Development and Internal Review
This evidence-based series was developed by the Supportive Care Guidelines Group (SCGG) of Cancer Care Ontario's (CCO's) Program in Evidence-Based Care (PEBC). The SCGG comprises medical, radiation, and surgical oncologists; psychiatrists; palliative care physicians; nurses; radiation therapists; methodologists; administrators; a psychologist; and an anesthetist.
External Review by Ontario Clinicians
Following review and discussion of sections 1 and 2 of this evidence-based series, the SCGG circulated the clinical practice guideline and systematic review to health care providers in Ontario for review and feedback.
Methods
Feedback was obtained through a mailed survey of 236 health care providers in Ontario including 101 psychiatrists, 40 medical oncologists, 41 pharmacists, 39 nurses, and 15 palliative care physicians. The survey consisted of items evaluating the methods, results, and discussion used to inform the draft recommendations and whether the draft recommendations should be approved as a practice guideline. Written comments were invited. The survey was mailed out over a period of four months (September through December 2005) as contact information for additional provider groups became available. Follow-up reminders were sent at two weeks (post card) and four weeks (complete package mailed again). The SCGG reviewed the results of the survey.
Report Approval Panel
The final Evidence-based Series report was reviewed and approved by the PEBC Report Approval Panel (RAP) in October 2006. The Panel consists of two members including an oncologist, with expertise in clinical and methodology issues. Key issues raised by the Panel included: a need for clarification on the intended provider audience for the report and consideration of the presentation of the information for the specific audience; a suggestion to separate the practitioner feedback results by clinician types; and, given the limited evidence for treatment options in cancer patients, a request for further discussion of evidence for treatment effectiveness in non-cancer populations.