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6 / 10

Strongly agree or agree

Neither agree nor disagree

Strongly disagree or disagree

No answer

39 (98%)

1 (3%)



39 (98%) 30 (75%) 36 (90%)

1 (3%) 8 (20%) 2 (5%)

0 2 (5%) 1 (3%)

0 0 1(3%)

40 (100%) 36 (90%) 20 (50%)

0 1 (3%) 7 (18%)

0 3 (8%) 4 (10%)

0 0 1 (3%)

24 (60%)

5 (13%)

4 (10%)

1 (3%)

36 (94%)


3 (8%)

1 (3%)

Likely or very likely


Not at all likely or unlikely

34 (85%)

2 (5%)

4 (10%)


Ontario Cervical Cancer Screening Clinical Practice Guidelines

Table 4. Practitioner responses to items on the practitioner feedback survey

n (%)


The rationale for developing a clinical practice guideline, as stated in the “Choice of Topic” section of the report, is clear.

There is a need for a clinical practice guideline on this topic. The literature search is relevant and complete

The results of the trials described in the report are interpreted according to my understanding of the data.

The draft recommendations in this report are clear. I agree with the draft recommendations as stated.

The draft recommendations reflect a more effective approach for improving patient outcomes than is current usual practice*

When applied, the draft recommendations will result in better use of resources than current usual practice†

This evidence report should be approved as a practice guideline.

If this evidence report were to become a practice guideline, how likely would you be to make use of it in your own practice?

Some items do not total 100% because of rounding. *8 respondents (20%) indicated “the draft recommendations are the same as current practice.”

  • 6 respondents (15%) indicated “the draft recommendations will result in the same outcomes as current practice.”

clinicians will instantly change practice when with new guideline recommendations. It is not realistic to expect cli- nicians to change their practice immediately when new clini- cal practice guidelines are disseminated. Effecting change in the face of variable clinical practice and modest evidence from the health care literature is a difficult and ongoing pro- cess. There are many barriers to effecting change among cli- nicians with respect to the use of clinical practice guidelines: practitioners may not accept the credibility and expertise of the guideline developers, that the full body of evidence was detected and analyzed correctly, or that recommendations were based on the available evidence. In addition, even the best-written guidelines cannot be effective if they do not reach their target audience, and they must acknowledge the clinician’s understanding of the clinical issue in the context of the existing health care system.

The Ontario Cervical Screening Program concluded that a rigorous methodological process, with input from key stakeholders, would be needed not only to inform best practices on cervical screening, but also to serve as an effec- tive tool to facilitate knowledge transfer. As part of the development, a panel of Ontario-based experts was recruited to produce a guideline on cervical screening. The panel was responsible for the systematic collection of data and its subsequent interpretation. Interpretation was aided

through the use of the AGREE tool and through the sys- tematic review process developed by the Program in Evidence-Based Care. The internal review acted as a quality control measure, and the external review process served to refine the document, add credibility and transparency to the process, and inform practitioners about the latest evidence and recommendations on cervical cancer screening in Ontario.


Because of the variable evidence used to inform practice on cervical screening, a rigorous methodological approach was taken to develop comprehensive recommendations, using systematic literature review, expert consensus, guideline evaluation instruments, evidence-rating systems, internal and external validation measures, and final approval by a practice guidelines coordinating committee. A dissemina- tion and knowledge transfer strategy was employed through community involvement with opportunities for document review and feedback.


The authors would like to thank the collaborators on the Cervical Screening Guidelines Development Committee (Appendix



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