Table 1.

Comparison of Clinical Practice Guidelines for the Management of Chronic Pain

	CDC Guideline for Prescribing Opioids for Chronic Pain4	ASCO Management of Chronic Pain in Survivors of Adult Cancers7	NCCN Clinical Practice Guidelines in Oncology: Adult Cancer Pain5	NCCN Clinical Practice Guidelines in Oncology: Survivorship6	ASH Guidelines for Sickle Cell Disease–Related Paina
Year published	Most recent version: March 2016	Most recent version: September 2016	Most recent version: June 2019 (Version 3.2019) Updated at least annually	Most recent version: June 2019 (Version 2.2019) Updated at least annually	Anticipated winter 2020
Patient population	Adult patients with chronic pain (≥3 months) outside of active cancer treatment, palliative care, and end-of-life care	Any adult who has been diagnosed with cancer and is experiencing pain lasting ≥3 months, irrespective of cause	Adult patients with cancer-related pain	Adult cancer survivors with long-term effects of treatment, including chronic pain	Children and adults with sickle cell disease–related acute or chronic pain
Purpose of the guideline	Provide recommendations for primary care clinicians prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care	Evaluate RCTs and other fundamental studies regarding chronic pain in cancer survivors reported in the literature, compare outcomes among trials, and provide guidance to clinicians on the effectiveness of treatment options for pain in adults with a history of cancer	Identify central principles for the assessment and management of cancer pain in adults, including aspects of opioids, nonopioids, adjuvant analgesics, and broad multimodal care	Provide a framework for general survivorship care and management of potential long-term and/or late effects of cancer and its treatment Intended as a survivor-specific supplement to recommendations within disease-specific NCCN Guidelines	Help clinicians make decisions about the management of acute and chronic pain for patients with sickle cell disease
Target audience	Primary care clinicians	Healthcare practitioners who provide care to cancer survivors	Healthcare practitioners who provide care to patients with cancer	Healthcare practitioners who provide care to cancer survivors	Healthcare practitioners who provide care to patients with sickle cell disease
Authorship/Expert representation	CDC sought input from experts (the “Core Expert Group”) to help review the evidence and provide individual perspectives on how CDC used the evidence to develop the draft recommendations, and from an Opioid Guideline Workgroup to review the draft guideline and report observations to the NCIPC’s Board of Scientific Counselors in order to obtain their consensus advice; the workgroup comprised the following perspectives: primary care, pain medicine, public health, behavioral health, substance abuse disorder treatment, pharmacy, patients, and research A 3-author Steering Committee authored the guideline for CDC	The ASCO Clinical Practice Guidelines Committee convened an Expert Panel with multidisciplinary representation in medical oncology, nursing, radiation oncology, pain medicine, anesthesiology, psychology, rehabilitation medicine, symptom management research, social work, palliative care, patient/advocacy representation, and guideline implementation The Expert Panel was led by 2 co-chairs	Each NCCN Guidelines Panel includes a Panel Chair, Vice Chair, and a group of representatives from the NCCN Member Institutions which are NCI-designated cancer centers NCCN Adult Cancer Pain Panel members represent multidisciplinary specialties, including supportive care (eg, palliative care, pain management, pastoral care, and oncology social work), anesthesiology, nursing, medical oncology, hematology oncology, internal medicine, neurology/neuro-oncology, radiotherapy/radiation oncology, psychiatry or psychology, complementary and alternative medicine, and pharmacology	Each NCCN Guidelines Panel includes a Panel Chair, Vice Chair, and a group of representatives from the NCCN Member Institutions which are NCI-designated cancer centers NCCN Survivorship Panel members represent multidisciplinary specialties, including medical oncology, internal medicine, pediatric oncology, bone marrow transplantation, urology, nutrition science/dietician, hematology oncology, gynecology/gynecologic oncology, surgery/surgical oncology, neurology/neuro-oncology, nursing, patient advocacy, supportive care (eg, palliative care, pain management, pastoral care, and oncology social work), cardiology, infectious diseases, epidemiology, and psychiatry or psychology	The ASH Guideline Panel on Sickle Cell Disease–Related Pain Panel includes a clinical cochair and a methods cochair, and a group of multidisciplinary experts in pain medicine, anesthesiology, psychiatry, nursing, and pediatric and adult hematology
Methodology & evidence source	Systematic review of RCTs; observational studies were included in the contextual evidence review	Systematic review of RCTs and observational studies	Recommendations based on expert panel consensus following critical review of RCTs, observational studies, clinical trial data, other peer reviewed data	Recommendations based on expert panel consensus following critical review of RCTs, observational studies, clinical trial data, other peer reviewed data	GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach; systematic review of RCTs and observational studies
Feedback processes	Solicitation of individual expert opinion, federal partner engagement, stakeholder comment, constituent engagement, public comment, and federal advisory committee recommendations	Expert Panel review followed by external review from content experts prior to Clinical Practice Guideline Committee approval	Annual institutional review and NCCN panel meetings at least annually (often more frequently) Feedback provided during educational programs and forums User feedback continually received through submission process, via survey, and informally	Annual institutional review and NCCN panel meetings at least annually (often more frequently) Feedback provided during educational programs and forums User feedback continually received through submission process, via survey, and informally	Public comment period followed by organizational review and approval

Abbreviations: NCIPC, National Center for Injury Prevention and Control; RCT, randomized controlled trial.

^aThe ASH Sickle Cell Disease–Related Pain Guidelines were still in development at the time of the meeting and thus not discussed during the meeting.