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Close×European Urology Open Science (Dec 2024)
- Vasileios Sakalis,
- Yagnaseni Bhattacharya,
- Katharina Beyer,
- Charlotte Murray,
- Emma Jane Smith,
- Peter-Paul M. Willemse,
- Giorgio Gandaglia,
- Romain Boissier,
- Angelika Borkowetz,
- Saeed Dabestani,
- Renee C.A. Leenen,
- Antoni Vilaseca,
- Gianluca Maresca,
- Jeremy Teoh,
- Juan Gómez Rivas,
- Pawel Rajwa,
- Michael Lardas,
- Nikolas Grivas,
- Thomas Van den Broeck,
- Benjamin Pradere,
- Natasha Schouten,
- Zafer Tandogdu,
- Susan Evans-Axelsson,
- Steven Maclennan,
- Marlene Thomas,
- Alberto Briganti,
- Anders Bjartell,
- Phil Cornford,
- Hagen Kruger,
- James N’Dow,
- Monique J. Roobol,
- Muhammad Imran Omar
Affiliations
- Vasileios Sakalis
- Hippokrateion General Hospital of Thessaloniki, Urology, Thessaloniki, Greece
- Yagnaseni Bhattacharya
- Division of Medical and Dental Education, Aberdeen Medical School, Aberdeen, UK
- Katharina Beyer
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
- Charlotte Murray
- Academic Urology Unit, University of Aberdeen, Aberdeen, Scotland, UK
- Emma Jane Smith
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
- Peter-Paul M. Willemse
- Department of Urology, Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Giorgio Gandaglia
- Department of Urology and Division of Experimental Oncology, Urological Research Institute, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Romain Boissier
- Department of Urology and Renal transplantation, APHM, Aix-Marseille Université, Marseille, France
- Angelika Borkowetz
- Department of Urology, Technische Universität Dresden, Dresden, Germany
- Saeed Dabestani
- Department of Urology, Kristianstad Central Hospital, Region Skane, Kristianstad, Sweden; Department of Translational Medicine, Section Division of Urological Cancers, Lund University, Lund, Sweden
- Renee C.A. Leenen
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
- Antoni Vilaseca
- Servicio de Urología, Hospital Clínic de Barcelona, Barcelona, Spain
- Gianluca Maresca
- Department of Urology, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK
- Jeremy Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
- Juan Gómez Rivas
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
- Pawel Rajwa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Silesia, Zabrze, Poland
- Michael Lardas
- Department of Urology, Metropolitan General Hospital, Athens, Greece
- Nikolas Grivas
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Thomas Van den Broeck
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
- Benjamin Pradere
- Department of Urology, La Croix Du Sud Hospital, Quint Fonsegrives, France
- Natasha Schouten
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
- Zafer Tandogdu
- Department of Urology, University College London Hospitals, London, UK
- Susan Evans-Axelsson
- Bayer AG, Berlin, Germany
- Steven Maclennan
- Academic Urology Unit, University of Aberdeen, Aberdeen, Scotland, UK
- Marlene Thomas
- Roche, Basel, Switzerland
- Alberto Briganti
- Department of Urology and Division of Experimental Oncology, Urological Research Institute, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Anders Bjartell
- Department of Translational Medicine, Lund University, Lund, Sweden
- Phil Cornford
- Department of Urology, Liverpool University Hospitals Foundation Trust, Liverpool, UK
- Hagen Kruger
- Medical Affairs, Pfizer, Berlin, Germany
- James N’Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, Scotland, UK
- Monique J. Roobol
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
- Muhammad Imran Omar
- Academic Urology Unit, University of Aberdeen, Aberdeen, Scotland, UK; Corresponding author at: Academic Urology Unit, Health Sciences Building (second floor), University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK.
- Journal volume & issue
- Vol. 70
pp. 183 – 193
Abstract
Background and objective: Clinical practice guidelines for prostate cancer (PCa) are a valuable resource for everyday clinical practice. The clinical practice guidelines and recommendations produced by various societies should demonstrate a considerable level of consistency in terms of quality, regardless of the society that developed these given the common evidence base. However, to date, no study has assessed the quality of PCa clinical practice guidelines. As part of the Optimal Treatment for Patients with Solid Tumours in Europe Through Artificial intelligence (OPTIMA) project, we evaluated the quality of the most frequently used national and international clinical practice guidelines for PCa using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool. Methods: The quality of the identified clinical practice guidelines was assessed independently by two assessors using the AGREE II tool. The AGREE II tool comprises 23 different items organised into six domains, rated on a 7-point scale (1: strongly disagree to 7: strongly agree). The total score of the appraisal was the mean value of the two assessments. The agreement between assessors’ scores was calculated using the interclass correlation coefficient (ICC). Four key recommendations were compared among the included clinical practice guidelines to assess consistency. Key findings and limitations: Sixteen clinical practice guidelines were assessed using their latest available version (cut-off April 2024). The European Association of Urology, S3LL PCa, Belgian Health Care Knowledge Centre, National Comprehensive Cancer Network, and Prostatacancer—Nationellt vårdprogram guidelines received the highest overall scores with a mean domain score of 82.4% (range: 75.5–88.3%). The de l’Association Française d’Urologie (AFU), American Urological Association, and National Institute for Health and Care Excellence received a mean domain score of 77.6% (range: 73.7–84.0%). Below average were the European Society for Medical Oncology, localised (L) and systemic (S) CPPC American Society of Clinical Oncology, and Nederlandse Vereniging voor Urologie (NVU) with a mean domain score of 58.4% (range: 43.5–76.3%). The reasons for scoring below average included the following: inadequate information about the methodology applied, limited scope of the guideline, and limited patient engagement. The highest inter-rater variability was observed in NVU (ICC: 0.58) and the lowest in AFU-L (ICC: 0.84). When examining the scores of each domain, “clarity of presentation” (domain 4) achieved the highest score with a mean of 86.9% ± 12.6%. The domain with the lowest score was applicability (domain 5), with a mean of 48.3% ± 24.8%. The ICC was calculated to be 0.72 (±0.08). Conclusions and clinical implications: This is the first study in which a comprehensive quality assessment of the majority of international and national clinical practice guidelines was undertaken, and the key recommendations were compared to assess consistency. Our study shows that the majority of international and national clinical practice guidelines demonstrate high-quality standards when assessed using the AGREE II evaluation tool. The clinical practice guidelines that did not meet the expected standards could be improved by adopting several key recommendations outlined by our study. Patient summary: The OPTIMA project used the Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool to evaluate the quality of 16 commonly used national and international clinical practice guidelines for prostate cancer. While some of these international and national clinical practice guidelines received the highest score, few guidelines scored below average due to methodological deficiencies and limited patient engagement. These findings highlight the need for a standardised process to ensure high-quality, consistent guidelines across practices.
Keywords
- Prostate cancer
- Clinical practice guidelines
- AGREE II
- Recommendations
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