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The use of Cochrane SR in the development of Clinical Practice Guidelines. The case of Syndromic Management of Sexually transmitted infections and other infections of the Genital Tract. 2012

Date and Location

Session: 

P3.013

Date

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

Location

Presenting author and contact person

Presenting author

Hernando Gaitan

Contact person

Hernando Gaitan
Abstract text
Background: In recent years, the GRADE approach has been broadly accepted by many GDG. The use of SR for GDG is highly expected. There is a lack of information about the relationship between the types of evidence with the strength of recommendations using GRADE. Objectives: To present the evidence mapping of the literature used to develop recommendations in the Guideline for Syndromic management of the Genital Tract Infections, with emphasis in the use of Cochrane SR. Methods:The evidence of each recommendation was reviewed and was classified according to the type of evidence, quality, quantity and strength of the recommendation. A descriptive analysis was performed as well as a cross-analysis to identify the relationship between the strength of the recommendation and the quality of the evidence. The quality of the SR was assessed with AMSTAR. Results:SR supported the 29.1% of the recommendations, 52% of them were Cochrane SR, RCT 25.6%, observational studies 5.9%, guidelines 9.3% and expert opinion 30.1%. The quality of the evidence was high (14%), moderate (15%), low (16%) and very low (55%). 63.7% of the recommendations were strong in favor. 14% of the strong in favor recommendations came from high quality evidence and 49% came from very low quality evidence. Not all the Cochrane SR had the same level of quality. Conclusions: The evidence shows a similar percentage of systematic reviews, RCT and expert opinion in the guideline. 15% of the recommendations were supported by RS Cochrane. The GRADE approach allows weighting other factors beyond quality of the evidence which are relevant for clinical practice. Research needs to be done on the most important factors in grading recommendations and how the collaboration can support GDG worldwide in order to become a source of high quality evidence for guideline developers.