Improving the WHO Classification of Tumours by an Evidence-Based Approach: A New Online/Blended Learning Training Program

Abstract

AbstractThe WHO Classification of Tumours (WCT) is a series of authoritative and concise reference books for the histological and molecular classification of tumors that underpins treatment and care of cancer patients, as well as research into cancer epidemiology, prevention, diagnosis, and treatment, and is essential for cancer diagnosis worldwide. This classification relies traditionally on consensus of pathological expert opinions as basis for cancer classification, but the understanding of cancer at a molecular level advances in prognosis, and other related fields have moved the WCT to find ways of translating diagnostic research into evidence synthesis that can effectively inform decisions relevant to the classification. Systematic reviews represent the top of the hierarchy of scientific evidence and allow to summarize evidence from many publications to inform decisions. This evidence-based approach is the cornerstone of evidence-based medicine and well established in many medical specialties. However, uptake of these principles within pathology has been slow, and such high-quality reviews of available evidence are not easily available for authors contributing to the WCT. In an effort to overcome reluctance in the field to adopt these methods, a collaborative project between the Advanced Oncology program of the University of Ulm in Germany, the Cochrane Netherlands, the Universidad de Campinas in Brazil, and the WCT has been started. This project called Evi-Pat (Evidence-Based Pathology Training Initiative) aims to develop and evaluate an online training for oncologists and pathologists to train them in the application of evidence-based practice to pathology and related specialties, thereby addressing and overcoming challenges in this, and to pathology, novel approach. Scientific and didactic evaluation of such an effective training tool for online-educated pathologists and oncologists will improve the evidence base in pathology and hence provide a solid foundation for diagnostic and prognostic decision-making. We believe that an evidence-based approach to informing key decisions that feed into tumor classification will allow the WCT editorial board to mitigate the potential inclusion of biased decisions into the classification and also benefit authors by providing structured, transparent, and reliable methods for the synthesis of available evidence for each tumor type, as the same time training to apply these methodologies.