Critical evaluation of oncology clinical practice guidelines

Bradley N. Reames, Robert W. Krell, Sarah N. Ponto, Sandra L. Wong

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Purpose: Significant concerns exist regarding the content and reliability of oncology clinical practice guidelines (CPGs). The Institute of Medicine (IOM) report “Clinical Practice Guidelines We Can Trust” established standards for developing trustworthy CPGs. By using these standards as a benchmark, we sought to evaluate recent oncology guidelines. Methods: CPGs and consensus statements addressing the screening, evaluation, or management of the four leading causes of cancer-related mortality in the United States (lung, breast, prostate, and colorectal cancers) published between January 2005 and December 2010 were identified. A standardized scoring system based on the eight IOM standards was used to critically evaluate the methodology, content, and disclosure policies of CPGs. All CPGs were given two scores; points were awarded for eight standards and 20 subcriteria. Results: No CPG fully met all the IOM standards. The average overall scores were 2.75 of 8 possible standards and 8.24 of 20 possible subcriteria. Less than half the CPGs were based on a systematic review. Only half the CPG panels addressed conflicts of interest. Most did not comply with standards for inclusion of patient and public involvement in the development or review process, nor did they specify their process for updating. CPGs were most consistent with IOM standards for transparency, articulation of recommendations, and use of external review. Conclusion: The vast majority of oncology CPGs fail to meet the IOM standards for trustworthy guidelines. On the basis of these results, there is still much to be done to make guidelines as methodologically sound and evidence-based as possible.

Original languageEnglish (US)
Pages (from-to)2563-2568
Number of pages6
JournalJournal of Clinical Oncology
Volume31
Issue number20
DOIs
StatePublished - Jul 10 2013

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Medical Oncology
Practice Guidelines
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Guidelines
Benchmarking
Conflict of Interest
Disclosure
Colorectal Neoplasms
Lung Neoplasms
Prostatic Neoplasms
Consensus
Breast Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Critical evaluation of oncology clinical practice guidelines. / Reames, Bradley N.; Krell, Robert W.; Ponto, Sarah N.; Wong, Sandra L.

In: Journal of Clinical Oncology, Vol. 31, No. 20, 10.07.2013, p. 2563-2568.

Research output: Contribution to journalArticle

Reames, Bradley N. ; Krell, Robert W. ; Ponto, Sarah N. ; Wong, Sandra L. / Critical evaluation of oncology clinical practice guidelines. In: Journal of Clinical Oncology. 2013 ; Vol. 31, No. 20. pp. 2563-2568.
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