Article type
Abstract
Background Fatigue is one of the most common adverse effects of cancer and continues to persist for years after finishing treatment. Cancer-related fatigue (CRF) causes disruption in all aspects of quality of life and might be a risk factor for reduced survival. Clinical practice guidelines (CPGs) are statements designed to improve the quality of healthcare and reduce patient suffering. In other words, robust implementation of CPGs can further the effective management of CRF. To date, some CPGs for CRF have been published; however, the methodological quality, clinical credibility or implementability of these guidelines has not been evaluated.
Objectives To investigate the current state of CPGs for CRF, generate an evidence map for visualizing research trends and gaps in CPGs and assess the methodological quality, clinical applicability, and implementability of all existing CRF guidelines.
Methods Our study was undertaken using PRISMA guidelines. We searched eight databases and ten websites till October 2023. We exacted basic information, recommendations and other related data by Excel 2010. Four reviewers independently assessed each identified CPG using AGREE II and AGREE-REX instruments. AGREE II consists of 6 domains (scope and purpose, stakeholder involvement, rigor of development, et al), with 23 items. AGREE-REX includes three domains (clinical applicability, values and preferences, and implementability) with 9 items. Mean with standard deviation (SD) was calculated for descriptive analyses, and ICC was used to assess evaluator consistency. The bubble plot format of evidence maps to describe the assessment results of each domain of each guideline and consensus statement was generated by R software.
Results & Conclusions: Interim findings indicate that despite existing CPGs potentially accurately reflecting clinical practice, with some areas of these CPGs performing reasonably well, there were deficiencies overall. Most CPGs lacked methodological rigor, evidence-based foundations, clarity and completeness in coding rules, and feasibility in application and implementation, which may undermine clinicians' adherence to CPGs, thereby reducing the effectiveness of clinical practice. Future CPGs should place greater emphasis on methodology, clinical credibility, and implementability to effectively guide clinicians in clinical practice. This study is ongoing, and results will be presented at the Summit as available.
Objectives To investigate the current state of CPGs for CRF, generate an evidence map for visualizing research trends and gaps in CPGs and assess the methodological quality, clinical applicability, and implementability of all existing CRF guidelines.
Methods Our study was undertaken using PRISMA guidelines. We searched eight databases and ten websites till October 2023. We exacted basic information, recommendations and other related data by Excel 2010. Four reviewers independently assessed each identified CPG using AGREE II and AGREE-REX instruments. AGREE II consists of 6 domains (scope and purpose, stakeholder involvement, rigor of development, et al), with 23 items. AGREE-REX includes three domains (clinical applicability, values and preferences, and implementability) with 9 items. Mean with standard deviation (SD) was calculated for descriptive analyses, and ICC was used to assess evaluator consistency. The bubble plot format of evidence maps to describe the assessment results of each domain of each guideline and consensus statement was generated by R software.
Results & Conclusions: Interim findings indicate that despite existing CPGs potentially accurately reflecting clinical practice, with some areas of these CPGs performing reasonably well, there were deficiencies overall. Most CPGs lacked methodological rigor, evidence-based foundations, clarity and completeness in coding rules, and feasibility in application and implementation, which may undermine clinicians' adherence to CPGs, thereby reducing the effectiveness of clinical practice. Future CPGs should place greater emphasis on methodology, clinical credibility, and implementability to effectively guide clinicians in clinical practice. This study is ongoing, and results will be presented at the Summit as available.