However, we do not feel our continued concern about move to HPV primary screening should prevent us from giving feedback on the updated guidelines. We have made some general comments first and then addressed some of the specific sections. General comments: In general the guidelines appear very focused on the mechanics of testing and the prescribed route of those requiring further investigations and tests. While this is obviously important we think not enough attention has been given to patient interactions, informed consent and allowing for women to make informed decisions about their screening and /or investigation pathway. We believe the sections on management of test results and equity and priority screening should also issues such as education and public perception of both the tests and the results and how health practitioners should manage these. In addition the process for informed consent for the changes to HPV testing should be defined. It should also be defined for the process of further screening and investigation. should also be a process for women who wish to continue with LBC testing. The data management strategies that will be put in place are not described. How women will be informed about the changes to the register and what information will be retained on the register is not described. Nor is managing the possibility that some women may wish to withdraw and not be part of the register which could record a diagnosis of HPV. The document should contain more information about the changes to the register and what this will mean for women including what information will be held. We are particularly concerned about monitoring of the move to HPV primary testing as any issues with a new programme would need to be identified early and openly discussed. It appears the current data analysis driving the program monitoring is contracted to the same group who designed the HPV modelling that drove the decision to use HPV screening in NZ. We believe the Independent Monitoring Group needs to be independent and not composed of the proponents of the new programme. It should also be independent of any industry links. The guidelines should include information about how the composition of the monitoring and evaluation group will be determined, what consumer representation will be included and how unscreened and under screened groups be represented /included? Finally the guidelines should include a description of
However, we do not feel our continued concern about move to HPV primary screening should prevent us from giving feedback on the updated guidelines. We have made some general comments first and then addressed some of the specific sections. General comments: In general the guidelines appear very focused on the mechanics of testing and the prescribed route of those requiring further investigations and tests. While this is obviously important we think not enough attention has been given to patient interactions, informed consent and allowing for women to make informed decisions about their screening and /or investigation pathway. We believe the sections on management of test results and equity and priority screening should also issues such as education and public perception of both the tests and the results and how health practitioners should manage these. In addition the process for informed consent for the changes to HPV testing should be defined. It should also be defined for the process of further screening and investigation. should also be a process for women who wish to continue with LBC testing. The data management strategies that will be put in place are not described. How women will be informed about the changes to the register and what information will be retained on the register is not described. Nor is managing the possibility that some women may wish to withdraw and not be part of the register which could record a diagnosis of HPV. The document should contain more information about the changes to the register and what this will mean for women including what information will be held. We are particularly concerned about monitoring of the move to HPV primary testing as any issues with a new programme would need to be identified early and openly discussed. It appears the current data analysis driving the program monitoring is contracted to the same group who designed the HPV modelling that drove the decision to use HPV screening in NZ. We believe the Independent Monitoring Group needs to be independent and not composed of the proponents of the new programme. It should also be independent of any industry links. The guidelines should include information about how the composition of the monitoring and evaluation group will be determined, what consumer representation will be included and how unscreened and under screened groups be represented /included? Finally the guidelines should include a description of
consultation-feedback-uupdated-clinical-practice-guidelines-cervical-screening-nz-aug17.docx