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Agreement, Compliance, and Practice Change of the Korean Practice Guidelines for Gastric Cancer 2022: A Nationwide
In-Ho Kim1, Tae-Han Kim2, Bang Wool Eom3
1Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Purpose:
The Korean Practice Guidelines for Gastric Cancer 2022 were developed using a rigorous, multidisciplinary, and evidence-based approach. However, their real-world acceptance and implementation have not yet been formally evaluated. This study assessed agreement, compliance, and practice changes associated with strong guideline recommendation statements.
Materials And Methods:
A nationwide anonymous survey was conducted between August and November 2025 among specialists involved in gastric cancer care. Of the 40 recommendation statements addressing the 33 key questions, 18 strong recommendations were evaluated. Respondents rated agreement, compliance, and practice change using a 5-point Likert scale and provided quantitative estimates of compliance and practice change rates.
Results:
A total of 103 physicians participated, and 100 specialists were included in the main analyses. Most respondents worked at tertiary hospitals (72.8%), and 61.2% had more than 10 years of experience in gastric cancer care. Overall, 93.2% agreed that the guidelines were high-quality, evidence-based documents, and 80.6% reported that they were highly useful in clinical practice. Across the 18 strong recommendation statements, qualitative agreement ranged from 78.5% to 100%, compliance from 60.0% to 100%, and reported practice changes from 11.4% to 40.9%. On average, 95.9% agreed with the recommendations, 92.1% reported compliance, and 23.2% reported a practice change. In the quantitative assessment, the mean compliance rate was 89.7%, and the mean practice change rate was 14.3%.
Conclusions:
The guidelines showed high agreement and compliance among the multidisciplinary specialists. Although changes in practice were relatively limited, the guidelines contributed to selected clinical improvements and promoted the standardization of evidence-based practices.
