Impact of clinical recommendations informed by Cochrane diagnostic accuracy reviews for infectious diseases prevalent in low- and middle-income countries

Session: 

Oral session: Diagnostic test accuracy review and prognostic methods (2)

Date: 

Tuesday 18 September 2018 - 14:20 to 14:30

Location: 

Ochil 1

All authors in correct order:

O'Rourke J1, Takwoingi Y1, Deeks JJ1
1 Institute of Applied Health Research, University of Birmingham, UK
Presenting author and contact person

Presenting author:

John O'Rourke

Contact person:

John O'Rourke
Abstract text
Background: There is an increasing drive for recommendations of diagnostic tests to be evidence-based. This is exemplified by the introduction of systematic reviews of diagnostic test accuracy (DTA) into the Cochrane Library in 2008 and the Essential Diagnostics List that the World Health Organization is setting up. The underlying assumption of evidence-based recommendations is that they will be implemented in clinical practice, and lead to improved patient management through the appropriate use or withdrawal of these tests.
Objectives: This study aims to assess the impact of recommendations for clinical guidelines made by Cochrane DTA reviews for infectious diseases prevalent in low- and middle-income countries (LMICs).
Methods: We identified Cochrane DTA reviews for infectious diseases by searching the Cochrane Library and assessed impact using a series of approaches. We performed forward citation searching for each of the Cochrane Reviews to identify literature directly related to them. We will conduct systematic searches in Web of Science, MEDLINE, and Embase to identify relevant guidelines and other papers published after publication of the reviews to provide an indication of indirect impact. Finally, where a new diagnostic test is being recommended, we will contact manufacturers for sales information from which we will infer clinical impact Results: We identified nine Cochrane Reviews covering five infectious diseases in LMICs: malaria (n = 3), leishmaniosis (n = 1), schistosomiasis (n = 1), tuberculosis (n = 3), and typhoid (n = 1). The nine reviews have been cited extensively with a total of over 1000 citations. We will present detailed results of the impact assessment at the Cochrane Colloquium covering the incorporation of evidence into guidelines, further research undertaken following publication of the reviews and impact on patient care.
Conclusions: Translation and adoption of evidence-based recommendations into practice is a key step in ensuring the best outcomes for patients and efficient use of limited resources. This study will shed light on this important transition from research into practice.
Patient or healthcare consumer involvement: This study will provide an insight into the downstream impact of Cochrane DTA reviews and whether they have changed clinical practice or the diagnostic tests that are available to patients.

Relevance to patients and consumers: 

This study will provide an insight into the downstream impact of Cochrane DTA reviews and whether they have changed clinical practice or the diagnostic tests that are available to patients.