Critical Appraisal of Clinical Practice Guidelines for Pancreatic Cancer Based on the Global Disease Burden_Chinese Journal of Evidence-Based Medicine

Authors：

 LICui-cui ^1,2 , WANGYing-qiang ³ ,  LIYou-ping ¹ , LIXiang-lian ¹

1. Chinese Evidence-Based Medicine Center, West China Hospital of Sichuan University, Chengdu 610041, China;
2. Department of Respiratory, Nuclear Industry 416 Hospital, Chengdu 610051, China;
3. Department of Medical Administration, 363 Hospital, Chengdu 610041, China;

Corresponding author：

LIYou-ping, Email: yzmylab@163.com

Keywords：

Pancreatic cancer; Clinical practice guideline; AGREE Ⅲ; Quality appraisal

DOI：

10.7507/1672-2531.20150026

Video：

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Objective To evaluate the quality of pancreatic cancer guidelines using evidence-based methods based on the global burden of pancreatic cancer, so as to explore its status, region distribution, characteristics of coverage themes, and difference of therapies recommended by the guidelines of various quality, and to provide references for clinical decisionmaking. Methods PubMed, The Cochrane Library (Issue 11, 2013), CBM, CNKI, and VIP, as well as the website of National Guidelines Clearinghouse (NGC), Guidelines International Network (GIN), and National Institute for Clinical Excellence (NICE) were systematically searched for pancreatic cancer treatment guidelines. The Appraisal of Guidelines for Research and Evaluation (AGREE Ⅲ) was applied to assess methodological quality of included guidelines. Results A total of 14 relevant guidelines (including five evidence-based guidelines) were included involving seven countries of four continents (Asia, Europe, North America and Oceania) and four international academic organizations. There were only two domains, namely "scope and purpose" and "clarity of presentations" which got high average scores (more than 60%) among all 14 guidelines. The mean AGREE domain scores in guidelines varied with areas, and the quality of five evidence-based guidelines was superior to that established by consensus. According to the outcomes of AGREE Ⅲ, 11 guidelines were weakly recommended, while 3 were not recommended due to poor methodological quality. The subjects of 14 guidelines covered six treatment categories, including chemotherapy, surgery, radiotherapy, support therapy, radiotherapy, and interventional therapy. Conclusion The overall methodological quality of pancreatic cancer guidelines is not high among different countries or regions. The quality of evidence-based guidelines is superior to that established by consensus. Chemotherapy, surgery, radiotherapy and support therapy were reccommended as predominant choice by these guidelines.

Citation： LICui-cui, WANGYing-qiang, LIYou-ping, LIXiang-lian. Critical Appraisal of Clinical Practice Guidelines for Pancreatic Cancer Based on the Global Disease Burden. Chinese Journal of Evidence-Based Medicine, 2015, 15(2): 144-151. doi: 10.7507/1672-2531.20150026 Copy

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17.	National Institute for Clinical Excellence. Technology appraisal No.25.Guidance on the use of gemcitabine for the treatment of pancreatic cancer.2001. Avialable at:http://www.nice.org.uk/nicemedia/live/11425/32185/32185.pdf.
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19.	Jonker D, Bouttell E, Kamra J, et al. Chemotherapy or Radiotherapy for Resectable Pancreatic Adenocarcinoma. Program in Evidencebased Care Evidence-based Series, 2-23 Version 2.
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23.	丁琳, 唐海沁, 李结华, 等. 中国慢病防治指南现状分析及评价. 中国循证心血管医学杂志, 2012, 4(4):308-312.
24.	张伶俐, 李幼平, 张川, 等. 中国儿童临床指南现状分析及循证临床指南评价. 中国循证医学杂志, 2011, 11(9):991-999.

1. Devesa S, Blot W, Stone B. Recent cancer trends in the United States. J Natl Cancer Inst, 1995, 87:175-182.
2. Parkin D, Bray F, Ferlay J. Global cancer statistics 2002. CA Cancer J Clin, 2005, 55:74-108.
3. Lemal A, Siegel R, Ward E. Cancer statistics, 2008. CA Cancer J Clin, 2008, 58:71-96.
4. Hidalgo M. Pancreatic Cancer. N Engl J Med, 2010, 362:1605-1617.
5. Gudjonssun B. Pancreatic cancer:survival, errors and incidence. Eur J Gastroenterol Hepatol, 2009, 21:1379-1382.
6. 吕文超, 崔云甫, 钟翔宇. 胰腺癌流行病学研究进展. 世界华人消化杂志, 2011, 19(27):2805-2809.
7. 陈尹, 胡世莲,李幼平, 等. 全球药物干预治疗单纯性高血压指南的系统评价. 中国循证医学杂志, 2012, 12(10):1180-1194.
8. Schmidt S, Follmann M, Malek N, et al. Critical appraisal of clinical practice guidelines for diagnosis and treatment of hepatocellular carcinoma. J Gastroenterol Hepatol, 2011, 26(12):1779-1786.
9. Yamaguchi K, Tanaka M. EBM-based Clinical Guidelines for Pancreatic Cancer 2009 from the Japan Pancreas Society:a synopsis. Jpn J Clin Oncol, 2011, 41(7):836-840.
10. 李槐. 胰腺癌经动脉灌注化疗指南(草案). 介入放射学杂志, 2012, 21(5):353-355.
11. 中华人民共和国国家卫生和计划生育委员会. 胰腺癌诊疗规范(2011年版). 2011.
12. 复旦大学附属肿瘤医院肝胆胰综合治疗组. 胰腺癌诊治指南. 2010.
13. 赵玉沛. 胰腺癌诊治指南. 中国实用外科杂志, 2007, 27(9):671-673.
14. Pancreatic Section of the British Society of Gastroenterology, et al. Guidelines for the management of patients with pancreatic cancer periampullary and ampullary carcinomas. Gut, 2005, 54(Suppl 5):v1-v16.
15. van Laethem JL, Verslype C, Iovanna JL, et al. New strategies and designs in pancreatic cancer research:consensus guidelines report from a European expert panel. Ann Oncol, 2012, 23(3):570-576.
16. Cascinu S, Falconi M, Valentini V, et al. Pancreatic cancer:ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2010, 21(Suppl 5):v55-58.
17. National Institute for Clinical Excellence. Technology appraisal No.25.Guidance on the use of gemcitabine for the treatment of pancreatic cancer.2001. Avialable at:http://www.nice.org.uk/nicemedia/live/11425/32185/32185.pdf.
18. Tempero MA, Arnoletti JP, Behrman SW, et al. Pancreatic Adenocarcinoma, version 2.2012:featured updates to the NCCN Guidelines. J Natl Compr Canc Netw, 2012, 10(6):703-713.
19. Jonker D, Bouttell E, Kamra J, et al. Chemotherapy or Radiotherapy for Resectable Pancreatic Adenocarcinoma. Program in Evidencebased Care Evidence-based Series, 2-23 Version 2.
20. Earle CC, Agboola O, Maroun J, et al. The treatment of locally advanced pancreatic cancer:a practice guideline. Can J Gastroenterol, 2003, 17(3):161-167.
21. Russo SM, Ove R, Saif MW. Identification of prognostic and predictive markers in pancreatic adenocarcinoma. Highlights from the "2011 ASCO Gastrointestinal Cancers Symposium". San Francisco CA USA. JOP, 2011, 12(2):92-95.
22. Pancreatic Cancer. Available at:www.gicancer.org.au.
23. 丁琳, 唐海沁, 李结华, 等. 中国慢病防治指南现状分析及评价. 中国循证心血管医学杂志, 2012, 4(4):308-312.
24. 张伶俐, 李幼平, 张川, 等. 中国儿童临床指南现状分析及循证临床指南评价. 中国循证医学杂志, 2011, 11(9):991-999.

Chinese Journal of Evidence-Based Medicine

Critical Appraisal of Clinical Practice Guidelines for Pancreatic Cancer Based on the Global Disease Burden

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