EBP Guideline for the National Comprehensive Cancer Network

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Guideline Developers

The National Comprehensive Cancer Network (NCCN) clinical guidelines are the recognized standard and most synoptic evidence-based practice (EBP) policies. One of the guidelines is the NCCN Guidelines for Patients with colon Cancer. The guideline was developed by a multidisciplinary panel comprising members of the NCCN institutions. The evidence is judged by experts in the medical field before the panel presentation and discussions commence. The NCCN special panel for guideline development is to get and scrutinize new evidence on cancer detection, risk reduction, prevention, workup, diagnosis, management, and supportive care (University library, 2022). The treatment recommendations the panelists provide are exact and integrated into practice through performance measurements.

Representation of Key Stakeholders

The guideline panel is representative as it includes oncology medical practitioners from reputable organizations and across all specialties. More than eighty different organizations are divided based on specialization, such as acute lymphoblastic leukemia, acute myeloid, and bone cancer, among others (Guidelines panels, 2022). Furthermore, the guideline update was done by a total of 61 panels comprising 1,700 oncology researchers and clinicians from 32 institutions registered by NCCN (About clinical practice guidelines, 2022). The selection of the panel is entirely based on merit and professionalism. Thus, there are no biases, and all stakeholders are represented.

Funding

The funding for the evidence-based guideline was primarily from the NCCN account. Notably, the organization relies solely on the grants and donations that it gets from the community. The NCCN foundation money is then allocated to different projects, including the continuous research and update of guidelines. Thus, the source of funding is ordinary people who care to give to enhance the treatment and prevention of cancer.

Status of Funding of Guideline Developers

Funding of individual researchers can create a conflict of interests because of the monetary investment. The NCCN guideline developers did not include a funded researcher of the reviewed studies (NCCN Guidelines, 2022). Oncology researchers from the NCCN institutions did all the reviewed studies. The money was used as part of the donations the community members gave to the NCCN account and then delegated for studies.

Development Strategy

The NCCN has a well-developed strategy used in selecting the panel and constructing the guidelines. First, the panel members are listed based on their specialties and institution. They then use flowcharts or algorithms to guide clinical decision-making (About clinical practice guidelines, 2022). Next is a discussion of clinical data and text describing the information that supports the recommendations. The following step is listing references and disclosing potential conflicts of interest to the NCCN headquarters staff or panel.

Explicit Decision Making

Arguably, the way decisions were made is sensible because the panel comprises many researchers and clinicians to minimize subjectivity. Moreover, each recommendation is backed-up by several references to studies that have been scrutinized for conflict of interests (About clinical practice guidelines, 2022). There was no impartiality in the identification, selection, and combination of the studies.

Literature Review

The studies included in the literature review were clinical trials with well-described methodologies. The implication is that they are reproducible as other interested researchers can replicate the study. Moreover, multiple studies are done for the same research question to confirm the findings. Moreover, the studies included in the development of the guideline are all recently published or revised within the past 12 months (About clinical practice guidelines, 2022). Therefore, the literature was comprehensive and combined several recent research studies with high credibility and validity.

Recommendations and Evidence

Each of the recommendations given is tagged by supporting the scientific clinical study. It is the norm for NCCN to ensure that all the recommendations they give are supported by research studies (About clinical practice guidelines, 2022). The strength of evidence is also considered such that meta-analysis is high in the hierarchy while expert opinions have low levels of strength. Moreover, the panel has to screen the studies to verify that it gives evidence for the recommendation.

Explicit Recommendations

The guideline provides explicit recommendations that reflect the value judgment on the result. For instance, there is a recommendation for colon cancer screening for all people for early identification of the disease (NCCN Guidelines for Patients, 2021). The recommendation for treatment is also different depending on the cancer stage. For instance, at stage one, no chemotherapy is done because it is not the most valuable solution at the point. Thus, there is a clear rationale for every suggestion in the guideline.

Peer Review and Testing

The panel members are expert researchers from the oncology department. They not only work by reviewing all the guidelines and discussing but also reviewing the final copy before the official publication (University library, 2022). Thus, the guideline is peer-reviewed and gets multiple updates from time to time as they receive new data that warrants a change in the guideline.

User Intent

All the NCCN guidelines are intended for national use because the studies are usually taken among the national representative sample. However, the NCCN is recognized as a reputable organization across many countries. Therefore, the guidelines are still internationally relevant for clinicians, oncologists, and cancer patients.

Clinical Relevance

The guideline is clinically relevant as it provides step-by-step recommendations for care options for cancer patients. It provides relevant information for the treatment and management of patients to improve their quality of life. In addition, it offers the best practices for clinicians, oncologists, and patients. Thus, following the guideline will likely minimize errors and ensure less hospital stay period.

Usefulness in Caring for Patients

The guideline is useful in caring for patients as it explains the different treatment recommendations for clients based on their stage of cancer. It also gives suggestions on the treatment planning process and the information that must be taken for diagnosis. For instance, the oncologist will need information including health history, colonoscopy, biopsy, imaging tests, biomarker testing, fertility, and family planning (NCCN Guidelines for Patients, 2021). The information is relevant in designing patient-centered care that is customized to suit the needs of the patient.

Practicality and Feasibility

The guideline is practical as it details what the patient and the clinician should do at each stage of the care continuum. For example, the guideline on taking patient history details the exact information that is needed. The guideline offers feasible suggestions that is useful in making a diagnosis.

Availability of Resources

The resources, including both people and technology, are available but limited. The increased prevalence of cancer creates a demand for oncologists, nurses, and other professionals working in the healthcare sector. The implication is that some hospitals may have a shortage of these staff. Similarly, the heavy machinery needed for chemotherapy is few, and patients must wait for their appointments by lining up.

Variation from Practice

The guideline recommendations are almost a replica of the standard practices. There are no significant variations because the information relies upon evidence from practice and select those that promises better outcome for the patients. Thus, clinicians are not asked to do anything outside the standard practice; every recommendation is backed by evidence from clinical trials.

Measurement of Outcome in Standard Care

The clinicians can measure the outcomes and make comparisons with the standard practice. For example, the quantitative assessment of the number of patients declared cancer-free after treatment following the guidelines. The reports and interviews are all possible measures to verify if there is an improvement in care.

References

About clinical practice guidelines. (2022). NCCN. Web.

Guidelines panels: Identification and disclosure of relationships with external entities. (2022). NCCN. Web.

NCCN Guidelines for Patients (2021). Colon cancer. Web.

NCCN Guidelines: Treatment by cancer type. (2022). NCCN. Web.

University library: Evidence based practice (NUR 4169): Practice guidelines. (2022). University Library at Florida Gulf Coast University. Web.

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