The recently published consensus guidelines for immunization of children with cancer in India [1] address an important ‘felt-need’ of the practicing pediatricians. It has been stated in the article that these guidelines were in the making since 2014 and were finalized in 2018. Based on the list of references cited, it appears that although the experts have considered various guidelines published till 2018, they have only reviewed original data generated till 2014. Since the guidelines have been published in December 2019, it would have been better if original studies, especially the Indian ones, published till 2019 were reviewed and considered while making the recommendations. It was also desirable to provide information regarding the quality of evidence supporting every recommendation and the strength of each recommendation. This would have helped healthcare providers in making appropriate informed decisions with greater confidence. It may be noted that the Infectious Disease Society of America guidelines that the authors have referred to, provide such information for each recommendation [2].

In the interest of enhancing confidence in such guidelines, it is necessary that the experts formulating these provide greater details of the methodology used for arriving at the recommendations (including the search strategy and process, evidence selection criteria, process of evaluation of the quality of evidence, procedure for formulating recommendations, use of external review and quality assurance process). A gist of these procedural details can be published in the published guidelines, and comprehensive methodological details can be put up at the organization’s website. This will enhance the transparency in the system of making recommendations and will also allow a critical appraisal of the judgments made while formulating the guidelines [3].

With a view to ensure comprehensive reporting, the editors of Indian Pediatrics encourage authors to adhere to relevant guidelines (eg. CONSORT guidelines and STROBE guidelines, etc) while writing research articles [4]. They can extend this principle to reporting recommendations and practice guidelines by encoura-ging the expert groups to adhere to AGREE Checklist [5] or the RIGHT statement [6], while formulating and reporting recommendations. This will promote trans-parency, allow critical appraisal and assure the readers about the evidence-base of the recommendations made.

REFERENCES

1. Moulick NR, Mandal P, Chandra J, Bansal W, Jog P, Sanjay S, et al. Immunization of Children with Cancer in India Treated with Chemotherapy- Consensus Guideline from the Pediatric Hematology- Oncology Chpater and the Advisory Committee on Vaccination and Immunization Practices of the Indian Academy of Pediatrics. Indian Pediatr. 2019;56:1041-7.

2. Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tamblyn M, et al. 2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host. Clin Infect Dis. 2014;58:e44-e100.

3. GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ. 2004;328:1490.

4. Indian Pediatrics. Instructions to Authors. Available from: https://www.indianpediatrics.net/author1.htm. Accessed January 21, 2020.

5. Brouwers MC, Kerkvliet K, Spithoff K, AGREE Next Step Consortium. The AGREE reporting checklist: A tool to improve reporting of clinical practice guidelines. BMJ. 2016;352:i1152.

6. RIGHT Checklist. Available from: http://www.right-statement.org/right-statement/checklist. Accessed January 21, 2020.