Browman G P, Newman T E, Mohide E A, Graham I D, Levine M N, Pritchard K I, Evans W K, Maroun J A, Hodson D I, Carey M S, Cowan D H
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
J Clin Oncol. 1998 Mar;16(3):1226-31. doi: 10.1200/JCO.1998.16.3.1226.
To present an update on the development of oncology practice guidelines (PGs) using the Practice Guidelines Development Cycle (Cycle), and to present the results of surveys of oncologists on the first 10 guidelines from the Cancer Care Ontario Practice Guidelines Initiative.
Practitioners' opinions about guidelines in development were sought using a mail survey method with systematic follow-up. Practitioners were identified by cancer center representatives. Survey packages included evidence-based recommendations (EBRs) and a one-page, nine-item feedback questionnaire. Data were collected between February 1995 and February 1996.
Nine hundred fourteen surveys that pertained to 10 guidelines were mailed to 423 practitioners in Ontario. Practitioners included 112 medical oncologists/hematologists, 34 radiation oncologists, 195 surgeons, and 82 practitioners from other medical specialities. One hundred practitioners were located in cancer centers and 323 had community-based practices. The overall response rate by practitioner was 72% and by survey questionnaire, 70%. For the five questionnaire items that assessed guideline quality, approval ratings ranged from 86% to 92%. For the 10 recommendations, 77% ( 63% to 82%) of respondents agreed that the EBR could be approved as a PG. Response and approval rates were consistent across medical specialities and locations of practice.
The process of obtaining practitioner feedback in the development of PGs is both feasible and useful. The high response rates to the survey indicate that it is possible to obtain broad participation in evidence-based guidelines development throughout Ontario. The changes made to the EBRs in response to feedback suggest that practitioners' opinions can be valuable in shaping evidence-based guidelines.
介绍使用实践指南制定周期（该周期）制定肿瘤学实践指南（PGs）的最新进展，并展示安大略癌症护理实践指南倡议中前10项指南的肿瘤学家调查结果。
采用邮件调查法并进行系统随访，征求从业者对正在制定的指南的意见。癌症中心代表确定从业者。调查问卷包括循证推荐意见（EBRs）和一份一页纸、包含九个条目的反馈问卷。数据收集时间为1995年2月至1996年2月。
与10项指南相关的914份调查问卷被邮寄给安大略省的423名从业者。从业者包括112名医学肿瘤学家/血液学家、34名放射肿瘤学家、195名外科医生以及82名来自其他医学专科的从业者。100名从业者在癌症中心工作，323名从业者在社区执业。从业者的总体回复率为72%，调查问卷的回复率为70%。对于评估指南质量的五个问卷项目，批准率在86%至92%之间。对于10项推荐意见，77%（63%至82%）的受访者同意EBR可作为PG被批准。回复率和批准率在不同医学专科和执业地点之间保持一致。
在PGs制定过程中获取从业者反馈的过程既可行又有用。调查的高回复率表明，在安大略省有可能在循证指南制定过程中获得广泛参与。根据反馈对EBRs所做的修改表明，从业者的意见在形成循证指南方面可能很有价值。
