title: Critical evaluation of oncology clinical practice guidelines.
abstract: OBJECTIVE
  Significant concerns exist regarding the content and reliability of oncology clinical practice guidelines (CPGs). The Institute of Medicine (IOM) report "Clinical Practice Guidelines We Can Trust" established standards for developing trustworthy CPGs. By using these standards as a benchmark, we sought to evaluate recent oncology guidelines.
  
  
  METHODS
  CPGs and consensus statements addressing the screening, evaluation, or management of the four leading causes of cancer-related mortality in the United States (lung, breast, prostate, and colorectal cancers) published between January 2005 and December 2010 were identified. A standardized scoring system based on the eight IOM standards was used to critically evaluate the methodology, content, and disclosure policies of CPGs. All CPGs were given two scores; points were awarded for eight standards and 20 subcriteria.
  
  
  RESULTS
  No CPG fully met all the IOM standards. The average overall scores were 2.75 of 8 possible standards and 8.24 of 20 possible subcriteria. Less than half the CPGs were based on a systematic review. Only half the CPG panels addressed conflicts of interest. Most did not comply with standards for inclusion of patient and public involvement in the development or review process, nor did they specify their process for updating. CPGs were most consistent with IOM standards for transparency, articulation of recommendations, and use of external review.
  
  
  CONCLUSIONS
  The vast majority of oncology CPGs fail to meet the IOM standards for trustworthy guidelines. On the basis of these results, there is still much to be done to make guidelines as methodologically sound and evidence-based as possible.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Michigan, Ann Arbor, MI 48109-5932, USA.
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Reames
authors.forename: Robert W
authors.initials: RW
authors.lastname: Krell
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Ponto
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Wong
mesh_terms: D016265:Conflict of Interest; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000592:standards*; D020380:Needs Assessment; D009369:Neoplasms / Q000175:diagnosis / Q000628:therapy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D018570:Risk Assessment; D014481:United States