European Society of Gynaecological Oncology (ESGO) Guidelines for Ovarian Cancer Surgery

2017 ◽  
Vol 27 (7) ◽  
pp. 1534-1542 ◽  
Author(s):  
Denis Querleu ◽  
François Planchamp ◽  
Luis Chiva ◽  
Christina Fotopoulou ◽  
Desmond Barton ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Decision Making ◽  
Surgical Management ◽  
Fallopian Tube ◽  
European Society ◽  
Scientific Evidence ◽  
Professional Experience ◽  
Evidence Based ◽  
Gynaecological Oncology ◽  
Development Group

MethodsThe European Society of Gynaecological Oncology council nominated an international multidisciplinary development group made of practicing clinicians who have demonstrated leadership and interest in the care of ovarian cancer (20 experts across Europe). To ensure that the statements are evidence based, the current literature identified from a systematic search has been reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group (expert agreement). The guidelines are thus based on the best available evidence and expert agreement. Before publication, the guidelines were reviewed by 66 international reviewers independent from the development group including patients representatives.ResultsThe guidelines cover preoperative workup, specialized multidisciplinary decision making, and surgical management of diagnosed epithelial ovarian, fallopian tube, and peritoneal cancers. The guidelines are also illustrated by algorithms.

European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer

2017 ◽  
Vol 27 (4) ◽  
pp. 832-837 ◽  
Author(s):  
Maaike H.M. Oonk ◽  
François Planchamp ◽  
Peter Baldwin ◽  
Mariusz Bidzinski ◽  
Mats Brännström ◽  
...  
Keyword(s):  
International Development ◽  
European Society ◽  
Vulvar Cancer ◽  
Scientific Evidence ◽  
Local Treatment ◽  
Distant Metastases ◽  
Evidence Based ◽  
Gynaecological Oncology ◽  
Patient Representatives ◽  
Development Group

ObjectiveThe aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology’s mission to improve the quality of care for women with gynecologic cancers across Europe.MethodsThe European Society of Gynaecological Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe). To ensure that the statements are evidence based, the current literature identified from a systematic search has been reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group (expert agreement). The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 181 international reviewers including patient representatives independent from the development group.ResultsThe guidelines cover diagnosis and referral, preoperative investigations, surgical management (local treatment, groin treatment including sentinel lymph node procedure, reconstructive surgery), radiation therapy, chemoradiation, systemic treatment, treatment of recurrent disease (vulvar recurrence, groin recurrence, distant metastases), and follow-up.

scholarly journals European Society of Gynaecological Oncology guidelines for the peri-operative management of advanced ovarian cancer patients undergoing debulking surgery

2021 ◽  
pp. ijgc-2021-002951 ◽  
Author(s):  
Christina Fotopoulou ◽  
François Planchamp ◽  
Tugce Aytulu ◽  
Luis Chiva ◽  
Alessandro Cina ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
European Society ◽  
Care Delivery ◽  
Advanced Ovarian Cancer ◽  
Operative Management ◽  
Evidence Based ◽  
Gynaecological Oncology ◽  
Operative Care ◽  
Management Of Complications ◽  
Development Group

The European Society of Gynaecological Oncology (ESGO) developed and established for the first time in 2016, and updated in 2020, quality indicators for advanced ovarian cancer surgery to audit and improve clinical practice in Europe and beyond. As a sequela of the continuous effort to improve oncologic care in patients with ovarian cancer, ESGO issued in 2018 a consensus guidance jointly with the European Society of Medical Oncology addressing in a multidisciplinary fashion 20 selected key questions in the management of ovarian cancer, ranging from molecular pathology to palliation in primary and relapse disease. In order to complement the above achievements and consolidate the promoted systemic advances and surgical expertise with adequate peri-operative management, ESGO developed, as the next step, clinically relevant and evidence-based guidelines focusing on key aspects of peri-operative care and management of complications as part of its mission to improve the quality of care for women with advanced ovarian cancer and reduce iatrogenic morbidity. To do so, ESGO nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of ovarian cancer (18 experts across Europe). To ensure that the guidelines are evidence based, the literature published since 2015, identified from a systematic search, was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 117 independent international practitioners in cancer care delivery and patient representatives.

scholarly journals The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the Management of Patients With Cervical Cancer

2018 ◽  
Vol 28 (4) ◽  
pp. 641-655 ◽  
Author(s):  
David Cibula ◽  
Richard Pötter ◽  
François Planchamp ◽  
Elisabeth Avall-Lundqvist ◽  
Daniela Fischerova ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
European Society ◽  
Invasive Cervical Cancer ◽  
Locally Advanced ◽  
Evidence Based ◽  
Cervical Lesions ◽  
Gynaecological Oncology ◽  
Cancer Management ◽  
Fertility Sparing ◽  
Development Group

BackgroundDespite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer.ObjectiveThe European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly develop clinically relevant and evidence-based guidelines in order to improve the quality of care for women with cervical cancer across Europe and worldwide.MethodsThe ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of cervical cancer (23 experts across Europe). To ensure that the guidelines are evidence based, the current literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 159 international reviewers, selected through ESGO/ESTRO/ESP and including patient representatives.ResultsThe guidelines cover comprehensively staging, management, and follow-up for patients with cervical cancer. Management includes fertility sparing treatment; stage T1a, T1b1/T2a1, clinically occult cervical cancer diagnosed after simple hysterectomy; early and locally advanced cervical cancer; primary distant metastatic disease; cervical cancer in pregnancy; and recurrent disease. Principles of radiotherapy and pathological evaluation are defined.

scholarly journals Exploring the Use of Evidence From the Development and Evaluation of an Electronic Health (eHealth) Trial: Case Study

10.2196/17718 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e17718
Author(s):  
Monika Jurkeviciute ◽  
Henrik Eriksson
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Patient Preferences ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Professional Experience ◽  
Evidence Based ◽  
Policy Decisions ◽  
Professional Experiences

Background Evidence-based practice refers to building clinical decisions on credible research evidence, professional experience, and patient preferences. However, there is a growing concern that evidence in the context of electronic health (eHealth) is not sufficiently used when forming policies and practice of health care. In this context, using evaluation and research evidence in clinical or policy decisions dominates the discourse. However, the use of additional types of evidence, such as professional experience, is underexplored. Moreover, there might be other ways of using evidence than in clinical or policy decisions. Objective This study aimed to analyze how different types of evidence (such as evaluation outcomes [including patient preferences], professional experiences, and existing scientific evidence from other research) obtained within the development and evaluation of an eHealth trial are used by diverse stakeholders. An additional aim was to identify barriers to the use of evidence and ways to support its use. Methods This study was built on a case of an eHealth trial funded by the European Union. The project included 4 care centers, 2 research and development companies that provided the web-based physical exercise program and an activity monitoring device, and 2 science institutions. The qualitative data collection included 9 semistructured interviews conducted 8 months after the evaluation was concluded. The data analysis concerned (1) activities and decisions that were made based on evidence after the project ended, (2) evidence used for those activities and decisions, (3) in what way the evidence was used, and (4) barriers to the use of evidence. Results Evidence generated from eHealth trials can be used by various stakeholders for decisions regarding clinical integration of eHealth solutions, policy making, scientific publishing, research funding applications, eHealth technology, and teaching. Evaluation evidence has less value than professional experiences to local decision making regarding eHealth integration into clinical practice. Professional experiences constitute the evidence that is valuable to the highest variety of activities and decisions in relation to eHealth trials. When using existing scientific evidence related to eHealth trials, it is important to consider contextual relevance, such as location or disease. To support the use of evidence, it is suggested to create possibilities for health care professionals to gain experience, assess a few rather than a large number of variables, and design for shorter iterative cycles of evaluation. Conclusions Initiatives to support and standardize evidence-based practice in the context of eHealth should consider the complexities in how the evidence is used in order to achieve better uptake of evidence in practice. However, one should be aware that the assumption of fact-based decision making in organizations is misleading. In order to create better chances that the evidence produced would be used, this should be addressed through the design of eHealth trials.

scholarly journals Exploring the Use of Evidence From the Development and Evaluation of an Electronic Health (eHealth) Trial: Case Study (Preprint)

2020 ◽  
Author(s):  
Monika Jurkeviciute ◽  
Henrik Eriksson
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Patient Preferences ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Professional Experience ◽  
Evidence Based ◽  
Policy Decisions ◽  
Professional Experiences

BACKGROUND Evidence-based practice refers to building clinical decisions on credible research evidence, professional experience, and patient preferences. However, there is a growing concern that evidence in the context of electronic health (eHealth) is not sufficiently used when forming policies and practice of health care. In this context, using evaluation and research evidence in clinical or policy decisions dominates the discourse. However, the use of additional types of evidence, such as professional experience, is underexplored. Moreover, there might be other ways of using evidence than in clinical or policy decisions. OBJECTIVE This study aimed to analyze how different types of evidence (such as evaluation outcomes [including patient preferences], professional experiences, and existing scientific evidence from other research) obtained within the development and evaluation of an eHealth trial are used by diverse stakeholders. An additional aim was to identify barriers to the use of evidence and ways to support its use. METHODS This study was built on a case of an eHealth trial funded by the European Union. The project included 4 care centers, 2 research and development companies that provided the web-based physical exercise program and an activity monitoring device, and 2 science institutions. The qualitative data collection included 9 semistructured interviews conducted 8 months after the evaluation was concluded. The data analysis concerned (1) activities and decisions that were made based on evidence after the project ended, (2) evidence used for those activities and decisions, (3) in what way the evidence was used, and (4) barriers to the use of evidence. RESULTS Evidence generated from eHealth trials can be used by various stakeholders for decisions regarding clinical integration of eHealth solutions, policy making, scientific publishing, research funding applications, eHealth technology, and teaching. Evaluation evidence has less value than professional experiences to local decision making regarding eHealth integration into clinical practice. Professional experiences constitute the evidence that is valuable to the highest variety of activities and decisions in relation to eHealth trials. When using existing scientific evidence related to eHealth trials, it is important to consider contextual relevance, such as location or disease. To support the use of evidence, it is suggested to create possibilities for health care professionals to gain experience, assess a few rather than a large number of variables, and design for shorter iterative cycles of evaluation. CONCLUSIONS Initiatives to support and standardize evidence-based practice in the context of eHealth should consider the complexities in how the evidence is used in order to achieve better uptake of evidence in practice. However, one should be aware that the assumption of fact-based decision making in organizations is misleading. In order to create better chances that the evidence produced would be used, this should be addressed through the design of eHealth trials.

scholarly journals The PICO strategy for the research question construction and evidence search

2007 ◽  
Vol 15 (3) ◽  
pp. 508-511 ◽  
Author(s):  
Cristina Mamédio da Costa Santos ◽  
Cibele Andrucioli de Mattos Pimenta ◽  
Moacyr Roberto Cuce Nobre
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Research Question ◽  
Clinical Decision ◽  
Evidence Based ◽  
Review Of The Literature

Evidence based practice is the use of the best scientific evidence to support the clinical decision making. The identification of the best evidence requires the construction of an appropriate research question and review of the literature. This article describes the use of the PICO strategy for the construction of the research question and bibliographical search.

scholarly journals Safe and effective praxis without scientific evidence: is it possible?

2020 ◽  
Vol 19 (3) ◽  
pp. 178
Author(s):  
Jefferson Petto ◽  
Igor Macedo De Oliveira ◽  
Alice Miranda De Oliveira ◽  
Marvyn De Santana Do Sacramento
Keyword(s):  
Decision Making ◽  
Health Professionals ◽  
Scientific Literature ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Science And Technology ◽  
Evidence Based ◽  
Scientific Thought ◽  
Daily Lives

The earliest accounts of scientific thought date back to thousands of years BC, where problems in the daily lives of our predecessors led to the search for effective and replicable forms of resolution. Nowadays, in the advent of science and technology, health professionals' decision making has been organized based on the analysis of the diverse evidence available in the scientific literature. This process has been identified Evidence Based Practice (EBP)...

scholarly journals Follow-up of patients who are clinically disease-free after primary treatment for fallopian tube, primary peritoneal, or epithelial ovarian cancer: a Program in Evidence-Based Care guideline adaptation

2016 ◽  
Vol 23 (5) ◽  
pp. 343 ◽  
Author(s):  
T. Le ◽  
E.B. Kennedy ◽  
J. Dodge ◽  
L. Elit
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Epithelial Ovarian Cancer ◽  
Fallopian Tube ◽  
Controlled Trial ◽  
Elevated Serum ◽  
Primary Treatment ◽  
Evidence Based ◽  
Guidance Document

Background A need for follow-up recommendations for survivors of fallopian tube, primary peritoneal, or epithelial ovarian cancer after completion of primary treatment was identified by Cancer Care Ontario’s Program in Evidence-Based Care.Methods We searched for existing guidelines, conducted a systematic review (medline, embase, and cdsr, January 2010 to March 2015), created draft recommendations, and completed a comprehensive review process. Outcomes included overall survival, quality of life, and patient preferences.Results The Cancer Australia guidance document Follow Up of Women with Epithelial Ovarian Cancer was adapted for the Ontario context. A key randomized controlled trial found that the overall survival rate did not differ between asymptomatic women who received early treatment based on elevated serum cancer antigen 125 (ca125) alone and women who waited for the appearance of clinical symptoms before initiating treatment (hazard ratio: 0.98; 95% confidence interval: 0.80 to 1.20; p = 0.85); in addition, patients in the delayed treatment group reported good global health scores for longer. No randomized studies were found for other types of follow-up. We recommend that survivors be made aware of the potential harms and benefits of surveillance, including a discussion of the limitations of ca125 testing. Women could be offered the option of no formal follow-up or a follow-up schedule that is agreed upon by the woman and her health care provider. Education about the most common symptoms of recurrence should be provided. Alternative models of care such as nurse-led or telephone-based follow-up (or both) could be emerging options.Conclusions The recommendations provided in this guidance document have a limited evidence base. Recommendations should be updated as further information becomes available.

Training trainers in risk assessment

1997 ◽  
Vol 170 (S32) ◽  
pp. 35-36 ◽  
Author(s):  
Michael Harris
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Scientific Evidence ◽  
Rapid Assessment ◽  
The Other ◽  
Decision Making Process ◽  
Evidence Based ◽  
Apprenticeship Model ◽  
Based Medicine ◽  
Early Training

Risk assessment has always been an essential part of all medical practice, and doctors have always been trained to make rapid assessment of risk. Much of the early training of doctors in both medicine and surgery centres on risk assessment. However, the method of acquiring that knowledge is predominantly through the apprenticeship model with observation by the trainee of the trainer's decision-making process. Those decisions, however, are often skewed and biased by a whole variety of influences, rather than always being based on scientific evidence. Clearly the increasing influence of evidence-based medicine will help this. At one extreme, however, there are heroic surgeons taking unnecessary risk or taking on cases which might more appropriately have been left without treatment, and at the other extreme, consultants who may feel demoralised or depressed might well become nihilistic about medicine and therefore might not attempt to treat cases that are treatable.

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