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Do Cochrane Systematic Reviews help decision makers from middle income countries? Update of the Chilean experience

Date and Location

Session: 

P3.100

Date

Sunday 22 September 2013 - 10:30 - 12:00

Location

Presenting author and contact person

Presenting author

Tomas Pantoja

Contact person

Tomas Pantoja
Abstract text
Background: Chile has been facing a health system reform since 2000, in which health services for 80 health conditions have been prioritized. Policy-makers need the best evidence to decide on the efficacy of interventions for these conditions. Systematic Reviews (SR) of comparative studies represent the best quality evidence for questions about effectiveness and the Cochrane Collaboration is committed to making them widely available. In 2006 we reported the availability of Cochrane SRs (CSRs) for clinical questions related to the first 56 health conditions of our health reform. Up to 2012, 24 additional conditions have been included. Objectives: To update to what extent CSRs respond to the needs of policy-makers in the Chilean health reform. Methods: We retrieved the last version of clinical guidelines issued for each of the 80 prioritised health conditions from the Ministry of Health (MoH) website. We identified the recommendations included in each guideline and the evidence supporting them (in footnotes and/or lists of references) focusing on the presence of SRs. Results: We assessed 72 clinical guidelines from the MoH website. There was no guideline available for the other 8 conditions. They presented a median of 19 recommendations (range 4 - 211). Fifty-seven of them (79%) made reference at least to one systematic review, with a median of 5.5 reviews cited (range 1 – 38) by guideline. Regarding Cochrane reviews, 39 (54%) of the guidelines cited at least one of them, with a median of 3 (range 1 – 21) reviews per guideline. Conclusions: Cochrane and non-Cochrane systematic reviews have been used by the guideline development groups in the Chilean health system. However, there is a wide variation in their use in the different clinical areas covered by the guidelines.