Systematic evidence-based clinical practice guidelines are ushering in a new stage of standardized management of hepatocellular carcinoma in Japan

Abstract

Since the European Association for the Study of the Liver published their guidelines for hepatocellular carcinoma HCC (EASL Guideline) in 2001, there have been many explorations of "transferring best current evidence into clinical decision-making" around the worldwide. Comparative analysis on current 17 characteristic guidelines for HCC indicated that evidence-based clinical practice guidelines for HCC are urgently needed and appropriate constructing approach is the factor most significantly influencing their implementation. The construction of evidence-based clinical practice guidelines for HCC in Japan made a good example of this practice. In accordance with evidence-based medicine (EBM), the first version of the J-HCC Guidelines was published in 2005, then revised in 2009, and the third version has just been published on October 15, 2013 with the incorporation of new evidence, which marks the construction of evidence-based clinical practice guidelines for HCC step into a systematic process in Japan. In order to make a more clear description on how to construct evidence-based clinical practice guidelines for HCC in Japan, the three versions of the J-HCC Guidelines were comparatively analyzed in this paper. Focus on methodology used to develop the updated version, the decision tree of 2013 J-HCC Guideline and its features were also revealed. It is expected that J-HCC Guidelines could be useful not only for Japanese physicians and patients in decision making at every clinical step, but also to benefit users internationally with the accumulated evidence and its interpretation in the guidelines.