Introduction/Objective: There is an increasing number of practice guideline development programs, using different organisational and methodological approaches. We reviewed the operations of two programs for practice guideline development in oncology, the Standards, Options and Recommendations (SOR) undertaken by the Federation of the French Cancer Centers (FNCLCC) and the Ontario Cancer Treatment Practice Guidelines Initiative (OCTPGI) from the Ontario Cancer Treatment and Research Foundation (OCTRF).

Methods/Results: We identified existing similarities between the two programs regarding the organisation of the health care system in oncology, the organisation and financing of the two programs and the methodology of the guideline development and review process. We further identified common methodological and organisational challenges the two programs have to face, particularly group management and practitioner participation, identification of optimal implementation and dissemination strategies, evaluation issues and the role of the private sector in supporting guideline programs. Several differences has been identified regarding in particular the accessibility to oncology treatment services.

Discussion: Based on these findings, the two groups started a formal collaboration on the methodological strategies for locating, analysing, synthesising and interpreting evidence for the generation of evidence-based recommendations. Based on the awareness that medical practice is influenced as much by research evidence as by collective societal and individual values, the cultural context and local circumstances, a common research program will explore how these mechanisms influence the guideline development process. A further objective is to share information and to avoid the duplication of effort Collaboration further concerns the joint development of dissemination and implementation strategies and the evaluation of impact of guidelines on the process and outcomes of care. The international setting of the collaboration provides an excellent field to explore specific scientific, methodological, organisational and cultural factors that interplay on the path from scientific evidence to individual decision making in order to better understand how evidence-based recommendations are interpreted and applied in practice The results will lead to a more explicit appreciation of the determinants of the guideline development process and clinical decision-making.