Author of

• 11398

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  O11 - Symptom Management (ID 137)

  • Event: WCLC 2013
  • Type: Oral Abstract Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:B. Ivimey, I.N. Olver
  • Coordinates: 10/28/2013, 16:15 - 17:45, Bayside Gallery A, Level 1

  • 11399

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    O11.01 - Wiki-based treatment guidelines for lung cancer (ID 1274)

    16:15 - 17:45  |  Author(s): J. Von Dincklage
    • Abstract
    • Presentation
    • Slides

    Background
    The updating of written clincial practice guidelines regularly is difficult and expensive. New evidence in cancer treatment is published frequently. Guideline booklets are difficult to disseminate widely and stakeholder feedback is mainly pre-publication. To enable lung cancer guidelines to be rapidly updated and widely disseminated and therefore more likely to be utilised, Cancer Council Australia developed a web-based wiki platform for guidelines and is evaluating its impact.

    Methods
    The initial methodology paralled the steps in published written guideline development but these were integrated with the wiki capability. An expert group, whose competing interests were documented, were identified, the key clinical questions and search strategies were developed for each question and literature searches recorded on the wiki. An online literature screening and critical appraisal process was developed. This provides data on which papers were used to form the guidelines and why papers were either selected or rejected depending on their quality. Evidence-based recommendations were formulated and evidence tables automatically generated. The wiki was closed in that only the invited experts could write or change a guideline but any stakeholder could comment on the guidelines at any time and the writing group would review and respond to comments. The initial vesion of the guidelines were distributed for targetted review by expert groups. We used web analytics to monitor usage. The writers remain engaged to appraise new papers and update the guideline rapidly as necessary. All previous versions could be accessed.

    Results
    Evaluation of the lung caner treatment guidelines developed on the wiki, showed that 22 authors had identified 67 clinical questions covering treatment of all stages of lung cancer. The literature search and screening process resulted in 2035 potentially relevant articles being forwarded for detailed methodological evaluation with another 571 added through snowballing and other methods. To fine-tune the initial draft content, the working party used the wiki to exchange 156 internal comments in 9 weeks. When the guidelines were released for the initial 30-day public consultation period, 1055 users visited lung cancer content pages. The majority of users (487) accessed the guidelines directly as a result of targeted emails, while 387 found the site by Google searches. Most respondents were from Australia (799) and New Zealand (60) with the United States (47) having the largest user group of respondents from the other countries who visited the site. A survey of the usability of the site indicated widespread acceptance. The average time on a content page was 1:27minutes. The landing page was the most popular content page with 3426 page views and an exit rate of 18.85%, which indicates that the landing page served as an important tool for visitors to navigate the guidelines. To date there were 38 external comments which occasioned 31 edits by the working party.

    Conclusion
    Adopting a platform built on MediaWiki, and moving to electronic guidelines has allowed rapid updates as new evidence becomes available and wider dissemination than print formats. The next strategy to boost uptake is to write Qstream education modules to accompany the guidelines.

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