Breast Cancer Guidelines in Canada: A Review of Development and Implementation
Identifieur interne : 004777 ( Pmc/Corpus ); précédent : 004776; suivant : 004778Breast Cancer Guidelines in Canada: A Review of Development and Implementation
Auteurs : Amy Folkes ; Robin Urquhart ; Louise Zitzelsberger ; Eva GrunfeldSource :
- Breast Care [ 1661-3791 ] ; 2008.
Abstract
A series of specific clinical practice guidelines (CPGs) were published in Canada in 1998. A primary objective of these ‘Clinical Practice Guidelines for the Care and Treatment of Breast Cancer’ was to decrease the variation in breast cancer care across the country. Prior to this, researchers found moderate compliance with consensus recommendations for breast cancer therapies in several Canadian provinces. However, a recent study concluded that the publication of the Canadian CPGs did not reduce variations in surgical care for breast cancer. If guidelines are to achieve their intended objectives, they must be implemented in ways that support, encourage, and facilitate their use. Evidence strongly suggests the simple publication and passive dissemination of CPGs are usually ineffective in changing how physicians actually care for patients. CPG implementation, therefore, requires active knowledge translation processes to ensure that the evidence is relevant to all with a stake in bettering breast cancer care. For example, implementation strategies that use computerized CPGs can make evidence-based decision-making routine practice in the clinical setting. The breast cancer community can also work with the newly formed Canadian Partnership Against Cancer to find ways to more successfully support and facilitate guideline use considering the local context.
Url:
DOI: 10.1159/000121732
PubMed: 21373213
PubMed Central: 2931084
Links to Exploration step
PMC:2931084Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Breast Cancer Guidelines in Canada: A Review of Development and Implementation</title>
<author><name sortKey="Folkes, Amy" sort="Folkes, Amy" uniqKey="Folkes A" first="Amy" last="Folkes">Amy Folkes</name>
<affiliation><nlm:aff id="aff1">Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Urquhart, Robin" sort="Urquhart, Robin" uniqKey="Urquhart R" first="Robin" last="Urquhart">Robin Urquhart</name>
<affiliation><nlm:aff id="aff1">Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Zitzelsberger, Louise" sort="Zitzelsberger, Louise" uniqKey="Zitzelsberger L" first="Louise" last="Zitzelsberger">Louise Zitzelsberger</name>
<affiliation><nlm:aff id="aff2">Canadian Partnership Against Cancer, Nova Scotia, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Grunfeld, Eva" sort="Grunfeld, Eva" uniqKey="Grunfeld E" first="Eva" last="Grunfeld">Eva Grunfeld</name>
<affiliation><nlm:aff id="aff1">Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff2">Canadian Partnership Against Cancer, Nova Scotia, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff3">Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">21373213</idno>
<idno type="pmc">2931084</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931084</idno>
<idno type="RBID">PMC:2931084</idno>
<idno type="doi">10.1159/000121732</idno>
<date when="2008">2008</date>
<idno type="wicri:Area/Pmc/Corpus">004777</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004777</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Breast Cancer Guidelines in Canada: A Review of Development and Implementation</title>
<author><name sortKey="Folkes, Amy" sort="Folkes, Amy" uniqKey="Folkes A" first="Amy" last="Folkes">Amy Folkes</name>
<affiliation><nlm:aff id="aff1">Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Urquhart, Robin" sort="Urquhart, Robin" uniqKey="Urquhart R" first="Robin" last="Urquhart">Robin Urquhart</name>
<affiliation><nlm:aff id="aff1">Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Zitzelsberger, Louise" sort="Zitzelsberger, Louise" uniqKey="Zitzelsberger L" first="Louise" last="Zitzelsberger">Louise Zitzelsberger</name>
<affiliation><nlm:aff id="aff2">Canadian Partnership Against Cancer, Nova Scotia, Canada</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Grunfeld, Eva" sort="Grunfeld, Eva" uniqKey="Grunfeld E" first="Eva" last="Grunfeld">Eva Grunfeld</name>
<affiliation><nlm:aff id="aff1">Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff2">Canadian Partnership Against Cancer, Nova Scotia, Canada</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff3">Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Breast Care</title>
<idno type="ISSN">1661-3791</idno>
<idno type="eISSN">1661-3805</idno>
<imprint><date when="2008">2008</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><title>Summary</title>
<p>A series of specific clinical practice guidelines (CPGs) were published in Canada in 1998. A primary objective of these ‘Clinical Practice Guidelines for the Care and Treatment of Breast Cancer’ was to decrease the variation in breast cancer care across the country. Prior to this, researchers found moderate compliance with consensus recommendations for breast cancer therapies in several Canadian provinces. However, a recent study concluded that the publication of the Canadian CPGs did not reduce variations in surgical care for breast cancer. If guidelines are to achieve their intended objectives, they must be implemented in ways that support, encourage, and facilitate their use. Evidence strongly suggests the simple publication and passive dissemination of CPGs are usually ineffective in changing how physicians actually care for patients. CPG implementation, therefore, requires active knowledge translation processes to ensure that the evidence is relevant to all with a stake in bettering breast cancer care. For example, implementation strategies that use computerized CPGs can make evidence-based decision-making routine practice in the clinical setting. The breast cancer community can also work with the newly formed Canadian Partnership Against Cancer to find ways to more successfully support and facilitate guideline use considering the local context.</p>
</div>
</front>
</TEI>
<pmc article-type="review-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Breast Care (Basel)</journal-id>
<journal-id journal-id-type="iso-abbrev">Breast Care (Basel)</journal-id>
<journal-id journal-id-type="publisher-id">BRC</journal-id>
<journal-title-group><journal-title>Breast Care</journal-title>
</journal-title-group>
<issn pub-type="ppub">1661-3791</issn>
<issn pub-type="epub">1661-3805</issn>
<publisher><publisher-name>S. Karger GmbH</publisher-name>
<publisher-loc>Lörracherstrasse 16 a, P.O. Box · Postfach · Case postale, D–79095, Freiburg, Germany · Deutschland · Allemagne, Phone: +49 761 45 20 70, Fax: +49 761 4 52 07 14, information@karger.de</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">21373213</article-id>
<article-id pub-id-type="pmc">2931084</article-id>
<article-id pub-id-type="doi">10.1159/000121732</article-id>
<article-id pub-id-type="publisher-id">brc0003-0108</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review Article · Übersichtsarbeit</subject>
</subj-group>
</article-categories>
<title-group><article-title>Breast Cancer Guidelines in Canada: A Review of Development and Implementation</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Folkes</surname>
<given-names>Amy</given-names>
</name>
<xref ref-type="aff" rid="aff1">a</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Urquhart</surname>
<given-names>Robin</given-names>
</name>
<xref ref-type="aff" rid="aff1">a</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Zitzelsberger</surname>
<given-names>Louise</given-names>
</name>
<xref ref-type="aff" rid="aff2">b</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Grunfeld</surname>
<given-names>Eva</given-names>
</name>
<xref ref-type="aff" rid="aff1">a</xref>
<xref ref-type="aff" rid="aff2">b</xref>
<xref ref-type="aff" rid="aff3">c</xref>
</contrib>
</contrib-group>
<aff id="aff1"><sup>a</sup>
Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada</aff>
<aff id="aff2"><sup>b</sup>
Canadian Partnership Against Cancer, Nova Scotia, Canada</aff>
<aff id="aff3"><sup>c</sup>
Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada</aff>
<author-notes><corresp id="cor1">*Amy Folkes Cancer Outcomes Research Program, Cancer Care Nova Scotia 1278 Tower Road, Room 523, 5th Floor Bethune Building Halifax, Nova Scotia B3H 2Y9, Canada Tel. +1 902 473-7501, Fax −4631 E-mail <email>amy.folkes@ccns.nshealth.ca</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>5</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="epub"><day>22</day>
<month>4</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>22</day>
<month>4</month>
<year>2008</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
. </pmc-comment>
<volume>3</volume>
<issue>2</issue>
<fpage>108</fpage>
<lpage>113</lpage>
<permissions><copyright-statement>Copyright © 2008 by S. Karger GmbH, Freiburg</copyright-statement>
<copyright-year>2008</copyright-year>
</permissions>
<abstract><title>Summary</title>
<p>A series of specific clinical practice guidelines (CPGs) were published in Canada in 1998. A primary objective of these ‘Clinical Practice Guidelines for the Care and Treatment of Breast Cancer’ was to decrease the variation in breast cancer care across the country. Prior to this, researchers found moderate compliance with consensus recommendations for breast cancer therapies in several Canadian provinces. However, a recent study concluded that the publication of the Canadian CPGs did not reduce variations in surgical care for breast cancer. If guidelines are to achieve their intended objectives, they must be implemented in ways that support, encourage, and facilitate their use. Evidence strongly suggests the simple publication and passive dissemination of CPGs are usually ineffective in changing how physicians actually care for patients. CPG implementation, therefore, requires active knowledge translation processes to ensure that the evidence is relevant to all with a stake in bettering breast cancer care. For example, implementation strategies that use computerized CPGs can make evidence-based decision-making routine practice in the clinical setting. The breast cancer community can also work with the newly formed Canadian Partnership Against Cancer to find ways to more successfully support and facilitate guideline use considering the local context.</p>
</abstract>
<trans-abstract xml:lang="de"><title>Zusammenfassung</title>
<p>Eine Reihe spezifischer klinischer Praxisrichtlinien (clinical practice guidelines, CPGs) wurden 1998 in Kanada veröffentlicht. Eines der Hauptziele der ‘Clinical Practice Guidelines for the Care and Treatment of Breast Cancer’ war die Reduzierung von landesweiten Unterschieden in der Betreuung von Brustkrebspatienten. Bis dahin hatten Forscher in mehreren kanadischen Provinzen eine nur mäβige Einhaltung der Konsensus-Empfehlungen für die Behandlung von Brustkrebs festgestellt. Eine neuere Studie kam jedoch zu dem Schluss, dass die Veröffentlichung der kanadischen CPGs die Unterschiede in der chirurgischen Betreuung von Brustkrebspatienten nicht reduziert hat. Damit Richtlinien ihre Ziele erreichen können, müssen sie auf eine Art und Weise implementiert werden, die ihre Nutzung unterstützt, gefördert und erleichtert. Es gibt deutliche Hinweise darauf, dass die einfache Veröffentlichung und passive Verteilung von CPGs zumeist nicht zu Änderungen in der Patientenbetreuung durch die behandelnden Ärzte führen. Die Implementierung von CPGs setzt daher eine aktive Umsetzung von Wissen in Verhalten (knowledge translation) voraus, um sicherzustellen, dass die getroffenen Aussagen für alle an der Verbesserung der Brustkrebsversorgung Beteiligten relevant sind. So können z.B. Implementierungsstrategien, die computerbasierte CPGs verwenden, dazu führen, dass die auf Fakten basierende Entscheidungsfin-dung in der Klinik zur Routine wird. Die Brustkrebs-Gemeinschaft kann des weiteren mit der neu gegründeten ‘Canadian Partnership Against Cancer’ zusammenarbeiten, um Wege zu finden, wie die Anwendung von Richtlinien mit Bezug auf lokale Gegebenheiten unterstützt und erleichtert werden kann.</p>
</trans-abstract>
<kwd-group><title>Key Words</title>
<kwd>Breast cancer</kwd>
<kwd>Clinical practice guidelines</kwd>
<kwd>Knowledge translation</kwd>
</kwd-group>
<counts><table-count count="1"></table-count>
<ref-count count="49"></ref-count>
<page-count count="6"></page-count>
</counts>
</article-meta>
</front>
</pmc>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 004777 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 004777 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Sante |area= LymphedemaV1 |flux= Pmc |étape= Corpus |type= RBID |clé= PMC:2931084 |texte= Breast Cancer Guidelines in Canada: A Review of Development and Implementation }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:21373213" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \ | NlmPubMed2Wicri -a LymphedemaV1
![]() | This area was generated with Dilib version V0.6.31. | ![]() |