2. METHODS
2.1. Introduction
For the 2023 EAU TC Guidelines, a forensic review and restructure was undertaken. An assessment of all newly published literature will be performed for the 2024 TC Guidelines.
Detailed search strategies for the 2022 guideline are available online: http://uroweb.org/guideline/testicular-cancer/?type=appendices-publications.
For each recommendation within the guidelines there is an accompanying online strength rating form which includes the assessment of the benefit to harms ratio and patients ‘preferences for each recommendation. The strength rating forms draws on the guiding principles of the GRADE methodology but do not purport to be GRADE [2,3]. Each strength rating form addresses a number of key elements namely:
- the overall quality of the evidence which exists for the recommendation, references used in this text are graded according to a classification system modified from the Oxford Centre for Evidence-Based Medicine Levels of Evidence [4];
- the magnitude of the effect (individual or combined effects);
- the certainty of the results (precision, consistency, heterogeneity and other statistical or study related factors);
- the balance between desirable and undesirable outcomes;
- the impact of patient values and preferences on the intervention;
- the certainty of those patient values and preferences.
These key elements are the basis which panels use to define the strength rating of each recommendation. The strength of each recommendation is represented by the words ‘strong’ or ‘weak’ [5]. The strength of each recommendation is determined by the balance between desirable and undesirable consequences of alternative management strategies, the quality of the evidence (including certainty of estimates), and nature and variability of patient values and preferences.
Additional information can be found in the general Methodology section of this print, and online at the EAU website: www.uroweb.org/guidelines.
A list of associations endorsing the EAU Guidelines can also be viewed online at the above address.
2.2. Review
The 2020 Guidelines document was subjected to peer-review following publication. The next peer-review is scheduled for 2024.
2.3. Future goals
- A collaborative SR on hypogonadism following orchidectomy with the EAU Male Sexual Health guidelines panel.
- Compilation of drug protocols as treatment guidelines for testicular cancer chemotherapy, which will be published online https://uroweb.org/guidelines/testicular-cancer/publications-appendices.
- A summary paper of the Testicular Cancer Guideline.
- The development of a TC survivorship plan in collaboration with patient associations.
- Care Pathways on diagnostic, treatment CS I, and treatment of metastatic disease.
- Collaboration with the patient office and patient representatives to develop a care pathway focusing on what the patient needs to know from diagnosis through to follow-up.