LUNG-CANCER PRACTICE GUIDELINES - LESSONS LEARNED AND ISSUES ADDRESSED BY THE ONTARIO-LUNG-CANCER-DISEASE-SITE-GROUP

Purpose: The primary objective was to identify the lessons learned and issues addressed by the Disease Site Group (DSG) developing guideline s on lung cancer for practitioners in the province of Ontario. Methods : The minutes of the Ontario Lung Cancer Disease group (LCDSG) and the meeting notes of a medical sociologist who attended all LCDSG meeting s were reviewed to identify the disease-specific and generic issues ad dressed by the LCDSG during guideline development. Results and Conclus ion: The Ontario LCDSG has completed three practice guidelines and has five evidence-based recommendations (EBRs) in production. Topics for guideline development were selected on the basis of known practice var iability (eg, advanced-stage nonsmall-cell lung cancer [NSCLC]); the s ize of the patient population that could potentially be affected by th e guideline; results of phase II trials of new and potentially expensi ve agents (vinorelbine, paclitaxel, and docetaxel); and randomized con trolled clinical trials that support new practice standards (combined modality therapy for unresectable stage III NSCLC). The wording of eac h EBR reflects the strength and quality of the evidence in support of the treatment option, the primary outcome(s), and the individual physi cian and discipline values concerning treatment outcomes in the absenc e of known patient values. (C) 1997 by American Society of Clinical On cology.