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Pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) practice guides - What's changed in Version 2020?

The pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) practice guides present evidence on symptom management in user-friendly formats and using plain language. The aim of this work is to summarize changes to the practice guides based on new evidence including management specific to immune checkpoint inhibitors (ICIs). A systematic review of literature was conducted to identify clinical practice guidelines and systematic reviews. For version 2020, there is new evidence from 86 sources (range 2-16; mean 9 per guide), including 14 specific to ICIs, and we removed 21 outdated sources. The 15 COSTaRS practice guides were updated and 2 new guides created for mouth dryness and skin rash. The National Cancer Institute's common terminology criteria for adverse events (NCI-CTCAE) grading was added to the assessment results. "Review self-care strategies" was changed to "Review 3 or more self-care strategies". There were changes based on new evidence and ensuring consistency across practice guides. The 2020 update was validated by oncology nurses from across Canada.