For Whom Are Clinical Practice Guidelines?-Is Minds the Imperial Standard?

It has been more than 20 years since the first guidelines(GL)for cancer treatment were published, and the methodology used to create GL have changed over the years. The methodologies are becoming fairer and more objective, but the rules have become so important that some are difficult for the GL users to understand. In this issue, an author discussed the confusion in the field in GL methodology based on the discussion of postoperative adjuvant therapy of NSCLC. In addition, lung cancer is becoming more and more segmented, and there are many clinical questions(CQs)which the evidence is fragmented and insufficient in lung cancer treatment. Also, only prospective papers are currently adapted for the base of evidence. It is difficult to provide recommendations for CQs in areas where prospective studies are difficult, for example, meningitis cases. How can we provide direction for areas where the evidence is insufficient at such times? We are currently in a transitional period, which will be resolved through further discussions, but we need to be a little more flexible in our methodology to make GLs and be able to provide direction for CQs. One way to provide direction for CQs, even in a form other than CQ, would be to present expert opinions or employ retrospective studies.