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Evaluating clinical practice guidelines for the management of rectal cancer: Did they get it RIGHT?

BACKGROUND AND OBJECTIVES: Clinical Practice Guidelines (CPGs) are crucial tools for clinicians seeking to deliver evidence-based patient care. We utilized the Reporting Items for practice Guidelines in HealThcare (RIGHT) checklist to assess the reporting quality of CPGs addressing the management of rectal cancer.

METHODS: Four multidisciplinary rectal cancer CPGs published 2017-2022 were evaluated: American Society of Colon and Rectal Surgeons (ASCRS), European Society for Medical Oncology (ESMO), National Comprehensive Cancer Network (NCCN), and National Institute for Health and Care Excellence (NICE). We quantitatively assessed each CPG using the RIGHT checklist and qualitative analysis was performed to generate common themes.

RESULTS: RIGHT checklist items fulfilled by each CPG ranged from 12 to 17 (out of 22). Each guideline demonstrated unique categories of weakness: ASCRS in Basic Information (1 of 4 items), ESMO in Evidence (1 of 3), NCCN in Recommendations (1 of 3), and NICE in Review and Quality Assurance (0 of 2). Common themes that emerged included sprase discussion on the financial aspects of rectal cancer management and lack of transparency in formulating recommendations.

CONCLUSIONS: Despite their variability, each of the 22 checklist elements are present in contemporary CPGs. Utilizing the RIGHT checklist would allow experts to create guidelines adhering to high-quality reporting standards.

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