Journal of Clinical Oncology, Vol 15, 3049-3059, Copyright © 1997 by American Society of Clinical Oncology
Lung cancer practice guidelines: lessons learned and issues addressed by the Ontario Lung Cancer Disease Site Group
WK Evans, T Newman, I Graham, JJ Rusthoven, D Logan, FA Shepherd and D Chamberlain
Ontario Cancer Treatment and Research Foundation, Ottawa Regional Cancer Centre, Canada. bevans@cancercare.on.ca
PURPOSE: The primary objective was to identify the lessons learned and
issues addressed by the Disease Site Group (DSG) developing guidelines on
lung cancer for practitioners in the province of Ontario. METHODS: The
minutes of the Ontario Lung Cancer Disease Site Group (LCDSG) and the
meeting notes of a medical sociologist who attended all LCDSG meetings were
reviewed to identify the disease-specific and generic issues addressed by
the LCDSG during guideline development. RESULTS AND CONCLUSION: The Ontario
LCDSG has completed three practice guidelines and has five evidence-based
recommendations (EBRs) in production. Topics for guideline development were
selected on the basis of known practice variability (eg, advanced-stage
non-small-cell lung cancer [NSCLC]); the size of the patient population
that could potentially be affected by the guideline; results of phase II
trials of new and potentially expensive agents (vinorelbine, paclitaxel,
and docetaxel); and randomized controlled clinical trials that support new
practice standards (combined modality therapy for unresectable stage III
NSCLC). The wording of each EBR reflects the strength and quality of the
evidence in support of the treatment option, the primary outcome(s), and
the individual physician and discipline values concerning treatment
outcomes in the absence of known patient values.
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