Cochrane Reviews are not a direct source of information for Swiss physicians

Article type
Authors
Burnand B1
1Cochrane Switzerland and IUMSP, Lausanne University Hospital
Abstract
Background:
Cochrane Switzerland promotes the use of Cochrane Reviews as a useful source of evidence to support medical decisions. A national license has facilitated access to the Cochrane Library since 2016.

Objectives:
To examine the interest for, and use of, the Cochrane Library by physicians in Switzerland.

Methods:
We used analysis of data from three studies that examined knowledge translation processes by physicians that were conducted within our unit. One study analysed all internet access by 39 medical residents in family medicine for one month in 2011. A mixed methods study on knowledge translation practices by Swiss physicians included 14 interviews, five focus groups (n = 39), and an online survey (n = 985) in 2014. The development of a guide for internet use for medical purposes allowed us to interview 16 family physicians about potentially useful sources of information for clinical practice in 2017.

Results:
In March 2011, the residents visited 23,438 web pages for a health-related search; the 350 most visited websites accounted for 88.4% of all visited web pages, but did not include Cochrane. In 2014, over three-quarters of Swiss physicians had a positive or very positive attitude towards evidence-based medicine (62% and 19%, respectively). Several physicians considered the lack of access to the Cochrane Library then as a barrier. The 2017 two-page guide to the internet for family medicine did not include Cochrane among the 23 specific websites proposed. However, the Cochrane Library was listed, together with PubMed and Google Scholar, as a source of scientific information. When evaluating the guide, a family physician indicated: “What’s the point to click on Cochrane? Which information do I get when facing a patient?”.

Conclusions:
Swiss family physicians do not favour or use Cochrane reviews and the Cochrane Library frequently in daily practice, even though they are available, thanks to a national license. Although evidence produced by Cochrane may be used when developing decision support tools (e.g. guidelines), progress in knowledge-implementation tools and processes need to be improved.

Patient or healthcare consumer involvement:
No direct involvment.