Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-28T18:50:59.314Z Has data issue: false hasContentIssue false
  • English
  • Français

KEEPING CANCER GUIDELINES CURRENT: RESULTS OF A COMPREHENSIVE PROSPECTIVE LITERATURE MONITORING STRATEGY FOR TWENTY CLINICAL PRACTICE GUIDELINES

Published online by Cambridge University Press:  21 April 2004

Mary E. Johnston ,
Melissa C. Brouwers  and
George P. Browman
Mary E. Johnston
Affiliation:
McMaster University
Melissa C. Brouwers
Affiliation:
McMaster University
George P. Browman
Affiliation:
Hamilton Regional Cancer Centre
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: To describe a methodology used to keep practice guidelines up to date and to summarize data collected during the first year of implementing this plan with a cancer practice guidelines program.

Methods: The updating strategy includes regular searches of peer-reviewed literature and meeting proceedings, review and interpretation of new evidence, review and revision of clinical recommendations, and notification to practitioners and policy makers about new evidence and its impact on recommendations.

Results: Eighty pieces of new evidence were found relating to seventeen of the twenty guidelines included in this study. On average, four pieces of new evidence were found per guideline, but there was considerable variation across the guidelines. Of the eighty pieces, nineteen contributed to modifications of clinical recommendations in six practice guidelines, whereas the remaining evidence served to support the original recommendations. None of the modifications led to changes that advised against original recommendations. MEDLINE, the Cochrane Library, and meeting proceedings yielded many pieces of evidence, whereas CancerLit and HealthStar did not contribute significantly to the overall yield. Furthermore, key pieces of evidence that led to modifications to the recommendations were often identified by members of the disease site groups before appearing in electronic databases.

Conclusions: The updating process is resource intensive but yields important findings. In response to this evaluation, the updating protocol has been revised such that literature searches are conducted quarterly and the scope of sources searched routinely is restricted to MEDLINE, the Cochrane Library, and meeting proceedings.

Keywords

Clinical practice guidelinesUpdatingCancer
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 19 , Issue 4 , December 2003 , pp. 646 - 655
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arnberg H, Letocha H, Nõu F, Westlin J, Nilsson S. 1998; GM-CSF in chemotherapy-induced febrile neutropenia: A double-blind randomized study. Anticancer Res. 18: 1255 1260.Google Scholar
Beveridge RA, Miller JA, Kales AN, et al. 1998; A comparison of efficacy of sargramostim (yeast-derived RhuGM-CSF) and Filgrastim (bacteria-derived RhuG-CSF) in the therapeutic setting of chemotherapy-induced myelosuppression. Cancer Invest. 6: 366 373.Google Scholar
Browman GP, Levine MN, Mohide EA, et al. 1995; The practice guidelines development cycle. A conceptual tool for practice guidelines development and implementation. J Clin Oncol. 13: 502 512.Google Scholar
Browman GP, Hodson DI, Newman T, and the Provincial Head and Neck Cancer Disease Site Group. 2000 Neoadjuvant chemotherapy in locally advanced squamous cell carcinoma of the head and neck (SCCHN) (excluding nasopharynx) [recommendation]. Cancer Care Ontario Practice Guidelines Initiative Web site. Available at: http://hiru.mcmaster.ca/ccopgi/guidelines/gas/cpg5_1.html. Accessed: July 5, 2000.
Browman GP, Newman TE, Mohide EA, et al. 1998; Progress of clinical oncology guidelines development using the practice guidelines development cycle: The role of practitioner feedback. J Clin Oncol. 16: 1226 1231.Google Scholar
Browman G, Brouwers M, De Vito C, Johnston M, Graham I. 2000; Participation patterns of oncologists in the development of clinical practice guidelines. Curr Oncol. 7: 252 257.Google Scholar
Brundage MD, Crook JM, Lukka H, and the Genitourinary Cancer Disease Site Group. 1998; Use of strontium89 in endocrine-refractory prostate cancer metastatic to bone. Cancer Prev Control. 22: 79 87.Google Scholar
Csáki C, Ferencz T, Schuler D, Borsi JD. 1998; Recombinant human erythropoietin in the prevention of chemotherapy-induced anaemia in children with malignant solid tumours. Eur J Cancer. 34: 364 367.Google Scholar
Eady A, Jadad A, Browman G. 1997. Generating an evidence-based recommendation: Procedures manual. Cancer Care Ontario Practice Guidelines Initiative. Ontario: Cancer Care Ontario;
Evans WK, Kocha W, Gagliardi A, et al. 1999; The use of gemcitabine in non-small-cell lung cancer. Cancer Prev Control. 3: 84 94.Google Scholar
Figueredo A, Germond C, Maroun J, et al. 1997; Adjuvant therapy for stage II colon cancer following complete resection. Cancer Prev Control. 15: 379 392.Google Scholar
Figueredo A, Germond C, Taylor B, et al. Postoperative adjuvant radiotherapy and/or chemotherapy for resected stage II or III rectal cancer [recommendation]. Cancer Care Ontario Practice Guidelines Initiative Web site. Available at: http://hiru.mcmaster.ca/ccopgi/guidelines/gas/cpg2_3.html. Accessed: July 5, 2000.
Figueredo A, Fine S, Maroun J, et al. 1997; Adjuvant therapy for stage III colon cancer following complete resection. Cancer Prev Control. 1: 304 319.Google Scholar
Findlay BP, Walker-Dilks C, and the Provincial Breast Cancer Disease Site Group and the Provincial Systemic Treatment Disease Site Group. 1998; Epirubicin, alone or in combination chemotherapy, for metastatic breast cancer. Cancer Prev Control. 2: 140 146.Google Scholar
Garcia-Carbonero R, Mayordomo JI, Tornamira MV, et al. 1999; Filgrastim in the treatment of high-risk febrile neutropenia: Results of a multicenter randomized phase III trial [abstract]. Proc Annu Meet Am Soc Clin Oncol. 18: 583a.Google Scholar
Germond C, Maroun J, Moore M, et al. 1999; Use of gemcitabine in the treatment of advanced pancreatic adenocarcinoma. Curr Oncol. 64: 224 227.Google Scholar
Germond C, Maroun J, Zwaal C, Wong S, and the Gastro-intestinal Disease Site Group. 1999; Use of raltitrexed in the management of metastatic colorectal cancer. Curr Oncol. 64: 217 223.Google Scholar
Goss G, Paszat L, Newman T, Evans WK, and the Lung Cancer Disease Site Group. 1998; Use of preoperative chemotherapy with or without postoperative radiotherapy in technically resectable stage IIIA non-small cell lung cancer. Cancer Prev Control. 2: 32 39.Google Scholar
Goss GD, Logan DM, Newman TE, Evans WK, and the Lung Cancer Disease Site Group. 1997; Use of vinorelbine in non-small cell lung cancer. Cancer Prev Control. 1: 28 38.Google Scholar
Helsing M, Bergman B, Thaning L, Hero U, for the Joint Lung Cancer Study Group. 1998; Quality of life and survival in patients with advanced non-small cell lung cancer receiving supportive care plus chemotherapy with carboplatin and etoposide or supportive care only. A multicentre randomized phase III trial. Eur J Cancer. 34: 1036 1044.Google Scholar
Keller SM, Adak S, Wagner H, et al. 1999; Prospective randomized trial of postoperative adjuvant therapy in patients with completely resected stage II and IIIa non-small cell lung cancer: An intergroup trial (E3590) [abstract]. Proc Am Soc Clin Oncol. 18: 465a.Google Scholar
Kuroda M, Kotake T, Akaza H, et al. 1998; Efficacy of dose-intensified MEC (methotrexate, epirubicin and cisplatin) chemotherapy for advanced urothelial carcinoma: A prospective randomized trial comparing MEC and M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin). Jpn J Clin Oncol. 28: 497 501.Google Scholar
Littlewood TJ, Bajetta E, Cella D, European Epoetin Alfa Study Group. 1999; Efficacy and quality of life outcomes of epoetin alfa in a double-blind, placebo-controlled multicenter study of cancer patients receiving non-platinum containing chemotherapy [abstract]. Proc Am Soc Clin Oncol. 18: A2217.Google Scholar
Logan DM, Lochrin CA, Darling G, et al. 1997; Adjuvant radiotherapy and chemotherapy for stage II or IIIA non-small cell lung cancer after complete resection. Cancer Prev Control. 15: 366 378.Google Scholar
Logan DM, Lochrin CA, Darling G et al. Adjuvant radiotherapy and chemotherapy for stage II or IIIA non-small cell lung cancer after complete resection [recommendation]. Cancer Care Ontario Practice Guidelines Initiative Web site. Available at: http://hiru.mcmaster.ca/ccopgi/guidelines/lung/cpg7_1.html. Accessed: September 27, 2000.
Lopez PG, Stewart DJ, Newman TE, Evans WK, and the Lung Cancer Disease Site Group. 1997; chemotherapy in stage IV (metastatic) non-small cell lung cancer. Cancer Prev Control. 1: 18 27.Google Scholar
Lopez PG, Stewart DJ, Newman TE, Evans WK, and the Lung Cancer Disease Site Group. Chemotherapy in stage IV (metastatic) non-small cell lung cancer [recommendation]. Cancer Care Ontario Practice Guidelines Initiative Web site. Available at: http://hiru.mcmaster.ca/ccopgi/guidelines/lung/cpg7_2u.html. Accessed: September 27, 2000.
Mirsky D, O'Brien SE, McCready DR, et al. 1997; Surgical management of early stage invasive breast cancer (stage I and II). Cancer Prev Control. 1: 10 17.Google Scholar
Oberhoff C, Neri B, Amadori D, et al. 1998; Recombinant human erythropoietin in the treatment of chemotherapy-induced anemia and prevention of transfusion requirement associated with solid tumours: A randomized, controlled study. Ann Oncol. 9: 255 260.Google Scholar
Okawara G, Rusthoven J, Newman T, et al. 1997; Unresected stage III non-small cell lung cancer. Cancer Prev Control. 1: 249 259.Google Scholar
Oshita F, Yamada K, Nomura I, Noda K. 1999; Prophylactic administration of granulocyte colony-stimulating factor (G-CSF) at the appearance of monocytopenia lessens neutropenia during cancer chemotherapy [abstract]. Proc Annu Meet Am Soc Clin Oncol. 18: 64a.Google Scholar
Pater JL, Browman GP, Brouwers MC, et al. 2001; Funding new cancer drugs in Ontario: Closing the loop in the practice guidelines development Cycle. J Clin Oncol. 14: 3392 3396.Google Scholar
PORT Meta-analysis Trialists Group. 1998; Postoperative radiotherapy in non-small-cell lung cancer: Systematic review and meta-analysis of individual patient data from nine randomized controlled trials. Lancet. 352: 257 263.
Quirt I, Micucci S, Moran LA, et al. 1997; Erythropoietin in the management of patients with non-hematologic cancer receiving chemotherapy. Cancer Prev Control. 1: 241 248.Google Scholar
Quirt I, Micucci S, Moran LA, et al. Erythropoietin in the management of patients with non-hematologic cancer receiving chemotherapy [recommendation]. Cancer Care Ontario Practice Guidelines Initiative Web site. Available at: http://hiru.mcmaster.ca/ccopgi/guidelines/sys/cpg12_1.html. Accessed: September 27, 2000.
Ravaud A, Chevreau C, Cany L, et al. 1998; Granulocyte-macrophage colony-stimulating factor in patients with neutropenic fever is potent after low-risk but not after high-risk neutropenic chemotherapy regimens: Results of a randomized phase III trial. J Clin Oncol. 16: 2930 2936.Google Scholar
Regan DH, Camp K, Cygnarowicz P, Dirolf J. 1999; Prospective study to evaluate CSF use for primary and secondary prevention of chemotherapy-induced neutropenia [abstract]. Proc Annu Meet Am Soc Oncol. 18: 605a.Google Scholar
Riccardi A, Brugnatelli S, Giordano M, et al. 1998; Myeloprotective effect of early primary granulocyte-colony stimulating factor during six courses of intensified 5-fluorouracil, epirubicin and cyclophosphamide (120FEC) chemotherapy for advanced breast cancer. Tumori. 84: 540 546.Google Scholar
Rusthoven J, Bramwell V, Stephenson B, and the Provincial Systemic Treatment Disease Site Group. 1998; Use of granulocyte colony-stimulating factor (G-CSF) in patients receiving myelosuppressive chemotherapy for the treatment of cancer. Cancer Prev Control. 2: 179 190.Google Scholar
Rusthoven J, Bramwell V, Stephenson B, and the Provincial Systemic Treatment Disease Site Group. Use of granulocyte colony-stimulating factor (G-CSF) in patients receiving myelosuppressive chemotherapy for the treatment of cancer [recommendation]. Cancer Care Ontario Practice Guidelines Initiative Web site. Available at: http://hiru.mcmaster.ca/ccopgi/guidelines/sys/cpg12_2.html. Accessed: September 27, 2000.
Seymour L, Bramwell V, Moran LA, and the Provincial Systemic Treatment Disease Site Group. 1999; Use of dexrazoxane as a cardioprotectant in patients receiving doxorubicin or epirubicin chemotherapy for the treatment of cancer. Cancer Prev Control. 3: 145 159.Google Scholar
Stöger H, Samonigg H, Krainer M, et al. 1998; Dose intensification of epidoxorubicin and cyclophosphamide in metastatic breast cancer: A randomised study with two schedules of granulocyte-macrophage colony stimulating factor. Eur J Cancer. 34: 482 488.Google Scholar
Terrell JE, Fisher SG, Wolf GT, for the Veterans Affairs Laryngeal Cancer Study Group. 1998; Long-term quality of life after treatment of laryngeal cancer. Arch Otol Head Neck Surg. 124: 964 971.Google Scholar
Thongprasert S. 1998; Lung cancer and quality of life. Aust NZ J Med. 28: 397 399.Google Scholar
Varan A, Büyükpamukçu M, Kutluk T, Akyüz C. 1999; Recombinant human erythropoietin treatment for chemotherapy-related anemia in children. Pediatrics. 103: e16.Google Scholar
Whelan TJ, Lada B, Laukkanen E, et al. 1997; Breast irradiation in women with early stage invasive breast cancer following breast conserving surgery. Cancer Prev Control. 13: 228 240.Google Scholar
Wolmark N, Dignam J, Fisher B. 1998. The addition of tamoxifen to lumpectomy and radiotherapy in the treatment of ductal carcinoma in situ: preliminary results of NSABP protocol B-24 [abstract]. Proc San Antonio Breast Cancer Symp.Google Scholar
Wright JR, Whelan TJ, McCready DR, O'Malley FP, and the Breast Cancer Disease Site Group. 1998; Management of ductal carcinoma in situ of the breast. Cancer Prev Control. 2: 312 319.Google Scholar
Wright JR, Whelan TJ, McCready DR, O'Malley FP, and the Breast Cancer Disease Site Group. Management of ductal carcinoma in situ of the breast [recommendation]. Cancer Care Ontario Practice Guidelines Initiative Web site. Available at: http://hiru.mcmaster.ca/ccopgi/guidelines/bre/cpg1_10.html. Accessed: September, 27, 2000.