Cancer Screening Recommendations for Solid Organ Transplant Recipients: A Systematic Review of Clinical Practice Guidelines.
Acuna SA, Huang JW, et al.American Journal of Transplantation 2017; 17(1): 103-114.
Aims
To conduct a systematic review to assess the availability, quality and consistency of cancer screening recommendations for the long-term care of solid organ transplant recipients (SOTRs) in clinical practice guidelines (CPGs).
Interventions
The databases MEDLINE, EMBASE, CINAHL and PsycINFO were searched from inception to January 2015 as well as transplant organizations, Google Scholar and bibliographies of relevant literature. Article titles, abstracts and full texts were independently screened by two researchers and records were included if they were a CPG for SOTRs and included recommendations for malignancy screening.
Participants
13 resources were considered CPGs and included in the systematic review.
Outcomes
The primary outcome measured was quality according to the AGREE II tool. Other outcomes measured included the level of evidence and strength of recommendations.
Follow-up
Not reported
CET Conclusions
This is an interesting systematic review that assesses the quality and consistency of cancer screening recommendations in clinical practice guidelines (CPGs) for long-term care of solid organ transplant (SOT) recipients. A comprehensive literature search was developed with the help of an information specialist and excluded non-English studies. Search results were screened independently by two reviewers and data extraction was also done by two reviewers. The quality of CPGs was assessed by three reviewers using the AGREE II tool, a widely accepted instrument that evaluates the process of guideline development and quality of reporting. The level of evidence of recommendations (strong or weak) and the strength of the recommendations (Grade A-D) were extracted according to a standardized grading scale developed by the authors. Ten original guidelines were included on kidney transplantation (n=5), liver transplantation (n=3), heart-lung transplantation (n=3) and SOT (n=1). CPGs scored well on the AGREE domains ‘Scope and Purpose’ and ‘Stakeholder Involvement’ and poor on the domain ‘Applicability’. Older guidelines were typically more reliant on expert opinion whilst more recent recommendations addressed the lack of evidence. The review addressed the limited availability of cancer screening guidelines and the authors make recommendations for the development of future CPGs.
Quality notes
Quality assessment not appropriate.
Trial registration
None