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在茫茫文献中寻找一根针:通过对学术和灰色文献的环境扫描来确定心理肿瘤学的临床实践指南。

Finding a needle in a haystack: The identification of clinical practice guidelines for psychosocial oncology through an environmental scan of the academic and gray literature.

机构信息

Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada.

Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

出版信息

Cancer Med. 2024 Feb;13(3):e7039. doi: 10.1002/cam4.7039.

Abstract

OBJECTIVE

Clinical practice guidelines (CPGs) are evidence-based tools well-suited to translate the latest research evidence into recommendations for routine clinical care. Given the rapid expansion of psychosocial oncology research, they represent a key opportunity for informing the treatment decisions of overburdened clinicians, standardizing service delivery, and improving patient-reported outcomes. Yet, there is little consensus on how clinicians can most effectively access these tools and little to no information on the current availability and scope of CPGs for the range of psychosocial symptoms and concerns experienced by patients with cancer.

METHOD

Our environmental scan consisted of an academic and gray literature designed to identify currently available CPGs addressing a range of cancer-related psychosocial symptoms.

RESULTS

Findings revealed a total of 23 existing psychosocial oncology CPGs that met full eligibility criteria. The gray literature search was found to be more effective at identifying CPGs (n = 22) compared to the academic search (n = 9).

CONCLUSION

Several concerns arose from the systematic search. The limited publication of CPGs in peer-reviewed journals may make clinicians and stakeholders more hesitant to implement CPGs due to uncertainties about the methodological rigor of the development process. Further, many existing CPGs are outdated or failed to be updated according to guideline recommendations, meaning that the recommendations may fall short of their purpose to translate up-to-date research findings.

FUTURE DIRECTIONS

Future research should seek to systematically assess the quality of existing psychosocial oncology CPGs and shed light on the current state of implementation and adherence in clinical practice in order to better inform guideline developers on the current needs of the psychosocial oncology community.

摘要

目的

临床实践指南(CPG)是一种基于证据的工具,非常适合将最新的研究证据转化为常规临床护理的建议。鉴于心理肿瘤学研究的迅速扩展,它们为告知负担过重的临床医生的治疗决策、标准化服务提供以及改善患者报告的结果提供了一个关键机会。然而,对于临床医生如何最有效地访问这些工具,以及关于针对癌症患者经历的各种心理社会症状和问题的 CPG 的当前可用性和范围,几乎没有共识。

方法

我们的环境扫描包括学术和灰色文献,旨在确定目前可用于解决一系列与癌症相关的心理社会症状的 CPG。

结果

研究结果共发现了 23 项符合完全合格标准的现有的心理肿瘤学 CPG。与学术搜索(n=9)相比,灰色文献搜索在识别 CPG 方面更有效(n=22)。

结论

系统搜索产生了一些关注。CPG 在同行评议期刊上的有限发表可能会使临床医生和利益相关者更不愿意实施 CPG,因为他们对开发过程的方法严谨性存在不确定性。此外,许多现有的 CPG 已经过时或未能根据指南建议进行更新,这意味着建议可能无法达到将最新研究结果转化为实际应用的目的。

未来方向

未来的研究应致力于系统地评估现有的心理肿瘤学 CPG 的质量,并阐明其在临床实践中的实施和遵守现状,以便为指南制定者提供有关心理肿瘤学社区当前需求的更好信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7a9/10891449/ddd4aeb0e298/CAM4-13-e7039-g001.jpg

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