Updating Evidence-Based Reviews

Methodology for Updating Published Evidence-Based Reviews Evaluating the Role of Blood and Marrow Transplantation in the Treatment of Selected Diseases: A Policy Statement by the American Society for Blood and Marrow Transplantation

Roy B. Jones,1 Yago Nieto,1 Donna Wall,2 John R. Wingard,3 J. Douglas Rizzo,4 Philip L. McCarthy, Jr.,5 Denise Oliansky,5 Theresa Hahn5

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INTRODUCTION

In 1999, the American Society for Blood and Marrow Transplantation (ASBMT) began the development of systematic evidence-based reviews and position statements on the effectiveness of autologous and allogeneic hematopoietic stem cell transplantation (SCT) for specific diseases. The purpose of these reviews is to achieve broader and more consistent coverage from payers for established indications for SCT, and provide evidence in support of clinical decisions and matters of public policy regarding SCT. The ASBMT Evidence-Based Review Steering Committee, chaired by Dr. Roy Jones, developed a policy outlining the methodology to be followed for these reviews [1]. Evaluation of this process after the completion of the first two reviews resulted in a revised policy statement in 2005 [2], which focused the review process to address questions most relevant to clinicians and scientists. Currently, seven reviews have been published in Biology of Blood and Marrow Transplantation on the use of SCT in the therapy of: diffuse large B-cell non-Hodgkin lymphoma (NHL) [3], multiple myeloma (MM) [4], pediatric acute lymphoblastic leukemia (ALL) [5], adult ALL [6], pediatric acute myelogenous leukemia (AML) [7], adult AML [8], and myelodysplastic syndromes (MDS) [9]. The ASBMT Evidence-Based Review Steering Committee has determined that previous reviews should be updated regularly at approximately 5-year intervals. Updated reviews will provide current summaries of the evidence and timely treatment recommendations, and will determine if recent clinical evidence strengthens or changes the treatment recommendations provided in the reviews at the time of first publication. To guide its own activities and that of the expert panels associated with each review, the ASBMT Evidence-Based Review Steering Committee has developed this policy statement regarding the Methodology for Updating Published Evidence-Based Reviews Evaluating the Role of Blood and Marrow Transplantation in the Treatment of Selected Diseases. The following statement has been submitted to and accepted by the ASBMT Executive Committee.

THE PROCESS FOR UPDATING PREVIOUSLY PUBLISHED REVIEWS

Expert Panel Selection

For updating prior reviews, the original expert panelists will be invited to participate in the update. In the event that members of the original panels are unavailable, new panelists will be nominated by the EBR Steering Committee and invited to participate as needed.

Presentation of New Evidence

New evidence published since the completion of the initial review will be presented in text format in the updated review, while referencing the previously published review. Summary tables will include all previous data and be updated to reflect new evidence. An updated Treatment Recommendations table will indicate whether each recommendation is new, changed, or unmodified since the previous review, and whether the supporting evidence for recommendations in the original review are unchanged or strengthened since the last review.

Order of Review Updates

Updates will occur in the same order as the publication of the original reviews, unless there is a substantial reason to promote the order of a specific review. The first update will address the clinical evidence on diffuse large B-cell NHL that has been published since 2001. Updated reviews will be published at the rate of one per year, in addition to new review topics published at the rate of one per year.

Summary

At its best, evidence-based medicine advances its field of inquiry and points toward research that will lead to better diagnostic and treatment options. By updating previously published evidence-based reviews and their treatment recommendations, physicians will have access to timely information that will facilitate and help disseminate advances in the field of transplantation. The goal is to provide every patient access to the treatment options that offer the best chance for survival and a high quality of life.

For more details, read the evidence-based review on this topic, or view our Powerpoint presentation on updating evidence-based reviews.

ENDNOTES

From the 1 M.D. Anderson Cancer Center, Houston, Texas; 2 Texas Transplant Institute, San Antonio, Texas; 3 University of Florida Health Science Center, Gainesville, Florida; 4 Medical College of Wisconsin, Milwaukee, Wisconsin; and 5 Roswell Park Cancer Institute, Buffalo, New York.

Correspondence and reprint requests: Theresa Hahn, PhD, Department of Medicine, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263 (email: theresa.hahn@ roswellpark.org).

© 2009 American Society for Blood and Marrow Transplantation 1083-8791/09/156-0001$36.00/0 doi:10.1016/j.bbmt.2009.02.008

REFERENCES

1. Jones R, Horowitz M, Wall D, et al. ASBMT policy statement regarding the methodology of evidence-based reviews in evaluating the role of blood and marrow transplantation in the treatment of selected diseases. Biol Blood Marrow Transplant. 2000;6:524-525.

2. Jones R, Nieto Y, Rizzo JD, et al. The evolution of the evidence-based review: evaluating the science enhances the art of medicine—Statement of the Steering Committee for Evidence-Based Reviews of the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant. 2005; 11:819-822.

3. Hahn T, Wolff SN, Czuczman M, et al. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of diffuse large cell B-cell non-Hodgkin’s lymphoma: an evidence-based review. Biol Blood Marrow Transplant. 2001;7: 308-331.

4. Hahn T, Wingard JR, Anderson KC, et al. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of multiple myeloma: an evidence-based review. Biol Blood Marrow Transplant. 2003;9:4-37.

5. Hahn T, Wall D, Camitta B, et al. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of acute lymphoblastic leukemia in children: an evidence-based review. Biol Blood Marrow Transplant. 2005;11:823-861.

6. Hahn T, Wall D, Camitta B, et al. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of acute lymphoblastic leukemia in adults: an evidence-based review. Biol Blood Marrow Transplant. 2006;12:1-30.

7. Oliansky DM, Rizzo JD, Aplan PD, et al. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of acute myeloid leukemia in children: an evidence-based review. Biol Blood Marrow Transplant. 2007;13:1-25.

8. Oliansky DM, Appelbaum F, Cassileth PA, et al. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of acute myeloid leukemia in adults: an evidencebased review. Biol Blood Marrow Transplant. 2008;14:137-180.

9. Oliansky D, Antin J, Bennett J, et al. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of myelodysplastic syndromes: an evidence-based review. Biol Blood Marrow Transplant. 2009;15:137-172.