Background: Cochrane reviews are considered as an ideal source of research information of clinical effectiveness in the preparation of health technology assessment (HTA) reports and evidence-based clinical practice guidelines. In this study we want to explore to what extent Cochrane reviews are incorporated in HTA reports and guidelines on epicondylitis and carpal tunnel syndrome.

Objectives: To give an answer to the following questions:

- To what extent topic relevant and available Cochrane reviews are included in HTA reports and guidelines?

- What are the reasons for omitting Cochrane reviews: different patient spectrum or study inclusion criteria, unknown?

- If a Cochrane review is not cited, do the authors refer to the same original articles as the Cochrane review?


Methods: Source material:

- all Cochrane reviews on epicondylitis and carpal tunnel syndrome;

- all HTA reports from The Cochrane Library on epicondylitis and carpal tunnel syndrome;

- all evidence-based guidelines on epicondylitis and carpal tunnel syndrome from Guidelines International Network (GIN), National Guideline Clearinghouse (NGC) and other guideline sources (Google search).


Intervention comparisons with references are tabulated.

Results: There are eleven pertinent Cochrane reviews with 146 intervention comparisons in The Cochrane Library 2006, Issue 1. Only patient related outcomes (pain, function, work ability, quality of life, harms) were considered. Nine HTA reports and fifteen guidelines were included. They incorporated Cochrane reviews to a varying extent. In particular, the statements of carpal tunnel surgery in HTA reports and guidelines presented different evidence than the corresponding Cochrane review. The reasons for inconsistency will be analysed.

Conclusions: Transfer of Cochrane reviews into HTA reports and evidence-based clinical guidelines could be more comprehensive. It would be worth studying whether the textual content of these documents vary as much as their evidence base.