Table 1. Pediatric Cooperative Group^† Strategies for Development, Implementation, Dissemination and Maintenance of Health Screening Guidelines for Childhood Cancer Survivors.

Establish aims and goals of guidelines	Provide guidance to clinicians caring for survivors. Standardize and enhance follow-up care of survivors Facilitate early identification of late treatment effects Promote timely intervention for late treatment effects Educate survivors and families about health risks Promote healthy lifestyle of survivors
Define target population for screening.	By age at diagnosis (childhood, adolescent, young adult, adult) By time from completion of therapy (≥ 2 years, ≥ 5 years, etc…) By disease status (maintained remission, stable disease, etc…)
Consider intended users of guidelines.	Hematology/oncology providers (pediatric/ medical, surgical, radiation, nursing, etc…) Primary care providers (pediatricians, family physicians, internist, gynecologists) Subspecialty providers (pediatric/medical, endocrine, cardiology, etc…) Cancer survivors and families
Identify expertise required to develop the guidelines.	Hematology/oncology (pediatric/medical, surgery, radiation, nursing, transplant) Primary care (pediatrics, family medicine, internal medicine, gynecology) Subspecialty (pediatric/ medical, endocrine, cardiology, etc…) Behavioral (psychology, social work) Supportive care (physical/occupational therapy, etc…) Patient/survivorship advocacy Analytical (epidemiology, biostatistics, public health services)
Adopt guideline methodology.	Systematic review of evidence with assessment of methodological quality of studies. Translation of evidence and clinical experience into screening recommendations.
Determine preferred guideline design.	Therapy/exposure-based Outcome-based (by organ, tissue, or function) Disease-based
Establish guideline content.	Address both medical and psychosocial outcomes Comprehensive versus selected key late effects Organization/venue of long-term follow-up care Provider versus survivor (patient education) format Treatment summary template Medical citations to support recommendations
Implement and disseminate guidelines.	Posting on internet website Presentations at cooperative group and professional society meetings Presentations in academic and community forums Publication of review manuscripts Incorporation into primary care pathways Collaboration with health care and insurance organizations
Organize plan to maintain currency of guidelines.	Ongoing monitoring of late effects literature Biennial systematic review by multidisciplinary task forces Consideration of guideline revisions by oversight committee International collaboration to harmonize recommendations.

^†Guidelines from the following Pediatric Cooperative Groups were reviewed for inclusion in this summary: Children's Oncology Group (COG),²⁵ Children's Cancer and Leukemia Group (CCLG)²³, Dutch Childhood Oncology Group (DCOG)²⁶, and Scottish Intercollegiate Guidelines Network (SIGN).²⁴