Usability of Cochrane-based evidence summaries in point-of-care guidelines

Article type
Authors
Jousimaa J1, Alenius H1, Kunnamo I1
1Duodecim Medical Publications Ltd, Finland
Abstract
Background: Evidence-based Medicine Guidelines (EBMG) is a collection of concise point-of-care guidelines produced by Finnish Medical Society Duodecim. The EBMG collection of almost 1000 guidelines is completed with Evidence Summaries indicating the level of evidence and some also the strength of recommendation. An Evidence Summary can be (1) directly linked to a specific point in guideline text; (2) linked to the guideline general topic (in a separate document named ‘Related Resources’), or (3) a lone summary not linked to any guideline.

Objectives: To assess the usability of Cochrane-Based Evidence Summaries attached to guidelines by assessing how they have been linked with guidelines.

Methods: A database search was done to find the number and type of EBMG Evidence Summary links. Special attention was paid to ‘lone summaries’ - whether they were actually not usable in this type of guideline of if there were other reasons for non-linking.

Results: Currently, there are 4355 EBMG Evidence Summaries, almost 3000 of them based on Cochrane Reviews. Of these 3000, 1000 are directly linked with guidelines, 1500 are linked to guideline topics, and 500 are lone summaries without links to guidelines. The distribution of linked summaries in different clinical specialties is presented.

Conclusions: Evidence summaries are most likely to influence clinical decisions, if they are clearly visible to guideline users. Summaries attached to ‘Related Resources’ and especially lone summaries are less likely to influence practices. In this presentation, possibilities to enhance evidence summary impact by developing their general appearance, visibility and concordance with guideline texts are discussed with practical examples in a live demo; and gaps in Cochrane evidence are identified.