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Evidence-Based Dermatology: Review
April 2013

Critical Appraisal of Clinical Practice Guidelines for Adaptation in the Evidence-Based Guideline “Prevention of Skin Cancer”

Author Affiliations
 

SECTION EDITOR: MICHAEL BIGBY, MD; ASSISTANT SECTION EDITORS: OLIVIER CHOSIDOW, MD, PhD; ROBERT P. DELLAVALLE, MD, PhD, MSPH; DAIHUNG DO, MD; URBÀ GONZÁLEZ, MD, PhD; CATALIN M. POPESCU, MD, PhD; HYWEL WILLIAMS, MSc, PhD, FRCP

Author Affiliations: Association of Dermatological Prevention, Hamburg, Germany (Ms Petrarca and Drs Breitbart and Nolte); German Cancer Society, Berlin, Germany (Dr Follmann); Elbe Klinikum Buxtehude, Center of Dermatology, Buxtehude, Germany (Dr Breitbart); Medical Clinic for Psychosomatics, Charité–University Medicine Berlin, Berlin, Germany (Dr Nolte); and School of Health & Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia.

JAMA Dermatol. 2013;149(4):466-471. doi:10.1001/jamadermatol.2013.3306
Abstract

Importance During guideline development, it is essential to systematically review existing guidelines that may be suitable for adaptation; however, such review is laborious and may not always uncover useful guidelines.

Objective To identify existing clinical practice guidelines and assess their methodologic quality and suitability for adaptation in the German evidence-based guideline “Prevention of Skin Cancer.”

Evidence Acquisition A systematic literature search was performed across a range of databases and homepages of guideline development institutions. The AGREE Instrument (Appraisal of Guidelines Research and Evaluation) was used to assess the methodologic quality of selected guidelines.

Results A total of 480 citations were identified and screened. Of these, 12 guidelines were deemed suitable for potential adaptation. After comprehensive quality assessment, only 2 melanoma guidelines, one from Australia/New Zealand and the other from Scotland, were identified as being of high methodologic quality according to predefined selection criteria. Subsequent synopsis, however, revealed that neither of these guidelines was sufficiently comprehensive for full adaptation.

Conclusions and Relevance It is surprising that most existing skin cancer guidelines that contain aspects on prevention are not appropriate for adaptation, with most lacking methodologic quality, particularly rigor applied during the development process. Of the 2 guidelines that met the predefined quality criteria, only a few aspects—limited to malignant melanoma—were adaptable. We conclude that, despite the labor-intensive search for existing guidelines, a de novo development, including systematic literature review, is indispensible for the development of the German evidence-based guideline Prevention of Skin Cancer.

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