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. 2014 Jun;68(6):761-70.
doi: 10.1111/ijcp.12393. Epub 2014 Feb 18.

To what extent are current guidelines for cutaneous melanoma follow up based on scientific evidence?

N J Marciano  1 , T L Merlin, T Bessen, J M Street
Affiliations

To what extent are current guidelines for cutaneous melanoma follow up based on scientific evidence?

N J Marciano et al. Int J Clin Pract. 2014 Jun.

Abstract

Background: Clinical practice guidelines should aim to assist clinicians in making evidence-based choices in the care of their patients. This review attempts to determine the extent of evidence-based support for clinical practice guideline recommendations concerning cutaneous melanoma follow up and to evaluate the methodological quality of these guidelines.

Methods: Current guidelines providing graded recommendations regarding patient follow up were identified through a systematic literature review. The authors reviewed the evidence base used to formulate recommendations in each of the guidelines and appraised the quality of the guidelines using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument.

Results: Most guideline recommendations concerning the frequency of routine skin examinations by a clinician and the use of imaging and diagnostic tests in the follow up of melanoma patients were based on low-level evidence or consensus expert opinion. Melanoma follow-up guidelines are of variable methodological quality, with some guidelines not recommended by the appraisers for use in clinical practice.

Conclusion: Clinicians should be aware of how scant the evidence base is for many recommended courses of action. As a consequence of the paucity of evidence in the field of melanoma follow up, there is considerable variability in the guidance provided. The variable methodological quality of guidelines for melanoma follow up could be improved by attention to the criteria described in AGREE II.

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Figures

Figure 1
Figure 1
Diagram of guideline selection
Figure 2
Figure 2
Example calculation of an AGREE II domain score
See this image and copyright information in PMC

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