Abstract
BackgroundIt is not clear whether clinical practice guidelines (CPGs) and consensus statements (CSs) are adequately promoting shared decision making (SDM).ObjectiveTo evaluate the recommendations about SDM in CPGs and CSs concerning breast cancer (BC) treatment.Search strategyFollowing protocol registration (Prospero no.: CRD42018106643), CPGs and CSs on BC treatment were identified, without language restrictions, through systematic search of bibliographic databases (MEDLINE, EMBASE, Web of Science, Scopus, CDSR) and online sources (12 guideline databases and 51 professional society websites) from January 2010 to December 2019.Inclusion criteriaCPGs and CSs on BC treatment were selected whether published in a journal or in an online document.Data extraction and synthesisA 31‐item SDM quality assessment tool was developed and used to extract data in duplicate.Main resultsThere were 167 relevant CPGs (139) and CSs (28); SDM was reported in only 40% of the studies. SDM was reported more often in recent publications after 2015 (42/101 (41.6 %) vs 46/66 (69.7 %), P = .0003) but less often in medical journal publications (44/101 (43.5 %) vs 17/66 (25.7 %), P = .009). In CPGs and CSs with SDM, only 8/66 (12%) met one‐fifth (6 of 31) of the quality items; only 14/66 (8%) provided clear and precise SDM recommendations.Discussion and conclusionsSDM descriptions and recommendations in CPGs and CSs concerning BC treatment need improvement. SDM was more frequently reported in CPGs and CSs in recent years, but surprisingly it was less often covered in medical journals, a feature that needs attention.
Highlights
IntroductionMAES-CARBALLO et al.2.1 | Data sources and searchesBreast cancer (BC) is the most common cancer in women, with 2.1 million new cases each year (25% of all female cancers), and it causes the greatest number (about 670000 in 2018, 15%) of cancer-related deaths among women[1,2]
MAES-CARBALLO et al.2.1 | Data sources and searchesBreast cancer (BC) is the most common cancer in women, with 2.1 million new cases each year (25% of all female cancers), and it causes the greatest number of cancer-related deaths among women[1,2]
shared decision making (SDM) was reported more often in recent clinical practice guidelines (CPGs) and consensus statements (CSs) published after 2015 (42/101 (42.0%) vs 46/66 (69.7%), P =.0003) but less often in CPGs and CSs published in medical journal (44/101 (43.5%) vs 17/66 (25.7%), P = .009) (Table 3)
Summary
MAES-CARBALLO et al.2.1 | Data sources and searchesBreast cancer (BC) is the most common cancer in women, with 2.1 million new cases each year (25% of all female cancers), and it causes the greatest number (about 670000 in 2018, 15%) of cancer-related deaths among women[1,2]. The best BC treatment must be personalized[4,5], and choosing the ideal approach requires a high degree of specialization, scientific-technical updating, multidisciplinary coordination and patient participation[6,7,8,9] This participation in shared decision making (SDM) is considered a keystone in the achievement of sustainable high-quality cancer care, and it becomes especially important when separate treatment options with overall similar potential can yield very different results depending on patients' preferences[9,10]. It is claimed to be a keystone to guarantee good quality cancer care[9], and it is highly recommended by medical associations[15,16,17] It is not clear whether clinical practice guidelines (CPGs) and consensus statements (CSs) are adequately promoting shared decision making (SDM). SDM was more frequently reported in CPGs and CSs in recent years, but surprisingly it was less often covered in medical journals, a feature that needs attention
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