Background: Cochrane Reviews provide systematic reviews of the evidence, but do not directly provide the systematic effort to include clinical expertise and patient values to reach recommendations or guidance. Guidelines may provide systematic efforts to reach recommendations, but a single guideline may be akin to a single study and additional guidelines (with different groups of people addressing the same recommendations) may replicate the results or come to different recommendations.

Objectives: This session will introduce the concept of a Systematically-Derived Recommendation (SDR), show examples where the approach taken in systematic reviews influences the results among recommendations, and provide considerations for improvements in Cochrane Reviews.

Methods: A group of guideline developers, raters and users developed the SDR concept from Institute of Medicine and Guidelines International Network (G-I-N) standards and application to single recommendations.

Results: An SDR is proposed as a new article type with methods and results following a format of systematic search and study selection, study quality appraisal, evidence summary, search for previously reported recommendations, recommendation panel selection, values and preferences, evidence-to-decision deliberation, and recommendation.

Conclusions: SDRs provide an opportunity for Cochrane to extend efforts and support deeper into clinical practice guidelines and clinical decision support.