Cochrane’s impact on child health guidance in three Western countries

Article type
Authors
Thomson D1, Sommerville M1, Hartling L1
1Child Health Field, Canada
Abstract
Background: The Cochrane Collaboration was founded on the premise that the preparation of systematic reviews is a foundation for better health care outcomes. However, the real impact of evidence synthesis comes from use. We measured the potential use of Cochrane evidence in child health by assessing the degree to which Cochrane Reviews are cited in pediatric policy statements and clinical practice guidelines in three Western countries.

Objectives: To evaluate the use of Cochrane evidence in child health guidance in Canada, the US and the UK.

Methods: We identified the practice guidelines and policy position statements of the Canadian Paediatric Society (CPS) and the American Academy of Pediatrics (AAP), as well as the child-relevant clinical guidelines of the National Institute for Clinical Evidence (NICE) in the UK. We extracted the number of references to Cochrane systematic reviews.

Results: AAP Practice Guidelines (n = 18): 44% reference CDSR; no trend by year, no CDSR references before 2001. AAP Policy Statements and Statements of Endorsement (n = 594): 4% reference CDSR, 5.5% from 2000 onwards; no trend by year, no CDSR references before 2000. CPS Position Statements (n = 194): 24% reference CDSR; no trend by year, no CDSR references before 2001. NICE Clinical Guidelines: 100% of Children and Youth guidelines (n = 19), 94% of all guidelines that mention children (Children and Youth + Children and Adults, n = 48)), and 90% of the guidelines tagged as Child Health (n = 10) reference CDSR. Further analysis by clinical area is ongoing.

Conclusions: There is considerable variability between Canada, the US and the UK in the degree to which Cochrane evidence is used in child health guidance. More detailed research would help establish if there are areas where guideline authors require evidence but Cochrane Reviews are not available. This could serve to identify and prioritize topics for future Cochrane Reviews.