Impact of American Society of Clinical Oncology Guidelines for Clinical Use of Colony-Stimulating Factors
Authors: I. Debrix, C. Bouleuc, H. Liote, B. Milleron, A. Beker, Charles L. Bennett, Mark R. Somerfield
Journal: Journal of Clinical Oncology (1999)

Article Tools Correspondence Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1999.17.10.3360 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 10506640 Impact of American Society of Clinical Oncology Guidelines for Clinical Use of Colony-Stimulating Factors I. DebrixxI. DebrixSearch for articles by this author , C. BouleucxC. BouleucSearch for articles by this author , H. LiotexH. LioteSearch for articles by this author , B. MilleronxB. MilleronSearch for articles by this author , A. BekerxA. BekerSearch for articles by this author Charles L. BennettxCharles L. BennettSearch for articles by this author , Mark R. SomerfieldxMark R. SomerfieldSearch for articles by this author Show More Tenon Hospital, Paris, FranceVeterans Affairs Chicago Health Care System, Chicago, ILAmerican Society of Clinical Oncology, Alexandria, VA https://doi.org/10.1200/JCO.1999.17.10.3360 First Page Full Text PDF Figures and Tables © 1999 by American Society of Clinical OncologyjcoJ Clin OncolJournal of Clinical OncologyJCO0732-183X1527-7755American Society of Clinical OncologyResponse101999In Reply: The study by Debrix et al confirms the findings of two ASCO surveys of clinical oncologists that assessed the use of CSFs.1,2 In particular, use of CSFs in the setting of primary prophylaxis continues to be an area associated with overuse of these agents, while use of CSFs in the setting of secondary prophylaxis has decreased. Prior studies indicate that dissemination of guidelines in the form of written handouts to physicians, as done in the Debrix et al study, is unlikely to lead to meaningful changes in physician practice patterns, unless they are accompanied by discrete and targeted interventions.3,4 Local involvement in guideline development is especially important for improving adherence to recommended practices.5Busy physicians, we suspect, rarely take the time to read forms such as those that summarize ASCO guidelines. Changes in CSF use, as described in this study, are more likely to reflect general temporal changes in physician practices rather than effects of publication and passive dissemination of written ASCO guidelines in the hospital setting. Other, more specific influences on CSF use might include increased experience with these agents, insurance denials, and widely publicized evidence.2 Nonetheless, targeted educational efforts that address patterns of CSF use in the setting of primary prophylaxis continue to be needed. These efforts should be carried out in the context of a randomized clinical trial of guidelines versus no guidelines.1. Bennett CL, Smith TJ, Weeks JC, et al: Use of hematopoietic colony-stimulating factors: The American Society of Clinical Oncology Survey. J Clin Oncol 14::2511,1997-2520, Google Scholar2. Bennett CL, Weeks JC, Somerfield MR, et al: Use of hematopoietic colony-stimulating factors for solid tumors and lymphomas: Comparison of the 1994 and 1997 American Society of Clinical Oncology surveys. J Clin Oncol (in press) Google Scholar3. Shortell SM, Bennett CL, Byck GR: Assessing the impact of continuous quality improvement on clinical practice: What will it take to accelerate progress. Milbank Q 76::593,1998-624, Crossref, Medline, Google Scholar4. Sarasin FP, Maschiangelo M, Schaller M, et al: Successful implementation of guidelines for encouraging the use of beta blockers in patients after acute myocardial infarction. Am J Med 106::499,1999-505, Crossref, Medline, Google Scholar5. Katterhagen G: Physician compliance with outcome-based guidelines and clinical pathways in oncology. Oncology 10::113,1996-121, Medline, Google Scholar