Practitioner feedback on clinical practice guidelines developed by Cancer Care Ontario's Lung Disease Site Group: Extending the circle of involvement

Abstract

6031 Background: Clinical practice guidelines (CPGs) are developed in Ontario through the disease site groups of Cancer Care Ontario's Program in Evidence-based Care. The Lung DSG consists of medical, radiation and surgical oncologists, methodologists, nurses and two consumer representatives. Guideline topics are selected by the DSG members and researched by specially trained research coordinators, who collate the evidence from the medical literature for review by the DSG. Since 1995, 10 CPGs have been published and 4 others have been completed in draft form. Methods: Completed CPGs are sent to practitioners for their feedback (PF) as part of the CPG development cycle. The CPG is accompanied by a survey instrument that asks about the acceptability and usefulness of the CPG to the practitioner. Results: 1198 questionnaires have been sent with the 14 CPGs to medical oncologists (52.3% of total questionnaires), radiation oncologists (16.3%), surgeons (15.9%), respirologists (13.7%) and other specialists (1.8%). The majority of questionnaires went to community-based practitioners (60%) and most practitioners surveyed were not members of the DSG (83.1%). Surveys were completed by 62.8% of those surveyed and 80% of those responding indicated that the CPG was relevant to their practice. Respondents indicated that they agreed or strongly agreed with the need for the CPG topic in 86.9% of cases, with the acceptability of the evidence summary (91.9%) and with the guideline recommendation as stated (86.1%). Overall, 77.1% indicated that they were likely to use the CPG in their practice. Practitioners frequently commented on issues of guideline clarity and adoption, or suggested wording edits. Explicit responses to these comments are included in the final CPG. Conclusions: PF enables a greater number of practitioners to participate in CPG development and review, obtains important feedback on the quality of the CPG document and the feasibility of CPG use in practice. By self-report, the majority of practitioners indicate that they would adopt CPG recommendations from the provincial Lung DSG. No significant financial relationships to disclose.