Breast Cancer Survivorship Guidelines

Rowan Hutchins — Sun, 08 Oct 2023 05:00:00 +0000

Date Added:

October 8, 2023

Journal/Publication:

Publisher:

ACS

Publication Date:

December 7, 2015

Issue:

Volume:

Pages:

URL:

Breast Cancer Survivorship Guidelines

Type:

Patient Education Materials

Format:

Article

DOI (1):

10.3322/caac.21322

Keywords

breast cancer

cancer

cancer survivors

education of patients

PMID (1):

26642105

MeSH

breast neoplasms

Patient Advocacy

Guideline recommendations for patients who have survived breast cancer from the ACA and ASCO. James W. Mold, MD, MPH

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What Is the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline?

The Breast Cancer Survivorship Care Guideline is advice from the American Cancer Society and the American Society of Clinical Oncology to help doctors, nurses, and other health care professionals provide care for breast cancer survivors who have finished cancer treatment. The cancer survivorship care guideline addresses issues that can occur in breast cancer survivors after their treatment.

Medical Care of Adults With Down Syndrome: A Clinical Guideline

Brian Desmarais — Thu, 22 Oct 2020 14:30:11 +0000

Date Added:

October 22, 2020

Journal/Publication:

Journal of the American Medical Association

Publication Date:

October 20, 2020

Issue:

Volume:

324

Pages:

1543-1556

URL:

Medical Care of Adults With Down Syndrome: A Clinical Guideline

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1001/jama.2020.17024

MeSH

cardiovascular diseases

Patient Advocacy

comorbidity

Abstracting and Indexing

A guideline for the medical care of adults with Down’s Syndrome (see Results section). James W. Mold,. MD, MPH

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Abstract

Importance: Down syndrome is the most common chromosomal condition, and average life expectancy has increased substantially, from 25 years in 1983 to 60 years in 2020. Despite the unique clinical comorbidities among adults with Down syndrome, there are no clinical guidelines for the care of these patients.

Objective: To develop an evidence-based clinical practice guideline for adults with Down syndrome.

Evidence review: The Global Down Syndrome Foundation Medical Care Guidelines for Adults with Down Syndrome Workgroup (n = 13) developed 10 Population/Intervention/ Comparison/Outcome (PICO) questions for adults with Down syndrome addressing multiple clinical areas including mental health (2 questions), dementia, screening or treatment of diabetes, cardiovascular disease, obesity, osteoporosis, atlantoaxial instability, thyroid disease, and celiac disease. These questions guided the literature search in MEDLINE, EMBASE, PubMed, PsychINFO, Cochrane Library, and the TRIP Database, searched from January 1, 2000, to February 26, 2018, with an updated search through August 6, 2020. Using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology and the Evidence-to-Decision framework, in January 2019, the 13-member Workgroup and 16 additional clinical and scientific experts, nurses, patient representatives, and a methodologist developed clinical recommendations. A statement of good practice was made when there was a high level of certainty that the recommendation would do more good than harm, but there was little direct evidence.

Findings: From 11 295 literature citations associated with 10 PICO questions, 20 relevant studies were identified. An updated search identified 2 additional studies, for a total of 22 included studies (3 systematic reviews, 19 primary studies), which were reviewed and synthesized. Based on this analysis, 14 recommendations and 4 statements of good practice were developed. Overall, the evidence base was limited. Only 1 strong recommendation was formulated: screening for Alzheimer-type dementia starting at age 40 years. Four recommendations (managing risk factors for cardiovascular disease and stroke prevention, screening for obesity, and evaluation for secondary causes of osteoporosis) agreed with existing guidance for individuals without Down syndrome. Two recommendations for diabetes screening recommend earlier initiation of screening and at shorter intervals given the high prevalence and earlier onset in adults with Down syndrome.

Conclusions and relevance: These evidence-based clinical guidelines provide recommendations to support primary care of adults with Down syndrome. The lack of high-quality evidence limits the strength of the recommendations and highlights the need for additional research.

Author/s:

Tsou, Amy Y., Bulova, Peter, Capone, George, Chicoine, Brian, Global Down Syndrome Foundation Medical Care Guidelines for Adults with Down Syndrome Workgroup