Updating gap in Cochrane systematic reviews: an observational pilot study. Preliminary results

Article type
Authors
Antequera Martín A1, Solà I2, Bonfill X3
1Universitat Autònoma de Barcelona, Centre-Biomedical Research Institute Sant Pau, Barcelona
2Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau-CIBER of Epidemiology and Public Health (CIBERESP-IIB Sant Pau), Barcelona
3Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau-CIBER of Epidemiology and Public Health (CIBERESP-IIB Sant Pau), Universitat Autònoma de Barcelona
Abstract
Background: Cochrane systematic reviews (SRs) are the cornerstone of setting clinical recommendations, which requires a rigorous developing and updating process. Although the Cochrane Collaboration's policy defines that Cochrane Reviews should be assessed for updating within two years of publication, previous studies suggest that a minority of Cochrane reviews were updated in the following 5 years after their publication. Musculoskeletal conditions are the leading contributor to disability worldwide (data from Global Burden Disease 2017 and WHO). Musculoskeletal Cochrane review group determined the priority setting, and for some of their topic areas, including osteoporosis and rheumatoid arthritis, they identified priority topics. We conducted a pilot study for monitoring the impact of updating gaps on osteoporosis and rheumatoid arthritis SRs.

Objectives: We described the updating status of osteoporosis Cochrane SRs and its relation with the response from non-Cochrane organizations in terms of recency of their reviews.

Methods: Observational pilot study. We searched reviews on the populations of interest in the Cochrane Database of Systematic Review and selected those that were out of the updating threshold set in current policies (3 years). We matched each Cochrane review question with a search in PubMed for retrieving more recent SRs using the fields of osteoporosis (according to their most representative subject heading combined with a text term searched at the title field). We globally searched and then limited the search to the core journals set in Pubmed and the 15 top journals in the Scimago ranking for Rheumatology. We collected data on the topic, publication year, search strategy period, and the number of inclusion into guidelines. We performed descriptive analyses and compared temporal trends over time.

Results: We identified 219 SRs of intervention within the Musculoskeletal Cochrane review group. Almost a quarter of the total (24.59%) was published in or after 2014, just over a third (33.34%) were for osteoarthritis and 6.4% (N=14) for osteoporosis. Six reviews addressed bisphosphonates therapy, four reviews focused on calcium and vitamin D treatments, and the remainder assessed other interventions. We found 49 non-Cochrane SRs published after the Cochrane SR publication date, ten of them published in leading journals. Regarding changes in the conclusions, 21% of non-Cochrane SRs suggested a shift in the conclusion. Extracting data on rheumatoid arthritis is ongoing.

Conclusion: The updating process for osteoporosis Cochrane SRs is poor. Osteoporosis Cochrane reviews are not covering the body of evidence in progress or completed.

Patient or healthcare consumer involvement: none.