Levels of evidence and grades of recommendation supporting European society for medical oncology clinical practice guidelines  

作　　者：MARKO SKELIN BRUNA PERKOV-STIPIČIN SANJA VUŠKOVIĆ MARINAŠANDRK PLEHAČEK ANE BAŠIĆ DAVIDŠARČEVIĆ MAJA ILIĆ IVAN KREČAK 

机构地区：[1]Pharmacy Department,General Hospital ofŠibenik-Knin County,Šibenik,Croatia [2]Faculty of Medicine,University of Rijeka,Rijeka,Croatia [3]Undergraduate Study in Nursing,University of Applied Sciences,Šibenik,Croatia [4]Department of Oncology,University Hospital Center Zagreb,Zagreb,Croatia [5]Pharmacies Joukhadar,Sveta Nedelja,Croatia [6]Pharmacies Prima Pharme,Zagreb,Croatia [7]Pharmacy Department,General Hospital Zadar,Zadar,Croatia [8]Pharmacy Department,General Hospital Pula,Pula,Croatia [9]Department of Internal Medicine,General Hospital ofŠibenik-Knin County,Šibenik,Croatia

出　　处：《Oncology Research》2024年第5期807-815,共9页肿瘤学研究(英文)

摘　　要：Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically investigated.This study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer settings.Methods:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each CPG.We examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer types.Results:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR A.Overall,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous versions.The proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current version.In the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)recommendations.Significant variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer types.Conclusion:One-third of the current ESMO CPG recommendations are supported by the highest level of evidence.More well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.

关 键 词：ESMO guidelines Clinical practice guidelines Level of evidence Grade of recommendation 

分 类 号：R730[医药卫生—肿瘤]