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The Presence of Complementary and Alternative Medicine Recommendations in Head and Neck Cancer Guidelines: Systematic Review and Quality Assessment

  • Integrative Care (C Lammersfeld, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of review

A high proportion of head and neck cancer (HNC) patients use complementary and alternative medicine (CAM), however, healthcare professionals generally have little knowledge about the safety and efficacy of these therapies. The purpose of this study was to determine the quantity and assess the quality of CAM recommendations across clinical practice guidelines (CPGs) for the treatment and/or management of HNC.

Recent findings

MEDLINE, EMBASE, and CINAHL were systematically searched for HNC CPGs published between 2009 and April 2020; the Guidelines International Network and the National Center for Complementary and Integrative Health websites were also were searched. Eligible CPGs containing CAM recommendations were assessed twice with the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument, once for the overall CPG and once for the CAM sections. Of 305 unique search results, 7 CPGs mentioned CAM and 4 CPGs made CAM recommendations. The overall CPG scored higher than the CAM section for 4 of 6 domains (overall, CAM): scope and purpose (93.8%, 93.8%), clarity of presentation (88.2%, 64.6%), stakeholder involvement (68.8%, 39.6%), rigor of development (58.3%, 34.6%), editorial independence (42.7%, 42.7%), and applicability (51.6%, 19.8%). Quality varied within and between CPGs.

Summary

Highly scoring CPGs serve as evidence-based resources that clinicians can use to inform their patients about safe and effective CAM use; CPGs achieving variable or lower scores could be improved in future updates based on currently available guideline development/implementation tools. Future research should identify CAM therapies supported by sufficient evidence to be included as part of HNC CPGs.

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Data Availability

All relevant data are included in this manuscript.

Abbreviations

AGREE II:

Appraisal of Guidelines for Research & Evaluation II

CAM:

complementary and alternative medicine

CIM:

complementary and integrative medicine

CPG:

clinical practice guideline

HNC:

head and neck cancer

NCCIH:

National Center for Complementary and Integrative Health

PICO:

Patients, Intervention, Comparison and Outcomes

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

References

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Acknowledgments

We gratefully acknowledge Manav Nayeni for assisting with screening and data extraction.

Funding

JYN was funded by a Research Scholarship and an Entrance Scholarship from the Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences at McMaster University.

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Authors and Affiliations

  1. Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada

    Jeremy Y. Ng & Ekaterina Dogadova

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Contributions

JYN: designed and conceptualized the study, collected and analysed data, co-drafted the manuscript, and gave final approval of the version to be published.

ED: assisted with the collection and analysis of data, co-drafted the manuscript, and gave final approval of the version to be published.

Corresponding author

Correspondence to Jeremy Y. Ng.

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Ethics Approval and Consent to Participate

This study involved a systematic review of peer-reviewed literature only; it did not require ethics approval or consent to participate.

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The authors declare that they have no competing interests.

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This article is part of the Topical Collection on Integrative Care

Supplementary Information

Supplementary File 1

MEDLINE Search Strategy for HNC CPGs Executed April 17th, 2020 (DOCX 26 kb).

Supplementary File 2

Modified AGREE II Questions Used to Guide Scoring of CAM Sections of Each CPG. Note: All Supplementary Files were created by the authors and do not require permission to reproduce (XLSX 14 kb).

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Ng, J.Y., Dogadova, E. The Presence of Complementary and Alternative Medicine Recommendations in Head and Neck Cancer Guidelines: Systematic Review and Quality Assessment. Curr Oncol Rep 23, 32 (2021). https://doi.org/10.1007/s11912-021-01024-y

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