P205 Systematic review and critical appraisal of malignant melanoma clinical practice guidelines: a Global Guidelines in Dermatology Mapping Project (GUIDEMAP)

Abstract

Melanoma is a potentially life-threatening malignancy arising from melanocytes, and accounts for significant global morbidity and mortality. Recent advancements have increased the complexity of melanoma diagnosis and management. High-quality and methodologically robust clinical practice guidelines (CPGs) are essential to support evidence-based and equitable healthcare delivery, and variability in CPG quality may have implications for patient care. The aim of this review is to identify accessible international CPGs on cutaneous melanoma and to assess their methodological quality, clarity, editorial independence and applicability using validated appraisal tools. A systematic search of major electronic databases was undertaken to identify CPGs published on melanoma between 24 April 2020 and 24 April 2025. Additionally, a comprehensive manual search was performed to identify guidelines available through major guideline depositories and through the society websites of the members of the International League of Dermatological Societies. Eligible guidelines were independently appraised by four reviewers using the AGREE II and NEATS instruments. Fifty CPGs produced by 27 professional societies spanning 16 geographical regions were included for final analysis. Most CPGs were developed in regions with a high or upper–middle sociodemographic index (SDI), with limited representation from regions with low SDI, and were predominantly published in English. No guideline achieved uniformly excellent performance across all AGREE II domains. Scope and clarity were the strongest AGREE II domains, while stakeholder involvement and applicability performed poorly. NEATS appraisal similarly showed high scores for clarity of recommendations but persistent deficiencies in patient involvement. Guidelines scored well with respect to scope definition and clarity of recommendations. However, persistent weaknesses in equitable stakeholder involvement and global representation indicate that current guidance may not meet the needs of diverse health systems. Improvements in these domains are essential to maximize the acceptability, relevance and engagement of CPGs by all stakeholders. Future CPGs should prioritize meaningful patient engagement and consideration of dissemination and resource constraints to support consistent melanoma care worldwide.