ASCO Publishes Novel Guideline-Development Approach

The American Society of Clinical Oncology (ASCO) has been at the forefront of developing clinical practice guidelines that oncologists can use as a framework when treating their patients. The process, which was initiated over 20 years ago, has definitely evolved over time, with more than 60 guidelines till date. Now, in a paper published in the Journal of Clinical Oncology, ASCO has shared the various innovative approaches toward guideline development and implementation.

The ASCO guidelines are developed under the leadership of a Clinical Practice Guidelines Committee (CPGC) and the society’s board of directors. The CPGC, the paper states, have worked toward streamlining the approaches to guideline development. The following are key considerations followed by CPGC to improve the process:

1. Integrating consideration of multiple chronic conditions (MCCs) into practice guidelines—improving relevance to real-world practice.

While there have been discussions to include MCCs in practice guidelines, clinical trials have not provided significant evidence to develop specific guidelines. With this in mind, ASCO created an MCC section that is now included in ASCO guidelines. Additionally, experts are being convened to serve on panels for better integration of MCC into guidelines at the development stage.

2. Keep more of its guidelines current by applying evolving signals or (more) rapid, for-cause updating approaches.

Keeping guidelines updated is an important but challenging task. To address this, ASCO CPGC’s Methodology Subcommittee has developed a signals approach, wherein expert guideline panels define formal criteria for identifying new practice-changing data that may translate into revised recommendations.

This approach requires a targeted literature search and expert opinions to identify potential signals.

3. Increase the number of high-quality guidelines available to its membership through endorsement and adaptation of other groups’ products.

A more recent innovation, ASCO’s board of directors have approved a policy for endorsing guidelines developed by other professional organizations. This can avoid duplication of efforts and allow physicians access to high-quality guidelines.

4. Improve coverage of its members’ guideline needs through a new topic nomination process.

Recommendations for new topics are provided by Guideline Advisory Groups that meet annually to review topics suggested by ASCO members. They help prioritize topics for guideline development for the CPGC.

5. Enhance dissemination and promote implementation of ASCO guidelines in the oncology practice community through a network of volunteer ambassadors.

The task is spearheaded by the Practice Guideline Implementation network—volunteers who disseminate and promote implementation of ASCO clinical practice guidelines in the oncology practice community.

Additionally, efforts are ongoing to integrate ASCO’s CancerLinQ platform into ASCO guidelines, in an effort to help physicians make clinical decisions that are informed by clinical practice guidelines and the experience of similar patients.

Additional details on ASCO’s efforts on practice guidelines can be found here.