Use of Cochrane Reviews in nationally developed clinical practice guidelines in Latin America

Article type
Authors
Garegnani L1, Rosón P1, Escobar Liquitay C2, Franco JVA1, Meza N3, Arancibia M4, Madrid E4
1Research Department, Associate Cochrane Centre, Instituto Universitario Hospital Italiano
2Biblioteca Central, Instituto Universitario Hospital Italiano
3Cochrane Centre School of Medicine, Universidad de Valparaíso
4Cochrane Centre School of Medicine, Universidad de Valparaíso; Interdisciplinary Centre for Health Studies (CIESAL), Universidad de Valparaíso; Biomedical Research Centre (CIB), Universidad de Valparaíso
Abstract
Background: Cochrane’s primary aim is to help people make well-informed decisions about healthcare by
preparing, maintaining and promoting accessible systematic reviews of evidence. Cochrane’s work is internationally recognized as the benchmark for high-quality information about the effectiveness of health care. By providing a reliable synthesis of the available evidence on a given topic, systematic reviews adhere to the principle that science is cumulative and facilitates decisions considering all the evidence on the effect of an intervention. Clinical practice guidelines (CPG) are currently one of the most useful tools for improving clinical practice and public health, as they offer information for interventions considering the balance between benefits and harms and the use of resources, reducing clinical variability and, in essence, improving health and ensuring the quality of care. In the framework of Cochrane’s Strategy to 2020 to put Cochrane’s evidence at the heart of health decision making all over the world and to make Cochrane the ‘home of evidence'; to inform health decision making, it would be reasonable for CPG development groups to base their recommendations on Cochrane Reviews, but to date, the contribution of Cochrane Reviews to CPGs in the Latin American region remains unknown.

Objectives: to evaluate the use of Cochrane Reviews in nationally developed CPGs in Latin America.

Methods: we conducted a comprehensive manual search in official government websites and biomedical
databases (MEDLINE, Embase, and LILACS) during December 2018. We included government-
sponsored CPG with recommendations for the management of health conditions or recommendations for a healthy lifestyle over the last 10 years. Documents identified as CPGs had to include a method for guideline development. We identified Cochrane Reviews by inspection of references. When we identified a Cochrane Review, we also verified if it supported recommendations and key recommendations.

Results: we included 166 CPG from three countries. We found that 20% of CPG cited no Cochrane Reviews in their recommendations and 84% of CPG that used Cochrane Reviews in their recommendations also used Cochrane Reviews in their key recommendations (Table 1). We also report the topics of the guidelines in which no Cochrane Review was cited in the recommendation (Table 2).

Conclusions: a significant proportion of CPG in Latin America do not use Cochrane evidence to frame their
recommendations. These guidelines covered a wide range of topics, for some of which there might be
up-to-date Cochrane evidence. These findings highlight the need to disseminate the results of current Cochrane Reviews and the need to identify topics in which updated Cochrane Reviews are not available. The final results with the incorporation of the other countries in the region will be presented at the Colloquium.

Patient or healthcare consumer involvement: no patient or healthcare consumer was involved in this project.