American Society of Clinical Oncology Clinical Practice Guidelines: Formal Systematic Review–Based Consensus Methodology
- 1 September 2012
- journal article
- practice guideline
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 30 (25), 3136-3140
- https://doi.org/10.1200/jco.2012.42.0489
Abstract
The American Society of Clinical Oncology (ASCO) guidelines program employs a systematic review–based methodology to produce evidence-based guidelines. This is consistent with the stance of the Institute of Medicine on guideline development, which is that high-quality evidence syntheses form the basis for recommendation development. In the absence of high-quality evidence, recommendation development becomes more complex. One option is to provide no recommendations or withdraw a guideline topic. However, it is often the areas of greatest uncertainty in which the evidentiary base is incomplete, and thus, guidelines are needed most. To provide recommendations in such circumstances, an explicit methodology is needed to ensure that a credible process is undertaken, and rigorous, reliable advice is provided. In 2010, the ASCO Board of Directors approved development of guideline recommendations using consensus methodology. A modified Delphi approach to recommendation development, based on the best available data identified in a systematic review, was piloted with an ASCO guideline. Consensus was achieved through the rating of a series of recommendations by a large group of clinicians, including academic and community-based content and methodology experts. A prespecified threshold of agreement was determined to indicate when consensus was achieved. Consensus was defined as agreement by ≥ 75% of raters. The formal consensus methodology used by ASCO enabled development of guideline recommendations on a challenging clinical issue based on limited evidence using a rigorous, transparent, and explicit method. This methodology is proposed for development of future ASCO guidelines on topics for which limited evidence is available.Keywords
This publication has 13 references indexed in Scilit:
- American College of Radiology Appropriateness Criteria permanent source brachytherapy for prostate cancerBrachytherapy, 2011
- Laparoscopic extraperitoneal rectal cancer surgery: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES)Surgical Endoscopy, 2011
- Development and Measurement of Guideline-Based Indicators for Patients With Non-Hodgkin's LymphomaJournal of Clinical Oncology, 2011
- The development of evidence-based European guidelines on the management of depression in palliative cancer careEuropean Journal Of Cancer, 2011
- The Management of Thymoma: A Systematic Review and Practice GuidelineJournal of Thoracic Oncology, 2009
- American Society of Clinical Oncology Clinical Practice Guidelines: Opportunities and ChallengesJournal of Clinical Oncology, 2008
- Asia Pacific consensus recommendations for colorectal cancer screeningGut, 2008
- Toward population‐based indicators of quality end‐of‐life careCancer, 2008
- American Society of Clinical Oncology Recommendations on Fertility Preservation in Cancer PatientsJournal of Clinical Oncology, 2006
- Colorectal Cancer Surveillance: 2005 Update of an American Society of Clinical Oncology Practice GuidelineJournal of Clinical Oncology, 2005