Study finds cancer guidelines do not fully meet IOM standards

June 12, 2013

In an age when evidence-based care is increasingly important, how trustworthy are current clinical practice guidelines?

Researchers at the University of Michigan Comprehensive Cancer Center looked at 169 cancer for lung, breast, prostate and and found that none of the guidelines fully met standards set in 2011 by the Institute of Medicine. Of eight criteria, the guidelines on average met fewer than three.

"None of the current guidelines we looked at meet all of the standards, but some of these are really good guidelines. It begs the question: How pragmatic are the Institute of Medicine standards? In some ways, are these standards too strict?" says lead study author Sandra Wong, M.D., M.S., associate professor of surgery at the University of Michigan Medical School.

The IOM standards for clinical practice guidelines were developed to ensure that guidelines truly reflect the best quality of care. The standards cover eight criteria, including disclosing , using systematic reviews of the literature, seeking external review and updating recommendations regularly.

In this new study, published in the Journal of Clinical Oncology, researchers reviewed guidelines for the four leading causes of cancer deaths – lung, colorectal, breast and . Guidelines covered recommendations for screening, diagnosis, treatment or follow-up care.

On average, guidelines met 2.75 of 8 major criteria and 8.24 of 20 sub-criteria. The most common gaps were in managing and including patients or other lay people in the process.

"The IOM was trying to define what you need to have trustworthy guidelines. But if a group does not include a forum for public comment on the guidelines, does that make the guideline less trustworthy? Is that as important as whether they incorporate a systematic review of the literature? One consideration is that perhaps all standards should not be weighted the same across the board," Wong says.

She also suggests creating a balance between ideal standards and what is practical to ensure guidelines can be put in place in a timely manner. Some guidelines already take more than a year to create.

"Everybody is much more worried about quality standards and evidence based care. Clinicians are inundated with a lot of information and must be able to rely on guidelines produced by major professional organizations. At the same time, standards must ensure a practical and pragmatic approach to creating ," Wong says.

Explore further: American Cancer Society revises cancer screening guideline process

More information: Journal of Clinical Oncology, DOI: 10.1200/JCO.2012.46.8371

Related Stories

RARE-Bestpractices: Researching rare diseases

April 1, 2013

Clinical research needs to optimise its agenda by taking into consideration both patients' and clinicians' needs and interests. This is the goal of a four-year project funded by the EU's Seventh Framework Programme, which ...

Guidelines issued to prevent infection with dental work

May 14, 2013

(HealthDay)—Practitioners might consider discontinuing prophylactic antibiotics for patients with prosthetic implants undergoing dental procedures, and these patients should be encouraged to maintain appropriate oral hygiene, ...

New statement released by anticoagulation forum

May 31, 2013

(HealthDay)—The Anticoagulation Forum has endorsed a new consensus statement aimed at optimizing the delivery of anticoagulation therapy to inpatients; the statement has been published in the May issue of the Annals of ...

Recommended for you

Combination therapy can prevent cytostatic resistance

November 26, 2015

Researchers at Karolinska Institutet have found a new way of preventing resistance to cytostatics used in the treatment of cancers such as medulloblastoma, the most common form of malignant brain tumour in children. The promising ...

Forecasting the path of breast cancer in a patient

November 23, 2015

USC researchers have developed a mathematical model to forecast metastatic breast cancer survival rates using techniques usually reserved for weather prediction, financial forecasting and surfing the Web.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.