Evidence map›Paper›PMID 25747860›Full record

ArticleBMJ (Clinical research ed.)2015

Uptake of systematic reviews and meta-analyses based on individual participant data in clinical practice guidelines: descriptive study.

Claire L Vale, Larysa H M Rydzewska, Maroeska M Rovers, Jonathan R Emberson, François Gueyffier, Lesley A Stewart, Cochrane IPD Meta-analysis Methods Group

Abstract read
In one paragraph

Article in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Claire L ValeMRC Clinical Trials Unit at UCL, London WC2B 6NH, UK.
Larysa H M RydzewskaMRC Clinical Trials Unit at UCL, London WC2B 6NH, UK larysa.rydzewska@ucl.ac.uk.
Maroeska M RoversRadboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, Netherlands.
Jonathan R EmbersonClinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK.
François GueyffierUniversité Claude Bernard Lyon 1, Université de Lyon, Lyon, France Hospices Civils de Lyon, Service de Pharmacologie Clinique & Essais Thérapeutiques, Bron cedex, France.
Lesley A StewartCentre for Reviews and Dissemination, A/B Block Alcuin College, University of York, York, UK.
Cochrane IPD Meta-analysis Methods Group

Funding

Medical Research Council G0800792Medical Research Council G0801402Medical Research Council G0902303Medical Research Council MC_UU_12023/24Medical Research Council MR/K025635/1Medical Research Council MR/L004933/1
6 · The paper itself

Abstract

objectiveTo establish the extent to which systematic reviews and meta-analyses of individual participant data (IPD) are being used to inform the recommendations included in published clinical guidelines.

designDescriptive study.

settingDatabase maintained by the Cochrane IPD Meta-analysis Methods Group, supplemented by records of published IPD meta-analyses held in a separate database. POPULATION: A test sample of systematic reviews of randomised controlled trials that included a meta-analysis of IPD, and a separate sample of clinical guidelines, matched to the IPD meta-analyses according to medical condition, interventions, populations, and dates of publication. DATA EXTRACTION: Descriptive information on each guideline was extracted along with evidence showing use or critical appraisal, or both, of the IPD meta-analysis within the guideline; recommendations based directly on its findings and the use of other systematic reviews in the guideline.

resultsBased on 33 IPD meta-analyses and 177 eligible, matched clinical guidelines there was evidence that IPD meta-analyses were being under-utilised. Only 66 guidelines (37%) cited a matched IPD meta-analysis. Around a third of these (n=22, 34%) had critically appraised the IPD meta-analysis. Recommendations based directly on the matched IPD meta-analyses were identified for only 18 of the 66 guidelines (27%). For the guidelines that did not cite a matched IPD meta-analysis (n=111, 63%), search dates had preceded the publication of the IPD meta-analysis in 23 cases (21%); however, for the remainder, there was no obvious reasons why the IPD meta-analysis had not been cited.

conclusionsOur results indicate that systematic reviews and meta-analyses based on IPD are being under-utilised. Guideline developers should routinely seek good quality and up to date IPD meta-analyses to inform guidelines. Increased use of IPD meta-analyses could lead to improved guidelines ensuring that routine patient care is based on the most reliable evidence available.

Indexed as

Meta-Analysis as TopicPractice Guidelines as TopicReview Literature as TopicHumansPublishingResearch Subjects

Identifiers

PMID25747860
PMCPMC4353308

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.