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A comprehensive evaluation of clinical practice guidelines (CPGs) is essential to measure their quality. This study introduces the function and meaning of the systematic review of CPGs and combs the development and current status of guideline appraisal tools. On this basis, we expound the content and characteristics of the Scientific, Transparent, and Applicable Rankings Tool (STAR) for Guidelines in depth, with the hope of providing reference for the improvement of the compressive guideline assessment system and the development of high-quality guidelines in the future.

Objective To investigate the current status of evidence of recommendations contained in Chinese clinical practice guidelines published in journals in 2019, so as to provide reference for the use of evidence for Chinese guidelines in the future. Methods We searched and analyzed information on Chinese guidelines published in 2019 with clear recommendations, grading of evidence quality and corresponding instructions of grading, as well as information on citations supporting the recommendations. Results A total of 31 guidelines (29 Chinese guidelines and 2 English guidelines) containing 568 recommendations and 3126 references were included. Each guideline included an average of 18 recommendations. Of these, 2541 references were presented as evidence in the statements of guideline recommendation(such references are referred to as 'evidence' hereafter). The average number of evidence was 82 in each guideline and every recommendation has 4 pieces of evidence. The top three countries where the evidence was from were China (28.8%), the United States (25.9%), and the United Kingdom (7.0%). Only 39.2% (995/2541) of the evidence was published in the last 5 years. The most common type of evidence for guidelines was randomized controlled trials (26.9%). The citation of systematic reviews was only 12.0%. Conclusions Most of the Chinese guidelines published in 2019 did not have clear and unambiguous recommendations. Those guidelines with clear recommendations had incomplete and untimely evidence citations. Guideline developers should strengthen the rational use of currently available research evidence.

At the 74th World Health Assembly, the WHO issued a strategy for the prevention and control of several major infectious diseases. To achieve the WHO-initiated targets for these infectious diseases, the elimination of mother-to-child transmission is essential. To date, a systematic review of the global and regional prevalence of infections with relevant mother-to-child transmission and outside the spectrum of congenital infections is lacking. We aimed to systematically review the prevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis in pregnant women. MEDLINE, Embase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure, WanFang database and China Biology Medicine disc database, and five WHO Regional Index Medicus databases. Original studies reporting the prevalence of infection or coinfection of HIV, HBV, HCV, and syphilis in pregnant women. This systematic review followed the preferred reporting items for systematic reviews and meta-analyses 2020 checklist. We used random-effects models to generate pooled prevalence estimates for each infection. The global pooled prevalence in pregnant women of HIV, HBV, HCV, and syphilis was 2.9% (95% CI, 2.4–3.4%), 4.8% (3.8–5.8%), 1.0% (0.8–1.3%), and 0.8% (0.7–0.9%). The pooled prevalence of HIV, HBV, HCV, and syphilis in low-income countries was higher than the global level (HIV: 5.2% [1.6–10.5%); HBV: 6.6% (5.4–7.9%); HCV: 2.7% (1.6–4.1%); syphilis: 3.3% (2.2–4.6%]). The pooled prevalence of HIV, HBV, HCV, and syphilis in lower-middle-income countries was higher than the global level (HIV: 2.9% [0.8–6.1%]; HBV: 4.9% [3.8–6.1%]; HCV: 2.3% [1.2–3.6%]; syphilis: 1.5% [1.0–2.2%]). The prevalence of these infections among pregnant women was particularly high in resource-poor settings. The relevance and feasibility of current global practice guidelines for the prevention of mother-to-child transmission of these infections in lower-middle-income countries must be evaluated, including timely access to screening and therapeutics. [ABSTRACT FROM AUTHOR]