Background: As a widely employed appraisal tool, AGREE is recognised for its reliability and authority. However, when it comes to China, some researchers questioned that it might not be perfectly matched to the local situation.

Objectives: To analyse studies about the appraisal of practice guidelines in China.

Methods: We systematically searched Chinese databases (CNKI, Wanfang data and CBM). For complementary searches we retrieved the references of included studies. Four researchers in 2 groups screened studies and extracted information independently.

Results: Fifty-eight studies, published from 2005 to 2016, met our criteria, they were from 26 journals and included guidelines regarding diagnosis and intervention, 35 studies only evaluated Chinese guidelines. We could divide included studies into 3 types: quality appraisal using AGREE (15.5%) or AGREE II(46.6%), application evaluation(12.1%) and practice evaluation (15.5%) using standardised questionnaires. On top of the quality evaluation, the complaint about AGREE focused on: (1) Not being applicable for Chinese guidelines, it is hard to evaluate the actual quality from a poorly reported document, which is quite common among guidelines in China; 2) only evaluating the methodological quality, the appraisal result is not equal to the quality of content in guidelines; and, 3) being hard to judge the overall quality of a guideline. What's more, 50% of the quality evaluation studies appeared unsatisfied with AGREE, 16.7% stated that they were urgent for a localised appraisal tool designed for China.

Conclusions: At present AGREE might be the best tool for guideline appraisal, but it is necessary to develop a new tool which is applicable to the environment of China.