Use of Cochrane Library in consensus conference on childhood asthma

Article type
Authors
Singh M, Kumar L
Abstract
Introduction/Objective: A Consensus Conference was held in April 1998 at the advanced Pediatric Center to formulate guidelines for the management of asthma in children in India. The objective of this study was to evaluate the contribution of Cochrane Library in making the guidelines evidence based. A total of 15 experts from different parts of the country participated in the proceedings of the conference.

Methods: Cochrane Library along with other literature data bases was searched before and during the conference. Cochrane library was searched using the advanced search strategy. In the advanced searches several terms (e.g. Beta -sympathomunetics, Inhaled steroids, Aminophylline, Magnesium) were combined with asthma by using "and".

Results: Advanced search on asthma gave a total of 2654 hits. Cochrane database of systematic reviews yielded 31 items out of 404 in total. Completed reviews were 10 in number. Eight reviews out of ten helped in formulation of the guidelines. There were 21 protocols out of which 17 related directly to asthma and they provided supplementary information to other searches. 13 reviews of effectiveness were found which helped in the formulation of the guidelines. Seven out of 307 quality assessed reviews were helpful. None of the two ACP journal clubs were relevant. Cochrane Controlled trial register gave 2607 hits out of 129952 trials. The review of trials was considered to be most helpful in making evidence based decisions. Since most of the trials had been carried out in the western countries, applicability and generalizability was the most important issue. Three of the controlled trials done by the participants and published in Indian and British journals were not found listed in the trial register. Medline search on internet for a similar period retrieved only 1552 trials (59.5% of the Cochrane Library.

Discussion: Cochrane library proved to be a vital document in formulation of evidence based guidelines for management of asthma in children in India. Availability of systematic reviews particularly led to consensus formation on controversial issues. The Cochrane library was much more readily availabile than Medline on the internet in Indian conditions.