Clinical Practice Guidelines for the management of locally advanced ...

APPENDIX 1 GUIDELINE DEVELOPMENT PROCESS
A1.1 Introduction
The Australian Cancer Network (ACN) initiated a proposal to develop the Clinical practice guidelines
for the management of advanced prostate cancer. A decision to proceed was taken in September
2005. To better describe the scope of the guidelines, the title was changed to Clinical practice
guidelines for the management of locally advanced and metastatic prostate cancer.
A Working Party composed of clinical specialists and consumers and a project team based in the
Cancer Epidemiology Research Unit of Cancer Council New South Wales, carried out the work. The
project team conducted literature searches, assisted in the critical evaluation of the literature and
extracted the relevant data. Financial support was provided by Andrology Australia, the Prostate
Cancer Foundation of Australia and ACN. NHMRC appointed a Guideline Assessment Reviewer
(GAR) to both monitor and aid the development process.
The development program was designed to meet the scientific rigour required by the guideline
development process, which is the subject of a series of handbooks on the main stages involved in the
development of clinical practice guidelines. 1–8 These handbooks have been previously condensed into
a single volume—Development of clinical practice guidelines for the management of cutaneous
melanoma and melanoma in special sites: a handbook for chapter leaders and expert working
groups 9 —which outlines the major steps and expectations involved in developing guidelines and
provided a clear path for everyone involved in the project. This handbook provides the definitions and
protocols for developing research questions and search strategies, conducting searches and critical
appraisal, summarising and assessing the relevant literature and finally, formulating the
recommendations. It includes checklists and templates created to satisfy designated standards of
quality and process. These condensed handbooks have been a most useful aid in the demanding and,
for some, new process of developing guidelines.
At its initial meetings the Guidelines Working Party prepared a table of topics and developed
questions to address identified clinical needs. The questions were divided into different topics and
subcommittees of the Guidelines Working Party were formed to address topics in their areas of
expertise.
A2.1 Steps in preparing clinical practice guidelines to
NHMRC criteria
A clear strategy was developed for every topic and each expert group followed the appropriate steps
in preparing the guidelines. While each subcommittee received significant assistance from the project
team skilled in methodology, the subcommittees themselves oversaw the synthesis of the evidence
and formulation of the recommendations for their topics.
The strategic steps followed are outlined below:
1. Structure the research questions
2. Develop a search strategy
3. Search the literature
4. Select, assess and summarise the literature
5. Critically appraise and summarise each selected article
6. Assess the body of evidence and formulate recommendations
117
Appendices