{
  "abstract": "Objective To explore stakeholder experiences with implementing the living guideline (LG) development framework in oncology, and to identify barriers, facilitators and solutions to support its uptake and sustainability.Design An exploratory sequential mixed methods design was used, beginning with qualitative semi-structured interviews with guideline development stakeholders, analysed thematically; and followed by a cross-sectional survey to quantitatively rate the importance of factors identified in phase one.Setting National and international oncology guideline development programmes using the LG development framework.Participants Stakeholders involved in LG development, including expert panel co-chairs, panel members, patient representatives, methodologists and administrative staff.Results Nine stakeholders participated in qualitative interviews, and 45 completed the survey. Most participants were male (5/9:56% qualitative; 26/45:58% quantitative) and based in the US (7/9:78% and 29/45:64%, respectively). Overall, the results from both the qualitative and quantitative strand revealed seven themes (34 subthemes) as barriers and six themes (21 subthemes) as facilitators. Additionally, 9 themes were proposed as solutions. The most frequently reported barriers included evidence timeliness, interpretation and publication delays. Prominent facilitators included effective management, resource optimisation and panel engagement. Participants strongly endorsed investment in artificial intelligence enhanced tools to improve the speed and efficiency of evidence acquisition and review.Conclusion While the LG framework provides strong methodological guidance, its practical application presents notable challenges, particularly in resource demands and implementation logistics. Successful adoption requires adequate infrastructure, expertise and oversight. These findings highlight critical considerations for developers aiming to implement sustainable LG models in oncology and beyond.",
  "authors": [
    {
      "affiliations": [
        "Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada",
        "American Society of Clinical Oncology, Alexandria, Virginia, USA"
      ],
      "name": "Nofisat Ismaila"
    },
    {
      "affiliations": [
        "American Society of Clinical Oncology, Alexandria, Virginia, USA"
      ],
      "name": "Brittany E Harvey"
    },
    {
      "affiliations": [
        "American Society of Clinical Oncology, Alexandria, Virginia, USA"
      ],
      "name": "Kaitlin Einhaus"
    },
    {
      "affiliations": [
        "Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada",
        "Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada",
        "Biostatistics Unit, Father Sean O’Sullivan Research Centre, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada",
        "Centre for Development of Best Practices in Health, Central Hospital of Yaounde, Yaoundé, Cameroon",
        "Department of Pediatrics, McMaster University, Hamilton, ON, Canada"
      ],
      "name": "Lawrence Mbuagbaw"
    },
    {
      "affiliations": [
        "Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Jinhui Ma"
    },
    {
      "affiliations": [
        "Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada",
        "Biostatistics Unit, Father Sean O’Sullivan Research Centre, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada",
        "Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa",
        "University of Johannesburg Faculty of Health Sciences, Johannesburg, South Africa"
      ],
      "name": "Lehana Thabane"
    }
  ],
  "title": "Barriers and facilitators to implementing the living guideline development framework in oncology: a mixed methods study",
  "uid": "25723dc7-6db4-51d1-b3bd-c35288e38503"
}