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Table 2 Barriers to guideline acquisition and implementation

From: Determinants of successful guideline implementation: a national cross-sectional survey

Barriers n (%)
Acquisition
So busy with work, no time to search for guidelines 992 (58.6)
Limited knowledge of searching for guidelines 631 (37.1)
Less convenient to search for or download foreign language guidelines 894 (52.5)
Difficulty in searching for high quality guidelines 516 (30.4)
Implementation
Wording too simple or recommendations too broad to solve the patient’s practical problem 746 (43.8)
Ambiguity and lack of clarity of recommendations 697 (41.0)
Methods of rating of evidence or recommendations too complex to understand 592 (34.8)
Lack of evidence from Chinese sample 654 (38.4)
Low quality of underlying evidence 365 (21.4)
Lack of agreement between different guidelines dealing with a similar topic 699 (41.1)
Guidelines deemed impractical for use in local setting due to resource factors, such as lack of staff, materials or funding 605 (35.5)
Guideline implementation affects physician’s income 153 (9.0)
Language barriers associated with international guidelines 638 (37.5)
Delayed updates 398 (23.4)
Worry about legal issues because of conflict with usual practice 513 (30.1)
Lack of validity, due to high possibility of the existence of conflict of interest 272 (16.0)
Guideline use is unnecessary, because three level ward-round system can safeguard medical treatment quality 123 (7.2)
Lack of education or training in guideline use 787 (46.2)
Lack of atmosphere to encourage guideline use, for example lack of support from leaders or no culture of EBM 320 (18.8)
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