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Which is the best current guideline for the diagnosis and management of cystic pancreatic neoplasms? An appraisal using evidence-based practice methods

  • Hepatobiliary-Pancreas
  • Published:
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Abstract

Background and aim

Cystic pancreatic neoplasms (CPNs) are an increasingly diagnosed entity. Their heterogeneity poses complex diagnostic and management challenges. Despite frequently encountering these entities, particularly in the context of the increased imaging of patients in modern medicine, doctors have to rely on incomplete and ambiguous published literature. The aim of this project was to review the guidelines relating to CPNs using evidence-based practice (EBP) methods.

Methods

A search of both the primary and secondary literature was performed. Five sets of guidelines were identified which were then methodologically appraised by the AGREE II instrument, a validated and widely utilised tool for guideline development assessment.

Results

The 2014 ‘Italian consensus guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms’ were found to be the most methodologically sound guidelines, on the basis of both the overall score and average weighted domain score.

Conclusions

The current best guidelines were identified. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument can be used for retrospective review of published guidelines or as a roadmap for guideline-writing groups. All guidelines found were methodologically limited. Further longitudinal/prospective studies are required to improve the level of evidence.

Key Points

• Cystic pancreatic neoplasms (CPNs) are an increasingly encountered entity in modern medicine.

• Clinical uncertainty remains with regard to optimal diagnostic and management strategies.

• The Italian consensus guidelines for cystic pancreatic neoplasms are currently the best guidelines.

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Acknowledgments

The scientific guarantor of this publication is Prof. Dermot Malone. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was not required because no patient interaction or treatment was required for this study. Methodology: performed at one institution.

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Authors and Affiliations

  1. St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland

    Alexis M. Cahalane, Y. M. Purcell, L. P. Lavelle, S. H. McEvoy, E. R. Ryan & D. E. Malone

  2. National Cancer Control Programme, King’s Inns House, 200 Parnell Street, Dublin 1, Ireland

    E. O’Toole

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  1. Alexis M. Cahalane
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  2. Y. M. Purcell
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Correspondence to Alexis M. Cahalane.

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Cahalane, A.M., Purcell, Y.M., Lavelle, L.P. et al. Which is the best current guideline for the diagnosis and management of cystic pancreatic neoplasms? An appraisal using evidence-based practice methods. Eur Radiol 26, 3121–3128 (2016). https://doi.org/10.1007/s00330-015-4160-y

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  • DOI: https://doi.org/10.1007/s00330-015-4160-y

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