PCN240 QUALITY ASSESSMENT OF BRAZILIAN CLINICAL GUIDELINES IN ONCOLOGY

Abstract

Oncology clinical guidelines are published by many institutions worldwide, using a sort of methodological paths which provide lot of variety in the presentation of these documents. The aim of the study was to evaluate the quality of Brazilian guidelines for the treatment of breast, prostate and colon and rectal cancers. Twelve Brazilian guidelines were selected, published by four distinct elaborator groups (Ministry of Health, supplementary health system and medical societies). AGREE II Instrument (Appraisal of Guidelines Research & Evaluation) was used by independents and trained methodologists or oncologists evaluators. The scores of each domain (“Scope and Purpose”, “Stakeholder Involvement”, “Rigour of Development”, “Clarity of Presentation”, “Applicability” and “Editorial Independence”) as the “Overall Guideline Assessment”, were calculated considering tree appraisers responses. In all evaluated guidelines, important weaknesses were identified in more than one domain, highlighting the low values in the “Applicability” and “Editorial Independence”. The patterns observed by domains are more connected to the type of elaborator group than to the guideline specific clinical condition (breast, prostate or colon and rectal cancers). Lower scores in domain “Rigour of Development” and “Editorial Independence” were mainly verified on non-governmental elaborator groups. Even though the “Clarity of Presentation” domain in Ministry of Health guidelines were inferior in relation to the others one, in “Applicability”, all evaluated guidelines presented significant limitations. Consequently, according to the overall assessment, none of evaluated guidelines was recommended without modification, and four of which were not recommended. The findings highlights the need to ensure the quality of brazilian guidelines. It is necessary to qualify the guideline recommendations regarding the evidences that support them, as well as to comprehensively and feasibly dispose the conducts to be adopted, so that a best care could be provided to cancer patients in Brazil.