The use of Cochrane evidence and guidance in World Health Organization guidelines

Article type
Authors
Hartling L1, Thomson D1, Sommerville M1, Bero L2
1Child Health Field, Canada
2US Cochrane Centre, USA
Abstract
Background: One of the key functions of the World Health Organization (WHO) is the preparation of global guidelines to address public health questions. Guidelines comprise recommendations that can impact upon health policies or clinical interventions. As The Cochrane Collaboration (Cochrane) is a leader in producing high-quality reviews for policy and practice decisions, it is important to assess the degree to which guidance and evidence from The Cochrane Collaboration are used in the formulation of WHO guidelines.

Objective: To assess the extent to which Cochrane’s guidance and evidence is cited in WHO guidelines.

Methods: We identified all currently available WHO guidelines (n = 76) and reviewed them for references to Cochrane guidance (e.g. The Cochrane Handbook for Systematic Reviews of Interventions, assistance from a particular Cochrane Review Group) and evidence (Cochrane Reviews). We analyzed guidelines overall and categorized topics as pertaining to children (n = 19), mixed adult and child (n = 6), and adult-only (no specific reference to children) (n=51).

Results: 53%of allWHO guidelines contain references to The Cochrane Collaboration. 90% of these references are to one or more Cochrane Review; 10% are to Cochrane guidance. Adult guidelines: 47% reference the Cochrane Collaboration. There is an increasing use of Cochrane evidence from 2008 (20%) to 2012 (78%). Mixed adult and child guidelines: 83% reference The Cochrane Collaboration. Child guidelines: 58% reference the Cochrane Collaboration. More detail about the citations in various disease and topic areas will be presented at Colloquium.

Conclusions: There is considerable use of Cochrane evidence in WHO guidelines, and some use of the guidance provided by the Collaboration. More research would be useful in detailing how and why Cochrane Reviews are cited, the use of non-Cochrane Reviews, and areas where systematic reviews are needed but are not available. This could serve to identify and prioritize topics for future Cochrane Reviews.