source: The Cancer Council Australia
SUMMARY OF CLINICAL PRACTICE RECOMMENDATIONS
These guidelines are intended for use by all practitioners and health workers who require information about surveillance colonoscopy – in adenoma follow-up, following curative resection of colorectal cancer, and for cancer surveillance in inflammatory bowel disease. They are specifically revising the colonoscopic surveillance sections of the Clinical Practice Guidelin es for the prevention, early detection and management of colorectal cancer 2005 chapters 8, 9, 17, and introduce a new chapter on cancer surveillance in inflammatory bowel disease. They also cover psychosocial care (chapter 18 in the 2005 Guidelines), socio economic factors and cost effectiveness (chapters 23 and 22 in the 2005 Guidelines). The guidelines have been produced by a process of systematic literature review; critical appraisal and consultation encompassing all interested parties in Australia (see Appendix 1). The following table provides a list of the evidence-based recommendations detailed in the text of each chapter. The table below provides details on the highest level of evidence identified to support each recommendation (I-IV). The Summary of Recommendations table includes the grade for each recommendation (A-D). The key references that underpin the recommendation are provided in the last column. Individual levels of evidence can be found in the Evidence Summaries for each recommendation in each chapter. Each recommendation was assigned a grade by the expert working group taking into account the volume, consistency, generalisability, applicability and clinical impact of the body of evidence supporting each recommendation. When no Level I or II evidence was available and in some areas, in particular where there was insufficient evidence in the literature to make a specific evidence-based recommendation, but also strong and unanimous expert opinion amongst the working group members about both the advisability of making a clinically relevant statement and its content, recommended best practice points were generated. Thus, the practice points relate to the evidence in each chapter, but are more expert opinion-based than evidence-based. These can be identified throughout the guidelines with the following: Practice point (PP).