Guidelines

Published guidelines

Other guidelines in preparation

UKMF Guidelines Group Annual Report 2008

Jenny Bird
Consultant Haematologist, Bristol
Chair, Guidelines Committee, UK Myeloma Forum
Member BCSH haematology-oncology task force

Introduction

What is a clinical guideline?

Clinical guidelines are documents with the broad aim of guiding decision-making in
diagnosis, management, and treatment in specific areas of healthcare. They are based on an examination of current evidence within the paradigm of evidence-based medicine. The use of guidelines by healthcare providers can be an effective way of achieving several objectives such as reducing variation in practice and improving the overall quality of care. They usually contain a summary and evaluation of the best evidence and most current data on prevention, diagnosis, prognosis, therapy and in some cases cost-effectiveness. They aim to define the most important questions related to clinical practice and to identify key decision points. This may result in either summarised consensus statements or recommendations and/or development of treatment algorithms.

The guideline-based approach originated in the United States in the 1990s. They are usually produced at national/international levels by medical associations or government bodies and are frequently adapted for local use by local healthcare providers.

What are they for and who uses them?

They are mainly written to aid health care professionals in caring for patients with myeloma and fulfil a number of roles

Guidelines can also be directly and indirectly informative to patients, particularly in the areas of what is the role of guidelines for patients?

What are the difficulties associated with guideline writing?

Why are our guidelines unique?

We believe that the UKMF/BCSH myeloma and related guidelines are unique because of the close collaboration of the group with Myeloma UK who provide financial support for their development and practical input to guideline development Ð keeping them Ôpatient-focussedÕ

Are they useful?

We hope that they are and believe them to be so but would welcome views from any individuals about how they could be further improved. We know that they are regularly used by Myeloma UK for education/ lobbying purposes but also have some more objective evidence that they are being ÔusedÕ. In 2006 the UK-Nordic myeloma guidelines topped the chart of most downloaded guideline from the BCSH website. In addition the hit rate to the BCSH website has increased from an average of 6,500 visits/month in 2003 to ~17,500 visits/ month in 2007 and continues to increase. Increasingly acknowledged and used by commissioners/NICE and other organisations involved in allocation of health care resources.

UKMF guidelines group 2000 to present Ð what have we done?

Guidelines published to date

Published updated recommendations/ guideline revisions

Other publications

 

Guidelines group progress 2008-09

The joint project with the Nordic myeloma study group (NMSG) on the production of the MGUS guideline has been completed and the guideline loaded onto the BCSH website. This has now been accepted for publication in the British Journal of Haematology and is in press. Similarly, the update to the plasmacytoma guideline has now been completed and submitted for publication. It is also available on the BCSH website.

Work on the new ‘Guidelines on diagnosis and management of multiple myeloma’ is making good progress and a final draft is close to completion. Importantly, a decision has been made to split future guidelines regarding investigation and treatment of myeloma into 2 independent documents. The second of these is entitled ‘Guidelines for the symptomatic and supportive care of patients with myeloma.’ and will be an important advance. The main reason for this change is the rather unwieldy nature and length of the combined document and also recognition that, in light of the many advances there have been in the area of therapy, the treatment section may need more frequent updating than the supportive care document. An ambitious target of publication of both documents by Autumn 2009 has been set.

A revision of the ‘Guidelines on the diagnosis and management of AL amyloidosis’ is also underway with the aim of publication in 2009. A final draft is expected from Julian Gillmore by the end of this week.

The future

Plans for future work of the Guidelines group include:


Jenny Bird
24th June 2009
UKMF guidelines group/Terms of reference

 

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