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Differential research impact in cancer practice guidelines’ evidence base: lessons from ESMO, NICE and SIGN
  1. Elena Pallari1,2,3,
  2. Anthony W Fox2,
  3. Grant Lewison3
  1. 1Health Service and Population Research Department, Centre for Implementation Science, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
  2. 2Institute of Pharmaceutical Sciences, Academic Centre, King’s College London, London, UK
  3. 3Division of Cancer Studies, Research Oncology, Institute of Cancer Policy, Guy’s Hospital, King’s College London, London, UK
  1. Correspondence to Ms. Elena Pallari; elena.pallari{at}


Background This is an appraisal of the impact of cited research evidence underpinning the development of cancer clinical practice guidelines (CPGs) by the professional bodies of the European Society for Medical Oncology (ESMO), the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN).

Methods A total of 101 CPGs were identified from ESMO, NICE and SIGN websites across 13 cancer sites. Their 9486 cited references were downloaded from the Web of Science Clarivate Group database, analysed on Excel (2016) using Visual Basic Application macros and imported onto SPSS (V.24.0) for statistical tests.

Results ESMO CPGs mostly cited research from Western Europe, while the NICE and SIGN ones from the UK, Canada, Australia and Scandinavian countries. The ESMO CPGs cited more recent and basic research (eg, drugs treatment), in comparison with NICE and SIGN CPGs where older and more clinical research (eg, surgery) papers were referenced. This chronological difference in the evidence base is also in line with that ESMO has a shorter gap between the publication of the research and its citation on the CPGs. It was demonstrated that ESMO CPGs report more chemotherapy research, while the NICE and SIGN CPGs report more surgery, with the results being statistically significant.

Conclusions We showed that ESMO, NICE and SIGN differ in their evidence base of CPGs. Healthcare professionals should be aware of this heterogeneity in effective decision-making of tailored treatments to patients, irrespective of geographic location across Europe.

  • cancer
  • clinical practice guidelines
  • research impact
  • evidence-base
  • Esmo, Nice, Sign

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  • Contributors Designed the study: EP. Carried out the literature review and developed the first draft: EP. Performed data quality check: all authors. All three coauthors had full access to all the data in the study and in the final responsibility for the decision to submit to publication.

  • Funding This project was supported by funding from the European Community’s Seventh Framework Programme [under grant agreement EC/FP7/602536] and the Economic and Social Research Council [grant number ES/P010962/1]. Open Access was provided by King’s College London UK’s Research Councils (RCUK) institutional block grant. EP is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King’s College Hospital NHS Foundation Trust. The views expressed are those of the author[s] and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Correction notice This article has been corrected since it first published. The Open access licence has been changed from CC BY-NC to CC BY.

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