dc.contributor.author | Hardman, JC | |
dc.contributor.author | Harrington, K | |
dc.contributor.author | Roques, T | |
dc.contributor.author | Sood, S | |
dc.contributor.author | Jose, J | |
dc.contributor.author | Lester, S | |
dc.contributor.author | Pracy, P | |
dc.contributor.author | Simo, R | |
dc.contributor.author | Repanos, C | |
dc.contributor.author | Stafford, F | |
dc.contributor.author | Jennings, C | |
dc.contributor.author | Winter, SC | |
dc.contributor.author | Wheatly, H | |
dc.contributor.author | Homer, J | |
dc.contributor.author | Kumar, BN | |
dc.contributor.author | Paleri, V | |
dc.coverage.spatial | England | |
dc.date.accessioned | 2022-09-26T13:00:00Z | |
dc.date.available | 2022-09-26T13:00:00Z | |
dc.date.issued | 2022-07-11 | |
dc.identifier | ARTN 189 | |
dc.identifier | 10.1186/s12874-022-01667-w | |
dc.identifier.citation | BMC Medical Research Methodology, 2022, 22 (1), pp. 189 - | |
dc.identifier.issn | 1471-2288 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/5500 | |
dc.identifier.eissn | 1471-2288 | |
dc.identifier.eissn | 1471-2288 | |
dc.identifier.eissn | 1471-2288 | |
dc.identifier.eissn | 1471-2288 | |
dc.identifier.doi | 10.1186/s12874-022-01667-w | |
dc.description.abstract | BACKGROUND: Methods for developing national recommendations vary widely. The successful adoption of new guidance into routine practice is dependent on buy-in from the clinicians delivering day-to-day patient care and must be considerate of existing resource constraints, as well as being aspirational in its scope. This initiative aimed to produce guidelines for the management of head and neck squamous cell carcinoma of unknown primary (HNSCCUP) using a novel methodology to maximise the likelihood of national adoption. METHODS: A voluntary steering committee oversaw 3 phases of development: 1) clarification of topic areas, data collection and assimilation, including systematic reviews and a National Audit of Practice; 2) a National Consensus Day, presenting data from the above to generate candidate consensus statements for indicative voting by attendees; and 3) a National Delphi Exercise seeking agreement on the candidate consensus statements, including representatives from all 58 UK Head and Neck Multidisciplinary Teams (MDT). Methodology was published online in advance of the Consensus Day and Delphi exercise. RESULTS: Four topic areas were identified to frame guideline development. The National Consensus Day was attended by 227 participants (54 in-person and 173 virtual). Results from 7 new systematic reviews were presented, alongside 7 expert stakeholder presentations and interim data from the National Audit and from relevant ongoing Clinical Trials. This resulted in the generation of 35 statements for indicative voting by attendees which, following steering committee ratification, led to 30 statements entering the National Delphi exercise. After 3 rounds (with a further statement added after round 1), 27 statements had reached 'strong agreement' (n = 25, 2, 0 for each round, respectively), a single statement achieved 'agreement' only (round 3), and 'no agreement' could be reached for 3 statements (response rate 98% for each round). Subsequently, 28 statements were adopted into the National MDT Guidelines for HNSCCUP. CONCLUSIONS: The described methodology demonstrated an effective multi-phase strategy for the development of national practice recommendations. It may serve as a cost-effective model for future guideline development for controversial or rare conditions where there is a paucity of available evidence or where there is significant variability in management practices across a healthcare service. | |
dc.format | Electronic | |
dc.format.extent | 189 - | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | BMC | |
dc.relation.ispartof | BMC Medical Research Methodology | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject | Audit | |
dc.subject | Cost effectiveness | |
dc.subject | Delphi | |
dc.subject | Guidelines | |
dc.subject | Head and neck cancer | |
dc.subject | Unknown primary | |
dc.subject | Consensus | |
dc.subject | Cost-Benefit Analysis | |
dc.subject | Delphi Technique | |
dc.subject | Humans | |
dc.title | Methodology for the development of National Multidisciplinary Management Recommendations using a multi-stage meta-consensus initiative. | |
dc.type | Journal Article | |
dcterms.dateAccepted | 2022-06-27 | |
dc.date.updated | 2022-09-22T14:35:58Z | |
rioxxterms.version | VoR | |
rioxxterms.versionofrecord | 10.1186/s12874-022-01667-w | |
rioxxterms.licenseref.startdate | 2022-07-11 | |
rioxxterms.type | Journal Article/Review | |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/35818027 | |
pubs.issue | 1 | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Cancer Biology | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Cancer Biology/Targeted Therapy | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Targeted Therapy | |
pubs.organisational-group | /ICR/Primary Group/Royal Marsden Clinical Units | |
pubs.organisational-group | /ICR/ImmNet | |
pubs.publication-status | Published online | |
pubs.publisher-url | http://dx.doi.org/10.1186/s12874-022-01667-w | |
pubs.volume | 22 | |
icr.researchteam | Targeted Therapy | |
dc.contributor.icrauthor | Hardman, John | |
dc.contributor.icrauthor | Harrington, Kevin | |
dc.contributor.icrauthor | Paleri, Vinidh | |
icr.provenance | Deposited by Mr Arek Surman on 2022-09-22. Deposit type is initial. No. of files: 1. Files: Methodology for the development of National Multidisciplinary Management Recommendations using a multi-stage meta-consensus .pdf | |