Differential research impact in cancer practice guidelines’ evidence base: lessons from ESMO, NICE and SIGN

Abstract

BackgroundThis is an appraisal of the impact of cited research evidence underpinning the development of cancer clinical practice guidelines (CPGs) by the professional bodies of the European Society for Medical Oncology (ESMO), the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN).MethodsA total of 101 CPGs were identified from ESMO, NICE and SIGN websites across 13 cancer sites. Their 9486 cited references were downloaded from the Web of Science Clarivate Group database, analysed on Excel (2016) using Visual Basic Application macros and imported onto SPSS (V.24.0) for statistical tests.ResultsESMO CPGs mostly cited research from Western Europe, while the NICE and SIGN ones from the UK, Canada, Australia and Scandinavian countries. The ESMO CPGs cited more recent and basic research (eg, drugs treatment), in comparison with NICE and SIGN CPGs where older and more clinical research (eg, surgery) papers were referenced. This chronological difference in the evidence base is also in line with that ESMO has a shorter gap between the publication of the research and its citation on the CPGs. It was demonstrated that ESMO CPGs report more chemotherapy research, while the NICE and SIGN CPGs report more surgery, with the results being statistically significant.ConclusionsWe showed that ESMO, NICE and SIGN differ in their evidence base of CPGs. Healthcare professionals should be aware of this heterogeneity in effective decision-making of tailored treatments to patients, irrespective of geographic location across Europe.

Re-engineering the Cypriot healthcare service system

“…Recently, it was demonstrated that CPGs in oncology differ in their underlying evidence-base due to the temporal and geographical discrepancies of cited evidence [21]. More recently, it was shown that Cyprus is lagging behind the development of clinical practice guidelines [22].…”

“…However, the mission of CQII is to support the efforts of healthcare staff and providers to best serve the Cypriot population with the vision of the institute to provide evidence-based recommendations for research and practice. Therefore, we are optimistic that the CQII will be favoured by all political parties, patient associations, providers, professional associations, private and public health insurance organisations and the Ministry of Health to support the New Cyprus National Health Service bill currently being in effect [21].…”

New drugs: patient hope or harm?

“…By contrast, the newspaper’s second story, published alongside the first, focused on a study by researchers at King’s College London published in the journal ESMO Open 5. The article said: “British cancer guidance is less likely to recommend innovative drug treatments for patients than versions used in other parts of Europe.”…”

How I treat cancer special issue

“…The European Society for Medical Oncology (ESMO) importantly and regularly publishes and updates guidelines on the treatment of cancers 51–54. This series of guidelines has become very much rightly truly iconic in the oncological community.…”

“…The current special issue of ESMO Open – Cancer Horizons is the result of a request we have sent out to key opinion leaders in various fields of cancer in which we have asked them to give a very succinct opinion on how they would treat cancer in a very special and circumscript situation related to predefined diagnosis. Thus, we have intended to present the oncological community with an endeavour which would encompass a series of ESMO’s attempts including the generation of guidelines,51 the results of the Magnitude of Clinical Benefit10 11 36 and personal considerations of key opinion leaders 55–58. We hope that these very short and succinct summaries will help you in your everyday care of patients with cancer who give the true meaning to all of our endeavours.…”