Evaluation of the clinical guidelines for the management of angina pectoris with traditional Chinese medicine in multi-level hospitals

摘要

Aim: To evaluate the quality and relevant factors of the clinical guidelines for the management of angina pectoris (ZYYXH/T17-2008) with traditional Chinese medicine by related physicians in hospitals of different level. Methods: Participants rated the quality of 28 indicators of the guidelines using a 4-point scale, 1 (very poor) to 4(very good). Demographic and professional information was recorded for these physicians after they had taken part in a clinical trial in which they treated 629 patients with angina pectoris according to and not to the guidelines. Rusult: Fifty physician participants completed a questionnaire about the quality of the clinical guidelines. Their mean age was 34.4 years, male was 40%. Among them, 60% participants worked in hospitals of level 2, others in level 3; 36% were residents, attending physicians 22%, associated chief and chief physicians were 20% and 22%, respectively. This guideline, which contained 6 domains and 28 items, was rated as “good”(median score was 3) by these participants. Physicians rated domain 2 (stakeholder involvement) and item 6(corporation among multiple disciplines) as the poorest one in their own groups, respectively. Domain 5(TCM characteristics) and item 14 (No-contradiction-among-contents) was rated as the best one, respectively. In regression models, level 2 hospital was significantly associated with higher score (better rating) assigned by these subjects to Domain 2, and 5, as well as item 6 and total score. The score for higher total score was significantly associated with younger age. Conclusions: The current clinical practical guidelines were “good” basing on a questionnaire survey. Stakeholder involvement and its sub-item corporation among multiple disciplines were the poorest indicators in the guidelines. The level of a hospital in which the appraiser was working was the strongest predictor of perceived evaluation of the guidelines.