The Evidence Base of International Clinical Practice Guidelines on Prostate Cancer: A Global Framework or Clinical Research Evaluation

Abstract

Clinical practice guidelines (CPGs) are being developed to ensure that medical diagnosis and treatment are based on the best available evidence. Their value depends critically on the evidence base that they cite. These references may provide a better indicator of the impact of clinical research than citation counts on papers. We searched for CPGs on prostate cancer, the most common cancer afflicting men, and found 72, from 28 countries, and seven international organisations, and identified 10, 273 cited references in journals processed on the Web of Science. They involved research on the three main means of treatment-chemotherapy, radiotherapy and surgery-but relatively few on genetics and palliative care. Most countries’ CPGs over-cite research from their own country, particularly if their presence in world prostate cancer research is small. Citations on own-country CPGs show their contribution to national healthcare provision, and citations on CPGs from other countries show the esteem in which they are held internationally. There are also differences between countries in how recent are the references that they cite, and some are not basing their recommendations on the latest research or best international evidence. Citations on CPGs provide an alternative source of information for the evaluation of clinical research.