Enhancing guidelines implementation: the example of ECIBC and its European Guidelines for breast-cancer screening and diagnosis.




Short oral session 4: Evidence implementation and evaluation


Wednesday 13 September 2017 - 16:00 to 17:30


All authors in correct order:

Saz Parkinson Z1, Pylkkanen L1, Dimitrova N1, Bramesfeld A1, Deandrea S1, Uluturk A1, Lerda D1
1 Joint Research Centre - European Commission, Italy
Presenting author and contact person

Presenting author:

Zuleika Saz Parkinson

Contact person:

Abstract text
Background:The European Commission Initiative on Breast Cancer (ECIBC) aims to ensure and harmonise the quality of breast cancer (BC) care across European countries on a sustainable basis, contributing to improving health and reducing health inequalities.

Objectives: 1.Development of a voluntary European Quality Assurance (QA) scheme (includes quality and safety requirements, relevant to citizens, for BC services in Europe, whenever possible based on evidence).
2.Compilation of evidence-based recommendations on BC screening and care services in Europe (developing European Breast Guidelines on screening and diagnosis, and collecting existing high-quality evidence-based guidelines on all BC-care processes on the Guidelines Platform).

Methods:The European Breast Guidelines are being developed using the GRADEpro Guideline Development Tool. Evidence-to-Decision frameworks (EtDs) are used to provide a systematic, transparent process from evidence to the healthcare decision. Guideline implementation will be enhanced:
via the European QA scheme; involving stakeholders at all ECIBC development phases, e.g. 27 'Country tables' (composed of national health authorities, national accreditation bodies, patients, professionals,etc.) were organised at the ECIBC Plenary 2016 to foster discussion on barriers and facilitators to implementing the first recommendations, and a ECIBC roadshow in all countries is being planned; and, using 'dedicated languages' for recommendations to be understood by policy makers, professionals and individuals.

Results:The first evidence-based recommendations on age ranges for BC screening have been published (complete EtDs) on a dedicated webpage. Policy makers can assess how the evidence (particularly resource use and cost effectiveness) relates to their particular population to enable informed decision making.This evidence is made available to define QA scheme requirements.

Conclusions:The multidisciplinary, transparent and robust development process used, together with coupling the guidelines with a QA scheme that will assess their correct implementation and continuous stakeholder engagement will enhance implementation.