From the Departments of Hematology, Internal Medicine, and Oncology, University of Pittsburgh Medical Center Cancer Center, Coraopolis, PA; Program in Evidence-Based Care, Cancer Care Ontario and McMaster University, Hamilton, Ontario, Canada; American Society of Clinical Oncology, Alexandria, VA; and Department of Medicine, Duke University School of Medicine and Duke Comprehensive Cancer Center, Raleigh, NC
Authors’ disclosures of potential conflicts of interest are found at the end of this article.
Address reprint requests to Edward P. Balaban, DO, FACP, Medical Oncologist, University of Pittsburgh Medical Center Cancer Center, 1600 Coraopolis Heights Road, Suite F, Coraopolis, PA 15108; e-mail: balabanep{at}upmc.edu
Overview: Clinical practice guidelines have gained increasing importance in clinical practice, as well as in health policy formulation and reimbursement. The scope of guidelines in clinical practice may range from broadly based on expert consensus to focused and highly evidence-based. Nevertheless, the translation of definitive clinical research results into practice guidelines is often slow and ineffective. Reasons for slow development and dissemination, as well as limited implementation, are multiple and varied. Improving the timely dissemination and implementation of clinical practice guidelines requires a comprehensive and committed partnership between professional organizations, clinicians, and methodology professionals. The ultimate goal of all of these efforts is to maximize the impact of guidelines on clinical practice and the quality of cancer care. The American Society of Clinical Oncology's clinical practice guidelines have been viewed as among the most valuable benefits of the society's membership, surpassed only by its Annual Meeting and the Journal of Clinical Oncology. Nevertheless, important limitations of the guidelines also have been pointed out, including their limited number, lack of frequent updates, and difficult implementation in daily practice. A number of new initiatives both alone and in partnership with other committed professional organizations, such as Cancer Care Ontario, to improve the timely development, dissemination, and implementation of clinical practice guidelines have been undertaken and will be reviewed. These efforts include the development of rapid updating options, a guideline endorsement policy, and the development of multiple derivative products to accompany each guideline in order to enhance dissemination.
