Evidence-based Guidelines
The BSC contributes to the development and endorsement of clinical practice guidelines to support behavioral health (e.g., mental, neurocognitive, psychosocial) across the cancer continuum from active treatment to long-term survivorship. To guide patient care during therapy, the COG Supportive Care Guidelines are a resource for up-to-date guidelines aligned with Institute of Medicine criteria7 that are reviewed, evaluated, and endorsed by the COG Supportive Care Guidelines sub-Committee (https://www.childrensoncologygroup.org/cog-supportive-care-endorsed-guidelines). Currently, there are COG-endorsed guidelines to assist in the psychosocial management of fatigue8 and chronic pain.9 However, there remains a critical gap in supportive care clinical practice guidelines that meet current methodological standards.10
BSC members help to evaluate recent evidence on potential behavioral health late effects of treatment and generate recommended surveillance in the COG Long-Term Follow-Up Guidelines (http://www.survivorshipguidelines.org). These guidelines recommend annual assessment for educational and vocational progress, social functioning, mental health disorders, risky health behaviors, sleep, fatigue, and healthcare or insurance access for all long-term survivors. For patients with a history of exposure to neurotoxic therapy, guidelines recommend formal neuropsychological evaluation upon entry to survivorship care with repeated evaluations as needed for survivors with impairments in educational or vocational progress. Despite the wealth of observational data documenting neurocognitive and behavioral health late effects and associated risk factors, interventions to address these late effects of treatment are lacking and desperately needed to promote QOL among long-term survivors.11–16