Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Ballini L, Maltoni S, Vignatelli L, Negro A, Trimaglio F. Criteria for appropriate use of FDG-PET in malignant lymphoma: Hodgkin's lymphoma, aggressive non-Hodgkin's lymphoma
. Bologna: Agenzia sanitaria e sociale regionale, Regione Emilia-Romagna (ASSR). ORIentamenti 8. 2012 Authors' conclusions Aim:
The criteria reported in this document are to be intended as guidance for programs of clinical governance aimed at: supporting clinicians on the use of FDG-PET; post hoc analyses of appropriate use of FDG-PET; contributing to the planning of the regional health service.
Method:
A panel of 25 experts working in Health Trusts and Teaching Hospitals of Emilia-Romagna was convened to discuss and agree on the methodology for a research program aimed at defining the criteria for appropriate use of FDG-PET in oncology. For each indication a systematic review was performed. The GRADE approach was applied to assess the quality of included studies, the level of confidence in the overall evidence for each outcome of interest. The GRADE approach for diagnostic recommendations was also used to elicit judgement from the panel members on benefit and harms trade-off for patient-important outcomes. The RAND method was used to vote and reach an agreement on the appropriateness criteria.
Results:
For each disease the panel examined and assessed the role of FDG-PET for the following 6 clinical indications (for a total of 12 clinical questions: staging; dose painting definition in involved-field radiation treatment; during treatment evaluation of early response to therapy; end of treatment evaluation of response to therapy; follow up of patients with no suspicion of recurrence; staging of recurrence). Nine systematic reviews and 33 primary studies, evaluating diagnostic accuracy of FDG-PET, were included.
Recommendations:
Criteria for the appropriate use of FDG-PET in Hodgkin's lymphoma: Staging: Appropriate (level of evidence: moderate); Dose painting definition in involved-field radiation treatment: Indeterminate due to lack of studies; During treatment evaluation of early response to therapy: Appropriate (level of evidence: moderate); End of treatment evaluation of response to therapy: Appropriate (level of evidence: moderate); Follow up of treated patients, with no suspicion of recurrence: Inappropriate (level of evidence: low): Staging of recurrence in treated patients: Appropriate (level of evidence: very low). Criteria for the appropriate use of FDG-PET in aggressive non-Hodgkin's lymphoma: Staging: Appropriate (level of evidence: moderate); Dose painting definition in involved-field radiation treatment: Indeterminate due to lack of studies; During treatment evaluation of early response to therapy: Inappropriate (level of evidence: moderate); End of treatment evaluation of response to therapy: Appropriate (level of evidence: moderate); Follow up of treated patients, with no suspicion of recurrence: Inappropriate (level of evidence: very low); Staging of recurrence in treated patients: Appropriate (level of evidence: very low). For all the above clinical indications the panel reached an agreement.
Indexing Status Subject indexing assigned by CRD MeSH Fluorodeoxyglucose F18; Hodgkin Disease; Humans; Lymphoma Language Published English Country of organisation Italy English summary An English language summary is available. Address for correspondence Viale Aldo Moro 21, 40127 Bologna, Italia tel. +39 051 5277177 fax +39 051 5277049
Email: Ballini_Lu@regione.emilia-romagna.it AccessionNumber 32014001417 Date abstract record published 08/12/2014 |