Quality Assessment of Clinical Practice Guidelines for Respiratory Diseases in China: A Systematic Appraisal.

BACKGROUND: There has been a significant increase in the publication of clinical practice guidelines (CPGs) for respiratory diseases in China. However, little is known about the quality and potential impacts of these CPGs. Our objective was to critically evaluate the quality of Chinese CPGs for respiratory diseases that were published in peer-reviewed medical journals. METHODS: A systematic search of scientific literature published between 1979 and 2013 was undertaken to identify and select CPGs that were related to respiratory diseases. Four Chinese databases (the Chinese Biomedical Literature database [CBM], the China National Knowledge Infrastructure [CNKI], the VIP database, and the WANFANG database) were used. The quality of eligible guidelines was assessed independently by four reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. The overall agreement among reviewers was evaluated using an intraclass correlation coefficient. RESULTS: A total of 109 guidelines published in 27 medical journals from 1979 to 2013 were evaluated. The overall agreement among reviewers was considered good (intraclass correlation coefficient, 0.838; 95% CI, 0.812-0.862). The scores of the six AGREE domains were low: 57.3% for scope and purpose (range, 4.2%-80.5%), 23.8% for stakeholder involvement (range, 2.8%-54.2%), 7.7% for rigor of development (range, 0%-27.1%), 59.8% for clarity and presentation (range, 22.2%-80.6%), 10.9% for applicability (range, 0%-22.9%), and 0.6% for editorial independence (range, 0%-16.7%). Scores for all guidelines were below 60%, and only three guidelines (2.8%) were recommended for clinical practice with modifications. CONCLUSIONS: The quality of the guidelines was low, and stakeholder involvement, rigor of development, applicability, and editorial independence should be considered in the future development of CPGs for respiratory diseases in China.

[Evaluation of sustainable development of Dalian Economic and Technological Development Zone based on MuSIASEM theory].

Based on the theory of multiple-scale integrated assessment of societal and ecosystem metabolism (MuSIASEM), a comprehensive evaluation was made on the human activity time, exosomatic energy input, and added value of Dalian Economic and Technological Development Zone in 2000-2007. During the study period, the life quality of local citizens increased year after year, while the agricultural industry dwindled. Manufacturing industry was still the main pillar industry, but its energy consumption was greater. Service industry was at its early stage, falling behind manufacturing industry. The exosomatic metabolic level of the whole zone and its various industries had an obvious increase, and the energy intensity decreased continuously. With the fact that both the human activity time and the exosomatic energy input had a ceaseless decrease, the economic added value increased steadily, and the zone was under its way towards sustainable development.

Numerical characterization of DNA sequences based on the k-step Markov chain transition probability.

A DNA sequence can be regarded as a discrete-time Markov chain. Based on k-step transition probabilities, we construct a series of 4 x 4 k-step transition matrices to characterize the DNA primary sequences. According to the properties of Markov chains, we obtain distributions of A, T, C and G, and analyze the changes among them from yesterday to tomorrow. We can calculate the probabilities of nucleotide triples of DNA primary sequences. Finally, we introduce a correlation of this kind of transition matrices and consider it as an invariant to analyze the similarities/dissimilarities of DNA sequences.