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Methodology for Lung Cancer Evidence Review and Guideline Development^*

ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition)

^* From the Department of Medicine and the Center for Clinical Health Policy Research (Dr. McCrory), Duke University Medical Center, Durham, NC; Center for Health Services Research in Primary Care (Dr. Durham), Department of Veterans Affairs Medical Center, Durham, NC; American College of Chest Physicians (Dr. Lewis and Ms. Heitzer), Northbrook, IL; Division of Pulmonary and Critical Care Medicine (Dr. Colice), Washington Hospital Center and The George Washington University School of Medicine, Washington, DC; and H. Lee Moffitt Cancer Center and the University of South Florida (Dr. Alberts), Tampa, FL.

Correspondence to: Douglas McCrory, MD, MHS, Duke Center for Clinical Health Policy Research, 2200 W. Main St, Suite 220, Durham, NC 27705; e-mail: douglas.mccrory{at}duke.edu

Background: To assemble a geographically diverse panel of experts in the diagnosis and treatment of lung cancer, representative of multiple clinical specialties, with the intention of developing clinically relevant practice guidelines for chest medicine and primary care physicians, including recommendations covering the full spectrum of care of the patient with non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).

Methods: The Duke University Center for Clinical Health Policy Research was selected to review and summarize the current evidence in the treatment of NSCLC. The BlueCross BlueShield Association Technology Evaluation Center was chosen and funded by the Agency for Healthcare Research and Quality to review and synthesize the current evidence on treatment of SCLC. Other chapters received existing guidelines, systematic reviews, and metaanalyses that were published since the first edition of these guidelines, as collected by the Duke University Evidence-based Practice Center. The writing committees for these chapters conducted searches for the primary articles and additional evidence in their topic area. The expert panel established clinical recommendations founded on the synthesis of this evidence.

Conclusions: This section describes the approach used to develop the guidelines, including identifying, evaluating, and synthesizing the evidence, assessing the strength of evidence and grading the individual recommendations, and suggestions for implementation of the guidelines.

Key Words: clinical practice guidelines • evidence-based medicine • non-small cell lung cancer • small cell lung cancer

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