{
  "abstract": "Objective The purpose of this study is to validate the taxonomy and framework using Chinese guidelines and identify actionable statements.Design and setting We searched five databases, to identify the health guidelines from 1 January 2020 to 1 May 2023. Five researchers categorised statements into six types: formal recommendations (Type I) with clear direction and strength, with explicit and direct evidence; good practice statements (GPS) (Type II), actionable in isolation with a significant benefit; remarks (Type III), an inseparable unit belonging to a formal recommendation or GPS that provides additional clarification; research only recommendations (Type IV) for specific populations; implementation considerations, tools and tips (Type V), that describe the how, who, where, what and when, in relation to implementing a recommendation and lacking a direct evidence link; and informal recommendations (Type VI), unrelated to evidence and not meeting GPS criteria.Results We included 116 guidelines, including 74 Western medicine guidelines, 12 traditional Chinese medicine guidelines and 30 integrated Chinese and Western medicine guidelines. 99 guidelines (85.3%) used the Grading of Recommendations Assessment, Development and Evaluation criteria. Medical specialty societies developed the highest number of guidelines (53.4%). Of all the statements, 4422 statements were extracted from the guidelines. Among them, 2154 (48.7%) were formal recommendations, 197 (4.4%) were GPS, 394 (8.9%) were remarks, 16 (0.4%) were research only recommendations, 1106 (25.0%) were implementation considerations, tools and tips, and 555 (12.6%) were informal recommendations.Conclusions Up to date, the Chinese guideline developers tend to overestimate the number of formal recommendations and underestimate the number of GPS, remarks, research only recommendations, implementation considerations, tools and tips, and informal recommendations. Thus the current quality of actionable statements in Chinese health guidelines requires further enhancement.",
  "authors": [
    {
      "affiliations": [
        "Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China"
      ],
      "name": "Xiangying Ren"
    },
    {
      "affiliations": [
        "Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada",
        "Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Tamara Lotfi"
    },
    {
      "affiliations": [
        "School of Nursing, Wuhan University, Wuhan, Hubei, China"
      ],
      "name": "Jiyu Chen"
    },
    {
      "affiliations": [
        "School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China"
      ],
      "name": "Yuling Lei"
    },
    {
      "affiliations": [
        "School of Nursing, Wuhan University, Wuhan, Hubei, China"
      ],
      "name": "Chenyibei Zhou"
    },
    {
      "affiliations": [
        "School of Nursing, Wuhan University, Wuhan, Hubei, China"
      ],
      "name": "Wei Zhang"
    },
    {
      "affiliations": [
        "Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China"
      ],
      "name": "Qiao Huang"
    },
    {
      "affiliations": [
        "Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China"
      ],
      "name": "Yongbo Wang"
    },
    {
      "affiliations": [
        "Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China"
      ],
      "name": "Siyu Yan"
    },
    {
      "affiliations": [
        "Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China"
      ],
      "name": "Shichun Wang"
    },
    {
      "affiliations": [
        "Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China"
      ],
      "name": "Siyuan Ruan"
    },
    {
      "affiliations": [
        "Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China"
      ],
      "name": "Wanru Wang"
    },
    {
      "affiliations": [
        "Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China"
      ],
      "name": "Qiyi Zhang"
    },
    {
      "affiliations": [
        "Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada",
        "Center for Clinical Practice Guideline Conduction and Evaluation, Children’s Hospital of Fudan University, Shanghai, China"
      ],
      "name": "Xiaomei Yao"
    },
    {
      "affiliations": [
        "Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China"
      ],
      "name": "Yinghui Jin"
    },
    {
      "affiliations": [
        "Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada",
        "Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton, Ontario, Canada",
        "Clinical Epidemiology and Research Center (CERC), Humanitas University and Research Hospital, Roberto Rocca Innovation Building, Via Rita Levi Montalcini 4-20090 Pieve Emanuele, Milan, Italy"
      ],
      "name": "Holger J Schuenemann"
    }
  ],
  "title": "Identifying actionable statements in Chinese health guidelines: a cross-sectional study",
  "uid": "d5815848-3478-5780-a57a-1cc3bf85db17"
}