MASCC is pleased to make available a new addendum to our Clinical Guidance Development & Publication Policy, which supports resource-stratification of supportive care clinical guidelines.
Resource-stratification of guidelines is an approach that attempts to tailor evidence-based recommendations to the level of resource availability and health system infrastructure within a specific country or region. The resources required for a particular treatment, context, or practice can be examined and prioritized based on their relative importance.
Resource-stratification is important in order to: 1) ensure guidelines are appropriate across all resource settings and 2) guide decision-making on maximizing healthcare services within a given budget.
For future MASCC guidelines, recommendations from the ‘parent’ guideline (developed for use in maximal resource settings) will be stratified against the three levels below: basic, core, and enhanced. Stratifying will occur at the basic level first – focusing on what basic aspects of care are required first and what is needed most. Stratifying recommendations should take a staircase approach, focusing on how to ‘step up’ to the next resource level.
| Basic Resources | Core Resources | Enhanced Resources | Maximal Resources |
|---|---|---|---|
| Resources or fundamental services that are absolutely necessary for any public health/primary health care system to function; basic-level services typically are applied in a single clinical interaction. | Resources or services that are intended to produce major improvements in outcomes and are attainable with limited financial means and modest infrastructure; core-level services may involve single or multiple interactions. | Resources or services that are optional but important; enhanced-level resources should produce further improvements in outcome and increase the number and quality of options and individual choice. | High-level/state-of-the-art resources or services that may be used/available in some high-resource countries and/or may be recommended by high-resource setting guidelines that do not adapt to resource constraints. |
This approach will help promote MASCC’s goal of equitable, accessible supportive care for all people affected by cancer, informed by high-quality, evidence-based guidelines that are promoted and implemented locally and globally.