Article type
Year
Abstract
Background: Systematic reviews are a key source of transparent evidence assessments for guideline development. This research, as part of the South African Guidelines Excellence (SAGE) project, maps the use and perceived benefits of Cochrane Systematic Reviews amongst primary care guideline developers in South Africa.
Methods: A modified snow-ball technique identified key stakeholders. Individual interviews were recorded and transcribed. Content and descriptive analysis was undertaken. Interview scripts were analysed using an inductive approach.
Results: Twenty-four interviews have been conducted with 23 key stakeholders actively involved with guidelines in government, public and private health care. Early exploratory analysis indicates that guideline development is a complex web of interactions between stakeholders; a process that is informed by individual values, politics and power at both the individual and group level.
Initially Cochrane-related work and research was not a focus of this study, but a trend emerged within the interviews. Without prompting from interviewers, 8/22 respondents named Cochrane as a key resource for guideline evidence assessments, or as a key player in reviews of evidence.
“Obviously I’m going to look at Cochrane . . .I’m going to try look at the highest level first. So the issue is what you want, you want integrity . . . “ (INT01/398).
Of the 14 interviewees who did not name Cochrane, four rely on World Health Organization (WHO) guidelines to inform the evidence they use in local guideline development. The remainder describe the need for an evidence grading process, but highlight a variety of barriers to establishing this process in the local context including limited human capacity and time.
Conclusion: Within the complex guideline development process in South Africa, it is clear that Cochrane evidence plays a role. Understanding this role can provide Cochrane reviewers with input on key areas of interest for policy and guideline writers, identifying where Cochrane Reviews can cater specifically to the needs of guideline writers, especially in LMICs.
Methods: A modified snow-ball technique identified key stakeholders. Individual interviews were recorded and transcribed. Content and descriptive analysis was undertaken. Interview scripts were analysed using an inductive approach.
Results: Twenty-four interviews have been conducted with 23 key stakeholders actively involved with guidelines in government, public and private health care. Early exploratory analysis indicates that guideline development is a complex web of interactions between stakeholders; a process that is informed by individual values, politics and power at both the individual and group level.
Initially Cochrane-related work and research was not a focus of this study, but a trend emerged within the interviews. Without prompting from interviewers, 8/22 respondents named Cochrane as a key resource for guideline evidence assessments, or as a key player in reviews of evidence.
“Obviously I’m going to look at Cochrane . . .I’m going to try look at the highest level first. So the issue is what you want, you want integrity . . . “ (INT01/398).
Of the 14 interviewees who did not name Cochrane, four rely on World Health Organization (WHO) guidelines to inform the evidence they use in local guideline development. The remainder describe the need for an evidence grading process, but highlight a variety of barriers to establishing this process in the local context including limited human capacity and time.
Conclusion: Within the complex guideline development process in South Africa, it is clear that Cochrane evidence plays a role. Understanding this role can provide Cochrane reviewers with input on key areas of interest for policy and guideline writers, identifying where Cochrane Reviews can cater specifically to the needs of guideline writers, especially in LMICs.