2. METHODS
2.1. Introduction
For the 2024 EAU Guidelines on Testicular Cancer (TC), new and relevant evidence was identified, collated and appraised through a structured assessment of the literature. A broad and comprehensive literature search, covering all sections of the TC Guidelines was performed. The search was limited to studies representing high levels of evidence, i.e. systematic reviews with meta-analysis, randomised controlled trials (RCTs), and prospective non-randomised comparative studies, published in the English language. Databases searched included Medline, EMBASE, and the Cochrane Libraries, covering a time frame between May 1st 2021 and May 1st 2023. A total of 1867 unique records were identified, retrieved and screened for relevance.
Detailed search strategies for the 2024 guideline are available online:
https://uroweb.org/guidelines/testicular-cancer/publications-appendices.
Recommendation within the Guidelines are developed by the panels to prioritise clinically important care decisions. 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 the nature and variability of patient values and preferences. This decision process, which can be reviewed in the strength rating forms which accompany each guideline statement, addresses a number of key elements:
- the overall quality of the evidence which exists for the recommendation [2];
- 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 and certainty of patient values and preferences on the intervention.
Strong recommendations typically indicate a high degree of evidence quality and/or a favourable balance of benefit to harm and patient preference. Weak recommendations typically indicate availability of lower quality evidence, and/or equivocal balance between benefit and harm, and uncertainty or variability of patient preference [3].
Additional information can be found in the general Methodology section of this print, and online at the EAU website: https://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 2025.
2.3. Future goals
- A collaborative systematic review (SR) on hypogonadism following orchidectomy with the EAU Male Sexual Health guidelines panel;
- 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.