Practice Patterns, Guideline-Based Treatments, Costs and Efficacy of Care, and Global Perspectives: A Call for Papers on Excellence in Cancer Care

Harold J. Burstein
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JNCCN – The Journal of the National Comprehensive Cancer Network is committed to publishing the world's most authoritative and comprehensive cancer treatment guidelines, the NCCN Clinical Practice Guidelines in Oncology. These invaluable, evolving, state-of-the-art documents articulate best known treatment based on evidence from the literature and collected wisdom of experts. To enhance its value, JNCCN also publishes timely reviews and commentaries that expand on important themes or emerging practices.

However, guidelines are not the end of determining quality health care. How are guidelines interpreted and applied? What trends emerge? To what extent should and do cost considerations affect both recommendations and treatments? What important benchmarks should define our best practices? In a vast and varied world, what can different cultures and perspectives teach us about optimal care? How can societies with fewer resources access appropriate innovations, and what lessons can we learn from medical care in places without the resources available here?

Although these questions are not unique to cancer care, they are particularly important in oncology. Cancer is a global health burden and a growing problem. Cancer care is also a high stakes game—the pairing of lethal disease and toxic treatment demands high-quality decisions executed correctly. Cancer treatments are expensive, and cancer care is complicated.

For all these reasons, JNCCN is issuing a call for papers on excellence in cancer care, from both academic and community perspectives. We are particularly seeking original research and insightful commentary on the best ways to use resources and improve outcomes for patients. Examples of such contributions might include:

  1. Studies of patterns of practice that reflect (or defy) appropriate guideline-based care, or changes in response to emerging data or treatment recommendations;
  2. Institutional programs that measure or enhance compliance with guideline-based care, particularly those associated with documented impact on clinical experience or treatment results;
  3. Investigations of communication and education strategies among clinicians or clinicians and patients that enhance treatment compliance and assure high-quality care and patient satisfaction;
  4. International perspectives on guideline-based care, highlighting significant differences between treatment recommendations in different societies and considering the scientific and clinical bases for those differences and the underlying priorities or resource decisions that shape those differences;
  5. Reports of outcomes for cancer patients and how guideline-based care, or lack thereof, may alter long-term results;
  6. Rigorous considerations of cost in treatment decision-making, adherence to proposed therapy, and opportunities for better resource use;
  7. Insights into the organization of cancer clinics and strategies for improving patient management through efficient use of non-physician health care providers and other resources that can enhance the patient experience;
  8. Global patterns of practice information documenting actual treatment methods in various geographic regions of the United States or globally, as a function of guideline recommendations, resource accessibility, and patient preferences;
  9. Comparative effectiveness studies, creating frameworks for understanding trade-offs between treatment side effects, costs, benefits, and outcomes so as to enhance the needed dialogue on optimal care.

At the heart of this call for papers is the conviction that outstanding clinical practices and insights around the world can be shared to create excellence in cancer care for more people. We are certain that important data on clinical excellence exist, and we look forward to publishing them in a thoughtful, peer-reviewed process.

We hope to engage clinicians, investigators and experts around the world. If you have an original manuscript or commentary to submit, please go to and see “Information for Contributors.” To discuss a concept for an article, please contact the editorial staff at (Please use “article submission” in subject line.) We look forward to your contributions.

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.

Harold J. Burstein, MD, PhD, editor-in-chief of JNCCN, is an Associate Professor of Medicine at Harvard Medical School and a medical oncologist at Dana-Farber Cancer Institute and Brigham & Women's Hospital. He is a clinician and clinical investigator specializing in breast cancer.

Dr. Burstein attended Harvard College and earned his MD at Harvard Medical School, where he also earned a PhD in immunology. He trained in internal medicine at Massachusetts General Hospital and was a fellow in medical oncology at Dana-Farber before joining the staff.

Dr. Burstein's clinical research interests include novel treatments for early- and advanced-stage breast cancer and studies of quality of life and health behavior among women with breast cancer. He has written widely on breast cancer in both traditional medical journals and on the web, including New England Journal of Medicine and Journal of Clinical Oncology. International committees focusing on cancer treatments that he has or continues to participate in include the NCCN Clinical Practice Guidelines Breast Cancer Panel, St. Gallen Breast Cancer Panel, CALGB Breast Cancer Committee, ASCO Health Services Research and Clinical Research Committees, the National Quality Forum Breast Cancer Technical Panel, and other ASCO expert panels.

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