This paper discusses the use of Cochrane systematic reviews in guideline development in Denmark, but has wider implications. Citation, abstract and a comment from me below.
CITATION: Usefulness of Cochrane Reviews in Clinical Guideline Development — A Survey of 585 Recommendations
Christoffer Bruun Korfitsen et al.
Int. J. Environ. Res. Public Health 2022, 19(2), 685; https://doi.org/10.3390/ijerph19020685
The Danish Health Authority develops clinical practice guidelines to support clinical decision-making based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and prioritizes using Cochrane reviews. The objective of this study was to explore the usefulness of Cochrane reviews as a source of evidence in the development of clinical recommendations. Evidence-based recommendations in guidelines published by the Danish Health Authority between 2014 and 2021 were reviewed. For each recommendation, it was noted if and how Cochrane reviews were utilized. In total, 374 evidence-based recommendations and 211 expert consensus recommendations were published between 2014 and 2021. Of the 374 evidence-based recommendations, 106 included evidence from Cochrane reviews. In 28 recommendations, all critical and important outcomes included evidence from Cochrane reviews. In 36 recommendations, a minimum of all critical outcomes included evidence from Cochrane reviews, but not all important outcomes. In 33 recommendations, some but not all critical outcomes included evidence from Cochrane reviews. Finally, in nine recommendations, some of the important outcomes included evidence from Cochrane reviews. In almost one-third of the evidence-based recommendations, Cochrane reviews were used to inform clinical recommendations. This evaluation should inform future evaluations of Cochrane review uptake in clinical practice guidelines concerning outcomes important for clinical decision-making.
COMMENT (NPW): In the full text I was surprised to read 'To the best of our knowledge, no guideline development group has investigated how Cochrane reviews have informed specific critical and important outcomes of interest in guidelines.' This is an indictment of research on guideline development. The paper also raises the question of what we know about the use of systematic reviews in clinical guideline development in low- and middle-income countries. Can anyone on HIFA point us to research on this?