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9TMR Non-Drug Therapy  2019, Vol. 2 Issue (4): 127-135    DOI: 10.12032/TMRND201902023
Review     
Quality evaluation and content analysis of non-drug guidelines on risk factors of secondary prevention of myocardial infarction
Wen-Jiao Li1, Meng-Zhu Zhao2, Chang Rao2, Xue-Chao Liu3, Qi Liu3, Chang-De Jin3,*(), Yan Li3,*()
1Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
2First Teaching Hospital of Tianjin University of Traditional Chinese Medicine
3School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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Highlights

The recommendations mainly cover the relevant target values of risk factors, providing evidence-based support in three aspects, such as blood pressure, blood sugar, which providing the theory basis for patients’ self-monitoring. It is recommended that clinical practice should be based on best-evidence and fully put the individual factors into account.

Editor’s Summary

By searching the professional guideline websites, databases, and the related references, eight guidelines about risk factors associated with secondary prevention of myocardial infarction were included in the study. After evaluating the methodological quality of these guidelines with Appraisal of Guidelines for Research and Evaluation II, the authors summarized and analyzed the relevant recommendations for myocardial infarction patients in the aspects of blood pressure, blood sugar and blood lipid. Finally, the paper concluded that clinical practice on risk factors of myocardial infarction should be based on best evidence and fully put the individual factors into account.

Abstract

Purpose: To strictly evaluate the quality of guidelines on risk factors related to secondary prevention of myocardial infarction (MI), and to summarize and analyze the relevant recommendations, and to provide evidence-based support for medical staff to develop interventions related risk factors for MI patients. Methods: The professional guideline websites and databases in English and Chinese were retrieved, and the references related guidelines were traced to get the published guidelines. Appraisal of Guidelines for Research and Evaluation II was used to evaluate the methodological quality of the guidelines. Then the relevant recommendations for MI were summarized and analyzed. Results: A total of 8 guidelines, including evidence-based guidelines and expert consensus were included in the initial review of 2,099 articles, among which 2 from the UK, 1 from the US and 5 from China. The overall quality of the included guidelines is moderate. However, some guidelines score relatively low in the dimensions of rigor of development, clarity of presentations and editorial independence. A total of 24 items were extracted, including three risk factors: blood pressure, blood sugar and blood lipid. The recommendations mainly cover the relevant target values of risk factors, providing evidence-based support for medical staff to control and guide the risk factors of patients with MI in three aspects, such as blood pressure, blood sugar and blood lipid, which providing the theory basis for self-monitoring. Conclusions: It is recommended that clinical practice on risk factors of MI should be based on best evidence and fully put the individual factors into account.



Key wordsMyocardial infarction      Guideline      Quality evaluation      Appraisal of Guidelines for Research and Evaluation II      Secondary prevention     
Received: 05 November 2019      Published: 06 December 2019
Fund:  This research was funded by National Natural Science Foundation (No. 81703936).
Corresponding Authors: Jin Chang-De,Li Yan   
E-mail: jcd1886@sina.cn;22019036@qq.com
Cite this article:

Wen-Jiao Li, Meng-Zhu Zhao, Chang Rao, Xue-Chao Liu, Qi Liu, Chang-De Jin, Yan Li. Quality evaluation and content analysis of non-drug guidelines on risk factors of secondary prevention of myocardial infarction. 9TMR Non-Drug Therapy, 2019, 2(4): 127-135. doi: 10.12032/TMRND201902023

URL:

https://www.tmrjournals.com/ndt/EN/10.12032/TMRND201902023     OR     https://www.tmrjournals.com/ndt/EN/Y2019/V2/I4/127

Figure 1 Study flow diagram. NICE, National Institute for Health and Clinical Excellence; SIGN, Scottish Intercollegiate Guidelines Network; NZGG, New Zealand Guidelines Group; WHO, World Health Organization; GIN, Guideline International Network; NGC, National Guideline Clearinghouse; ACPG, Australian Clinical Practice Guidelines; MI, myocardial infarction.
Number Title Publish time
(year)
Country/
Region
Type of guidelines Topic Number of references
1 MI-secondary prevention: secondary prevention in primary and secondary care for patients following a myocardial infarction: partial update of NICE CG48 [14] 2013 England Evidence-based guidelines Secondary prevention 480
2 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction [15] 2013 America Evidence-based guidelines Management 656
3 Myocardial infarction with ST-segment elevation: the acute management of myocardial infarction with ST-segment elevation [16] 2013 England Evidence-based guidelines Acute management 340
4 Guidelines for diagnosis and treatment of non-ST-segment elevation acute coronary syndrome (2016) [17] 2016 China Evidence-based guidelines Diagnosis, treatment 109
5 Chinese expert consensus of diagnosis and treatment of senile coronary heart disease [18] 2016 China Expert consensus Diagnosis, treatment 46
6 Consensus of Chinese experts on rehabilitation and secondary prevention of coronary heart disease [19] 2013 China Expert consensus Rehabilitation, secondary prevention 36
7 Guidelines for diagnosis and treatment of acute ST-segment elevation MI [20] 2015 China Evidence-based guidelines Diagnosis, treatment 98
8 Chinese expert consensus on exercise rehabilitation for patients aged more than 75 with stable coronary artery disease [21] 2018 China Expert consensus Exercise rehabilitation 45
Table 1 Characteristics of included guidelines
Number The score of domain standardization (%) ≥ 60% Domain number ≤ 30% Domain number Recommended level
I II III IV V VI
1 90.28 81.94 86.46 77.78 55.21 60.42 5 0 B
2 86.11 65.28 79.69 97.22 60.42 91.67 6 0 A
3 88.89 86.11 70.83 69.44 52.08 4.17 4 1 B
4 51.39 18.06 31.25 73.61 13.54 37.50 1 2 B
5 76.39 36.11 14.58 58.33 10.42 41.67 1 2 B
6 72.22 25.00 11.46 62.50 35.42 0.00 2 3 C
7 56.94 43.78 23.96 72.22 17.71 0.00 1 3 C
8 75.00 25.00 6.25 36.11 27.08 16.67 1 4 C
Median score 74.65 47.66 40.56 68.40 33.99 31.51 - - -
Table 2 The domains score of included guidelines
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pmid: 23906394
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doi: 10.1007/s11239-019-01996-6 pmid: 31754904
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