An Analysis of the Evidence Informing Clinical Practice Guidelines in the Management and Treatment of Breast Cancer

• Published in: Clinical breast cancer 2022-08, Vol.22 (6), p.588-600
• Main Authors: Snider, Kelsey, Moore, Ty, Walters, Corbin, Brachtenbach, Travis, Woods, William, Hartwell, Micah, Torgerson, Trevor, Rauh, Shelby, Vassar, Matt
• Format: Article
• Language: English
• Subjects: AMSTAR-2; ESMO; evidence-based medicine; NCCN; PRISMA; Systematic reviews
• ISSN: 1526-8209; 1938-0666
• DOI: 10.1016/j.clbc.2022.04.009

The aim of this study was to assess the methodological quality and accuracy of reporting within systematic reviews (SRs) that provide evidence to form clinical practice guidelines (CPGs) in the management and treatment of breast cancer. The 5 included CPGs for breast cancer management among National Comprehensive Cancer Network and European Society for Medical Oncology were searched for all SRs and meta-analyses. The characteristics of each study along with their methodological reporting were extracted from each SR using the PRISMA (Preferred Reporting Instrument for Systematic Reviews and Meta-Analyses) and AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews 2) tools. Our second objective was to compare SRs produced by Cochrane groups vs non-Cochrane. Our study included 5 CPGs for the management of breast cancer, containing 1341 total references with 69 being unique SRs we analyzed. PRISMA completeness percent had a mean 76.3% (n = 69), while AMSTAR-2 completeness score mean was 66.5% (n = 59). Cochrane SRs were found to adhere far better to PRISMA (0.91 vs. 0.74) and AMSTAR-2 (0.95 vs. 0.62) guidelines compared to the non-Cochrane SRs. The reporting quality of SRs that underpin CPGs in breast cancer management widely varies. We recommend that authors of SRs adopt a more uniform approach in assessing the quality of reporting within their studies. In addition, CPGs should use a more standardized method to seek out evidence to establish their recommendations. With improved reporting, clinicians may have increased confidence in CPGs and thus increased utilization of CPGs in clinical decision making. We assessed the methodological quality of reporting within systematic reviews underpinning evidence in breast cancer clinical practice guidelines. We analyzed 5 CPGs containing 1,341 total references, containing 69 being unique SRs. The reporting quality within systematic reviews varies, as one-third were of “critically low” quality. Improved reporting allows clinicians to have increased confidence in the guidelines, and thus increased utilization in clinical decision making.