Cancer-related fatigue: appraising evidence-based guidelines for screening, assessment and management.
There is inconsistent management of cancer-related fatigue (CRF) by health professionals worldwide. This research aims to identify the most appropriate guidelines for the management of cancer-related fatigue.



A systematic search of international literature identified evidence-based clinical practice guidelines for CRF. Four reviewers independently appraised the highest quality guidelines using the AGREE-II instrument and National Heath and Medical Research Council (NHMRC) guideline standards.



Five guidelines met the inclusion criteria. Of these, the 2015 Canadian Association of Psychosocial Oncology (CAPO) CRF guidelines and the 2014 American Society of Clinical Oncology (ASCO) fatigue guidelines for cancer survivors were selected for in-depth appraisal. The CAPO guideline scored higher than the ASCO for five domains of the AGREE-II. For one domain, the differences were statistically significant (p ≤ 0.05). The CAPO guideline met 37 of 47 NHMRC mandatory guideline standards and the ASCO guideline met 20. The difference in the proportion of standards met was statistically significant for one domain (p ≤ 0.05). Both guidelines had low scores for applicability and implementation.



Currently, the CAPO guideline for cancer-related fatigue has the strongest evidence for use. To enhance implementation, further strategies for guideline dissemination and application are needed.
Rural Health School, La Trobe University, Bendigo, Victoria, Australia. elizabeth.jm.pearson@gmail.com.
Elizabeth J M
EJ
Pearson
School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
Meg E
ME
Morris
Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
Carol E
CE
McKinstry
D005221:Fatigue / Q000209:etiology*; D006287:Health Planning Guidelines; D006801:Humans; D008403:Mass Screening; D009369:Neoplasms / Q000150:complications* / Q000473:pathology; D017741:Survivors
AGREE-II; Cancer-related fatigue; Clinical guideline; Critical appraisal; NHMRC guideline standard