Comparison of the Cochrane Neonatal Group systematic reviews and Danish guidelines for newborns

Tags: Poster
Gluud C, Greisen G

Background: The need for the best available external evidence for clinical practice has been widely recognized. However, several studies have reported lack of randomised clinical trials or convincing non-randomised trials supporting interventions within different specialties. This indicates that discrepancy between research and clinical practice may occur or/and lack of randomised clinical trials. Physicians may also have difficulties in keeping up to date with the high number of published trials, approximately 12.500/year. The Cochrane Neonatal Group accounts for 169 systematic Reviews, representing 9% of all Cochrane Reviews and covering the most important interventions for newborns. Further, there has been an increase in trials within paediatrics/ neonatology following the Paediatric Exclusivity Provision Law in USA in 1997. This law allowed an additional six months patent protection for drugs assessed in trials with children. All Danish physicians have free access to The Cochrane Library and should therefore be well equipped to practise evidence-based medicine and to improve the medical care of newborns.

Objective: To assess whether the Danish guidelines on how to treat newborns are in accordance with the results of Cochrane Neonatal Group systematic Reviews.

Methods: The interventions were divided into three categories: A: The intervention is based on evidence supporting its clinical use (beneficial effects on mortality and/or morbidity). B: The intervention is based on some evidence supporting its clinical use (beneficial effects on surrogate outcomes). C: No evidence to support or refute the intervention or evidence showing detrimental effect of the intervention. We will approach the 18 Danish hospitals with a neonatal or paediatric department. We will search for discrepancies between the national and local guidelines for newborns and the Cochrane Neonatal systematic Reviews. We will also try to identify discrepancies in between the guidelines.

Results and Conclusions: The study is currently running and is expected to finish mid September 2004. Therefore, the results and conclusions will be presented at the Cochrane Colloquium.