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STATUS REPORT WP 6: Clinical Practice Guidelines

STATUS REPORT WP 6: Clinical Practice Guidelines. STATUS REPORT TTF Guidelines WP 6: Clinical Practice Guidelines. RARE SOLID ADULT CANCERS. Peter Hohenberger, MD Kiangenda Trésor Sungu-Winkler, MPH Div . of Surgical Oncology & Thoracic Surgery

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STATUS REPORT WP 6: Clinical Practice Guidelines

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  1. STATUS REPORT WP 6: Clinical Practice Guidelines

  2. STATUS REPORT TTF Guidelines WP 6: Clinical Practice Guidelines RARE SOLID ADULT CANCERS

  3. Peter Hohenberger, MD KiangendaTrésor Sungu-Winkler, MPH Div. ofSurgicalOncology & ThoracicSurgery Mannheim University Medical Center, University of Heidelberg, WP6 JARC Project Team Thomas Langer, MSc Dipl.-Soz. , Guideline Program Markus Follmann,MPH MSc, Head Guideline Program Ellen Griesshammer, administrative part German Cancer Society Deutsche Krebsgesellschaft (DKG), Berlin

  4. WP6: Description of work • Task 6.1 Available clinical practice guidelines at the European level on all families of rare cancers • Task 6.2 Quality evaluation of existing clinical practice guidelines for rare cancer subtypes • Task 6.3 Open issues about implementation of clinical practice guidelines at the local level, with special regard to their relation with local reimbursement mechanisms and to study innovative models to provide value-based rare cancer care • Task 6.4 Solutions on how to incorporate clinical practice guidelines within ERNs.

  5. WP6 Milestone Tasks 2017/8 START TASK2 START TASK 6.1 TASK 6.1 TASK 6.1 TASK 6.1 TASK 6.1 TASK 6.1 Nov 30 Jan 1 Sep 30 Oct 30 Aug 01 Jun 15 Jul 01 2018 Jun Dec 2017 Oct Aug Nov Jul Sep Today Apr CPGs Research => online medical database (PubMed/Medline, ScienceDirect…) Start Appraisal of Guidelines for Research and Evaluation AGREE and other tools Exchange with UK, France (Inserm), Germany, Italy Kick-off-Meeting with JARC WP6 - Mannheim 4/15 - 6/30 6/29 - 11/3 Task 2 Task 1 Enquiry JARC Domain Leaders Collection of existing guidelines for the 12 rare cancer types

  6. During 2017 we collected guidelines across all domains in collaboration with ESMO, Eurordis, OECI, INSERM (OrphaNet), NCEC (Network of Centers of Excellence Cancer Germany), START, ECPC and others. • We searched all available internet resources and domains listing guidelines. • An expert opinion request on centralized guidelines was addressed to all domain leaders. • Circular mails were sent to all associated and collaborating partners to obtain further information regarding existing guidelines or local referral guidelines. • Looking for availability in national or local level in each European countries participating and involving in the EU JARC project. • Selection of guidelines were limited to those published from 2013 onward. Oxford – EURACAN April 2018

  7. OBJECTIVES Oxford – EURACAN April 2018

  8. Prioritizingfor T6.2 required • Istherecontacttotherespective ERN EURACAN: yes • EuroBlodNet: no • PaedCan ERN: no • Isthere an ERN- domain at theworkinglevel ? • Isthe ERN domaincapableofcollaborating ? • Start with Domain 8 - thoracic, then CNS, NET…

  9. WP 6 in JARC = TTF ‚Guidelines‘ in ERN- EURACAN

  10. WP 6 in JARC = TTF ‚Guidelines‘ in ERN- EURACAN

  11. Correlation between the domains of AGREE II andtheMiChe • The average overall quality rating of the 10 guidelines using MiChe was highly correlated (Pearson’s correlations between 0.74 and 0.87) with the expert ratings in the AGREE II domains II - IV and VI. • Correlations for the domains I and V were not statistically significant

  12. Evaluation of Guideline Quality • Appraisal Tool: Mix Methods • Using of Cluzeau instrument with 19 sample questions (Evaluation Criteria) • Using of the international Centre for Allied Health Evidence (iCAHE)instrument for scoring (binary scored instrument) => appraisal score calculation • Multiple choice answer, mostly the “yes/no” score • =>Yes=1; No=0 • Quality assessmentratingscales: • 1 = STRONG (total score 80% – 100%) • 2 = MODERATE (total score 50% – 80%) • 3 = WEAK (total score 50% or less)

  13. This is a qualitative assessment that is aimed to be achieved by using two critical appraisal tools for clinical practice guidelines: • Cluzeauinstrument (a previous version of AGREE II instrument, which is divided into 3 dimensions and consists of 37 items for this evaluation it is suggested to use only 19 key items and • binary scored instrument, iCAHE(international Centre for Allied Health Evidence). • The Cluzeau Instrument could serve as a basis for the evaluation criteria by referring to the selection criteria for Guidelines. • The scores for each guideline will be calculated by using the iCAHE Instrument, which tests questions binary-scored, yes = 1 or no = 0 • response by providing one overall score a total score is determined by the sum of the scores • that will be estimated in percentages for scores • between 80%-100% as Strong with notation 1, • between 50%- 80% as Moderate with notation 2 • 50% or less as Weak with notation 3 .

  14. Still missing: involvementofpatientadvocacygroups Cluzeaupublishedin 1999 not intendedfor Rare Cancer !

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