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Editorial: can China master the guideline challenge?

机译：社论：中国能否掌握指南挑战？

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摘要

China is experiencing increased health care use and expenditures, without sufficient controls to ensure quality and value. Transparent, cost-conscious and patient-centered guidelines based on the best available evidence could help establishing these quality and practice measures.We examined how guidelines could support the Chinese health reform. Specifically, we summarized the current state of the art and related challenges in guideline development and explored possible solutions in the context of the Chinese health reform.China currently lacks capacity for evidence-based guideline development and coordination by a central agency. Most Chinese guideline users rely on recommendations developed by professional groups that lack demonstration of transparency (including conflict of interest management and evidence synthesis) and quality. These deficiencies appear larger than in other regions of the world. In addition, misperceptions about the role of guidelines in assisting practitioners as opposed to providing rules requiring adherence, and a perception that traditional Chinese medicine (TCM) cannot be appropriately incorporated in guidelines are present.China’s capacity could be strengthened by a central guideline agency to provide or coordinate evidence synthesis for guideline development and to oversee the work of guideline developers. China can build on what is known and work with the international community to develop methods to meet the challenges of evidence-based guideline development.
机译：中国正在经历越来越多的医疗保健使用和支出，而没有足够的控制措施来确保质量和价值。基于最佳证据的透明，成本意识和以患者为中心的指南可以帮助建立这些质量和实践措施。我们研究了指南如何支持中国的医疗改革。具体而言，我们总结了指南制定的最新技术现状和相关挑战，并在中国卫生改革的背景下探讨了可能的解决方案。中国目前缺乏中央机构开展循证指南制定和协调的能力。大多数中国指南使用者依赖于缺乏透明度（包括利益冲突管理和证据综合）和质量证明的专业团体提出的建议。这些缺陷似乎比世界其他地区更大。此外，人们对指南在协助从业者方面的作用存在误解，而不是提供需要遵守的规则，而且人们认为中医药（TCM）无法适当地纳入指南中。中央指导机构可以增强中国的能力提供或协调用于指南制定的证据综合，并监督指南制定者的工作。中国可以利用已知的知识，并与国际社会合作，开发方法，以应对循证指南制定的挑战。

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