目的 系统评价公共卫生决策证据质量分级方法相关研究问题。方法 计算机检索PubMed、Web of Science、CNKI、WanFang Data、CBM和VIP数据库，搜集公共卫生决策证据质量分级方法应用相关研究，检索时限均为建库至2022年12月。根据SPIDER模型构建问题，采用CASP清单对纳入文献进行质量评价，利用主题综合法对公共卫生决策证据质量分级方法的应用问题进行三级诠释分析，建立问题条目池。结果 共纳入14篇文献，涵盖7个国家。GRADE是常用的证据质量分级方法。CASP评价结果显示高质量研究8篇，中等质量研究4篇，低质量研究2篇。主题综合法归纳出7类13个问题条目。结论 现有的公共卫生决策证据质量分级方法存在证据来源多样、复杂干预研究的证据等级被低估等问题。

Objectives: (i) To analyze trends and gaps in evidence of health effects on pollutants and extreme temperatures by evidence mapping; (ii) to conduct a cross-sectional survey on the use of the Grades of Recommendations Assessment Development and Evaluation (GRADE) in systematic reviews or meta-analyses (SR/MAs) of health effects on pollutants and extreme temperatures. Study Design and Setting: PubMed, Embase, the Cochrane Library, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched until July 7, 2022. SR/MAs investigated health effects of pollutants and extreme temperatures were included.Results: Out of 22,658 studies, 312 SR/MAs were included in evidence mapping, and the effects of pollutants on cancer and congenital malformations were new research hotspots. Among 16 SR/MAs involving 108 outcomes that were rated using GRADE, the certainty of evidence was mostly downgraded for inconsistency (50, 42.7%), imprecision (33, 28.2%), and risk of bias (24, 20.5%). In contrast, concentration-response gradient (26, 65.0%) was the main upgrade factor.Conclusion: GRADE is not widely used in SR/MAs of health effects on pollutants and extreme temperatures. The certainty of evidence is generally low, mainly because of the serious inconsistency or imprecision. Use of the GRADE in SR/MAs of health effects on pollutants and extreme temperatures should strengthen.& COPY; 2023 Elsevier Inc. All rights reserved.

Objective: Clinical Practice Guidelines (CPGs) have an indispensable role in guiding the selection of various treatments for insomnia, however, little is known about the quality of released insomnia CPGs. This study aims to critically appraise the quality of existing insomnia CPGs and identify quality limitations. Methods: PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang, China Biology Medicine disc, and 6 databases of international guideline developing institutions were systematically searched. CPGs on the diagnosis or treatment of insomnia were included. Reviewers independently extracted basic information and development methods, and assessed methodological quality and reporting quality using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and Reporting Items for practice Guidelines in Healthcare (RIGHT) checklist respectively. Intraclass correlation coefficients (ICCs) were used to measure the agreement among reviewers and assess inter-rater reliability. Results: Twenty-six CPGs were identified that focused on adults, children, or children with autistic spectrum disorder, patients in the intensive care unit, patients with cancer and pregnant, lactating or menopausal women. Twenty-two CPGs used nine grading systems to rate the level of evidence and strength of recommendation. 53.85% CPGs were classified as "recommended with modification" according to the AGREE II scores (ICC from 0.64 to 0.90), and 2 CPGs were "recommended". The "clarity of presentation" domain achieved the highest mean score (67.9% +/- 11.04%) but the "applicability" domain (37.1% +/- 12.67%) achieved the lowest. The average reporting rate of RIGHT items in all guidelines was 67.87%. Conclusions: The quality of guidelines varied substantially. Guideline developers should realize the importance of guideline applicability, patients' preferences and values. (c) 2022 Elsevier B.V. All rights reserved.

针对营养学研究个性化需求，Schwingshackl研究组制定了NutriGrade分级系统，独立评估营养学随机对照试验和队列研究的证据质量，旨在总结不同营养因素和结果的关联或影响，满足证据使用者的具体需要，其优势在于分类新颖、可量化性、独立性和针对性，且具较好的一致性、公平性、可靠性和可行性。相比于随机对照试验，开展前瞻性队列研究在营养领域可行性更高。队列研究的证据质量分级涉及8个条目：(1)偏倚风险、研究质量和研究局限性；(2)精确性；(3)异质性；(4)间接性；(5)发表偏倚；(6)资助偏倚；(7)效应量；(8)剂量-反应关系。综合上述各条目评价结果可将证据质量划分为高（8～10）、中（<8）、低（<6）和极低（<4）四个等级。本文旨在介绍Nutri Grade分级系统的基本原理、具体内容及应用方法，并列举实例，为相关研究者提供参考。

Objective: To conduct a cross-sectional survey on the application status of the Grades of Recommendations Assessment Development and Evaluation (GRADE) in Cochrane systematic reviews (CSRs) of traditional Chinese medicine (TCM). Study Design and Setting: : We searched CSRs of TCM from the inception to December 2020 in the Cochrane Library database. General characteristics and details of GRADE were extracted. Results: Among 226 CSRs of TCM, 86 (38.05%) involving 711 outcomes used GRADE to rate the certainty of evidence. Topics mainly focused on genitourinary diseases (17.44%), diseases of the musculoskeletal system or connective tissue (11.63%), and diseases of the nervous system (10.47%). Only 15.89% of the outcomes reported high or moderate certainty of evidence. Acupuncture was the most common intervention. There were no significant differences in evidence certainty between acupuncture and non-acupuncture, between TCM alone and integrated Chinese and western medicine, or between Chinese patent medicines and non-Chinese patent medicines ( P > 0.05). Among 1 273 instances of downgrading, 44.62% were due to the risk of bias and 40.14% due to imprecision. Conclusion: Overall, GRADE approach is not widely used in CSRs of TCM. The certainty of evidence is generally low to very low, mainly because of the serious risk of bias and imprecision. (c) 2021 Elsevier Inc. All rights reserved.

Objective: To describe and record the evolution of EBM in China. Study Design and Setting: We conducted the study following the general methodology of oral history. The interviews were done at Lanzhou University, between 18th and 22 nd April 2019 using pre-defined questions. All interviews were videorecorded. Two investigators extracted and analyzed the information from the interviews independently. Results: One international expert and ten Chinese experts participated in the interviews. After the introduction of EBM in China in the mid-1990s, more than 20 EBM centres have been established. According to the interviewees, Gordon Guyatt, David Sackett and lain Chalmers are the international experts who played the most important role in the development of EBM in China. China has contributed to EBM on the international level by conducting systematic reviews, developing reporting checklists, and introducing the principles of EBM into Traditional Medicine. The Chinese Cochrane Centre and the EBM Centre of Lanzhou University were ranked the top two EBM Centres in China by the interviewees. Conclusion: EBM has been developing in China for nearly a quarter of a century. Many achievements have been reached, however, EBM is still facing many challenges in China, including shortages of funding support and personnel, as well as limited local high-quality evidence. (C) 2021 Elsevier Inc. All rights reserved.

Objective: To share the experience of promoting GRADE in China. Study design and setting: We designed the study and collected data on the following three aspects of the GRADE in China: the key activities related to GRADE, the main achievements of the GRADE, and potential challenges and future opportunities. Results: Three GRADE centres have been established in China since 2011. Seventeen articles of the GRADE working group have been translated and published in Chinese, and 31 articles have been written by Chinese scientists in Chinese to introduce and interpret the GRADE approach so far. More than 50 GRADE workshops and meetings have been held by GRADE centres in China, covering two-thirds of all provinces and autonomous regions of China. The percentages of societies from the Chinese Medical Association (CMA) and the Chinese Medical Doctor Association (CMDA) that used the GRADE system to develop guidelines were 30% and 18%, respectively. Conclusion: Over the past decade, China has made progress in promoting the GRADE system and Chinese GRADE centres have made a significant contribution.

Influenza is a major public health problem worldwide. Mutations and resistance development make the use of antiviral therapy challenging. Chinese patent medicines are often used to treat influenza in China and well tolerable. However, the misuse of Chinese patent medicines is common. We therefore aimed to develop an evidence-based guideline on treating influenza with Chinese patent medicines in adults to guide clinical practice. We formed a steering committee, a consensus panel, a consultants' group and an evidence synthesis team to guide the development of the guideline. We formulated the clinical questions through two rounds of survey, and finally selected five questions. We then systematically searched the related evidence and conducted meta -analyses, evidence summaries and GRADE decision tables to draft the recommendations, which the consensus panel then voted on using the Delphi method. Finally, we formulated six recommendations based on the evidence synthesis and experts' consensus. For treating mild influenza, we suggest either Lianhua Qingwen capsule, Jinhua Qinggan granule, Banlangen granule, Shufeng Jiedu capsule, or Jinfang Baidu pill, depending on the manifestations. For severe influenza, or mild influenza in patients at high risk of developing severe influenza, we suggest Lianhua Qingwen capsule in combination with antiviral medications and supportive therapy. The strength of all recommendations was weak. Traditional Chinese medicine has great potential to help in the fight against influenza worldwide, but more high-quality studies are still needed to strengthen the evidence.

NutriGrade 证 据 质 量 分 级 系 统 针 对 营 养 学 研 究 证 据 所 基 于 的 随 机 对 照 试 验 （ r a n d o m i z e d c o n t r o l l e d t r i a l ， R C T ） 和 队 列 研 究 分 别 建 立 了 不 同 的 证 据 质 量 分 级 方 法 。 应 用 于 随 机 对 照 试 验 的 N u t r i G r a d e 证 据 质 量 分 级 部 分 包 括 7 个 评 价 条 目 ： ① 偏 倚 风 险 、 研 究 质 量 和 研 究 局 限 性 （ 3 分 ） ； ② 精 确 性 （ 1 分 ） ； ③ 异 质 性 （ 1 分 ） ； ④ 直 接 性 （ 1 分 ） ； ⑤ 发 表 偏 倚 （ 1 分 ） ； ⑥ 资 助 偏 倚 （ 1 分 ） ； ⑦ 研 究 设 计 （ 2 分 ） 。 依 据 评 分 标 准 分 别 对 评 价 条 目 计 分 ， 最 终 将 各 条 目 的 评 分 结 果 汇 总 转 化 为 ： 高 质 量 证 据 （ 8  1 0 分 ） 、 中 等 质 量 证 据 （ ＜ 8 分 ） 、 低 质 量 证 据 （ ＜ 6 分 ） 和 极 低 质 量 证 据 （ ＜ 4 分 ） 四 个 证 据 质 量 等 级 。 本 文 系 统 解 读 该 部 分 N u t r i G r a d e 的 评 价 条 目 及 评 分 标 准 ， 应 用 实 例 加 以 分 析 ， 以 期 为 国 内 研 究 者 理 解 和 应 用 此 工 具 提 供 参 考