Bridging the divide: addressing discrepancies between clinical guidelines, policy guidelines, and biomarker utilization
-
Denis Horgan
,
Paul Hofman
Abstract
Objectives
This paper aims to identify and address gaps in cancer treatment and diagnosis within European health services, focusing specifically on discrepancies between clinical guidelines and policy guidelines. It seeks to highlight how the underutilization of advanced diagnostic techniques recommended by medical societies contributes to missed opportunities for improving patient outcomes.
Methods
A comprehensive analysis was conducted across multiple European countries to assess the compliance and integration of clinical guidelines with the availability of advanced diagnostic technologies. Secondary data related to clinical and policy guidelines in cancer care were collected and analyzed. Key indicators of adoption and utilization of next-generation sequencing and liquid biopsy were examined to evaluate their impact on health service efficiency and patient care.
Results
The analysis revealed significant discrepancies between the recommendations of medical societies regarding advanced diagnostic techniques and their adoption in health policy decisions across Europe. Country-specific assessments indicated varying levels of alignment between clinical guidelines and the availability of advanced diagnostics. These findings underscored missed opportunities for optimizing patient care and health service efficiency through better alignment and integration of clinical guidelines with policy decisions.
Conclusions
This study concludes that there is a critical need for health policy decision-makers to prioritize the adoption of clinical guidelines in resource allocation and health service organization. Greater attention to the recommendations of medical societies regarding advanced diagnostic techniques could significantly enhance diagnostic accuracy, treatment efficacy, and overall patient outcomes in cancer care. The paper advocates for policy reforms that acknowledge and leverage the potential benefits of advanced diagnostics in improving health service performance and patient-centered care across Europe.
Funding source: European Commission EU4Health Program 2021–2027
Award Identifier / Grant number: 101080009
Funding source: Reducing Disparities Across the European Union (BEACON)
Award Identifier / Grant number: 101080005
-
Research ethics: Not applicable.
-
Informed consent: Not applicable.
-
Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: The authors state no conflict of interest.
-
Research funding: This research was funded by Reducing Disparities Across the European Union (BEACON) Project Number: 101080005, and by the CAN.HEAL project through the European Commission EU4Health Program 2021–2027 under Grant No. 101080009.
-
Data availability: Not applicable.
References
1. Espina, C, Soerjomataram, I, Forman, D, Martin-Moreno, JM. Cancer prevention policy in the EU: best practices are now well recognised; no reason for countries to lag behind. J Cancer Policy 2018;18:40–51. https://doi.org/10.1016/j.jcpo.2018.09.001.Search in Google Scholar PubMed PubMed Central
2. Mosele, F, Remon, J, Mateo, J, Westphalen, CB, Barlesi, F, Lolkema, MP, et al.. Recommendations for the use of next-generation sequencing (NGS) for patients with metastatic cancers: a report from the ESMO precision medicine working group. Ann Oncol 2020;31:1491–505. https://doi.org/10.1016/j.annonc.2020.07.014.Search in Google Scholar PubMed
3. ESMO. New ESMO recommendations on the use of ctDNA 2022. https://www.esmo.org/newsroom/esmo-society-updates/new-esmo-recommendations-on-the-use-of-ctdna [Accessed 19 Apr 2024].Search in Google Scholar
4. Guerra-Farfan, E, Garcia-Sanchez, Y, Jornet-Gibert, M, Nunez, JH, Balaguer-Castro, M, Madden, K. Clinical practice guidelines: the good, the bad, and the ugly. Injury 2023;54:S26–9. https://doi.org/10.1016/j.injury.2022.01.047.Search in Google Scholar PubMed
5. ESC Guidelines on Diabetes. Pre-diabetes and cardiovascular diseases – executive summary 2007. https://www.escardio.org/static-file/Escardio/Guidelines/publications/DIABETguidelines-diabetes-ES.pdf [Accessed 08 Jul 2024].Search in Google Scholar
6. Cosentino, F, Grant, PJ, Aboyans, V, Bailey, CJ, Ceriello, A, Delgado, V, et al.. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41:255–323. https://doi.org/10.1093/eurheartj/ehz486.Search in Google Scholar PubMed
7. Mukaka, MM. Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J 2012;24:69–71.Search in Google Scholar
8. Chatzi, A, Doody, O. The one-way ANOVA test explained. Nurse Res 2023;31:8–14. https://doi.org/10.7748/nr.2023.e1885.Search in Google Scholar PubMed
9. Ringborg, U, von Braun, J, Celis, J, Baumann, M, Berns, A, Eggermont, A, et al.. Strategies to decrease inequalities in cancer therapeutics, care and prevention: proceedings on a conference organized by the Pontifical Academy of Sciences and the European Academy of Cancer Sciences, Vatican city, February 23–24, 2023. Mol Oncol 2024;18:245–79. https://doi.org/10.1002/1878-0261.13575.Search in Google Scholar PubMed PubMed Central
10. Bosserman, LD, Cianfrocca, M, Yuh, B, Yeon, C, Chen, H, Sentovich, S, et al.. Integrating academic and community cancer care and research through multidisciplinary oncology pathways for value-based care: a review and the city of hope experience. J Clin Med 2021;10. https://doi.org/10.3390/jcm10020188.Search in Google Scholar PubMed PubMed Central
11. Prager, GW, Braga, S, Bystricky, B, Qvortrup, C, Criscitiello, C, Esin, E, et al.. Global cancer control: responding to the growing burden, rising costs and inequalities in access. ESMO Open 2018;3:e000285. https://doi.org/10.1136/esmoopen-2017-000285.Search in Google Scholar PubMed PubMed Central
12. Qiu, T, Liang, S, Wang, Y, Dussart, C, Borissov, B, Toumi, M. Reinforcing collaboration and harmonization to unlock the potentials of advanced therapy medical products: future efforts are awaited from manufacturers and decision-makers. Front Public Health 2021;9. https://doi.org/10.3389/fpubh.2021.754482.Search in Google Scholar PubMed PubMed Central
13. American Cancer Society Cancer Action Network. Improving access to biomarker testing 2020. https://www.fightcancer.org/sites/default/files/Improving%20Access%20to%20Biomarker%20Testing_FINAL.pdf [Accessed 19 Apr 2024].Search in Google Scholar
14. Dias-Santagata, D, Heist, RS, Bard, AZ, da Silva, AFL, Dagogo-Jack, I, Nardi, V, et al.. Implementation and clinical adoption of precision oncology workflows across a healthcare network. Oncol 2022;27:930–9. https://doi.org/10.1093/oncolo/oyac134.Search in Google Scholar PubMed PubMed Central
15. European Commission. Europe’s beating cancer plan: a new EU approach to prevention, treatment and care 2021. https://health.ec.europa.eu/system/files/2022-02/eu_cancer-plan_en_0.pdf [Accessed 19 Apr 2024].Search in Google Scholar
© 2024 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- Systematic review and meta-analysis of observational studies evaluating glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCHL1) as blood biomarkers of mild acute traumatic brain injury (mTBI) or sport-related concussion (SRC) in adult subjects
- Opinion Papers
- From stable teamwork to dynamic teaming in the ambulatory care diagnostic process
- Bringing team science to the ambulatory diagnostic process: how do patients and clinicians develop shared mental models?
- Vitamin D assay and supplementation: still debatable issues
- Original Articles
- Developing a framework for understanding diagnostic reconciliation based on evidence review, stakeholder engagement, and practice evaluation
- Validity and reliability of Brier scoring for assessment of probabilistic diagnostic reasoning
- Impact of disclosing a working diagnosis during simulated patient handoff presentation in the emergency department: correctness matters
- Implementation of a bundle to improve diagnosis in hospitalized patients: lessons learned
- Time pressure in diagnosing written clinical cases: an experimental study on time constraints and perceived time pressure
- A decision support system to increase the compliance of diagnostic imaging examinations with imaging guidelines: focused on cerebrovascular diseases
- Bridging the divide: addressing discrepancies between clinical guidelines, policy guidelines, and biomarker utilization
- Unnecessary repetitions of C-reactive protein and leukocyte count at the emergency department observation unit contribute to higher hospital admission rates
- Quality control of ultrasonography markers for Down’s syndrome screening: a retrospective study by the laboratory
- Short Communications
- Unclassified green dots on nucleated red blood cells (nRBC) plot in DxH900 from a patient with hyperviscosity syndrome
- Bayesian intelligence for medical diagnosis: a pilot study on patient disposition for emergency medicine chest pain
- Case Report – Lessons in Clinical Reasoning
- A delayed diagnosis of hyperthyroidism in a patient with persistent vomiting in the presence of Chiari type 1 malformation
- Letters to the Editor
- Mpox (monkeypox) diagnostic kits – September 2024
- Barriers to diagnostic error reduction in Japan
- Superwarfarin poisoning: a challenging diagnosis
- Reviewer Acknowledgment
- Reviewer Acknowledgment
Articles in the same Issue
- Frontmatter
- Review
- Systematic review and meta-analysis of observational studies evaluating glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCHL1) as blood biomarkers of mild acute traumatic brain injury (mTBI) or sport-related concussion (SRC) in adult subjects
- Opinion Papers
- From stable teamwork to dynamic teaming in the ambulatory care diagnostic process
- Bringing team science to the ambulatory diagnostic process: how do patients and clinicians develop shared mental models?
- Vitamin D assay and supplementation: still debatable issues
- Original Articles
- Developing a framework for understanding diagnostic reconciliation based on evidence review, stakeholder engagement, and practice evaluation
- Validity and reliability of Brier scoring for assessment of probabilistic diagnostic reasoning
- Impact of disclosing a working diagnosis during simulated patient handoff presentation in the emergency department: correctness matters
- Implementation of a bundle to improve diagnosis in hospitalized patients: lessons learned
- Time pressure in diagnosing written clinical cases: an experimental study on time constraints and perceived time pressure
- A decision support system to increase the compliance of diagnostic imaging examinations with imaging guidelines: focused on cerebrovascular diseases
- Bridging the divide: addressing discrepancies between clinical guidelines, policy guidelines, and biomarker utilization
- Unnecessary repetitions of C-reactive protein and leukocyte count at the emergency department observation unit contribute to higher hospital admission rates
- Quality control of ultrasonography markers for Down’s syndrome screening: a retrospective study by the laboratory
- Short Communications
- Unclassified green dots on nucleated red blood cells (nRBC) plot in DxH900 from a patient with hyperviscosity syndrome
- Bayesian intelligence for medical diagnosis: a pilot study on patient disposition for emergency medicine chest pain
- Case Report – Lessons in Clinical Reasoning
- A delayed diagnosis of hyperthyroidism in a patient with persistent vomiting in the presence of Chiari type 1 malformation
- Letters to the Editor
- Mpox (monkeypox) diagnostic kits – September 2024
- Barriers to diagnostic error reduction in Japan
- Superwarfarin poisoning: a challenging diagnosis
- Reviewer Acknowledgment
- Reviewer Acknowledgment
