Use of Cochrane reviews in nationally-developed clinical practice guidelines in Latin America.

INTRODUCTION

Cochrane reviews, recognized as the benchmark for high-quality summaries, facilitates healthcare decision-making bringing together all the evidence on an intervention. To date, their inclusion in the Latin American guidelines remains unknown.

OBJECTIVE

To evaluate the use of Cochrane reviews in nationally-developed clinical practice guidelines in Latin America.

METHODS

We conducted a hand search in official government websites and biomedical databases between October 2019 and December 2019, including government-sponsored clinical practice guidelines with recommendations for both the management of health conditions or a healthy lifestyle of the last ten years.

RESULTS

We included 408 clinical practice guidelines from ten countries. We found that 69.8% of them cited Cochrane reviews in their recommendations, and 76.1% of those also used them in their key recommendations. Clinical practice guidelines that did not use Cochrane reviews covered a wide range of topics for which several Cochrane reviews can be found. Countries using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach for grading recommendations were more likely to use Cochrane reviews in a higher percentage of their guidelines (79.4% vs. 61.8%; odds ratio: 2.3; 95% confidence interval: 1.5 to 3.7, p = 0.0001).

CONCLUSIONS

Over two-thirds of clinical practice guidelines in Latin America use Cochrane reviews to frame their recommendations. It is necessary to increase the uptake of Cochrane reviews in the region for the development of clinical practice guidelines.