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Although two independent trained appraisers conducted the assessment using a standardised instrument, the involvement of subjective bias in the evaluation was unavoidable. The AGREE collaboration recommends that each guideline be assessed by at least two appraisers, but that without proper training, adding appraisers may increase the rating bias.51 Conclusion The overall methodological quality of the CPGs for hypertension in China was generally low throughout the appraisal process as determined using the AGREE II instrument. Considerable variability remained between guidelines, and strategies should be implemented to enhance the clarification of the subject of CPGs, the application of evidence-based systematic methods, and the transparency of CPGs. In addition, learn more multidisciplinary groups associated with professional organisations in China, especially the methodological experts in the field for which the CPG is being drawn up, should be consulted. Acknowledgments The authors would like to thank Boxi Yan at West China Medical School, West China Hospital of Sichuan University, for his kind and insightful suggestions in the review. Footnotes Contributors: YC and SH contributed in the conception and design. YC, LW and XF participated in the searching for and extracting the data. YC, LW, XF, WX and GS were involved in assessing and analysing the quality of the guideline. YC participated in the writing the manuscript. SH, WX and GS provided administrative and technical support. Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. Competing interests: None declared. Provenance and peer review: Not commissioned; externally peer reviewed. Data sharing statement: No additional data are available.""A medical chaperone is an impartial observer present during a consultation between a doctor or allied health professional and a patient. A medical chaperone acts as an advocate for the patient and can help patients understand exactly what is happening, and why. Increasingly, chaperones are seen as important from a medicolegal perspective, as protection for the clinician against unjust allegations but also being prepared to raise concerns about a clinician's behaviour and action if they deem them to be inappropriate. In the UK, medical practitioners are provided with clear professional guidance on appropriate use of chaperones. The General Medical Council (GMC), the Royal College of Nursing, the NHS Clinical Governance Support Teams and the medical defence organisations have all generated guidance around chaperoning.1�C4 In the 2013 update of Good Medical Practice, Intimate Examinations and Chaperones formed a key part of the Maintaining Boundaries section.