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Table 6 Authors’ conclusions and summary remarks on the research question

From: Intensive follow-up for women with breast cancer: review of clinical, economic and patient’s preference domains through evidence to decision framework

Should women be followed intensively after breast cancer treatment?
Type of recommendation Strong recommendation against the option Conditional recommendation against the option Conditional recommendation for either the option or the comparison Conditional recommendation for the option Strong recommendation for the option
Recommendation We suggest that women with breast cancer are followed-up once a year with a mammography (as opposed to other regimens) (provisional and conditional recommendation).
Justification There is moderate certainty of evidence that intensive follow-up compared with less intensive follow-up (more frequent diagnostic tests or visits) does not reduce 5–10-year overall mortality and recurrences in women with breast cancer. The cost of different regimens of follow-up is variable, with more intensive regimens being more expensive and cost-effectiveness favouring less intensive regimens. Resources could be mobilised to other aspects of breast cancer care, or other areas of healthcare, potentially increasing equity.
This recommendation is provisional because of the uncertainty about the net benefit of the interventions.
This recommendation is conditional because it might be different depending on the feasibility of the setting of the intensive follow-up policy.
Subgroup considerations Not applicable (no specific subgroup of women were considered).
Implementation considerations Women should be informed in detail at baseline about different types of follow-up and their related impacts, to increase their satisfaction and reassurance with a less intensive follow-up.
Resources could be mobilised to other aspects of breast cancer care, or other areas of health care, potentially increasing equity.
Monitoring and evaluation Health outcomes related to less intensive follow-up should be periodically assessed (we suggest every 5 years).
Research priorities Patient-centred endpoints should be explored, and the relationship between follow-up intensity and technical and psychological support to continue endocrine treatment should be further studied. Similarly, organisational aspects related to the coordination of follow-up activities should be addressed.
  1. Legend: This table represents the third and last part of the Evidence to Decision framework