Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
With the development of evidence-based medicine (EBM), the concept of "transfer of current best evidence into clinical decision-making" has garnered substantial attention worldwide. As such a good tool, many clinical practice guidelines (CPGs) for hepatocellular carcinoma (HCC) have been published worldwide under the guide of current best evidence. Our study did a systematic evaluation of the current 17 guidelines for HCC worldwide, which found that the appropriate constructing approach is the most important factor that influences guidelines implementation. Three factors of organizations or bodies drafting the guideline, exploration for achieving current best evidence, and purpose of constructing evidence-based CPGs for HCC should be paid close attention to. In order to achieve the current best evidence and promote evidence-based CPGs to be widely accepted and fully implemented, we recommend to conduct a systematic approach with 4 steps of global guidelines assessment, systematic literature review, experts' consensus and draft implementation, as well as implementation evaluation and periodic update in constructing and implementing evidence-based CPGs for HCC.