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2013 ; 31
(20
): 2563-8
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Critical evaluation of oncology clinical practice guidelines
#MMPMID23752105
Reames BN
; Krell RW
; Ponto SN
; Wong SL
J Clin Oncol
2013[Jul]; 31
(20
): 2563-8
PMID23752105
show ga
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.