rss
Arch Dis Child Fetal Neonatal Ed 2008;93:F225-F229 doi:10.1136/adc.2007.118000
  • Original article

Agreement between Cochrane Neonatal reviews and clinical practice guidelines for newborns in Denmark: a cross-sectional study

  1. J Brok1,2,3,4,5,6,7,8,9,10,11,
  2. G Greisen1,2,3,4,5,6,7,8,9,10,11,
  3. L P Madsen1,2,3,4,5,6,7,8,9,10,11,
  4. K Tilma1,2,3,4,5,6,7,8,9,10,11,
  5. J Faerk1,2,3,4,5,6,7,8,9,10,11,
  6. K Børch1,2,3,4,5,6,7,8,9,10,11,
  7. E Garne1,2,3,4,5,6,7,8,9,10,11,
  8. H T Christesen1,2,3,4,5,6,7,8,9,10,11,
  9. H Stanchev1,2,3,4,5,6,7,8,9,10,11,
  10. T Jacobsen1,2,3,4,5,6,7,8,9,10,11,
  11. J P Nielsen1,2,3,4,5,6,7,8,9,10,11,
  12. T B Henriksen1,2,3,4,5,6,7,8,9,10,11,
  13. C Gluud1,2,3,4,5,6,7,8,9,10,11
  1. 1
    Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
  2. 2
    Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
  3. 3
    Department of Paediatrics, Aalborg Sygehus Nord, Denmark
  4. 4
    Department of Paediatrics, Vendsyssel Hospital, Hjørrring, Denmark
  5. 5
    Department of Paediatrics, Holbæk Hospital, Holbæk, Denmark
  6. 6
    Department of Paediatrics, Hvidovre Hospital, Hvidovre, Denmark
  7. 7
    Department of Paediatrics, Kolding Hospital, Kolding, Denmark
  8. 8
    Department of Paediatrics, Odense University Hospital, Odense, Denmark
  9. 9
    Department of Paediatrics, Naestved Hospital, Naestved, Denmark
  10. 10
    Department of Paediatrics, Sygehus Viborg, Denmark
  11. 11
    Perinatal Epidemiology Research Unit, Departments of Obstetrics and Paediatrics, Aarhus University Hospital, Skejby, Denmark
  1. J Brok, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 3344, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; jbrok{at}ctu.rh.dk
  • Accepted 27 August 2007
  • Published Online First 24 September 2007

Abstract

Objective: To assess agreement between Cochrane Neonatal Group reviews and clinical practice guidelines in Denmark.

Design: Retrospective analysis of clinical guidelines for newborn infants.

Materials: All Cochrane neonatal reviews and Danish clinical guidelines for newborn infants.

Main outcome measures: The recommendations from the Cochrane reviews and local clinical guidelines were compared and classified as being in agreement, in partial agreement or in disagreement. Authors of guidelines were asked whether Cochrane reviews had been considered during guideline development and reasons for any disagreements. Heterogeneity among departments was assessed.

Results: 173 interventions evaluated in Cochrane neonatal reviews were included. All 17 Danish neonatal departments agreed to participate, but only 14 (82%) delivered data. Agreement between reviews and guidelines was observed for a median of 132 interventions (76%) (range 129–134), partial agreement was observed for 31 interventions (18%) (range 29–33), and disagreement was observed for 10 interventions (6%) (range 8–13) (κ  = 0.56, range 0.53–0.59). Most of the latter 10 interventions were not recommended in the reviews but were recommended in the guidelines. There were numerous reasons for disagreement, the most common being usage of evidence with higher bias risks than randomised trials in guidelines development. Overall, Cochrane reviews were rarely (10%) used during guideline development. For nine guideline topics (5%) there was diversity among the Danish departments’ recommendations.

Conclusions: There is good agreement between Cochrane reviews and neonatal guidelines in Denmark. However, Cochrane reviews were rarely used for guideline development. Heterogeneity among guidelines produced by the various neonatal departments seems moderate.

Footnotes

  • Competing interests: None.

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. All versions of this article:
    1. adc.2007.118000v1
    2. 93/3/F225 most recent

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.