Jiang Zefei, Li Jianbin, Chen Jiayi, Liu Yueping, Wang Kun, Nie Jianyun, Wang Xiaojia, Hao Chunfang, Yin Yongmei, Wang Shusen, Yan Min, Wang Tao, Yan Ying, Chen Xiaoyuan, Song Erwei
The Fifth Medical Center of PLA General Hospital, Beijing, China.
Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Transl Breast Cancer Res. 2022 Apr 30;3:13. doi: 10.21037/tbcr-22-21. eCollection 2022.
Developing guidelines for the diagnosis and treatment of common cancers in China based on the evidence-based practice, the availability of diagnosis and treatment products, and the up-to-date advances in precision medicine is one of the basic tasks of the Chinese Society of Clinical Oncology (CSCO). In recent years, the availability of medical resources has become a major concern in clinical guidelines, which is particularly important for developing countries or socioeconomically diverse countries and territories. China is the world's largest developing country, with a large territory and uneven economic and academic developments. The CSCO guidelines must take into account the differences in regional development, the availability of medicines and diagnostic methods, and the social value of cancer treatment. Therefore, for each clinical problem and intervention in the CSCO guidelines, the levels of evidence should be graded according to the currently available evidences and expert consensuses, and the grades of recommendations should be based on the availability and cost-effectiveness of the products. Protocols with high evidence level and good availability are used as the Level I recommendations; protocols with relatively high evidence level but slightly lower expert consensus or with poor availability are used as the Level II recommendations; and protocols that are clinically applicable but with low evidence level are regarded as the Level III recommendations. Based on the findings of clinical research at home and abroad and the opinions of CSCO experts, the CSCO guidelines determine the levels of recommendations for clinical application. The CSCO Guidance Working Group firmly believes that evidence-based, availability-concerned, and consensus-based guidelines will be more feasible for clinical practice. Again, any comments from our readers are greatly appreciated and will be considered in updates of these guidelines, so as to maintain the accuracy, fairness, and timeliness of the CSCO guidelines.
基于循证实践、诊断和治疗产品的可及性以及精准医学的最新进展,制定中国常见癌症的诊断和治疗指南是中国临床肿瘤学会(CSCO)的基本任务之一。近年来,医疗资源的可及性已成为临床指南中的一个主要关注点,这对于发展中国家或社会经济多样化的国家和地区尤为重要。中国是世界上最大的发展中国家,地域辽阔,经济和学术发展不均衡。CSCO指南必须考虑到区域发展差异、药品和诊断方法的可及性以及癌症治疗的社会价值。因此,对于CSCO指南中的每个临床问题和干预措施,应根据现有证据和专家共识对证据水平进行分级,推荐等级应基于产品的可及性和成本效益。证据水平高且可及性好的方案用作I级推荐;证据水平相对较高但专家共识稍低或可及性较差的方案用作II级推荐;临床适用但证据水平低的方案视为III级推荐。基于国内外临床研究结果和CSCO专家的意见,CSCO指南确定临床应用的推荐等级。CSCO指南工作组坚信,基于证据、关注可及性且基于共识的指南在临床实践中将更可行。再次感谢读者的任何意见,这些意见将在这些指南的更新中予以考虑,以保持CSCO指南的准确性、公正性和及时性。