Comparison of international breast cancer guidelines: are we globally consistent? Cancer Guideline AGREEment
Comparison of international breast cancer guidelines: are we globally consistent? Cancer Guideline AGREEment
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DOI：
10.3747/co.19.930
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发表时间：
2012-06-01
期刊：
影响因子：
2.6
通讯作者：
Simmons, C. E.
中科院分区：
文献类型：
--
作者：
Hogeveen, S. E.;Han, D.;Simmons, C. E.
背景世界各地的医疗保健系统都使用基于证据的指南，以帮助做出治疗决策并确保患者护理的质量和一致性。在乳腺肿瘤学方面，护理指南由几个国际公认的组织发布，包括来自美国、加拿大和英国的组织。本研究比较了美国临床肿瘤学会（ASCO，美国）、安大略省癌症护理协会（CCO，加拿大）和国家健康与临床卓越研究所（NICE，英国）的临床乳腺癌指南，以确定各个国际组织内容的质量和一致性。方法我们检索了 ASCO、CCO 和 NICE 发布的乳腺癌指南。跨组织确定了同一主题的指南，并由 4 名独立评审员使用研究和评估指南评估 (AGREE) 工具进行了评估。还对每个指南的内容进行了评分，以确保各组织之间总体建议的一致性以及所引用证据的一致性。结果目标组织制定的乳腺癌指南的质量在范围和目的、制定的严谨性、清晰度和表述方面始终保持良好，但在利益相关者参与、适用性和编辑独立性方面存在差异。指南内容的建议强度略有不同。结论我们的审查证明了各个组织发布的乳腺癌实践指南的质量和内容的一致性。这些组织未来制定的指南应重点关注如何实施和衡量指南的采用情况。
BackgroundEvidence-based guidelines are used in health care systems throughout the world to aid in treatment decisions and to ensure quality and consistency in patient care. In breast oncology, guidelines for care are published by several internationally recognized organizations, including those from the United States, Canada, and the United Kingdom. The present study compared clinical breast cancer guidelines from the American Society of Clinical Oncology (ASCO, United States), Cancer Care Ontario (CCO, Canada), and the National Institute for Health and Clinical Excellence (NICE, United Kingdom) to determine the quality and consistency of content across international organizations.MethodsWe searched for breast cancer guidelines published by ASCO, CCO, and NICE. Guidelines on the same theme were identified across organizations and appraised by 4 independent reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Content of each guideline was also scored for consistency in overall recommendations across organizations and for consistency in cited evidence.ResultsThe quality of breast cancer guidelines produced by the targeted organizations was consistently good in the areas of Scope and Purpose, Rigor of Development, and Clarity and Presentation, but variable in the domains of Stakeholder Involvement, Applicability, and Editorial Independence. The content of the guidelines varied slightly in the strength of their recommendations.ConclusionsOur review demonstrated consistency in quality and content for breast cancer practice guidelines published by various organizations. Future guidelines developed by these organizations should focus on how to implement and measure uptake of a guideline.