Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Biosci Trends. 2012 Jun;6(3):147-52. doi: 10.5582/bst.2012.v6.3.147.
With the development of evidence-based medicine (EBM), the concept of "transfer of current best evidence into clinical decision-making" has garnered substantial attention worldwide. As such a good tool, many clinical practice guidelines (CPGs) for hepatocellular carcinoma (HCC) have been published worldwide under the guide of current best evidence. Our study did a systematic evaluation of the current 17 guidelines for HCC worldwide, which found that the appropriate constructing approach is the most important factor that influences guidelines implementation. Three factors of organizations or bodies drafting the guideline, exploration for achieving current best evidence, and purpose of constructing evidence-based CPGs for HCC should be paid close attention to. In order to achieve the current best evidence and promote evidence-based CPGs to be widely accepted and fully implemented, we recommend to conduct a systematic approach with 4 steps of global guidelines assessment, systematic literature review, experts' consensus and draft implementation, as well as implementation evaluation and periodic update in constructing and implementing evidence-based CPGs for HCC.
随着循证医学(EBM)的发展,“将当前最佳证据转化为临床决策”的理念在全球范围内受到了广泛关注。作为一种很好的工具,许多基于当前最佳证据的肝细胞癌(HCC)临床实践指南(CPG)已在全球范围内发布。我们对全球目前的 17 项 HCC 指南进行了系统评价,发现适当的构建方法是影响指南实施的最重要因素。在指南草案的组织或机构、探索获得当前最佳证据以及构建 HCC 循证 CPG 的目的这三个方面应密切关注。为了获得当前最佳证据,并促进循证 CPG 被广泛接受和充分实施,我们建议在构建和实施 HCC 循证 CPG 时,采用全球指南评估、系统文献综述、专家共识和草案实施以及实施评估和定期更新的 4 步系统方法。