Evidence-Based Clinical Practice Guidelines: Lung Cancer

Credibility

The evidence-based clinical practice guidelines (CPGs) developed by Detterbeck, Mazzone, Naidich, and Bach (2013) target early detection of lung cancer in patients based on screening tools and techniques suggested by the recent literature. The mentioned guidelines were developed by scholars from the American College of Chest Physicians, while the same organization acted as the sponsor of the project. At the same time, the key stakeholders of these guidelines are representative of the given organization. A valid development strategy, the systematic review method, was used in the course of preparing lung cancer screening guidelines. The process of planning, review and analysis was thoroughly developed and implemented by the authors of the article. More to the point, the processes were explicit, sensible, and transparent to ensure study credibility. However, it is not stated whether any comprehensive literature review was conducted within one year after the publication of this study or not.

Having read these clinical practice guidelines, one may assume that all significant options and outcomes were taken into account. The authors pay attention to various data presented by the recent literature and integrate knowledge in an attempt to provide the most appropriate guidelines. For example, it is noted that for patients aged from 55 to 74, who smoke or quit smoking recently, it is highly recommended to have annual screening with low-dose CT (LDCT), while persons younger the given age should not be subjected to this procedure. Even though Detterbeck et al. (2013) thoroughly examine every option, they fail to outline the level of evidence used for designing recommendations. Nevertheless, the paramount importance of the mentioned guidelines is that they explicitly pinpoint recommendations that may be used by practitioners in their care. The fact that the article is peer-reviewed proves its scholarly nature and shows that it promotes evidence-based decision-making in the field of early detection of lung cancer.

Applicability

The evidence-based clinical practice guidelines under discussion do not evidently represent the intent of the authors. While the review of the recommendations, articles used to create these guidelines, and endorsement organizations demonstrate that the authors target the international clinical community. Speaking of the clinical relevance of the proposed recommendations, it should be emphasized that they are rather significant in terms of the growing lung cancer mortality worldwide. There is an urgent need to combat lung cancer, and the use of adequate screening tools is one of the solutions to this health concern. In my point of view, these guidelines will be helpful in diagnosing at-risk patients and providing them with the most relevant health care services.

The implementation of the mentioned CPGs is feasible as it requires a reasonable number of personnel, equipment, and awareness. Currently, oncology has already adopted some of the recommendations given by Detterbeck et al. (2013), yet the distinction between age, smoking status, occupation, and other factors is the contribution made by these authors to the existing theory. It is unknown whether the outcomes of the application of these guidelines may be measured through standard care since the article presents no related information. It seems that further research is needed to understand the above point. In general, the discussed CPGs should be explored in future studies to reveal any limitations and weaknesses and elaborate on them, thus improving the current guidelines used by practitioners in diagnosing lung cancer and increasing patients life expectancy and quality.

Reference

Detterbeck, F. C., Mazzone, P. J., Naidich, D. P., & Bach, P. B. (2013). Screening for lung cancer: Diagnosis and management of lung cancer: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 143(5), 78-92.

Appendix

Credibility

1. Who were the guideline developers?	Scholars from American College of Chest Physicians
2. Were the developers representative of key stakeholders in the specialty (interdisciplinary)?	Yes	No	Unknown
3. Who funded the guideline development?	American College of Chest Physicians
4. Were any of the guideline developers funded researchers of the reviewed studies?	Yes	No	Unknown
5. Did the team have a valid development strategy?	Yes	No	Unknown
6. Was an explicit (how decisions were made), sensible and impartial process used to identify, select, and combine evidence?	Yes	No	Unknown
7. Did its developers carry out a comprehensive, reproducible literature review within the past 12 months of its publication/revision?	Yes	No	Unknown
8. Were all important options and outcomes considered?	Yes	No	Unknown
9. Is each recommendation in the guideline tagged by the level/strength of evidence upon which it is based and linked with the scientific evidence?	Yes	No	Unknown
10. Do the guidelines make explicit recommendations (reflecting value judgments about outcomes)?	Yes	No	Unknown
11. Has the guideline been subjected to peer review and testing?	Yes	No	Unknown

Applicability/Generalizability

12. Is the intent of use provided (e.g.; national, regional, local)?	Yes	No	Unknown
13. Are the recommendations clinically relevant?	Yes	No	Unknown
14. Will the recommendations help me in caring for my patients?	Yes	No	Unknown
15. Are the recommendations practical/feasible (e.g., resources-people and equipment-available)?	Yes	No	Unknown
16. Are the recommendations a major variation from the current practice?	Yes	No	Unknown
17. Can the outcomes be measured through standard care?	Yes	No	Unknown

Table 1. Rapid critical appraisal checklist for evidence-based clinical practice guidelines.

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