Use of Cochrane Reviews in developing Clinical Practice Guidelines (CPGs) in Malaysia

Abdullah Thani NSI1, Muhamad NA1, Lai NM2, Tan ML3, Ho J3
1Institute for Medical Research, Malaysia, 2Taylor's University, Malaysia, 3Penang Medical College , Malaysia

Background: Clinical Practice Guidelines (CPGs) are developed to improve the quality in healthcare practice based on the best available evidence. The process of developing the CPGs include systematically screening available evidence from systematic reviews. To-date, there have been 70 CPGs developed in Malaysia since 2004. Cochrane Reviews are widely regarded as the chief source of best evidence in health care that should be cited in the CPGs.

Objectives: We examined the citation of Cochrane Reviews in Malaysian CPGs.

Methods: Seventy CPGs were retrieved from the official Ministry of Health (MOH) Malaysia website: The reference list of each CPG was screened manually to assess whether Cochrane Reviews were included. Two authors determined whether there was a key Cochrane Review that should be cited in each topic of the CPG without knowledge of the CPG references, and a third author assessed whether these key reviews were included in the corresponding CPG. Key reviews are large reviews with clear results and recommendations for practice.

Results: Seventy CPGs covered 17 topics. A total of 219 (2.94%) Cochrane Reviews and 527 (5%) non-Cochrane reviews were identified from 9893 references. A median of one Cochrane and four non-Cochrane reviews were cited per CPG (Table 1). From 2004 to 2014 Cochrane Reviews have been increasingly cited (Table 2). Out of 50 key Cochrane Reviews relevant to the CPG topics, 16 key reviews (30.8%) were included while 34 were not.

Conclusions: Despite an encouraging trend of increasing citation, which suggests rising awareness of the importance of Cochrane Reviews, the inclusion of certain key Cochrane Reviews in the Malaysian CPGs remains unsatisfactory.