实践指南是很有必要的。

利益冲突声明:所有作者均声明不存在利益冲突。


参考文献|References

1.Institute of Medicine. Clinical practice guidelines: directions for a new program[M]. Washington, DC: National Academy Press, 1990.

2.Institute of Medicine. Clinical practice guidelines we can trust[M]. Washington, DC: The National Academies Press, 2011.

3.陈耀龙,胡嘉元,李承羽,等. 中国临床实践指南的发展与变革[J]. 中国循证医学杂志, 2018, 18(8): 25-30.DOI:10.7507/1672-2531.201804062. [Chen YL, Hu JY, Li CY, et al. Development and changes of clinical practice guidelines in China[J]. Chinese Journal of Evidence-Based Medicine, 2018, 18(8): 25-30.]

4.陈耀龙, 陈恳, 叶志康,等. 中国万古霉素治疗药物监测指南的制订[J]. 中国循证医学杂志, 2015, 15(2): 236-239. DOI: 10.7507/1672-2531.20150040. [Chen YL, Chen K, Ye ZK, et al. Development of Chinese practice guidelines on therapeutic drug monitoring of vancomycin[J]. Chinese Journal of Evidence-Based Medicine, 2015, 15(2): 236-239.]

5.李楠,姚亮, 吴琼芳, 等. 2012–2013年中国大陆期刊发表临床实践指南质量评价[J]. 中国循证医学杂志, 2015, 15(3): 259-263. DOI: 10.7507/1672-2531.20150045. [Li N, Yao L, Wu QF, et al. Quality evaluation of clinical practice guidelines published in journals of mainland China during 2012-2013[J], Chinese Journal of Evidence-Based Medicine, 2015, 15(3): 259-263.]

6.National Collaborating Centre for Cancer (UK). Colorectal Cancer: The Diagnosis and Management of Colorectal Cancer (NICE Clinical Guidelines, No.131)[EB/OL]. Cardiff: National Collaborating Centre for Cancer (UK), 2011. [Access on 2019-12-28]. https://www.ncbi.nlm.nih.gov/books/NBK116638/.

7.王强, 黄超, 李俊, 等. 2017年中国发布的临床实践指南中利益冲突与经济学证据的调查分析[J].中国循证医学杂志, 2018, 18(4): 379-387. DOI: 10.7507/1672-2531.201803010. [Wang Q, Huang C, Li J, et al. A survey of reporting status of conflict of interest and economic evidence in Chinese clinical practice guidelines published in 2017[J]. Chinese Journal of Evidence-Based Medicine, 2018, 18(4): 379-387.]

8.中国痴呆与认知障碍写作组, 中国医师协会神经内科医师分会认知障碍疾病专业委员会. 2018中国痴呆与认知障碍诊治指南(二):阿尔茨海默病诊治指南[J]. 中华医学杂志, 2018, 98(13): 971-977. DOI: 10.3760/cma.j.issn.0376-2491.2018.13.004. [China Dementia and Cognitive Dis-orders Writing Group, Cognitive Disorders Professional Committee of Neurophysicians Branch of Chinese Medical Association. 2018 China's diagnosis and treatment guide for dementia and cognitive impairment (II): diagnosis and treatment guide for Alzheimer's disease[J]. National Medical Journal of China. 2018, 98(13): 971-977.]

9.中国痴呆与认知障碍诊治指南写作组, 中国医师协会神经内科医师分会认知障碍疾病专业委员会. 2018中国痴呆与认知障碍诊治指南(八):快速进展性痴呆的诊断[J]. 中华医学杂志, 2018, 98(21): 1650-1652. DOI: 10.3760/cma.j.issn.0376-2491.2018.21.006. [China Dementia and Cognitive Disorders Writing Group, Cognitive Disorders Professional Committee of Neurophysicians Branch of Chinese Medical Association. 2018 China's diagnosis and treatment guide for dementia and cognitive impairment(VIII): Diagnosis of rapidly progressive dementia[J]. National Medical Journal of China. 2018, 98(21): 1650-1652.]

10.中华医学会骨科学分会创伤骨科学组, 中国医师协会骨科医师分会创伤专家工作委员会.成人股骨颈骨折诊治指南[J]. 中华创伤骨科杂志, 2018, 20(11): 921-928. DOI: 10.3760/cma.j.issn.1671-7600.2018.11.001. [Trauma Orthopedics Group of Orthopedics Branch of Chinese Medical Association, Trauma Expert Working Committee of Orthopedics Branch of Chinese Medical Association. Diagnosis and treatment of femoral neck fracture in adults[J]. Chinese Journal of Orthopaedic Trauma, 2018, 20(11): 921-928.]

11.中国医师协会睡眠医学专业委员会. 成人阻塞性睡眠呼吸暂停多学科诊疗指南[J]. 中华医学杂志, 2018,  98(24): 1902-1914. DOI: 10.3760/cma.j.issn.0376-2491. 2018.24.003. [Sleep Medicine Committee of Chinese Medical Association. Guidelines for multidisciplinary diagnosis and treatment of adult obstructive sleep apnea[J]. National Medical Journal of China, 2018, 98(24): 1902-1914.]

12.洪广亮, 卢才教, 赵光举, 等. 创伤弧菌脓毒症诊疗方案(2018)[J]. 中华急诊医学杂志, 2018, 27(6): 594-598. DOI: 10.3969/j.issn.1002-1949.2018.07.003. [Hong GL, Lu CJ, Zhao GJ, et al. Diagnosis and treatment plan of vibrio vulnificus sepsis (2018)[J]. Chinese Journal of Critical Care Medicine, 2018, 27(6): 594-598.]

13.中华医学会妇产科学分会内分泌学组及指南专家组. 多囊卵巢综合征中国诊疗指南[J]. 中华妇产科杂志, 2018, 53(1): 2-6. DOI: 10.3760/cma.j.issn.0529-567x. 2018.01.002. [Endocrinology Group and Guidance Expert Group of Obstetrics and Gynecology Branch of Chinese Medical As-sociation. Guidelines for diagnosis and treatment of polycystic ovary syndrome in China[J]. Chinese Journal of Obstetrics and Gynecology, 2018, 53(1): 2-6.]

14.国家卫生计生委儿童用药专家委员会,中国医师协会儿科医师分会儿童呼吸专业委员会, 等.儿童喘息性疾病合理用药指南[J]. 中华实用儿科临床杂志, 2018, 33(19): 1460-1471. DOI: 10.3760/cma.j.issn.2095-428X.2018.19.005. [Expert Committee on Child Medication of National Health and Family Planning Commission, Child Respiratory Professional Committee of Pediatric Branch of Chinese Medical Association, et al. Guidelines for rational use of drugs in children with asthmatic diseases[J]. Chinese Journal of Applied Clinical Pediatrics, 2018, 33(19): 1460-1471.]

15.中国腹膜透析相关感染防治专家组. 腹膜透析相关感染的防治指南[J]. 中华肾脏病杂志, 2018, 34(2): 139-148. DOI: 10.3760/cma.j.issn.1001-7097.2018.02.010. [Chinese Expert Group on Prevention and Treatment of Peritoneal Dialysis Related Infections. Guidelines for prevention and treatment of peritoneal dialysis related infections[J]. Chinese Journal of Nephrology, 2018, 34(2): 139-148.]

16.周琦, 吴小华, 刘继红, 等.宫颈癌诊断与治疗指南(第四版)[J]. 中国实用妇科与产科杂志, 2018, 34(6): 41-50. DOI: 10.19538/j.fk2018060111. [Zhou Q, Wu XH, Liu JH, et al. Guidelines for di-agnosis and treatment of cervical cancer (Fourth Edition) [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2018, 34(6): 41-50.]

17.中华医学会骨科学分会关节外科学组. 骨关节炎诊疗指南(2018年版)[J]. 中华骨科杂志, 2018, 38(12): 705-715. DOI: 10.3760/cma.j.issn.0253-2352.2018.12.001. [Joint Surgery Group, Oste-ology Branch, Chinese Medical Association. Guidelines for diagnosis and treatment of osteoarthritis (2018 Edition) [J]. Chinese Journal of Orthopaedics, 2018, 38(12): 705-715.]

18.中华医学会外科分会胃肠外科学组, 中国抗癌协会大肠癌专业委员会. 结直肠癌肝转移诊断和综合治疗指南(V2018)[J]. 中华胃肠外科杂志, 2018, 21(6): 601-626. DOI: 10.3760/cma.j.issn.1671-0274.2018.06.001. [Department of Gastroenterology, Surgery Branch of Chinese Medical Association, Colorectal cancer Committee of Chinese Anti Cancer Association. Guidelines for diagnosis andcomprehensive treatment of liver metastasis of colorectal cancer (V2018)[J], Chinese Journal of Gastrointestinal Surgery, 2018, 21(6): 601-626.]

19.中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等.慢性肺源性心脏病基层诊疗指南(2018年)[J]. 中华全科医师杂志, 2018, 17(12): 959-965. DOI: 10.3760/cma.j.issn.1671-7368.2018.12.002. [Chinese Medical Association, Journal of Chinese Medical Association, General Practice Branch of Chinese Medical Association, et al. Guidelines for primary diagnosis and treatment of chronic pulmonary heart disease (2018) [J]. Chinese Journal of General Practitioners, 2018, 17(12): 959-965.]

20.中华医学会妇产科学分会妇科内分泌学组. 排卵障碍性异常子宫出血诊治指南[J]. 中华妇产科杂志, 2018, 53(12): 801-807. DOI:10.3760/cma.j.issn.0529-567x.2018.12.001. [Gynecological En-docrinology Group, Obstetrics and Gynecology Branch, Chinese Medical Association. The guideline of diagnosis and treatment of dysovulatory uterine bleeding[J], Chinese Journal of Obstetrics and Gynecology, 2018, 53(12): 801-807.]

21.中华医学会儿科学分会围产医学专业委员会, 中国医师协会新生儿科医师分会超声专业委员会,中国医药教育协会超声医学专业委员会重症超声学组, 等. 新生儿肺脏疾病超声诊断指南[J]. 中华实用儿科临床杂志, 2018, 33(14): 1057-1064. [Special Committee of Perinatal Medicine, Pediatric Branch of Chinese Medical Association, Ultrasound Special Committee of Pediatric Branch of Chinese Medical Association, Severe Ultrasound Group of Ultrasound Special Committee of Chinese Medical Education Association, et al. Guidelines for ultrasonic diagnosis of lung diseases in neonates[J], 2018, 33(14): 1057-1064.]

22.中国医师协会胰腺病专业委员会慢性胰腺炎专委会. 胰腺外分泌功能不全诊治规范(2018年,广州)[J]. 中华消化杂志, 2018, 38(12): 795-799. DOI: 10.3760/cma.j.issn.0254-1432.2018.12.002. [Chronic Pancreatitis Committee of Pancreatic Disease Committee of Chinese Medical Association. Standard for diagnosis and treatment of pancreatic exocrine dysfunction (Guangzhou, 2018)[J]. Chinese Journal of Digestion, 2018, 38(12): 795-799.]

23.中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等.支气管哮喘基层诊疗指南(2018年)[J]. 中华全科医师杂志, 2018, 17(10): 751-762. DOI: 10.3760/cma.j.issn.1671-7368.2018.10.002. [Journal of Chinese Medical Association. General Practice Branch of Chinese Medical Association, et al. Guidelines for primary diagnosis and treatment of asthma (2018)[J]. Chinese Journal of General Practitioners, 2018, 17(10): 751-762.]

24.中华医学会整形外科学分会颅颌面外科专业学组(筹备组), 中华医学会整形外科学分会外耳整形再造专业学组(筹备组), 中华医学会整形外科学分会脂肪移植专业学组(筹备组), 等.中国半侧颜面短小畸形·下颌骨畸形临床诊疗指南[J]. 中华整形外科杂志, 2018, 34(1): 1-5. DOI: 10.3760/cma.j.issn.1009-4598.2018.01.001. [Craniomaxillofacial Surgery Group (preparatory group) of Plastic Surgery Credit Association of Chinese Medical Association, External Ear Plastic Reconstruction Group (preparatory group) of Plastic Surgery Branch of Chinese Medical Association, Fat Transplantation Group (preparatory group) of Plastic Surgery Credit Association of Chinese Medical Association, et al. Clinical diagnosis and treatment guide of Chinese hemifacial malformation and mandible malformation[J], Chinese Journal of Plastic Surgery, 2018, 34(1): 1-5.]

25.中华医学会骨科学分会骨肿瘤学组. 中国骨巨细胞瘤临床诊疗指南[J]. 中华骨科杂志, 2018, 38(14): 833-840.DOI: 10.3760/cma.j.issn.0253-2352.2018.14.001. [Bone Oncology Group, Bone Science Branch, Chinese Medical Association. Clinical diagnosis and treatment of giant cell tumor of bone in China[J]. Chinese Journal of Orthopaedics, 2018, 38(14): 833-840.]

26.中华医学会血液学分会, 中国医师协会血液科医师分会. 中国急性早幼粒细胞白血病诊疗指南(2018年版)[J]. 中华血液学杂志, 2018, 39(3): 179-183. DOI: 10.3760/cma.j.issn.0253-2727.2018.03.002. [Hematology Branch of Chinese Medical Association, Hematology Branch of Chinese Medical Association. Guidelines for diagnosis and treatment of acute promyelocytic leukemia in China (2018) [J]. Chinese Journal of Hematology, 2018, 39(3): 179-183.]

27.张绪超,陆舜,张力,等.中国间变性淋巴瘤激酶阳性、ROS1阳性非小细胞肺癌诊疗指南[J]. 中华病理学杂志, 2018, 47(4): 241-247. DOI: 10.3760/cma.j.issn.0529?5807. 2018.04.003. [Zhang XC, Lu S, Zhang L, et al. Guidelines for diagnosis and treatment of anaplastic lymphoma kinase positive and ROS 1 positive NSCLC in China[J]. Chinese Journal of Pathology, 2018, 47(4): 241-247.] 

28.中华人民共和国卫生和计划生育委员会医政医管局, 中华医学会肿瘤学分会. 中国结直肠癌诊疗规范(2017年版)[J]. 中华外科杂志, 2018, 56(4): 241-258.DOI:10.3760/cma.j.issn.0529-5815.2018.04.001. [Medical Administration and Medical Administration Bureau of Health and Family Planning Commission of the people's Republic of China, Oncology Branch of Chinese Medical Association. Chinese standard for diagnosis and treatment of colorectal cancer (2017 Edition)[J]. Chinese Journal of Surgery, 2018, 56(4): 241-258.]

29.许吕宏,方建培. 重型β地中海贫血的诊断和治疗指南(2017年版) [J]. 中华儿科杂志, 2018, 56(10): 724-729. DOI:10.3760/cma.j.issn.0578-1310.2018.10.002. [Xu LH, Fang JP. Diagnosis and treatment guidelines for severe beta thalassemia (2017 Edition)[J]. Chinese Journal of Pediatrics, 2018, 56(10): 724-729.]

30.王临虹, 赵更力. 中国子宫颈癌综合防控指南[J]. 中国妇幼健康研究, 2018, 29(1): 1-3. DOI: 10.3969/j.issn.1673-5293.2018.01.001. [Wang LH, Zhao GL. Guidelines for comprehensive pre-vention and control of cervical cancer in China[J]. Chinese Journal of Woman and Child Health Research, 2018, 29(1): 1-3.]

31.中华医学会肝病学分会脂肪肝和酒精性肝病学组,中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018更新版)[J]. 中华肝脏病杂志, 2018, 26(3): 195-203. DOI: 10.3760/cma.j.issn.1007-3418. 2018.03.008. [Fatty Liver and Alcoholic Hepatology Group, Hepatology Branch, Chinese Medical Association, Fatty Liver Disease Expert Committee of Chinese Medical Association. Guidelines for the prevention and treatment of nonalcoholic fatty liver disease (2018)[J]. Chinese Journal of Hepatology, 2018, 26(3): 195-203.]

32.中华人民共和国国家卫生和计划生育委员会. 近视防治指南[J]. 中国眼镜科技杂志, 2018, (13): 98-102. [National Health and Family Planning Commission of the People's Republic of China. Guidelines for the prevention and treatment of myopia[J]. China Glasses Science-Technology Magazine, 2018, (13): 98-102.]

33.中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 酒精性肝病防治指南(2018年更新版)[J]. 临床肝胆病杂志, 2018, 34(5): 939-946. DOI: 10.3969/j.issn.1001-5256.2018.05.006. [Fatty Liver and Alcoholic Hepatology Group, Hepatology Branch, Chinese Medical Association, Fatty Liver Disease Expert Committee of Chinese Medical Association. Guidelines for the prevention and treatment of alcoholic liver disease (updated in 2018)[J]. Journal of Clinical Hepatology, 2018, 34(5): 939-946.]

34.中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版)[J]. 中华糖尿病杂志, 2018, 10(1): 4-67. DOI:10.3760/cma.j.issn.1674-5809.2018.01.003. [Chinese Diabetes Society. Guidelines for the prevention and treatment of type 2 diabetes in China (2017)[J]. Chinese Journal of Diabetes Mellitus, 2018, 10(1): 4-67.]

35.中华预防医学会医院感染控制分会. 中国艰难梭菌医院感染预防与控制指南[J]. 中华医院感染学杂志, 2018, 28(23): 3674-3680. DOI: 10.11816/cn.ni.2018-183451. [Hospital Infection Control Branch of Chinese Preventive Medicine Association. Guidelines for the prevention and control of nosocomial infection of Clostridium difficile in China[J]. Chinese Journal of Nosocomiology, 2018, 28(23): 3674-3680.]

36.中华医学会骨质疏松和骨矿盐疾病分会骨与关节学组, 中国医师协会骨科医师分会骨质疏松工作委员会. 骨质疏松性骨折围手术期干预指南[J]. 中华骨质疏松和骨矿盐疾病杂志, 2018, 11(5): 438-448. DOI: 10.3969/j.issn.1674-2591.2018.05.002. [Osteoarthritis Group, Osteoporosis and Bone Mineral Diseases Branch, Chinese Medical Association, Osteoporosis Working Committee of Orthopaedic Branch of Chinese Medical Doctor Association. Perioperative intervention guide for osteoporotic fracture[J].Chinese Journal of Osteoporosis and Bone Mineral Research, 2018, 11(5): 438-448.]

37.原慧萍, 杨泽, 史晓红. 老年人糖尿病前期干预指南[J]. 中国老年保健医学, 2018, 84(03): 24-25. DOI: 10.3969/j.issn.1672-2671.2018.03.005. [Yuan HP, Yang Z, Shi XH. Intervention guide for the elderly in pre diabetes[J]. Chinese Journal of Geriatric Care, 2018, 84(03): 24-25.]

38.中华医学会妇产科学分会绝经学组. 中国绝经管理与绝经激素治疗指南(2018)[J]. 协和医学杂志, 2018, 9(6): 512-525. DOI: 10.3969/j.issn.1674-9081.2018.06.007. [Menopause Group of Obstetrics and Gynecology Branch of Chinese Medical Association. Chinese menopause management and menopausal hormone therapy guidelines (2018) [J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(6): 512-525.]

39.国家卫生计生委合理用药专家委员会, 中国药师协会. 冠心病合理用药指南(第2版)[J]. 中国医学前沿杂志(电子版), 2018, 10(6): 1-130. DOI: 10.12037/YXQY.2018.06-01. [Expert Committee on Rational Drug Use of National Health and Family Planning Commission, Chinese Pharmacist Asso-ciation. Guidelines for rational administration of coronary heart disease (2nd Edition)[J]. Chinese Journal of the Frontiers of Medical Science (Electronic Version), 2018, 10(6): 1-130.]

40.中国老年保健医学研究会老龄健康服务与标准化分会. 老年人慎用药物指南[J]. 中国老年保健医学, 2018, 84(3): 20-24. DOI: 10.3969/j.issn.1672-2671.2018.03.004. [Aging Health Service and Standardization Branch of China Geriatric Medical Research Association. Guide for the elderly to use drugs with caution[J]. Chinese Journal of Geriatric Care, 2018, 84(3): 20-24.]

41.中华医学会外科学分会疝与腹壁外科学组, 中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊断和治疗指南(2018年版)[J]. 中华胃肠外科杂志, 2018, 21(7): 721-724. DOI: 10.3760/cma.j.issn.1671-0274.2018.07.001. [Hernia and Abdominal Wall Surgery Group of Surgery Credit Association of Chinese Medical Association, Committee of Hernia and Abdominal Wall Sur-geons, Branch of Surgeons, Chinese Medical Association. Guide for diagnosis and treatment of adult inguinal hernia (2018 Edition) [J]. Chinese Journal of Gastrointestinal Surgery, 2018, 21(7): 721-724.]

42.中华医学会血液学分会血栓与止血学组, 中国血友病协作组. 凝血因子Ⅷ/Ⅸ抑制物诊断与治疗中国指南(2018年版)[J]. 中华血液学杂志, 2018, 39(10): 793-799. DOI: 10.3760/cma.j.issn.0253-2727.2018.10.001. [Thrombus and Hemostasis Group, Hematology Branch, Chinese Medical Association, China Hemophilia Cooperation Group. Chinese guidelines for the diagnosis and treatment of coagulation factor Ⅷ/ⅸ inhibitors (2018) [J]. Chinese Journal of Hematology, 2018, 39(10): 793-799.]

43.国家老年中心.居家(养护) 老年人跌倒干预指南[J]. 中国老年保健医学志, 2018, 16(3): 32-34. DOI: 10.3969/j.issn.1672-2671.2018.03.009. [National Center for the Elderly. Intervention guide for falls of the elderly at home[J]. Chinese Journal of Geriatric Care, 2018, 16(3): 32-34.]

44.中华医学会外科学分会疝与腹壁外科学组, 中国医师协会外科医师分会疝和腹壁外科医师委员会. 腹壁切口疝诊断和治疗指南(2018年版)[J]. 中华外科杂志, 2018, 56(7): 499-502. DOI: 10.3760/cma.j.issn.0529-5815. 2018.08.003. [Hernia and Abdominal Wall Surgery Group of Sur-gery Credit Association of Chinese Medical Association, Committee of Hernia and Abdominal Wall Surgeons, Branch of Surgeons, Chinese Medical Association. Guide to diagnosis and treatment of abdominal incisional hernia (2018 Edition)[J]. Chinese Journal of Surgery, 2018, 56(7): 499-502.]

45.刘继红, 朱笕青. 卵巢恶性肿瘤诊断与治疗指南(第四版)[J]. 中国实用妇科与产科杂志, 2018, 34(7): 739-749. DOI: 10.19538/j.fk2018070110. [Liu JH, Zhu JQ. Guidelines for diagnosis and treatment of ovarian cancer (Fourth Edition)[J]. Chinese Journal of Practical Gynecology and Ob-stetrics, 2018, 34(7): 739-749.]

46.中国抗癌协会妇科肿瘤专业委员会. 妊娠滋养细胞疾病诊断与治疗指南(第四版)[J]. 中国实用妇科与产科杂志, 2018, 34(9): 46-53. DOI: 10.19538/j.fk2018090113. [Gynecological Oncology Committee of China Anti Cancer Association. Guidelines for diagnosis and treatment of gestational trophoblastic diseases (Fourth Edition)[J].Chinese Journal of Practical Gynecology and Obstetrics, 2018, 34(9): 46-53.]

47.中华医学会感染病学分会, 中华医学会热带病与寄生虫学分会, 中华中医药学会急诊分会. 中国登革热临床诊断和治疗指南[J]. 中华临床感染病杂志, 2018, 31(5): 385-392. DOI: 10.3760/cma.j.issn.1674-2397.2018.05.001. [Infectious Diseases Branch of Chinese Medical Asso-ciation, Society of Tropical Diseases and Parasitology, Chinese Medical Association, Emergency Branch of Chinese Society of Traditional Chinese Medicine. Guidelines for clinical diagnosis and treatment of dengue fever in China[J]. Chinese Journal of Clinical Infectious Diseases, 2018, 31(5): 385-392.]

48.郭卫, 牛晓辉, 肖建如, 等.多发性骨髓瘤骨病外科治疗循证医学指南[J]. 中华骨与关节外科杂志, 2018, 11(4): 252-259. DOI: 10.3969/j.issn.2095-9958.2018.04.002. [Guo W, Niu XH, Xiao JR, et al. Evidence based medicine guidelines for surgical treatment of multiple myeloma osteopathy[J]. Chinese Journal Bone and Joint Surgery, 2018, 11(4): 252-259.]

49.中华医学会肝病学分会. 肝硬化腹水及相关并发症的诊疗指南[J]. 中华肝脏病杂志, 2018, 25(9): 664-677. DOI: 10.3760/cma.j.issn.1007-3418.2017.09.006. [Hepatology Branch of Chinese Med-ical Association. Guidelines for the diagnosis and treatment of ascites and related complications in cirrhosis[J]. Chinese Journal of Hepatology, 2018, 25(9): 664-677.]

50.中华医学会肝病学分会. 肝硬化肝性脑病诊疗指南[J]. 中华内科杂志, 2018, 57(10): 705-718. DOI: 10.3760/cma.j.issn.0578-1426.2018.10.004. [Hepatology Branch of Chinese Medical Association. Guidelines for diagnosis and treatment of hepatic encephalopathy due to cirrhosis[J]. Chinese Journal of Internal Medicine, 2018, 57(10): 705-718.]

51.郭卫, 李建民, 沈靖南, 等.骨巨细胞瘤临床循证诊疗指南[J]. 中华骨与关节外科杂志, 2018, 11(4): 41-52.DOI: 10.3969/j.issn.2095-9958.2018.04.004. [Guo W, Li JM, Shen JN, et al. Clinical evi-dence-based diagnosis and treatment of giant cell tumor of bone[J]. Chinese Journal Bone and Joint Surgery, 2018, 11(4): 41-52.]

52.郭卫, 牛晓辉, 肖建如, 等.骨肉瘤临床循证诊疗指南[J]. 中华骨与关节外科杂志, 2018, 11(04): 53-66. DOI:  10.3969/j.issn.2095-9958.2018.04.005. [Guo W, Niu XH, Xiao JR, et al. Clinical evidence-based diagnosis and treatment of giant cell tumor of bone[J]. Chinese Journal Bone and Joint Surgery, 2018, 11(04): 53-66.]

53.中华中医药学会心血管病分会.冠心病心绞痛介入前后中医诊疗指南[J]. 中国实验方剂学杂志, 2018, 24(15): 4-6. DOI: 10.13422/j.cnki.syfjx.20184101. [Chinese Society of Traditional Chinese Medicine Cardiovascular Disease Branch. Guidelines for diagnosis and treatment of coronary heart disease and angina pectoris before and after intervention[J]. Chinese Journal of Experimental Tra-ditional Medical Formulae, 2018, 24(15): 4-6.]

54.中华医学会骨质疏松和骨矿盐疾病分会, 中华医学会内分泌分会代谢性骨病学组. 甲状旁腺功能减退症临床诊疗指南[J]. 中华骨质疏松和骨矿盐疾病杂志, 2018, 11(4): 7-22. DOI: 10.3969/j.issn.1674-2591.2018.04.001. [Osteoporosis and Bone Mineral Disease Branch of Chinese Medical Association, Metabolic Osteopathy Group, Endocrine Branch, Chinese Medical Association. Clinical diagnosis and treatment of hypoparathyroidism[J]. Chinese Journal of Osteoporosis and Bone Mineral Research, 2018, 11(4): 7-22.]

55.中华中医药学会风湿病分会. 类风湿关节炎病证结合诊疗指南[J]. 中医杂志, 2018, 59(20): 1794-1800. DOI: 10.13288/j.11-2166/r.2018.20.018. [Rheumatism Branch of Chinese Association of Traditional Chinese Medicine. Rheumatoid arthritis syndrome combined diagnosis and treatment guide[J]. Journal of Traditional Chinese Medicine, 2018, 59(20): 1794-1800.]

56.中华中医药学会肝胆病专业委员会, 中国民族医药学会肝病专业委员会, 等.慢性乙型肝炎中医诊疗指南(2018年版)[J]. 临床肝胆病杂志, 2018, 34(12): 39-44. DOI:  10.3969/j.issn.1001-5256.2018.12.007. [Hepatobiliary Disease Committee of Chinese Society of Traditional Chinese Medicine, Committee of Hepatology, Chinese Society of Ethnic Medicine. Tra-ditional Chinese medical science diagnosis and treatment guide for chronic hepatitis B(2018)[J]. Journal of Clinical Hepatology, 2018, 34(12): 39-44.]

57.唐旭东, 王凤云, 李慧臻, 等. 痞满中医临床实践指南(2018)[J]. 中医杂志, 2019, 60(17): 1520-1530. DOI: 10.13288/j.11-2166/r.2019.17.019. [Tang XD, Wang FY, Li HZ, et al. Clinical practice guide of PI man traditional Chinese medicine (2018) [J]. Journal of Traditional Chinese Medicine, 2019, 60(17): 1520-1530.]

58.郭卫, 邵增务, 张伟滨, 等. 软骨肉瘤临床循证诊疗指南[J]. 中华骨与关节外科杂志, 2018, 11(4): 302-311.DOI: 10.3969/j.issn.2095-9958.2018.04.006. [Guo W, Sao ZW, Zhang WB, et al. Clinical evidence-based diagnosis and treatment of chondrosarcoma [J]. Chinese Journal Bone and Joint Surgery, 2018, 11(4): 41-52.]

59.中华人民共和国国家卫生健康委员会. 手足口病诊疗指南(2018年版)[J]. 中华临床感染病杂志, 2018, 11(3): 161-166. DOI: 10.3760/cma.j.issn.1674-2397.2018.03.001. [National Health and Health Commission of the People's Republic of China. Guidelines for diagnosis and treatment of HFMD (2018)[J]. Chinese Journal of Clinical Infectious Diseases, 2018, 11(3): 161-166.]

60.周琦, 吴小华, 刘继红, 等. 外阴癌诊断与治疗指南(第四版)[J]. 中国实用妇科与产科杂志, 2018, 34(11): 50-57. DOI: 10.19538/j.fk2018110112. [Zhou Q, Wu XH, Liu JH, et al. Guide to diagnosis and treatment of vulvar cancer (Fourth Edition) [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2018, 34(11): 50-57.]

61.中国抗癌协会妇科肿瘤专业委员会. 阴道恶性肿瘤诊断与治疗指南(第四版)[J]. 中国实用妇科与产科杂志, 2018, 34(11): 1227-1229. DOI: 10.19538/j.fk2018110111. [Gynecological Oncology Committee of China Anti Cancer Association. Guide for diagnosis and treatment of vaginal cancer (Fourth Edition) (2018) [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2018, 34(11): 1227-1229.]

62.郭卫, 王臻, 郭征, 等. 尤文肉瘤肿瘤家族(ESFT)临床循证诊疗指南[J]. 中华骨与关节外科杂志, 2018, 11(4): 25-40. DOI: 10.3969/j.issn.2095-9958.2018.04.003. [Guo W, Wang Z, Guo Z, et al. Ewing sarcoma family (ESFT) clinical evidence-based diagnosis and treatment guidelines[J]. Chinese Journal Bone and Joint Surgery, 2018, 11(4): 25-40.]

63.中国中西医结合学会男科专业委员会. 早泄中西医结合诊疗指南(试行版)[J], 中华男科杂志, 2018, 24(2):176-181. DOI: 10.13263/j.cnki.nja.2018.02.016. [Professional Committee of Andrology, Chinese Association of Integrative Chinese and Western Medicine. Guide to diagnosis and treatment of premature ejaculation with integrated Chinese and Western Medicine (Trial Edition) [J]. National Journal of Andrology, 2018, 24(2): 176-181.]

64.中华医学会消化内镜学分会ERCP学组, 中国医师协会消化医师分会胆胰学组, 国家消化系统疾病临床医学研究中心. 中国ERCP指南(2018版)[J]. 中华消化内镜杂志, 2018, 53(11): 1185-1215. DOI: 10.3760/cma.j.issn.1007-5232.2018.11.001. [ERCP Group, Gastroenterology Branch, Chinese Medical Association, Cholangiopancreatology Group of Digestive Branch of Chinese Medical As-sociation, National Center for Clinical Medicine of Digestive System Diseases. China ERCP guidelines (2018)[J]. Chinese Journal of Digestive Endoscopy, 2018, 53(11): 1185-1215.]

65.中华医学会感染病学分会艾滋病丙型肝炎学组, 中国疾病预防控制中心. 中国艾滋病诊疗指南(2018版)[J]. 中华传染病杂志, 2018, 36(12): 705-724. DOI: 10.3760/cma.j.issn.1000-6680.2018.12.001. [Group of AIDS and Hepatitis C, Infectious Diseases Branch, Chinese Medical Association, China Center for Disease Control and Prevention. China AIDS diagnosis and treatment guidelines (2018) [J]. Chinese Journal of Infectious Diseases, 2018, 36(12): 705-724.]

66.中国医师协会胰腺病专业委员会慢性胰腺炎专委会. 慢性胰腺炎诊治指南(2018,广州)[J]. 中华消化内镜杂志, 2018, 35(11): 814-822. DOI: 10.3760/cma.j.issn.1007-5232.2018.11.002. [Chronic Pancreatitis Committee of Pancreatic Disease Committee of Chinese Medical Association. Guidelines for diagnosis and treatment of chronic pancreatitis (Guangzhou, 2018) [J]. Chinese Journal of Di-gestive Endoscopy, 2018, 35(11): 814-822.]

67.李茂全. 糖尿病足介入综合诊治临床指南(第4版)[J]. 中国介入影像与治疗学, 2018, 117(1): 8-17. DOI: 10.13929/j.1672-8475.201710021. [Li MQ. Clinical guidelines for comprehensive interven-tional diagnosis and treatment of diabetic foot (4th Edition)[J]. Chinese Journal of Interventional Imaging and Therapy, 2018, 117(1): 8-17.]

68.中国抗癌协会胰腺癌专业委员会. 胰腺癌综合诊治指南(2018版)[J]. 中华外科杂志, 2018, 56(7): 481-494. DOI: 10.3760/cma.j.issn.0529-5815.2018.07.001. [Pancreatic Cancer Committee of China Anti Cancer Association. Guidelines for comprehensive diagnosis and treatment of pancreatic cancer (2018) [J], Chinese Journal of Surgery, 2018, 56(7): 481-494.]

69.超声引导经皮热消融治疗子宫肌瘤全国多中心研究协作组. 超声引导经皮微波(射频)消融治疗子宫肌瘤临床应用指南(2017)[J]. 中华医学超声杂志(电子版), 2018, 15(2): 15-19. DOI: 10.3877/cma.j.issn.1672-6448. 2018.02.002. [Ultrasound-Guided Percutaneous Thermoablation for Hysteromyoma. Guide for clinical application of ultrasound-guided percutaneous microwave (RF) ablation in the treatment of hysteromyoma (2017) [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(2): 15-19.]

70.中国卒中学会, 中国卒中学会神经介入分会, 中华预防医学会卒中预防与控制专业委员会介入学组. 急性缺血性卒中血管内治疗中国指南2018[J]. 中国卒中杂志, 2018, 13(7): 706-728. DOI: 10.3969/j.issn.1673-5765.2018.07.014. [Chinese Stroke Society, Neurointerventional Branch of Chinese Stroke Society, Intervention Group of Stroke Prevention and Control Committee of Chinese Preventive Medicine Association. Chinese guidelines for intravascular treatment of acute ischemic stroke 2018[J]. Chinese Journal of Stroke, 2018, 13(7): 706-728.]

71.朱精强,田文,苏安平, 等.甲状腺围手术期甲状旁腺功能保护指南(2018版)[J]. 中国实用外科杂志, 2018(10): 1108-1113. DOI: 10.19538/j.cjps.issn.1005-2208.2018.10.03. [Zhu JQ, Tian W, Su AP, et al. Guidelines for the protection of parathyroid function during perioperative period (2018) [J].Chinese Journal of Practical Surgery, 2018(10): 1108-1113.]

72.中国医师协会急诊医师分会.中国急性心力衰竭急诊临床实践指南(2017)[J].中华急诊医学杂志, 2017, 12(26): 1347-1357. DOI: 10.3760/cma.j.issn.1671-0282.2017.12.003. [Emergency Physi-cians Branch of Chinese Medical Association. China's emergency clinical practice guide for acute heart failure (2017)[J],Chinese Journal of Emergency Medicine, 2017, 12(26): 1347-1357.]

73.中国整形美容协会瘢痕医学分会常务委员会专家组. 中国瘢痕疙瘩临床治疗推荐指南[J]. 中国美容整形外科杂志, 2018, 29(5): 9-20. DOI: 10.3969/j.issn.1673-7040. 2018.05.001. [Expert Group of Standing Committee of Scar Medicine Branch of China Plastic and Cosmetic Association. Rec-ommended guidelines for clinical treatment of keloid in China[J]. Chinese Journal of Aesthetic and Plastic Surgery, 2018, 29(5): 9-20.]

74.中华医学会重症医学分会. 中国成人ICU镇痛和镇静治疗指南[J]. 中华重症医学电子杂志, 2018, 4(2): 90-113. DOI: 10.3760/cma.j.issn.2095-4352.2018.06.001. [Severe Medicine Branch of Chi-nese Medical Association. Guidelines for analgesia and sedation in Chinese adult ICU[J]. Chinese Critical Care Medicine, 2018, 4(2): 90-113.]

75.中国研究型医院学会泌尿外科学专业委员会, 中国医疗保健国际交流促进会, 泌尿健康促进分会, 等. 中国良性前列腺增生症经尿道等离子双极电切术治疗指南(2018标准版)[J]. 中华医学杂志, 2018, 98(20): 1549-1560. DOI: 10.3760/cma.j.issn.0376-2491.2018.20.005. [Urology Committee of Chinese Research Hospital Association, China Association for the Promotion of International Exchanges in Healthcare, Urinary health Promotion Branch. Guidelines for the treatment of BPH in China (2018 Standard Edition) [J]. National Medical Journal of China, 2018, 98(20): 1549-1560.]

76.中国医师协会急诊医师分会.中国脓毒症/脓毒性休克急诊治疗指南(2018)[J]. 临床急诊杂志, 2018, 19(9): 6-27. DOI: 10.3969/j.issn.1002-1949.2018.09.001. [Emergency Physicians Branch of Chi-nese Medical Association. Guidelines for emergency treatment of sepsis / septic shock in China (2018)[J].Chinese Journal of Critical Care Medicine, 2018, 19(9): 6-27.]

77.中华医学会胸心血管外科学分会胸腔镜外科学组, 中国医师协会胸外科医师分会微创胸外科专家委员会. 中国胸腔镜肺叶切除临床实践指南[J]. 中华医学杂志, 2018, 98(47): 3832-3841. DOI: 10.3760/cma.j.issn.0376- 2491.2018.47.005. [Thoracoscopic Surgery Group, Thoracic and Car-diovascular Surgery Branch, Chinese Medical Association, Minimally Invasive Thoracic Surgery Expert Committee of Thoracic Surgery Branch of Chinese Medical Doctor Association. Clinical practice guide of thoracoscopic lobectomy in China[J]. National Medical Journal of China, 2018, 98(47): 3832-3841.]

78.中国抗癌协会妇科肿瘤专业委员会. 子宫肉瘤诊断与治疗指南(第四版)[J]. 中国实用妇科与产科杂志, 2018, 34(10): 1106-1110. DOI: 10.19538/j.fk2018100110. [Gynecological Oncology Com-mittee of China Anti Cancer Association. Diagnosis and treatment of uterine sarcoma (4th Edition) [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2018, 34(10): 1106-1110.]

79.中华医学会心血管病学分会介入心脏病学组, 中国医师协会心血管内科医师分会血栓防治专业委员会.稳定性冠心病诊断与治疗指南[J]. 中华心血管病杂志, 2018, 46(9): 680-694. DOI: 10.3760/cma.j.issn.0253-3758. 2018.09.004. [Interventional Cardiology Group, Cardiovascular Branch, Chinese Medical Association, Thrombus Prevention and Treatment Committee of Cardio-vascular Physician Branch of Chinese Medical Doctor Association. Guidelines for diagnosis and treatment of stable coronary heart disease[J]. Chinese Journal of Cardiology, 2018, 46(9): 680-694.]

80.中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心血管病杂志, 2018, 46(10): 760-788. DOI: 10.3760/cma.j.issn.0253-3758.2018.10.004. [Heart Failure Group, Cardiovascular Branch, Chinese Medical Association, Editorial Board of Chinese Journal of Cardiovascular Disease. China heart failure diagnosis and treatment guidelines 2018[J]. Chinese Journal of Cardiology, 2018, 46(10): 760-788.]

81.中国心血管病预防指南(2017)写作组, 中华心血管病杂志编辑委员会. 中国心血管病预防指南(2017)[J]. 中华心血管病杂志, 2018, 46(1): 10-25. DOI: 10.3760/cma.j.issn.0253-3758.2018.01.004. [China Cardiovascular Disease Prevention Guidelines (2017) Writing Group, Editorial Board of Chinese Journal of Cardiovascular Disease. Guidelines for cardiovascular disease prevention in China (2017)[J]. Chinese Journal of Cardiology, 2018, 46(1): 10-25.]

82.中华医学会感染病学分会肝衰竭与人工肝学组. 肝衰竭诊治指南(2018年版)[J]. 中华传染病杂志, 2019, 37(1): 1-9. DOI: 10.3760/cma.j.issn.1000-6680.2019.01.001. [Liver Failure and Artificial Liver Group, Infectious Diseases Branch, Chinese Medical Association. Guidelines for diagnosis and treatment of liver failure (2018 Edition)[J]. Chinese Journal of Infectious Diseases, 2019, 37(1): 1-9.]

83.中国中西医结合学会神经科专业委员会. 中国脑梗死中西医结合诊治指南(2017)[J]. 中国中西医结合杂志, 2018, 38(2): 136-144. DOI: 10.7661/j.cjim.20171221.483. [Neurology Committee of Chinese Society of Integrated Traditional and Western Medicine. Guidelines for the diagnosis and treatment of cerebral infarction in China (2017) [J]. Chinese Journal of Integrated Traditional and Western Medicine, 2018, 38(2): 136-144.]

84.中华医学会心血管病学分会, 中国心肌炎心肌病协作组. 中国扩张型心肌病诊断和治疗指南[J]. 临床心血管病杂志, 2018, 34(5): 421-434. DOI: 10.13201/j.issn.1001-1439.2018.05.001. [Chinese Society of Cardiology, Chinese Myocarditis Cardiomyopathy Cooperation Group. Guidelines for diagnosis and treatment of dilated cardiomyopathy in China[J]. Journal of Clinical Cardiology, 2018, 34(5): 421-434.]

85.中华医学会心血管病学分会肺血管病学组, 中华心血管病杂志编辑委员会. 中国肺高血压诊断和治疗指南2018[J]. 中华心血管病杂志, 2018, 46(12): 933-964. DOI: 10.3760/cma.j.issn.0253-3758.2018.12.006. [Pulmonary Vascular Group, Cardiovascular Branch, Chinese Medical Association, Editorial Board of Chinese Journal of Cardiovascular Disease. Guide-lines for diagnosis and treatment of pulmonary hypertension in China 2018[J].Chinese Journal of Cardiology, 2018, 46(12): 933-964.]

86.马远征, 王以朋, 刘强, 等. 中国老年骨质疏松症诊疗指南(2018)[J].中华健康管理学杂志, 2018, 12(6): 484-509. DOI: 10.3760/cma.j.issn.1674-0815.2018.06.002. [Ma YZ, Wang YP, Liu Q, et al. Guidelines for diagnosis and treatment of osteoporosis for the elderly in China (2018) [J]. Chinese Journal of Health Management, 2018, 12(6): 484-509.]

87.中华医学会风湿病学分会. 2018中国类风湿关节炎诊疗指南[J]. 中华内科杂志, 2018, 57(4): 242-251. DOI: 10.3760/cma.j.issn.0578-1426.2018.04.004. [Rheumatology Branch of Chinese Medical Association. 2018 China rheumatoid arthritis diagnosis and treatment guide[J]. Chinese Journal of Internal Medicine, 2018, 57(4): 242-251.]

88.中国医师协会皮肤科分会变态反应性疾病专业委员会. 慢性瘙痒管理指南(2018版)[J]. 中华皮肤科杂志, 2018, 51(7): 481-485. DOI: 10.3760/cma.j.issn. 0412-4030.2018.07.001. [Allergic Disease Committee of Dermatology Branch of Chinese Medical Association. Chronic pruritus man-agement guide (2018)[J]. Chinese Journal of Dermatology, 2018, 51(7): 481-485.]

89.叶进, 喻闽凤, 徐卉卉, 等.中医儿科临床诊疗指南·蛲虫病(修订)[J]. 中医儿科杂志, 2018, 14(1): 1-4. DOI: 10.16840/j.issn1673-4297.2018.01.01. [Ye J, Yu MF, Xu HH, et al. Guidelines for clinical diagnosis and treatment of Pediatrics in traditional Chinese Medicine Enterobiasis (Revised)[J]. Journal of Pediatrics of Traditional Chinese Medicine, 2018, 14(1): 1-4.]

90.顾敏勇,杨燕, 孙彦丽, 等. 中医儿科临床诊疗指南·胎黄(修订)[J]. 中医儿科杂志, 2018, 14(2): 5-9. DOI: 10.16840/j.issn1673-4297.2018.02.02. [Gu MY, Yang Y, Dun YL, et al. Guidelines for clinical diagnosis and treatment of Pediatrics in traditional Chinese Medicine-fetal yellow (Revised) [J].Journal of Pediatrics of Traditional Chinese Medicine, 2018, 14(2): 5-9.]

91.姜之炎, 王雪峰, 张靖延,等. 中医儿科临床诊疗指南·小儿口疮(修订)[J]. 中医儿科杂志, 2018, 14(4): 1-5. DOI: 10.16840/j.issn1673-4297.2018.04.01. [Jiang ZY, Wang XF, Zhang JY, et al. Guidelines for clinical diagnosis and treatment of Pediatrics in traditional Chinese Medicine-pediatric aphtha (Revised)[J]. Journal of Pediatrics of Traditional Chinese Medicine, 2018, 14(4): 1-5.]

92.赵颖. 中医儿科临床诊疗指南·小儿胃炎(修订)[J]. 中医儿科杂志, 2018, 14(3): 1-5. DOI: 10.16840/j.issn1673- 4297.2018.03.01. [Zhao Y. Guidelines for clinical diagnosis and treatment of pediatrics in Traditional Chinese Medicine - infantile gastritis (Revised)[J]. Journal of Pediatrics of Traditional Chinese Medicine, 2018, 14(3): 1-5.]

93.王仲易, 杜可, 李晨, 等. 中医儿科临床诊疗指南·小儿遗尿症(修订)[J]. 中医儿科杂志, 2018, 14(1): 4-8.DOI: 10.16840/j.issn1673-4297.2018.01.02. [Wang ZY, Du K, Li C, et al. Guidelines for clinical diagnosis and treatment of pediatrics in Traditional Chinese Medicine and enuresis in children (Revised)[J]. Journal of Pediatrics of Traditional Chinese Medicine, 2018, 14(1): 4-8.]

94.靳英辉, 曾宪涛. 中国非肌层浸润性膀胱癌治疗与监测循证临床实践指南(2018年标准版)[J]. 现代泌尿外科杂志, 2019, 24(7): 516-542. DOI: 10.3969/j.issn.1009-8291.2019.07.004. [Jin YH, Zeng XT. Evidence based clinical practice guide for the treatment and monitoring of non-muscular invasive bladder cancer in China (2018 Standard Edition) [J]. Journal of Modern Urology, 2019, 24(7): 516-542.]

95.中国医疗保健国际交流促进会骨科分会. 关节腔注射富血小板血浆治疗膝骨关节炎的临床实践指南(2018年版)[J]. 中华关节外科杂志(电子版), 2018, 12(4): 444-448. DOI:10.3877/cma.j.issn.1674-134X.2018.04.001. [Orthopaedic branch of China Association for international exchange and promotion of health care. Clinical practice guide for the treatment of knee osteoarthritis by intra-articular injection of platelet rich plasma (2018 version) [J]. Chinese Journal of Joint Surgery (Electronic Version), 2018, 12(4): 444-448.]

96.中国医师协会介入医师分会. 中国肝细胞癌经动脉化疗栓塞治疗(TACE)临床实践指南[J]. 中华肝脏病杂志, 2019, 27(3): 172-181. DOI: 10.3760/cma.j.issn.1007-3418. 2019.03.003. [Interven-tion Branch of Chinese Medical Association. Transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma in China[J]. Chinese Journal of Hepatology, 2019, 27(3): 172-181.]

97.钱素云,陆国平,许峰,等.危重症儿童营养评估及支持治疗指南(2018,中国,简化版)[J]. 中国循证儿科杂志, 2018, 13(1): 1-29. DOI: 10.3969/j.issn.1673-5501. 2018.01.001. [Qian SY, Lu GP, Xu F, et al. Guidelines for nutritional assessment and supportive treatment of critically ill children (2018, China, Standard Edition)[J], Chinese Journal of Evidence Based Pediatrics, 2018, 13(1): 1-29]

98.中国医师协会中西医结合医师分会, 中国中西医结合学会心血管病专业委员会, 中国中西医结合学会重症医学专业委员会, 等. 急性心肌梗死中西医结合诊疗指南[J]. 中国中西医结合杂志, 2018, 38(3): 272-284. DOI: 10.7661/j.cjim.20180119.038. [Chinese and Western Medicine Branch of Chinese Medical Association, Special Committee of Cardiovascular Disease of Chinese Society of Integrated Traditional and Western Medicine, Severe Medicine Committee of Chinese Association of Integrated Traditional and Western Medicine, et al. Guide to Diagnosis and treatment of acute my-ocardial infarction with integrated Chinese and Western Medicine[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2018, 38(3): 272-284.]

99.中国医师协会器官移植医师分会,中华医学会器官移植学分会.中国肝癌肝移植临床实践指南(2018版)[J]. 中华普通外科杂志, 2019, 34(2): 190-192. DOI: 10.3760/cma.j.issn.1007-631X.2019.02.036. [Organ Transplant Branch of Chinese Medical Doctor Association, Organ Transplantation Branch of Chinese Medical Association. Guidelines for clinical practice of liver transplantation for liver cancer in China (2018) [J]. Chinese Journal of General Surgery, 2019, 34(2): 190-192.]

100.刘雅莉,车刚,马圆,等. 2010~2017年中国大陆中文期刊发表儿内科临床实践指南的现状分析[J], 中国循证医学杂志, 2019, 19(10): 1151-1157. DOI: 10.7507/1672-2531.201903014. [Liu YL, Che G, Ma Y, et al. Analysis of current status of pediatric internal medicine clinical practice guidelines published in journals of mainland China from 2010 to 2017[J]. Chinese Journal of Evidence-Based Medicine, 2019, 19(10): 1151-1157.]

101.赵明娟,靳英辉,张菁,等.临床实践指南制定方法--利益冲突的声明和管理[J]. 中国循证心血管医学杂志, 2018, 10(5): 6-10. DOI: 10.3969/j.issn.1674-4055.2018.05.01. [Zhao MJ, Jin YH, Zhang J, et al. Methodology for clinical practice guidelines-declaration and management of conflict of interest [J]. Chinese Journal of Evidence Based Cardiovascular Medicine, 2018, 10(5): 6-10.]

102.桂裕亮, 杨亮, 曾宪涛, 等. 临床实践指南制订方法——经济学证据在指南制订中的应用[J]. 中国循证心血管医学杂志, 2018, 10(11): 11-14. DOI: 10.3969/j.issn.1674-4055.2018.11.02. [Gui YL, Y L, Zeng XT, et al. The method of making clinical practice guidelines -the application of economic evidence in the development of guidelines[J]. Chinese Journal of Evidence Based Cardiovascular Medicine, 2018, 10(11):11-14.]

103.NICE. Process and methods guidelines: the guidelines manu-al.Availableat:https://www.nice.org.uk/process/pmg6/resources/theguidelines-manual-pdf-2007970804933

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