Reply to the Letter to the Editor "Critical appraisal of the Minimal Clinical Recommendations (MCR) of the European Society for Medical Oncology (ESMO): challenges for a European framework for the development of clinical practice guidelines", by B. Fervers, T. Philip and G. P. Browman (Ann Oncol 2002; 13: 1507–1509)

R. Stahel

ESMO Guidelines Task Force, ESMO Head Office, Via La Santa 7, CH-6962 Viganello-Lugano, Switzerland (E-mail: mariacristina@esmo.org)

Both the task and the process of developing clinical practice guidelines in oncology in a European context are certainly challenging. The ESMO Guidelines Task Force undertook this task because the National Representatives felt that there was a need to develop guidelines applicable throughout Europe, both to assist medical oncologists in their daily clinical practice and to support them in negotiations with politicians, administrators or insurance companies.

Europe is characterized by a diversity of regional situations, including cultural aspects, education, health care resources and drug availability. While a few European countries have developed extensive national guidelines, in many countries the process of formulating guidelines is still in its initial stages. The ESMO Guidelines Task Force decided to develop evidence-based Minimum Clinical Recommendations (MCR) to assist medical oncologists by providing a basic set of information important for the quality of care of cancer patients, irrespective of national and local situations. It is the opinion of the ESMO Guidelines Task Force that ESMO MCR could trigger the development and extension of national guidelines throughout Europe.

ESMO MCR undergo a yearly revision, and medical oncologists are welcome to send remarks and suggestions regarding the content to the ESMO Head Office (Education Department). In addition, ESMO members are invited to use and discuss the ESMO MCR at national, regional and local levels, and to send specific comments or suggestions to the ESMO Guidelines Task Force for consideration. Through this procedure ESMO hopes to establish interaction that will benefit the quality of care. Of course, the ESMO Guidelines Task Force is aware that the relevance of ESMO MCR to local practice, should be analyzed through the development of a feedback mechanism, which, in turn, would further improve and broaden the relevance of clinical practice.

The ESMO Guidelines Task Force hopes that the expertise currently developed by ESMO will, in the long-term, promote collaboration with other disciplines and lead to multidisciplinary recommendations. Thereby furthering ESMO’s ultimate goal of high common standards of medical practice throughout Europe for the assistance of cancer patients.

Acknowledgements

The current ESMO Guidelines Task Force consists of: Rolf Stahel (Chair), Gunta Purkalne (Vice chair), Lorenz Jost (Central coordinator), Jorn Herrstedt, Svetislav Jelic, Vesa Kataja, Otto Kloke, Hakan Mellstedt and Nicolas Pavlidis.

R. Stahel

ESMO Guidelines Task Force, ESMO Head Office, Via La Santa 7, CH-6962 Viganello-Lugano, Switzerland (E-mail: mariacristina{at}esmo.org)





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