Article type
Year
Abstract
Background:
The need to develop an evidence-based approach to decision making has been recognised by clinicians, healthcare managers and policy makers. The National Institute for Health Research (NIHR) funds Cochrane Review Groups (CRGs) in the UK, but there is less evidence about the impact of Cochrane Reviews on policy, practice and research.
Objectives:
This study, funded by the NIHR, aimed to (1) evaluate the impact of Cochrane Reviews from 20 NIHR-funded CRGs from 2007 to 2011 on clinical practice, use in clinical guidance and influence on future research; and (2) to identify barriers and facilitators to the use of reviews in developing guidelines.
Methods:
We used bibliometrics and documentary review to assess CRG impact, with an in-depth evaluation of a sample of 60 Cochrane Reviews. The analysis was based on a framework of knowledge production, research targeting, informing policy development, and impact on practice/services. We employed mixed methods, including questionnaires to CRGs and interviews with guideline developers.
Results:
Overall 483 systematic reviews were cited in 247 sets of guidance. We identified 40 examples of reviews influencing primary research, with many contributing to new knowledge. Examples of health benefits included improved patient safety or the identification of new effective treatments. Potential economic benefits included cost savings, improved quality of care, decreased use of unwarranted practices and improvements in patient/carer experiences. Thematic analysis from interviews with guideline developers identified the need for up-to-date evidence, better fit with the guideline scope, positive collaboration and timely communication between guideline developers and CRGs.
Conclusions:
Whilst there were clear impacts on research targeting and healthcare policy, appropriate methods need to be developed for measuring impact on clinical practice and service organisation and delivery, for which there was less evidence. Guideline developers, CRGs and review authors should aim to improve collaboration and communication to ensure that guidance development is useful for decision makers.
The need to develop an evidence-based approach to decision making has been recognised by clinicians, healthcare managers and policy makers. The National Institute for Health Research (NIHR) funds Cochrane Review Groups (CRGs) in the UK, but there is less evidence about the impact of Cochrane Reviews on policy, practice and research.
Objectives:
This study, funded by the NIHR, aimed to (1) evaluate the impact of Cochrane Reviews from 20 NIHR-funded CRGs from 2007 to 2011 on clinical practice, use in clinical guidance and influence on future research; and (2) to identify barriers and facilitators to the use of reviews in developing guidelines.
Methods:
We used bibliometrics and documentary review to assess CRG impact, with an in-depth evaluation of a sample of 60 Cochrane Reviews. The analysis was based on a framework of knowledge production, research targeting, informing policy development, and impact on practice/services. We employed mixed methods, including questionnaires to CRGs and interviews with guideline developers.
Results:
Overall 483 systematic reviews were cited in 247 sets of guidance. We identified 40 examples of reviews influencing primary research, with many contributing to new knowledge. Examples of health benefits included improved patient safety or the identification of new effective treatments. Potential economic benefits included cost savings, improved quality of care, decreased use of unwarranted practices and improvements in patient/carer experiences. Thematic analysis from interviews with guideline developers identified the need for up-to-date evidence, better fit with the guideline scope, positive collaboration and timely communication between guideline developers and CRGs.
Conclusions:
Whilst there were clear impacts on research targeting and healthcare policy, appropriate methods need to be developed for measuring impact on clinical practice and service organisation and delivery, for which there was less evidence. Guideline developers, CRGs and review authors should aim to improve collaboration and communication to ensure that guidance development is useful for decision makers.