Pearson Elizabeth J M, Morris Meg E, McKinstry Carol E
Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
Support Care Cancer. 2016 Sep;24(9):3935-42. doi: 10.1007/s00520-016-3228-9. Epub 2016 Apr 26.
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.
全球范围内卫生专业人员对癌症相关疲劳（CRF）的管理存在不一致的情况。本研究旨在确定管理癌症相关疲劳的最恰当指南。
对国际文献进行系统检索，以确定基于证据的CRF临床实践指南。四名评审员使用AGREE-II工具和澳大利亚国家卫生与医学研究委员会（NHMRC）指南标准，独立评估了质量最高的指南。
五项指南符合纳入标准。其中，2015年加拿大心理肿瘤学协会（CAPO）CRF指南和2014年美国临床肿瘤学会（ASCO）癌症幸存者疲劳指南被选作深入评估。在AGREE-II的五个领域中，CAPO指南的得分高于ASCO指南。在一个领域中，差异具有统计学意义（p≤0.05）。CAPO指南符合47项NHMRC强制性指南标准中的37项，ASCO指南符合20项。在一个领域中，符合标准的比例差异具有统计学意义（p≤0.05）。两项指南在适用性和实施方面的得分都较低。
目前，CAPO癌症相关疲劳指南有最强的使用证据。为加强实施，需要进一步的指南传播和应用策略。
