Heterogeneity of nutrition care procedures in nutrition guidelines for cancer patients

Zhao, Xiaohu; Yang, Ting; Ma, Xudong; Qi, Yanfei; Lin, Yueying; Chen, Xiongzhi; Duan, Yong-Qing; Sun, Dingyong

doi:10.1016/j.clnu.2019.08.022

Cited by 20 publications

(24 citation statements)

References 29 publications

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“…The findings of quality assessment for the guidelines in this study are similar to the results in previous studies [ 10 , 12 , 14 ], which are mainly related to the different methodologies adopted by different guideline development teams.…”

Section: Discussionsupporting

confidence: 90%

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Quality assessment of the guidelines for the management of malignant pleural effusions and ascites

Shi

et al. 2020

World J Surg Onc

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Objectives To fully assess the quality of the guidelines for the management of malignant pleural effusions (MPE) and ascites and reveal the heterogeneity of recommendations and possible reasons among guidelines. Methods A systematic search was performed in the database to obtain guidelines for the management of MPE and ascites. The AGREE IIGtool was used to assess the quality of these guidelines. The Measurement Scale of Rate of Agreement (MSRA) was introduced to assess the scientific agreement of formulated recommendations for the management of MPE and ascites among guidelines, and evidence supporting these recommendations was extracted and analyzed. Results Nine guidelines were identified. Only 4 guidelines scored more than 60% and are worth recommending. Recommendations were also heterogeneous among guidelines for the management of MPE, and the main reasons were the different emphases of the recommendations for the treatment of MPE, the contradictions in recommendations, and the unreasonably cited evidence for MPE. Conclusions The quality of the management guidelines for patients with MPE and malignant ascites was highly variable. Specific improvement of the factors leading to the heterogeneity of recommendations will be a reasonable and effective way for developers to upgrade the recommendations in the guidelines for MPE.

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Section: Discussionsupporting

confidence: 90%

“…This tool has been validated in guideline evaluation studies in critical care medicine, pain medicine, urinary system diseases, nutrition support, etc. [ 10 – 14 ]. Currently, there is no guideline appraisal for the management of malignant pleural effusion and ascites available.…”

Section: Introductionmentioning

confidence: 99%

Quality assessment of the guidelines for the management of malignant pleural effusions and ascites

Shi

et al. 2020

World J Surg Onc

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“…A recent international review of nutrition care procedures in nutrition-specific guidelines for patients with cancer identified 17 guidelines [21]. Using the Appraisal of Guidelines for Research and Evaluation (AGREE II) methodology to evaluate the quality of those guidelines, Zhao et al rated the European Society for Clinical Nutrition and Metabolism (ESPEN) [11] guidelines and Australian guidelines [22] as having the highest total quality scores (>60%).…”

Section: International Nutrition-specific Oncology Care Guidelinesmentioning

confidence: 99%

“…Using the Appraisal of Guidelines for Research and Evaluation (AGREE II) methodology to evaluate the quality of those guidelines, Zhao et al rated the European Society for Clinical Nutrition and Metabolism (ESPEN) [11] guidelines and Australian guidelines [22] as having the highest total quality scores (>60%). They further evaluated 12 of the guidelines and found heterogeneity in the content/tools of nutrition screening and/or assessment, application of immune nutrients, and selection of nutrition support pathways, and they concluded that the quality of nutrition guidelines for patients with cancer was highly variable [21].…”

Section: International Nutrition-specific Oncology Care Guidelinesmentioning

confidence: 99%

“…For example, one way in which physician practices participating in the OCM can enhance their services is by following national treatment guidelines. However, in nutrition-specific oncology care, the standards and guidelines are inconsistent and may be of limited quality [21]. Furthermore, nutrition is frequently not included in general oncology standards, guidelines, quality measures, and initiatives.…”

Section: Quality Framework For Nutrition In Cancer Carementioning

confidence: 99%

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Opportunities for Quality Improvement Programs (QIPs) in the Nutrition Support of Patients with Cancer

Arensberg

Richards²,

Benjamin

et al. 2020

Healthcare

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Malnutrition in patients with cancer is a ubiquitous but neglected problem that can reduce patient survival/quality of life and increase treatment interruptions, readmission rates, and healthcare costs. Malnutrition interventions, including nutrition support through dietary counseling, diet fortification, oral nutrition supplements (ONS), and enteral and parenteral nutrition can help improve health outcomes. However, nutritional care standards and interventions for cancer are ambiguous and inconsistently applied. The lack of systematic malnutrition screening and intervention in ambulatory cancer care has especially significant consequences and thus the nutrition support of patients with cancer represents an area for quality improvement. United States healthcare payment models such as the Oncology Care Model are linked to quality of care and health outcomes. Quality improvement programs (QIPs) can advance patient-centered care, perfect care processes, and help healthcare professionals meet their quality measure performance goals. Malnutrition QIPs like the Malnutrition Quality Improvement Initiative (MQii) have been shown to be effective in identifying and treating malnutrition. However, little is known about or has been reported on nutrition or malnutrition-focused QIPs in cancer care. This paper provides information to support translational research on quality improvement and outlines the gaps and potential opportunities for QIPs in the nutrition support of patients with cancer.

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Current guidelines for nutrition therapy in cancer: The arrival of a long journey or the starting point?

Laviano

2021

J Parenter Enteral Nutr

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Large epidemiological data reveal that cancer is progressively becoming a chronic and disabling disease. Implementation in daily practice of early therapies aiming at addressing patients' needs is imperative. Nutrition is a major determinant of patients' quality of life, yet it is frequently neglected. Hopefully, reverting this skeptical clinical approach to nutrition, clinical practice guidelines of nutrition care in patients with cancer have been developed and published by international oncology and nutrition societies. By analyzing the more recent guidelines, it appears that a number of issues may contribute to their insufficient implementation in daily practice. Among them are heterogeneity of recommendations across different guidelines and insufficient robustness of evidence, as well as questionable generalization of recommendations.Future guidelines should aim at providing tumor-specific recommendations for the whole clinical journey of patients with cancer. Also, new, interesting areas should be covered, including fasting metabolism and circadian rhythmicity.

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Heterogeneity of nutrition care procedures in nutrition guidelines for cancer patients

Cited by 20 publications

References 29 publications

Quality assessment of the guidelines for the management of malignant pleural effusions and ascites

Quality assessment of the guidelines for the management of malignant pleural effusions and ascites

Opportunities for Quality Improvement Programs (QIPs) in the Nutrition Support of Patients with Cancer

Current guidelines for nutrition therapy in cancer: The arrival of a long journey or the starting point?

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