Article type
Year
Abstract
Background: The Institute of Medicine has redefined clinical practice guidelines (CPGs) as statements that include recommendations intended to optimize patient care that are informed by a systematic review (SR) of evidence. It is unclear whether commonly used CPGs for hypertension meet this standard despite the availability of many systematic reviews on the management of this condition. The Cochrane Library, the foremost 'provider’ of SRs has over 35 reviews on the management of hypertension.
Objectives: To determine the extent to which recently-developed hypertension CPGs are informed by Cochrane (or non-Cochrane) SRs.
Methods: We searched MEDLINE, EMBASE, guidelines' websites and Google for recently published (2006-2010) CPGs on the general management of hypertension in any practice setting and that were written in English or have an English abstract. Two reviewers assessed each guideline for quality using the AGREE tool and determined whether they were informed by available SRs.
Results: Ten CPGs were identified; 8 included references. Seven CPGs cited a total of 59 non-Cochrane SRs and/or meta-analysis. Of these, 5 were cited by 3 CPGs and 10 by 2 CPGs. Only 4 CPGs referred to a total of 14 of the 35 Cochrane reviews (CRs); no CR was cited in more than one CPG. The country CPGs citing most were: Japan (8) and Malaysia (3). The relationship between the evidence generated by the reviews and the corresponding recommendation could not always be recognized.
Conclusions: Despite the increased production of SRs in general and CRs in particular, few guidelines refer to available SRs. The reasons for lack of inclusion of SRs need to be explored. And the need for the Cochrane Collaboration to consider the practical means by which its knowledge can be translated clearly stands out.
Objectives: To determine the extent to which recently-developed hypertension CPGs are informed by Cochrane (or non-Cochrane) SRs.
Methods: We searched MEDLINE, EMBASE, guidelines' websites and Google for recently published (2006-2010) CPGs on the general management of hypertension in any practice setting and that were written in English or have an English abstract. Two reviewers assessed each guideline for quality using the AGREE tool and determined whether they were informed by available SRs.
Results: Ten CPGs were identified; 8 included references. Seven CPGs cited a total of 59 non-Cochrane SRs and/or meta-analysis. Of these, 5 were cited by 3 CPGs and 10 by 2 CPGs. Only 4 CPGs referred to a total of 14 of the 35 Cochrane reviews (CRs); no CR was cited in more than one CPG. The country CPGs citing most were: Japan (8) and Malaysia (3). The relationship between the evidence generated by the reviews and the corresponding recommendation could not always be recognized.
Conclusions: Despite the increased production of SRs in general and CRs in particular, few guidelines refer to available SRs. The reasons for lack of inclusion of SRs need to be explored. And the need for the Cochrane Collaboration to consider the practical means by which its knowledge can be translated clearly stands out.