Brok Jesper, Greisen Gorm, Jacobsen Thorkild, Gluud Lise L, Gluud Christian
The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, H:S Rigshospitalet, Denmark.
Acta Paediatr. 2007 Jan;96(1):39-43. doi: 10.1111/j.1651-2227.2006.00035.x.
To assess the agreement between Cochrane Neonatal Group reviews and clinical guidelines of a University Neonatology Department, to evaluate the reasons for potential disagreements and to ascertain whether Cochrane reviews were considered for the guidelines development.
The recommendations in the reviews and guidelines were compared and classified as being in 'agreement', 'partial agreement' or 'disagreement'. The guideline authors were interviewed for reasons about disagreement and whether Cochrane reviews were considered during the guideline development.
Agreement between reviews and guidelines was found for 133 interventions (77%), partial agreement for 31 interventions (18%) and disagreement for nine interventions (5%). Six interventions were recommended in the guidelines, but not in the reviews. Three interventions were recommended in the reviews, but not in the guidelines. Use of consensus statements, evidence on surrogate markers, observational studies, basic immunology and pathophysiological knowledge, expert opinion, economical constraints, reservations about the external validity and unawareness of reviews were reasons for disagreement. Cochrane reviews were rarely (22%) used during the guideline development.
We found agreement between more than three quarters of Cochrane reviews and neonatal guidelines. However, few important disagreements occurred. Reviews were only used for guideline development in about a fifth of cases.
评估Cochrane新生儿组综述与某大学新生儿科临床指南之间的一致性，评估潜在分歧的原因，并确定在制定指南时是否考虑了Cochrane综述。
比较综述和指南中的建议，并分类为“一致”、“部分一致”或“不一致”。就分歧原因以及在制定指南时是否考虑了Cochrane综述对指南作者进行访谈。
133项干预措施（77%）的综述和指南之间存在一致性，31项干预措施（18%）部分一致，9项干预措施（5%）不一致。指南中推荐了6项干预措施，但综述中未推荐。综述中推荐了3项干预措施，但指南中未推荐。使用共识声明、替代指标证据、观察性研究、基础免疫学和病理生理学知识、专家意见、经济限制、对外部有效性的保留意见以及对综述的不了解是存在分歧的原因。在制定指南时很少（22%）使用Cochrane综述。
我们发现超过四分之三的Cochrane综述与新生儿指南之间存在一致性。然而，出现了一些重要分歧。在大约五分之一的情况下，综述仅用于指南制定。
