Progress and challenges of network meta-analysis.

In the past years, network meta-analysis (NMA) has been widely used among clinicians, guideline makers, and health technology assessment agencies and has played an important role in clinical decision-making and guideline development. To inform further development of NMAs, we conducted a bibliometric analysis to assess the current status of published NMA methodological studies, summarized the methodological progress of seven types of NMAs, and discussed the current challenges of NMAs.

The quality of clinical practice guidelines in China: a systematic assessment.

BACKGROUND: Clinical guidelines are an important tool for improving service quality, the benefits of guidelines depend on their quality. In China, there has been a great increase in production of guidelines. However, little is known about their quality. METHOD: We identified Chinese guidelines published between 2006 and 2010 by searching three Chinese full-text databases, major Chinese guidelines websites and Google. Three appraisers independently evaluated each guideline by using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Subgroup analyses were performed according to source, title, version, aspect of care and developer of guidelines. RESULTS: A total of 327 guidelines were eligible and 57 were excluded for their lacking of any account of the guideline development methodology. Of the 270 guidelines, 77 (28.5%) can be recommended, 6 (2.2%) were evidence-based guidelines. Sixteen (5.9%) guidelines described the methods used to search for evidence, 61 (22.6%) appraised the quality of evidence and 53 (19.6%) graded the strength of recommendations. Two guidelines declared the involvement of methodological experts and none reported considering patients' values. 29 (10.7%) guidelines received drug company sponsorship but only two declared the views of the funding bodies did not influence the recommendations, 259 (95.9%) didn't declare the interest conflicts of guideline developers. Guidelines downloaded from Internet and with updated versions yielded higher quality than the rest. CONCLUSIONS: Although numerous guidelines were produced in China, the quality was generally low. Focusing on improving the quality of Chinese guidelines, rather than continuing to produce them in great quantity, is urgently needed.

An assessment of the genetic diversity within Ganoderma strains with AFLP and ITS PCR-RFLP.

Ganoderma lucidum is one of the most important medicinal materials and plant pathogens. Because of its specific interhybridization, the genetic background, however, is relatively unclear. It made identification of Ganoderma strains, especially closely related strains difficulty. Amplified fragment length polymorphism (AFLP) using 14 primer combinations and internal transcribed spacer (ITS) PCR-RFLP were used in a comparative study which was designed to investigate the closely related Ganoderma strains genetic relations at molecular level. The analysis of 37 Ganoderma strains showed there were 177 polymorphic AFLP markers and 12 ITS PCR-RFLP markers, and all accessions could be uniquely identified. Among the Ganoderma accessions, similarity coefficients ranged from 0.07692 to 0.99194 in AFLP. The Ganoderma strains formed a tight cluster in nine groups in AFLP whereas seven groups in ITS PCR-RFLP. The cluster analysis revealed that the taxonomical system of subgenus Ganoderma is composed of Sect. Ganoderma and Sect. Phaeonema, and the strain 22 should be a variant form of strain 21. All methods delineated the Ganoderma strains from the different regions seeming to show a greater level of genetic diversity. It indicated that the genotype study at molecular level is a useful complement method to the current classification system of Ganoderma strains based on morphological traits. The congruency of the experiments was analyzed using the biostatistical software DPS V3.01.