Article Text

Download PDFPDF

Do guidelines for treating chest disease in children use Cochrane Reviews effectively? A systematic review
  1. Andrew P Prayle1,
  2. Tessy Cox1,
  3. Sherie J Smith1,
  4. Joanne Rycroft-Malone2,
  5. Kim S Thomas3,
  6. Dyfrig A Hughes4,
  7. Alan R Smyth1
  1. 1 Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK
  2. 2 School of Healthcare Sciences, Bangor University, Bangor, UK
  3. 3 Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
  4. 4 Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
  1. Correspondence to Professor Alan R Smyth, Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, E Floor East Block, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK; alan.smyth{at}


Cochrane Reviews summarise best evidence and should inform guidelines. We assessed the use of Cochrane Reviews in the UK guidelines for paediatric respiratory disease. We found 21 guidelines which made 1025 recommendations, of which 96 could be informed by a Cochrane Review. In 38/96 recommendations (40%), some or all of the relevant Cochrane Reviews were not cited. We linked recommendations to 140 Cochrane Reviews. In 37/140 (26%) cases, the guideline recommendation did not fully agree with the Cochrane Review. Guideline developers may fail to use Cochrane Reviews or may make recommendations which are not in line with best evidence.

  • Asthma Guidelines
  • Paediatric Lung Disaese

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

Statistics from


  • Author note The protocol is available for this study at (part 1) and (part 2).

  • Twitter Follow Andrew Prayle @andrewprayle and Alan R Smyth @AlanRSmyth

  • Contributors The study was conceived by ARS, with development by APP and TC. Final study design was achieved by discussion of all authors. Data collection and analysis: TC, APP and SJS. Data analysis, statistics and programming: APP. Final manuscript written and approved by all authors.

  • Funding This work did not receive specific funding. APP was funded by a NIHR Doctoral Research Fellowship (DRF-2009-02-112), and is currently funded by a NIHR ACL post. DAH receives financial support from the MRC North West Hub in Trial Methodological Research: MR/K025635/1. The funders and sponsor had no involvement in the decision to publish, or the contents of the publication. This report presents independent research funded by the National Institute for Health Research.

  • Competing interests All authors have completed the Unified Competing Interests form at (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years, no other relationships or activities that could appear to have influenced the submitted work. Professor Smyth reports personal fees from Vertex, personal fees from Gilead, personal fees from Roche, personal fees from PTC Therapeutics, outside the submitted work. In addition, Professor Smyth has a patent Alkyl Quinolones as Biomarkers of Pseudomonas aeruginosa Infection and Uses Thereof issued.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The raw data and computer code underlying this study to fully reproduce all the statistics and figures reported are available as a downloadable online supplementary file on GitHub

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.