What is included in the Cancer Guidelines Database?
Guidelines are defined as documents that provide explicit recommendations, include a search of the relevant literature and are developed by a medical/health organization, professional society, government agency or expert panel at the international, national, provincial/territorial, regional or organizational level.
To identify guidelines for inclusion in the Cancer Guidelines Database, the Partnership searches biomedical databases such as MEDLINE, as well as specialized database repositories such as CPG Infobase, National Guidelines Clearing House and G-I-N databases. We examine websites of Canadian territorial and provincial cancer agencies or networks to identify cancer guidelines. We also encourage guideline developers to submit, revise and update their guidelines.
We update the database twice a year to retrieve and include the most current guidelines.
What does each record in the database include?
Each entry in the Cancer Guidelines Database includes:
- details about the guideline and the developer
- a short description of the guideline’s contents
- AGREE II quality appraisal scores, if available
- Each guideline is tagged with characteristics of the guideline to enable search function
- links to the full-text version of the guideline, the National Guideline Clearinghouse quality assessment and/or MEDLINE abstract, if available
How are guidelines in the database selected and appraised?
Quality appraisal thresholds
To facilitate the goals of the Cancer Guidelines Database and advance the quality of guidelines, the Partnership uses quality appraisal filters.
We have appraised all guidelines that meet the full inclusion criteria using the items in the domain of Rigour of Development of the AGREE II. Guidelines scoring 60% or higher in this domain are appraised using the full AGREE II Instrument. Learn more about how we use the AGREE II.
Guidelines from key Canadian and provincial cancer-focused organizations
Through consultations with stakeholders, the Partnership has identified key Canadian and provincial cancer-focused organizations that produce guidelines. These organizations are uniquely suited to provide guidance that is relevant to the Canadian setting, and recommendations that are appropriate to the local context. For this reason, guidelines and guidance documents developed by these organizations are given special considerations and are included in the Cancer Guidelines Database, even if they do not meet the formal inclusion criteria (such guidelines and guidance documents have a note indicating why they are included but without AGREE II scores).
Key Canadian and provincial cancer-focused organizations included in the Cancer Guidelines Database:
- Alberta Health Services – Provincial Tumour Teams
- Atlantic Provinces Pediatric Hematology Oncology Network
- BC Cancer Agency
- C17 Council
- Canadian Partnership Against Cancer
- CancerCare Manitoba
- Cancer Care Nova Scotia
- Cancer Care Ontario
- Eastern Health Cancer Care Program
- New Brunswick Cancer Network
- Pediatric Oncology Group of Ontario
- Saskatchewan Cancer Agency
Full Inclusion and Evaluation Criteria
A guideline must meet criteria in section A or B to be included in the Cancer Guidelines Database.
A) Canadian and international guidelines published in English that:
- Address a topic within the cancer care continuum
- Are developed by a medical/health organization, professional society, government agency or expert panel at the international, national, provincial, territorial, regional or organizational level
- Refer to a literature search supporting the guideline
- Note: The search does not need to have been a systematic review, and the search strategy does not need to have been described in detail to satisfy the criteria (although both of these would satisfy the inclusion criteria).
- Provide explicit recommendations based on evidence
- Recommendations are statements that describe when an action or intervention should or should not be performed.
- Recommendations should be clear and unambiguous and must be identifiable within the guideline (i.e., separate statements, differently formatted or highlighted, not embedded within long paragraphs of text without any indication that they are recommendations).
- Often recommendations are indicated by phrasing such as “we recommend that…,” “it is not recommended…,” “clinicians should…,” “consider including…,” etc.
- Content that would satisfy the “based on evidence” component of these criteria include:
- Eplicitly defined levels of evidence or strength of recommendation such as GRADE.
- Recommendations that are followed by a summary statement describing the evidence that specifically supports them. The statement could include some information about the quality, quantity or consistency of the body of evidence (e.g., “The level of certainty of the evidence was deemed high, and the magnitude of net health benefit from avoiding potentially ineffective and harmful treatment, along with promoting more immediate access to what could be the next most effective treatment, is at least moderate…”).
- Recommendations that are linked to evidence tables.
- A description clearly summarizing the published literature supporting the recommendation (e.g., “Two high-quality RCTs were identified that support this intervention…”).
Note: Consensus recommendations can satisfy these criteria if rationale is provided for why they are based on consensus, such as a statement describing the lack of published or good-quality evidence in the area. Most grading systems include specific levels of evidence for consensus recommendations
B) Guidelines and guidance documents from a specified list of prominent Canadian cancer organizations
- Resources (e.g. guidance documents, guidelines, organization standards) included from this list of organizations are not required to meet the more rigorous inclusion criteria listed above, but still must provide guidance or recommendations (other publication types such as systematic reviews or implementation literature will not be included at this time).