Use of Cochrane Evidence in Mexican clinical practice guidelines

Article type
Authors
Leyva De Los Ríos CD1, Pérez-Gaxiola G2, Izabal Delgado DE1, Coronado Araujo J1, Rodríguez Páez IV1, Rodríguez Lizárraga JD1
1Universidad Autónoma de Sinaloa - Medical School
2Cochrane México - Hospital Pediátrico de Sinaloa
Abstract
Background: In Mexico, national clinical practice guidelines (CPGs) are developed by Cenetec, a government agency that collaborates with different health institutions. Guidelines are published in an online master catalog and are available to all health professionals. The elaboration of CPGs involves public and private institutions as well as medical associations and colleges.

Objectives: To describe the use of Cochrane systematic reviews (C-SRs) and GRADE within Mexican CPGs.

Methods: We retrieved all CPGs available in Cenetec’s online catalogue during February 2017. We reviewed all references for CSRs and non-Cochrane systematic reviews (NC-SRs). We also identified all grading systems used and screened for use of GRADE.

Results: A total of 374 national CPGs were identified and reviewed. All were created or updated between 2010 and 2016. 40% of CPGs cited at least one C-SR. Overall there were 13 576 citations of which 437 were C-SR. The citations of C-SR ranged from 0 to 17 with an average of 1.17. 56% of CPGs cited NC-SRs. There were multiple grading systems used, with 38% of CPGs using more than one system within the guideline. Only 39 CPGs used GRADE.

Conclusions: There is an underuse of Cochrane systematic reviews in Mexican CPGs. There is wide variability in grading systems and thus in the elaboration of recommendations within CPGs. The use of Cochrane Evidence and GRADE should be actively promoted in Mexican health institutions.