Clinical Practice Guideline  Development Process

The Guidelines Subcommittee, of ASTRO’s Clinical Affairs and Quality Council, oversees the development of clinical practice guidelines based on systematic methods to evaluate and classify evidence. Task force members translate the best available scientific evidence into recommendations that serve as the foundation of quality care in radiation oncology. They guide physicians and the patients they serve, improve patient care, reduce practice variation and resource utilization, identify gaps in the evidence base, and support measure development and national quality reporting requirements.

ASTRO has a rigorous development process that aligns with the National Academy of Medicine and Council of Medical Specialty Societies standards for developing trustworthy guidelines and systematic reviews. See ASTRO's methodology guide and guideline development process overview for details, which include these main steps:

• Guideline initiation
• Evidence review
• Draft development
• Peer review
• Approval
• Publication and Implementation

During panel selection, the Guideline Subcommittee strives to avoid bias by selecting a multidisciplinary group of experts from academic settings, private practice and residency, with variation in geographic region, gender, ethnicity, race, and areas of expertise. Additional organizations and professional societies with related interests and expertise may also be invited to participate as partners, collaborators, or endorsers.

Guidelines are evaluated annually for publication of potentially practice-changing studies that could result in a guideline update. In addition, the Guideline Subcommittee will commission a replacement or reaffirmation within 5 years of publication.

Guideline Status terminology:

• Reaffirmed - confirmation of the validity and accuracy based on an updated analysis of current evidence
• Replacement - a complete replacement of a prior guideline or statement
• Update - a revision to specific key questions based on new evidence and/or clinical studies
• Withdrawn - a previous guideline no longer reflecting current evidence or technology

ASTRO guidelines are currently submitted to Practical Radiation Oncology for publishing.