Implementing clinical practice guidelines: time to assess it

Abstract

ESMO clinical practice guidelines (CPGs) have been developed to provide recommendations for the standard of care according to the highest quality evidence-based data (EBD). European Society for Medical Oncology (ESMO) is also conducting consensus conference (CC) activities to provide answers to crucial questions of clinical relevance, which are then formulated as recommendations. To be successful, a CPG has to be implemented in daily practice, a multistep process which can be affected by CPG features (complexity, poor access), external factors (social norms, health carers workload, local and national guidelines) and physician personal factors (knowledge and attitudes), but mostly relies on dissemination and physician awareness.1 2 Compliance of physicians with national and/or international guidelines has emerged as an important criterium to assess quality of care. Studies to evaluate the compliance with international guidelines, like National Comprehensive Cancer Network (NCCN), have been performed in patients with breast cancer and in elderly patients with stage III colon cancer3 4 by auditing patients medical records. In 2014, the three main European societies active in gynaecological oncology (ESMO, European Society of Gynaecological Oncology (ESGO), European SocieTy for Radiotherapy and Oncology (ESTRO)) performed a CC in endometrial cancer (EC), the most common gynaecological cancer in developed countries, for the treatment of which a multidisciplinary approach is needed.5 To evaluate the clinical implementation of the recommendations 5 years after the endometrial CC, the three societies conducted a survey, the results of which were reported at ESMO 2020.6 The survey was based on three clinical cases, one by each society. Each case consisted of five questions, each with five possible answers, but only one correct according to CC recommendations and adequate for the specific clinical situation. The selected topics were the management of early stage endometrioid EC, of high-grade serous histotype and of poorly differentiated stage …