Annals of Oncology Advance Access originally published online on February 6, 2006
Annals of Oncology 2006 17(4):691-701; doi:10.1093/annonc/mdl003
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© 2006 European Society for Medical Oncology
Quality of systematic reviews used in guidelines for oncology practice
1 Department of Biomedical Sciences and Human Oncology, University of Torino, Torino, Italy; 2 Department of Medical Sciences, Avogadro University, Novara, Italy; 3 Department of Epidemiology and Public Health, Imperial College, London, UK; 4 University of Modena and Reggio Emilia, Modena, Italy
* Correspondence to: Dr F. Vigna-Taglianti, Department of Medical Sciences, Avogadro University, Via Solaroli 17, 28100 Novara, Italy; Phone: +39-011-40188305; Fax: +39-011-40188301; E-mail: federica.vignataglianti{at}oed.piemonte.it
Background: Systematic reviews are an important tool for developing clinical recommendations. Those of high quality assure a good level of confidence on the strength of the recommendations.
Methods: A QUOROM-based checklist was applied to the reviews cited in a sample of guidelines on breast and colon cancer prevention and therapy. The checklist provided a weight for each criterion and a total quality score. Each review was independently evaluated by two reviewers; disagreements were solved by consensus.
Results: Eighty reviews (96%) were retrieved and evaluated; 36 focused on breast, and 44 on colorectal cancer. Twenty-three reviews (29%) did not match the definition of systematic review. In 17 (21%) the searching methods were unclear or described elsewhere. Forty (50%) were systematic. Not systematic, low and very low quality reviews accounted for 70% of the total. No review obtained the A+ class score; only 5 (6%) the A– and 7 (9%) the B+.
Conclusions: The results of this assessment provide a sober picture of the quality of the sources used to build guidelines. Oncologists should be aware that they could be relying on poor underlying documents. Writing groups should be aware of methodological problems, and should consult the existing manuals for the preparation of guidelines.
Key words: breast cancer, colorectal cancer, evidence-based medicine, guidelines, quality assessment, reviews
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