I recently read a news story from a 1996 issue of JNCI (J Natl Cancer Inst 1996; 88:488–490) that discussed the debut of a then-new product: the NCCN Clinical Practice Guidelines in Oncology. That news story cited the main challenges facing the program as 1) integrating the guidelines into practice and 2) collecting data and evaluating the guidelines' impact on practice and patient outcomes. A third challenge was gaining employer and payor acceptance. As we approach the NCCN's 13th Annual Conference, it's interesting to see where we are in facing these 3 challenges and looking at the additional challenges that have arisen in the intervening years.
Looking back, I think these expectations were right on target. What the writer did not foresee was the degree to which electronic methods of communication and informatics initiatives would change how clinical information is distributed and used. At first, the NCCN guidelines were published only as paper-based proceedings of our annual meeting, with only the guidelines presented at the meeting published in a given year. Now the original 7 guidelines have been updated (at least annually and usually more often) for 13 years. In addition, they have been joined by more than 35 additional guidelines, also aggressively updated, and all published continuously on the Internet.
The ease of Web publication has certainly changed expectations, with the anticipation that standard-changing new data can and will be incorporated into guidelines in almost real time. Similarly, newer derivatives of the guidelines, such as the NCCN Drugs and...
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Joan S. McClure, MS, is Senior Vice President of Clinical Information and Publications for the NCCN. She is responsible for the NCCN Clinical Practice Guidelines in Oncology; associated Guidelines for Patients in both English and Spanish; the NCCN Drugs & Biologics Compendium; NCCN Information Technology; and JNCCN; and also serves as an Associate Editor for JNCCN. Ms. McClure previously managed national oncology information programs on contract with the U.S. National Cancer Institute (NCI). She directed investigator and patient recruitment efforts in oncology for a multinational contract research organization, where she also managed efforts to identify and develop standards for data for submission to regulatory authorities in the United States, Europe, and Japan.
The ideas and viewpoints expressed in this editorial are those of the author and do not necessarily represent any policy, position, or program of the NCCN.