Are Cochrane reviews of diagnostic test accuracy informing clinical guidelines?

Tags: Oral
Harris B1, Beese S1, O'Rourke J1, Carter E2, Davenport C1, Mallett S1, Takwoingi Y1, Eisinga A2, Deeks J1
1University of Birmingham, 2UK Cochrane Centre

Background: Cochrane has been publishing Diagnostic Test Accuracy (DTA) reviews for 10 years, and over 100 DTA reviews will have been published by the 2018 Colloquium. The methods and reporting of Cochrane DTA reviews were designed to ensure they address patient management questions by providing evidence summaries suitable for incorporation in clinical guidelines.

Objectives: To assess the extent to which Cochrane DTA reviews have been incorporated in clinical guidelines; identify which guideline developers and topics are most likely to make use of Cochrane DTA evidence; and note key features of reviews most cited.

Methods: To monitor impact of Cochrane evidence, Cochrane UK tracks citations of all Cochrane Reviews in clinical guidelines published worldwide by searching online, open-access sources of accredited guidelines (free at the point of use) for the word 'Cochrane'. We will analyse citations of Cochrane DTA reviews, identified up until the end of March 2018, according to: guideline developer, topic and key characteristics of reviews, including:

1) focus on comparative accuracy questions;

2) number of studies included;

3) clear positioning of the test in the clinical pathway;

4) presentation of consequences of testing;

5) clear clinical recommendations;

6) involvement of patients in the review process and reporting.

Results: As of 2 March 2018, 41 of 92 published DTA reviews (45%) from 17 Cochrane Review Groups have been used to inform 56 clinical guidelines. Fourteen reviews have been used in more than one guideline (frequency: 8 reviews in 2 guidelines; 3 in 3; 1 in 4; 1 in 5, and 1 in 7). We will present a description and analysis of the reviews and identify characteristics that most clearly link to their use.

Conclusions: Completion of Cochrane DTA reviews is a resource-intensive process and it is important that the topics chosen, the methods used, and patient involvement to optimise relevance and accessibility, enable Cochrane DTA evidence to benefit patients by helping to inform clinical guidelines.

Patient or healthcare consumer involvement: Use of Cochrane DTA reviews in guidelines can create patient benefit, but the complexity of the methods and data are often a barrier. We will report whether involving patients has happened in existing reviews, and any evidence that it relates to citation of these reviews.