Cochrane Reviews: the linchpins of knowledge translation and impact

Middleton P1, Green S2, Crowther C1
1Cochrane Pregnancy and Childbirth Group, Australia, 2Australasian Cochrane Centre, Australia

Background:

As systematic reviews represent the synthesis of a body of evidence, it stands to reason that they should often be the basic unit of knowledge translation.

Objectives:

To measure the use of Cochrane Reviews (CRs) in several different knowledge transfer systems including clinical practice guidelines (CPGs), cites within The Cochrane Library and in SCOPUS; “actionable” Cochrane Clinical Answers (CCA and altmetric) and to assess if there were relationships between systems and other factors.

Methods:

We used RevMan and Excel to manage our database of 790 perinatal or part-perinatal CRs (pCRs) from 25 Cochrane Review Groups. We manually searched several hundred open access perinatal evidence-based guidelines for cites of these pCRs. We used Cochrane Library citations and altmetric tabs within pCRs; accessed a spreadsheet of all CCAs and searched SCOPUS for cites of CRs.

Results:

Over a third of pCRs (284/790; 36%) were cited in at least one CPG (range 1 to 8), with differences between review focus (less than 10% of neonatal CRs cited in CPGs). CPG citations are rarely captured (in only 3/284 CR cite tabs). pCRs selected for CCAs were just as likely to be cited in a CPG as not; and SCOPUS citation rates showed no clear relationships with any other factor. Four pCRs had exceptionally high altmetric scores (exercise for depression, home births, midwife-led models and cord clamping in term babies) and a further 13 were in the top 5%, but 136 pCRs had a score of zero (mostly older CRs).

Conclusions:

Cochrane Reviews make a substantial, but underestimated contribution to knowledge translation and impact. As there are presently no systems to capture the substantial use of CRs in CPGs, linkage systems are necessary not only between trials and CRs but also between CRs and CPGs. Usage patterns are very different between review focus (e.g. neonatal/antenatal) and between bibliometric and social networking systems, indicating wide and diverse use of Cochrane Reviews and the concomitant need for sophisticated analysis and interpretation.