SOR: project methodology.

B Fervers,P Bey,S Theobald,J Hardy,R Pinkerton,F Farsi,A Bataillard,S Guillo,S Debuiche,J L Renaud-Salis,T Philip,G Gory,M P Blanc-Vincent

doi:10.1054/bjoc.2000.1757

Abstract

Clinical practice guidelines (CPGs) have been defined as ‘systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances’ (Institute of Medicine, 1990). The aim is to inform the clinician and the patient of the current best clinical practice in a given situation, based on a synthesis of the available evidence. The ‘Standards, Options and Recommendations’ (SOR) project develops evidence-based CPGs in oncology and has been undertaken by the French National Federation of Cancer Centers (FNCLCC) since 1993 (Fervers et al, 1995). The project is a collaboration between the FNCLCC (a Federation of the 20 French comprehensive cancer centres) and specialists from French public universities, general hospitals and private clinics. The aim of the project is to increase the quality and efficiency of care given to cancer patients by developing, disseminating and implementing CPGs. SORs are designed to provide a decision guide for cancer specialists in the choice of strategies for the diagnosis, treatment and follow-up of cancer patients. The FNCLCC represents the regional cancer centres (CRCCs) as a collaborative body at national and international level and coordinates activity in scientific, economic and social domains. The CRCCs are public service hospitals and have a mission of multidisciplinary cancer care, education and research. Twenty-five percent of all cancer patients in France (240 000 new cases every year) are managed within the CRCCs. The remainder are treated in public universities, general hospitals and private clinics. The SOR project encompasses the progressive development of CPGs for the initial management of cancer in adults and children, for supportive care and control of symptoms in cancer patients and for the standardization of ‘good clinical practice’ throughout the various disciplines involved in cancer care. It has also undertaken the development of CPGs specifically for nursing and paramedical staff, as well as the provision of evidence-based information for patients.

Highlights

The SOR program has an annual budget of 6.9 million French francs (1.05 million Euros) and is funded primarily by the FNCLCC through contributions from each of the CRCCs and by grants from a major cancer charity, the National League against Cancer
Private industry has no financial, organizational or scientific participation in the guideline development process, financial contributions are received from pharmaceutical companies to aid the dissemination of the SOR documents outside the CRCCs
There is no personal remuneration for the formulation or review of the SOR documents

Summary

Literature search

The literature search is performed by a professional information librarian and is carried out according to standard procedures (Bonichon et al, 1998), including the search of electronic databases (Medline, Cancerlit), databases of systemic reviews (Cochrane library) and Internet sites of organizations developing and/or evaluating guidelines. To limit bias in the selection of relevant studies and to facilitate the data review process, critical appraisal checklists have been developed for different types of publications (Fervers, 2000). The critical appraisal checklists contain the criteria necessary for the assessment of the quality and the clinical relevance of the information (Figure 2). Explicit criteria are used for the assessment of the validity of trial results and the quality of the methodology according to the type of publication

Is the number of patients required specified?

Findings

CONCLUSION