Citations of Cochrane nutrition reviews in guidelines: appraising the “payback” on investment in nutrition evidence synthesis
Marrianne Visser, Stellenbosch University, Centre for Evidence Based Healthcare (CEBHC)
2Cochrane South Africa, South African Medical Research Council, South Africa
Background: High quality systematic reviews are pivotal to evidence-informed guideline development. The extent to which Cochrane nutrition reviews inform health guidelines is unknown.
Objectives: To describe numbers and proportions of Cochrane nutrition reviews cited in published health guidelines and assess the main characteristics and scope of these guidelines.
Methods: We extracted information about citations of reviews in published health guidelines reported in the Cochrane Library for all versions of the reviews in the Cochrane Nutrition review repository. We then accessed the guideline documents citing these reviews to extract their characteristics and scope, translating to English, where needed. We developed a categorisation for the guideline scope and topic coverage informed by the Guidelines International Network guideline library.
Results: Of the 701 reviews in the Cochrane Nutrition repository (August 2021), 441 (all versions) were cited 2,267 times in guidelines between 2010 and 2021. Review Groups with the greatest number of citations were Pregnancy and Childbirth (22.9%), Neonatal (11.6%), Metabolic and Endocrine Disorders (7.2%), Gut (5.2%) and Heart (4.5%). We identified 863 unique guidelines citing nutrition reviews. Of these, 141 were from international developers (professional bodies n=66; expert groups n=38; intergovernmental organisations n=33; other n=4). National guidelines (n=668) were mostly from European and North American professional bodies (n=369) (e.g. American College of Physicians), followed by governmental bodies (n=175) (e.g. NICE, SIGN), and expert groups from Europe, North America and Australia (n=65). Fifty-four guidelines were sub-national. Less than 10% of national/sub-national guidelines were from low- and middle-income countries, and none from Africa. The guidelines scope covered management/treatment (84%), diagnosis (34%), assessment/screening (27%), prevention (25%), patient education/counselling (13%), implementation (10%), and rehabilitation (4%). Topics within these categories included a range of key health conditions and treatments; most addressed chronic conditions (e.g. diabetes, cancer), maternal and child health, enteral and parenteral nutrition and gastroenterological conditions.
Conclusions: Cochrane nutrition reviews are supporting international, national and sub-national guidelines across many key areas in the Global Challenges Framework, including chronic conditions, cancer, and maternal and child health.
Patient, public and/or healthcare consumer involvement: No direct involvement. Guidelines impact practices and policies that affect health outcomes in these groups.