Usefulness of Cochrane Reviews in Clinical Guideline Development—A Survey of 585 Recommendations

Abstract

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.

Assessment of health equity consideration in Cochrane systematic reviews and primary studies on urolithiasis

“…10 They are a valuable source for designing guidelines, policy making and clinical practice. 11 Given that the first step in eliminating health injustice is to identify the causes, the aim of the present study was to evaluate equity considerations in Cochrane reviews and the included primary studies on urinary stones using the PROGRESS framework.…”

“…Cochrane reviews are important, high‐quality and practice‐relevant systematic reviews, mainly due to their rigorous, clear and accurate methods and a regular updating process 10 . They are a valuable source for designing guidelines, policy making and clinical practice 11 . Given that the first step in eliminating health injustice is to identify the causes, the aim of the present study was to evaluate equity considerations in Cochrane reviews and the included primary studies on urinary stones using the PROGRESS framework.…”

Telehealth and Health Equity in Older Adults With Heart Failure: A Scientific Statement From the American Heart Association

“…Cochrane systematic reviews are internationally recognized as high-quality evidence synthesis reports that inform the development of clinical guidelines and recommendations. 49 One of the most well-known and highly cited reviews of noninvasive telehealth interventions for patients with HF is the Cochrane systematic review by Inglis et al (2015), 28 28 Similar results in terms of direction and magnitude of effects have been reported by other high-quality systematic reviews and meta-analyses of telehealth interventions. [50][51][52] A more recent systematic review and metaanalysis of 16 RCTs comparing mobile health interventions with usual care found both clinically and statistically significant risk reductions in all-cause mortality (RR, 0.80 [95% CI, 0.65-0.97]; P=0.02, n=4002 patients; high-quality evidence) and HF-related hospitalizations (RR, 0.77 [95% CI, 0.67-0.88]; P=0.0001, n=3379 patients; high-quality evidence).…”

Availability of evidence and comparative effectiveness for surgical versus drug interventions: an overview of systematic reviews

“…This study covers the entire Cochrane database which is considered a high-quality comprehensive collection of systematic reviews. Cochrane reviews tend to address questions typically asked in routine clinical practice and underpin many clinical guideline recommendations, making this sample all the more relevant to everyday practice [49]. Another strength of this study is that all surgical specialties were included.…”