{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:18:39Z","timestamp":1787678319259,"version":"build-2784847793"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"8","funder":[{"DOI":"10.13039\/100007217","name":"VA Health Services Research Career Development","doi-asserted-by":"publisher","award":["HX003682"],"award-info":[{"award-number":["HX003682"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014848","name":"Arnold Ventures","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014848","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Clinical practice guidelines influence coverage policy, utilization management, and health care spending. In oncology, some function as drug compendia that guide Medicare coverage of off-label therapies, yet little empirical work has examined their governance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional descriptive study using publicly available documentation to evaluate responses to 75 standardized external change requests submitted to 26 National Comprehensive Cancer Network disease-site panels concerning pembrolizumab or nivolumab dosing. Requests concerning subcutaneous formulations served as a comparator. We characterized request disposition, review timing, transparency, scope interpretation, and financial conflict-of-interest (FCOI) context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>By March 6, 2026, 10 of 75 dosing-related requests (13%) had been adopted, 51 (68%) rejected or determined to be outside panel scope, and 14 (19%) remained pending (median time to decision, 190 days). In contrast, requests concerning US Food and Drug Administration\u2013approved subcutaneous formulations were adopted in 52 of 53 cases (98%) and reviewed substantially more rapidly (median, 11 days). Public documentation incompletely described panel deliberations, voting, participation, and management of FCOIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Standardized requests revealed operational heterogeneity and limitations in publicly available documentation within a Centers for Medicare &amp; Medicaid Services\u2013recognized compendium, identifying opportunities to strengthen transparency and governance in coverage-relevant decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/haschl\/qxag215","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T11:49:55Z","timestamp":1787140195000},"source":"Crossref","is-referenced-by-count":0,"title":["Variation in guideline decision-making: a cross-sectional study of oncology compendium panels"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2973-3040","authenticated-orcid":false,"given":"Garth W","family":"Strohbehn","sequence":"first","affiliation":[{"name":"Veterans Affairs Center for Clinical Management Research , Ann Arbor, MI 48109 ,","place":["United States"]},{"name":"Rogel Cancer Center, University of Michigan , Ann Arbor, MI 48109 ,","place":["United States"]},{"name":"Division of Hematology\/Oncology, Department of Internal Medicine, University of Michigan , Ann Arbor, MI 48109 ,","place":["United States"]},{"name":"Institute for Health Policy and Innovation, University of Michigan , Ann Arbor, MI 48109 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samyukta","family":"Mullangi","sequence":"additional","affiliation":[{"name":"Thyme Care , Nashville, TN 37210 ,","place":["United States"]},{"name":"Tennessee Oncology , Nashville, TN 37203 ,","place":["United 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