title: Possibilities for transborder cooperation in breast cancer care in Europe: a comparative analysis regarding the content, quality and evidence use of breast cancer guidelines.
abstract: To encourage transborder cooperation in breast cancer care in Europe, we explored possibilities with the German-Dutch border area as an example. Evidence-based breast cancer guidelines were searched and compared on the: (1) methodological quality (with AGREE (Appraisal of Guidelines for Research and Evaluation)), (2) content of recommendations and (3) evidence use. The methodological quality of the German (n=2) and Dutch guidelines (n=2) was generally sufficient and comparable, although the applicability and the editorial independence were not clearly documented in the Dutch guidelines. Regarding the content analysis, German recommendations were taken as a reference point, because of the highest AGREE scores. Twenty-one of 25 recommendations discussed in both guidelines were corresponding and 4 were different, 32 were not mentioned in the Dutch guideline. The guidelines shared little evidence (< or =11%). We conclude that there are possibilities to encourage transborder cooperation. The clinical context of our results should be examined by measuring the actual care in both countries preferably with quality indicators.
authors.affiliation: Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. l.wennekes@kwazo.umcn.nl
authors.forename: L
authors.initials: L
authors.lastname: Wennekes
authors.forename: R P M G
authors.initials: RP
authors.lastname: Hermens
authors.forename: K
authors.initials: K
authors.lastname: van Heumen
authors.forename: V
authors.initials: V
authors.lastname: Runde
authors.forename: H
authors.initials: H
authors.lastname: Schoelen
authors.forename: H C H
authors.initials: HC
authors.lastname: Wollersheim
authors.forename: R P T M
authors.initials: RP
authors.lastname: Grol
authors.forename: P H M
authors.initials: PH
authors.lastname: de Mulder
authors.forename: P B
authors.initials: PB
authors.lastname: Ottevanger
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy*; D005069:Evaluation Studies as Topic; D019317:Evidence-Based Medicine / Q000592:standards*; D005260:Female; D005858:Germany; D006801:Humans; D007391:International Cooperation; D008495:Medical Oncology / Q000592:standards; D009426:Netherlands; D017410:Practice Guidelines as Topic / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000592:standards