Patient Care and Research

Guideline Development Process

In accordance with established ASTRO policy, the guidelines subcommittee, of ASTRO’s Clinical Affairs and Quality Council, recruits a guideline panel of recognized topic experts, patients and caregiver representatives. The guideline panel members are drawn from academic settings, private practice and residency. The ASTRO Board of Directors approves the topic proposal and panel membership. The guideline panel, with ASTRO staff support, completes a systematic review, creates literature tables and formulates the recommendation statements and narratives for the guideline. A draft is placed on the ASTRO website for public comment. Following integration of the feedback, the document is submitted for approval to the ASTRO Board of Directors.

Clinician practice statements are prepared based on information available at the time the panel was conducting its research and discussions on the guideline topic. There may be new developments that are not reflected in the guidelines and that may, over time, be revisited and updated. 

Completed ASTRO guidelines are published in one of ASTRO's journals:

Status terminology:

  • Reaffirmed - confirmation of the validity and correctness based on current evidence
  • Replacement - a complete replacement of a prior statement
  • Update - a revised version based on new evidence and/or clinical studies
  • Withdrawn - a previous statement no longer supported by current evidence

ASTRO’s Guideline Development Process is very involved and includes five main phases.



The initial phase of the guideline development process is preparation. Guideline topic selection, Conflict of Interests assessments, appointments and approval by ASTRO leadership entities are all completed during this phase. Click on the image to the right to view in full size.


The research phase of the guideline development process involves the major literature review as well as the development of the Key Questions that will be addressed in the guideline. Click on the image to the right to view in full size.


The review phase of the development process is an integral part of the process as it is the first time the drafted document is reviewed outside of the development panel. Click on the image to the right to view in full size.


This phase of the development process includes the final draft and publication in one of ASTRO's journals. Click on the image to the right to view in full size.


This important phase occurs regularly to confirm validity of the statement based on new evidence. Click on the image to the right to view in full size.

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