idx int64 | source string | title string | text string |
|---|---|---|---|
0 | cpg | None | none. # questions diagnosis / staging what benefit to clinical management does positron emission tomography ( pet ) or positron emission tomography / computed tomography ( pet / ct ) contribute to the diagnosis or staging of head and neck cancer? what benefit to clinical management does pet or pet / ct contribute to th... |
1 | cpg | None | different and less optimal results ). pet changed stage and treatment planning. 32 ) and guido et al ( 33 ) indicated that the addition of pet improved primary tumour delineation and nodal staging and subsequently changed the clinical management of several patients in each study. pet is recommended in all patients afte... |
2 | cpg | None | respect to regional nodes ( n ) : in the clinically n - 0 neck, pet does not appear to be better than conventional imaging, because of an unacceptably high false - negative rate. there is little evidence that pet leads to change in patient management ( 2005 - 2008 update : hafidh et al ng et al schoder et al wensing et... |
3 | cpg | None | none. # guideline objectives to update clinical guidance on the use of multigene profiling assays in individuals with earlystage invasive breast cancer. # target population individuals diagnosed with early - stage invasive breast cancer for whom further information is needed for prognosis and treatment decision making.... |
4 | cpg | None | 1 - 3 lymph nodes ) disease who are under consideration for adjuvant chemotherapy if the use is supported by other clinical, pathological, or patient - related factors. clinical and pathological features include patient age, tumour grade, tumour size and nodal status. - one multigene profiling assay should be requested... |
5 | cpg | None | none. # guideline objectives to make recommendations with respect to the use of t2 - weighted magnetic resonance imaging ( mri ) ± functional sequences in the pre - treatment local staging of patients with newly diagnosed prostate cancer. - mri refers to t2 - weighted mri. - functional sequences include dynamic contras... |
6 | cpg | None | none. evidence - based series 4 - 5 is current as of november 2022. in june 2016 a literature search and review determined that the recommendations were still valid and not causing harm but all relevant aspects of the topic were not covered by the original guideline. this document was identified for an update but it is... |
7 | cpg | None | and abstracts published in the proceedings of the annual meetings of the american society of clinical oncology from 1999 to 2004 were systematically searched for evidence relevant to this practice guideline report. evidence was selected and reviewed by members of the practice guidelines initiative's gynecology cancer d... |
8 | cpg | None | none. # guideline objectives to make recommendations with respect to the role of adjuvant systemic chemotherapy in stage ii and iii colon cancer patients who have undergone complete resection with curative intent. # target population the target population consists of adult patients with stage ii and iii colon cancer wh... |
9 | cpg | None | consider folfox for high - risk patients as part of an informed discussion between patients and their medical oncologists regarding treatment options. # added to the 2019 endorsement - additional evidence is expected that will inform decisions on duration of treatment with oxaliplatin - based treatment in patients with... |
10 | cpg | None | a patient does not require adjuvant chemotherapy, msi / dmmr testing is not recommended as it will not influence that decision. # qualifying statements for recommendation 3 - in patients with high - risk stage ii colon cancer ( e. g., t4 ) and high msi / dmmr status ( a low risk factor ), the choice of treatment is bet... |
11 | cpg | None | the 2019 endorsement - the idea collaboration evaluated 3 vs 6 months of therapy in a randomized, pre - planned, pooled analysis of 6 individual trials focusing on stage iii patients. the treatment choice of capox or folfox was left to the treating physician. overall, noninferiority was not met for 3 vs 6 months ( 3 - ... |
12 | cpg | None | none. # section 1 : recommendations section 2 : recommendations and key evidence section 3 : guideline methods overview section 4 : systematic review section 5 : internal and external review for information about this document, please contact alex sun, the lead author, through the pebc via : phone : 905 - 527 - 4322 ex... |
13 | cpg | None | none. these guideline recommendations have been endorsed, which means that the recommendations are still current and relevant for decision making. # guideline objective how should patients presenting to family physicians and other primary care providers ( pcps ) with signs and / or symptoms of prostate cancer, includin... |
14 | cpg | None | point of referral, coordination of care using a clinical navigator, fast tracking of diagnostic tests, and a multidisciplinary team approach. they are an ontario - wide strategic priority designed to improve patient access and outcomes, as outlined in the ontario cancer plan, 2005 - 2011 and 2011 - 2014 ( 1 ). added in... |
15 | cpg | None | cancer was very weak. two studies suggested that dres performed by fps may be useful in identifying patients who should be referred ( 7, 8 ), and four studies suggested that psa values were good predictors of prostate cancer with ppvs ranging from 34. 3 % to 47 % ( 7, ( 9 ) ( 10 ) ( 11 ). the working group chose to end... |
16 | cpg | None | . the working group also excluded unexplained hematuria as a symptom of metastatic prostate cancer because although it can be associated with advanced prostate cancer, the working group believed the vast majority of men with gross hematuria usually have a different underlying cause such as benign prostate hyperplasia, ... |
17 | cpg | None | . f. i. a cut - off risk value of 5 % was chosen because in ontario, canada, the hospital admission rate for urological complications within 30 days of trus - guided biopsy was found to be 4. 1 % in 2005 ( 17 ). the working group decided to use 5 % as a cut - off to separate patients into a higher risk category because... |
18 | cpg | None | that specifically investigate the diagnostic performance of signs, symptoms, or tests for prostate cancer in the primary care setting. # glossary age - based psa age - based psa values ( upper limit of normal ) : 40 - 50 years : 2. 5 ng / ml 50 - 60 years : 3. 5 ng / ml 60 - 70 years : 4. 5 ng / ml 70 years and over : ... |
19 | cpg | None | diagnosis of prostate cancer was likely, the patient refused a biopsy and further diagnostic tests. his pain was quite severe and he was admitted to a palliative care unit for pain control and died within three weeks. a healthy 72 year old man with some symptoms of urinary retention and urgency presented to a fp. his o... |
20 | cpg | None | none. to jointly update the cancer care ontario guideline on brachytherapy for patients with prostate cancer to account for new evidence. an update panel conducted a targeted systematic literature review and identified more recent randomized controlled trials comparing dose - escalated external beam radiation therapy (... |
21 | cpg | None | 26, 120 deaths. 1 for this reason, there is great interest in finding optimum treatment strategies to reduce the burden of disease in this patient population. the cancer care ontario systematic review 2 and clinical practice guideline 3 on low - dose rate ( ldr ) brachytherapy for patients with low - or intermediate - ... |
22 | cpg | None | ldr alone, ebrt alone, or rp should be offered to eligible patients - for patients with intermediate - risk prostate cancer choosing ebrt with or without androgen - deprivation therapy ( adt ), brachytherapy boost ( ldr or high - dose rate should be offered to eligible patients. for low - intermediate risk prostate can... |
23 | cpg | None | trials were designed or powered to detect a meaningful difference in survival outcomes. ( continued on following page ) are performing a joint review of hypofractionated radiotherapy ( including stereotactic ablative body radiotherapy. 10 where reported, these classifications are summarized. androgen - deprivation ther... |
24 | cpg | None | not applicable to other interventions, diseases, or stages of diseases. this information does not mandate any particular course of medical care. further, the information is not intended to substitute for the independent professional judgment of the treating provider, as the information does not account for individual v... |
25 | cpg | None | participate jco. org of a qualified clinician. cco makes no representations or guarantees of any kind whatsoever regarding the report content or its use or application and disclaims any responsibility for its use or application in any way. # guideline and conflicts of interest the update panel ( appendix table a1, onli... |
26 | cpg | None | ##a et al 13 in 2005, randomly assigned 104 patients with t2 to 3 nonmetastatic prostate cancer to either ebrt ( four - field box radiation to the prostate and seminal vesicles with a 2 - cm margin at 66 gy total dose given in 33 fractions over 6. 5 weeks ; n 5 53 ) or brachytherapy boost ( iridium implant, 35 gy over ... |
27 | cpg | None | shaped blocks or threedimensional volumetric planning and conformal three - field plans at 55 gy given in 20 fractions ; n 5 111 ) or ebrt ( 35. 75 gy, 13 fractions ) with high - dose rate brachytherapy boost ( hdr - b ; iridium implant delivering a total of 17 gy in two fractions over 24 hours ; n 5 109 ). patients we... |
28 | cpg | None | ebrt : 46 gy, 23 fractions followed by an 125 i boost to a minimum dose of 115 gy to prostate ; n 5 198 ). patients were stratified by risk category ( intermediate v high risk ). twelve months ( 8 months neoadjuvant, 2 months concurrent, 2 months adjuvant ) of adt was used in all patients. the primary outcome was bdfs ... |
29 | cpg | None | 588 patients with low - intermediate risk prostate cancer ( gleason 6, psa 10 to 20 ng / ml or gleason 7, psa 10 ng / ml ) 1 : 1 to ebrt ( 45 gy, 25 fractions mini - pelvis ) with ldr boost ( 110 gy 125 i or 100 gy 103 pd ) or ldr alone ( 145 gy or 125 gy, respectively ). the primary outcome was progression - free surv... |
30 | cpg | None | grade 2 or higher gi toxicity, or quality of life ( measured by expanded prostate index composite every 6 months ). for late toxicity, a difference was detected between treatment arms in favor of the single fraction for grade 2 erectile dysfunction ( 12 % v 29 % ; p 5. 025 ). no differences in late gi toxicity were rep... |
31 | cpg | None | cost considerations asco recognizes that there is often a wide array of choices for treating many cancer types, with often a wide disparity in cost to patients and payers ( despite much difference in effectiveness or toxicity ). 20 halpern et al 21 reported that of the radiation modalities used in the treatment of pros... |
32 | cpg | None | committee as well as the cancer care ontario program in evidence - based care report approval panel for their thoughtful reviews and insightful comments on this guideline document. we also thank rodney breau, md, msc, w. robert lee, md, ms, med, and ronald c. chen, md, mph, for reviewing an earlier draft of this guidel... |
33 | cpg | None | none. in canada in 2010, an estimated 2600 new cases of ovarian cancer will be diagnosed and, of those cases, 1750 women will die, making ovarian cancer the seventh most prevalent form of cancer in canadian women and their fifth leading cause of cancer death ( 1 ). women with ovarian cancer typically have subtle, non -... |
34 | cpg | None | and quality of life in women with ovarian cancer is also unknown. the purpose of this document is to identify evidence that would inform optimal recommended protocols for the identification and surgical management of adnexal masses suspicious for malignancy. the evidence - based series ( ebs ) guidelines developed by t... |
35 | cpg | None | clinical practice guideline identified through this environmental scan were deemed to be the most appropriate to answer the guideline questions. the 2006 ahrq report ( 3 ) addressed the identification of an adnexal mass suspicious for malignancy question. the 2004 acn clinical practice guideline ( 6 ) addressed the sur... |
36 | cpg | None | ##entified in the update of the ahrq report literature search were included based on the same inclusion criteria put forth in the ahrq report ( 3 ). for studies investigating single modality identification of an adnexal mass, the inclusion criteria were : 1 ) comparison of the test ( e. g., bimanual pelvic exam or ultr... |
37 | cpg | None | exist between sensitivity and specificity ( 8 ). the model assumes that the logit sensitivities and specificities are normally distributed and makes use of the variance estimates to compute study weights ( 7 ). heterogeneity in the current review was assessed visually. given that between - study heterogeneity is widesp... |
38 | cpg | None | the updated search for the most appropriate surgical procedure, of which 16 met the inclusion criteria ( 85 ) ( 86 ) ( 87 ) ( 88 ) ( 89 ) ( 90 ) ( 91 ) ( 92 ) ( 93 ) ( 94 ) ( 95 ) ( 96 ) ( 97 ) ( 98 ) ( 99 ) ( 100 ). # study design and quality the acn evidence - based guideline ( 6 ) earned 80. 2 % for the rigour of de... |
39 | cpg | None | the remaining 94 % of studies not describing any such blinding. in general, the quality of evidence for studies identified for the surgical question was poor. no meta - analyses or systematic reviews were identified. only one of the 16 eligible surgical studies was an rct ( 89 ), and another was designed as a " histori... |
40 | cpg | None | value classifies the mass as either malignant or benign. # sassone scoring system the model originally described by sassone et al ( 105 ) is based on a weighted sum of the following four morphological features : inner wall structure, wall thickness, septa, and echogenicity. a score of greater than 9 is suggestive of ma... |
41 | cpg | None | called shadowing. a cutoff of 3 was determined to best differentiate benign from malignant masses. the ahrq report did not separately evaluate the lerner model. geomini et al ( 16 ) reported eight studies that evaluated the lerner model, in addition to the original, and found a pooled sensitivity of 90 % and specificit... |
42 | cpg | None | as a cutoff to suggest malignancy. the ahrq report identified three studies explicitly using the ferrazzi et al criteria and the meta - analysis by geomini et al ( 16 ) pooled seven studies. an updated search of the literature identified 1 additional study reporting on the ferrazzi et al scoring system ( 58 ). pooling ... |
43 | cpg | None | and 83 % for specificity. # explicit scoring systems the ahrq report considered scoring systems that included data combined from the following categories : 1 ) imaging, including ultrasound, ct, and mri ; 2 ) patient risk factors, such as age and menopausal status ; and 3 ) laboratory data, primarily ca - 125. # risk o... |
44 | cpg | None | to the tingulstand et al original, while geomini et al ( 16 ) evaluated seven studies and, at a cutoff level of 200, reported pooled estimates for sensitivity and specificity of 79 % and 81 %, respectively ( table 4 ). the updated literature search indentified only one additional study evaluating the diagnostic accurac... |
45 | cpg | None | cutoff of 50 %, the pooled sensitivity and specificity of four data sets were 60 % and 93 %, respectively ( table 4 ). our updated search of the literature did not identify any other studies that evaluated the diagnostic performance of the tailor et al model. ( 130 ) in the late 1990s to predict the malignancy of an ad... |
46 | cpg | None | preoperatively. one such logistic regression model ( lr1 ) ( 131 ), developed in the late 1990s by timmerman et al, included the following variables in the analysis : menopausal status, ca - 125 level, presence of ≥1 papillary growth ( > 3mm in length ), and a colour score indicative of tumour vascularity and blood flo... |
47 | cpg | None | of ultrasound evaluation of ovarian tumours ( 133 ). # 2d power doppler ( 2d pd ) the updated search of the literature identified five qualifying studies that evaluated 2d pd technology in the preoperative discrimination between malignant and benign adnexal masses. the sensitivity in these studies ranged from 49 % to 1... |
48 | cpg | None | that met the inclusion criteria. when we analysed the 21 studies with 22 data sets, using a bivariate random effects model, we obtained an overall sensitivity of 80. 6 % and specificity of 79. 9 % ( table 7, figure 2c ). # peak systolic velocity the peak or maximum systolic velocity ( psv ) is the maximum flow recorded... |
49 | cpg | None | in the differential assessment of adnexal masses ( table 8 ). # other imaging modalities mri the ahrq report identified 15 articles investigating the performance of mri in the diagnosis of adnexal masses. an updated search of the literature since the ahrq report was published identified a meta - analysis ( 15 ) evaluat... |
50 | cpg | None | ahrq report found a pooled sensitivity of 67 % and specificity of 79 % in the diagnosis of adnexal masses with pet technology ( table 9 ). # serum marker ca - 125 the ahrq report identified 66 studies that investigated the use of ca - 125 serum marker in the evaluation of an adnexal mass. an updated literature search i... |
51 | cpg | None | , 39, 43, 56, 61, 65, 66, 79, 81, 82 ) published in or since 2004 that considered the diagnostic accuracy of frozen - section diagnosis and were not included in either systematic review. all 15 studies were retrospective cohort - like in design, with seven reporting the selection of consecutive patients. only one study... |
52 | cpg | None | and specificity of 97. 9 % ( 95 % ci, 96. 6 to 98. 7 % ) ( table 10, figure 2d ). # acog / sgo referral guidelines the american college of obstetricians and gynecologists ( acog ) and the society of gynecologic oncologists ( sgo ) jointly published guidelines for the referral of women with pelvic masses that are suspic... |
53 | cpg | None | management of women with epithelial ovarian cancer made recommendations on, among other things, the most appropriate surgical approach to take in such patients. eight studies were included in the surgery for pelvic mass section of the guideline and are not discussed further here. an updated search of the literature ide... |
54 | cpg | None | ##sefjell et al reported a statistically significant improvement in 5 - year overall survival rates in patients undergoing a lymphadenectomy versus those that did not ( 87 % vs. 64 %, respectively ; p = 0. 02 ). survival analyses performed by both skirnisdottir et al ( 91 ) and hornung et al ( 88 ) also demonstrated a ... |
55 | cpg | None | the management of patients with early borderline ovarian tumours, romagnolo et al ( 98 ), park et al ( 99 ), and desfeux et al ( 94 ) found that a laparoscopic versus laparotomic surgical approach did not appear to influence survival rates, although desfeux et al acknowledged that the number of events was too small to ... |
56 | cpg | None | group compared to 6. 6 % in patients undergoing a laparotomy ( p < 0. 0001 ). similarly, lecuru et al ( 96 ) found 31 % of laparoscopic patients experienced intraoperative tumour rupture versus 16 % in the laparotomy group. however, this difference did not reach statistically significance. in patients with borderline t... |
57 | cpg | None | masses is based on inspection of the summary data obtained from the meta - analyses conducted. these results suggest that 3d ultrasonography has both a higher sensitivity and specificity when compared to 2d ultrasound. established morphological scoring systems also performed with respectable sensitivity and specificity... |
58 | cpg | None | that systematic lymphadenectomy improves survival, as does proper surgical staging. there is an exception to this benefit, however, with tumours of low malignant potential. in such tumours, conservative fertilitypreserving surgical approaches appear to have no adverse survival effect ( 99 ). the accuracy and adequacy o... |
59 | cpg | None | thereby by nature blinding the outcome, the reference test should also be interpreted without knowledge of the index test results ( 142 ). the vast majority of studies considered in the identification of a suspicious adnexal mass did not report such blinding. one third of the diagnostic studies had data collection that... |
60 | cpg | None | to perform the best, although results were not statistically different from ct. pet did not perform as well as either mri or ct. the measurement of the ca - 125 tumour marker appears to be less reliable than do other available assessment methods. finally, frozen section analysis has both a high sensitivity and especial... |
61 | cpg | None | an interpretation of and consensus agreement on that evidence by our groups or panels, the resulting recommendations, and an external review by ontario clinicians and other stakeholders in the province for whom the topic is relevant. the pebc has a formal standardized process to ensure the currency of each document, th... |
62 | cpg | None | preoperative diagnosis of an adnexal mass. - the authors'first recommendation, and the one for which the most detailed analysis exists, concludes that 3d us, ct and mri are " all recommended " with considerations of more " local factors " then suggested as determinants of the modality of choice. the authors should reco... |
63 | cpg | None | , non - randomized comparisons, etc. the authors do not provide background in their methods section about their approach to this question ( including literature search criteria ). the results section largely is divided into positive vs. negative studies as opposed to a systematic presentation of the literature. as a re... |
64 | cpg | None | number of specified content experts and a professional consultation that is intended to facilitate dissemination of the final guidance report to ontario practitioners. following the review and discussion of section 1 : recommendations and section 2 : evidentiary base of this ebs and the review and approval of the repor... |
65 | cpg | None | and specificity obtained from the meta - analysis. - a meta - analysis of six cohort studies that investigated 3d sonography ( 1 - 6 ) indicated an enhanced sensitivity of 93. 5 % and specificity of 91. 5 % with 3d technology ( section 2, figure 2a ). - a meta - analysis of 22 cohort studies with 24 data sets that inve... |
66 | cpg | None | 2 % ( section 2, figure 2c ). # qualifying statement - assessment of an adnexal mass by colour doppler technology, using the ri, pi and psv indices, was neither as sensitive nor specific as simple ultrasonography. furthermore, because of the overlap of vascular parameters between malignant and benign masses, a firm dia... |
67 | cpg | None | be indicative of malignancy, reported the summary sensitivity and specificity were 79. 2 % and 91. 7 %, respectively ( section 2, figure 2b ). ➢ as a stand - alone modality, serum ca - 125 is not recommended for distinguishing between benign and malignant adnexal masses. # key evidence - this recommendation is based on... |
68 | cpg | None | three reviewers agreed, and the draft report and a questionnaire were sent via email for their review. the questionnaire consisted of items evaluating the methods, results, and interpretive summary used to inform the draft recommendations and whether the draft recommendations should be approved as a guideline. written ... |
69 | cpg | None | . one fleischer paper was included in the evidence base for the guideline. in the end, no modifications to the evidence base were made on the basis of this reviewer comment. professional consultation : sixty responses were received. key results of the feedback survey are summarized in table 2. 3. i would recommend this... |
70 | cpg | None | use for post - op women. - a summary table outlining the sensitivities and specificities of the various diagnostic procedures is presented in section 2 of the report. - referral criteria are considered to be outside of the scope of this review and guideline. for more information on referral criteria, readers may refer ... |
71 | cpg | None | appendix to this guideline. also related to rmi : i. recommendation on the use of rmi ii and how the general gynecologist should use it for guidance when considering referral to a tertiary care centre. ii. reference to rmi cutoff of 200 instead of 400 which is what is commonly used. 4. there was also a request for an a... |
72 | cpg | None | most common cutoff value, therefore, the group decided to not to include reference to a cutoff of 400. d. other definitions such as ri, pi, and psv can be found in section 2 of the document. this ebs report reflects the integration of feedback obtained through the external review process with final approval given by th... |
73 | cpg | None | predictive adnexal model had been extensively studied with acceptable sensitivity and specificity. this can serve as potential alternative diagnostic strategy to the rmi score. " the following paragraphs are the justification for the inclusion of this qualifying statement.. inconclusive result can be classified using s... |
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