Most healthcare interventions tested in Cochrane Reviews are not effective according to high quality evidence: a systematic review and meta-analysis
- PMID: 35447356
- DOI: 10.1016/j.jclinepi.2022.04.017
Most healthcare interventions tested in Cochrane Reviews are not effective according to high quality evidence: a systematic review and meta-analysis
Abstract
Objective: To estimate the proportion of healthcare interventions tested within Cochrane Reviews that are effective according to high-quality evidence.
Methods: We selected a random sample of 2,428 (35%) of all Cochrane Reviews published between 1 January 2008 and 5 March 2021. We extracted data about interventions within these reviews that were compared with placebo, or no treatment, and whose outcome quality was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. We calculated the proportion of interventions whose benefits were based on high-quality evidence (defined as having high quality GRADE rating for at least one primary outcome, statistically significant positive results, and being judged by review authors as effective. We also calculated the proportion of interventions that suggested harm.
Results: Of 1,567 eligible interventions, 87 (5.6%) had high-quality evidence supporting their benefits. Harms were measured for 577 (36.8%) interventions. There was statistically significant evidence for harm in 127 (8.1%) of these. Our dependence on the reliability of Cochrane author assessments (including their GRADE assessments) was the main potential limitation of our study.
Conclusion: More than 9 in 10 healthcare interventions studied within recent Cochrane Reviews are not supported by high-quality evidence, and harms are under-reported.
Keywords: Epidemiology; Evidence; Harm; Quality; Safety; Systematic review.
Copyright © 2022 Elsevier Inc. All rights reserved.
Similar articles
-
Interventions for Tobacco Cessation in Adults, Including Pregnant Women: An Evidence Update for the U.S. Preventive Services Task Force [Internet].Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 Jan. Report No.: 20-05264-EF-1. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 Jan. Report No.: 20-05264-EF-1. PMID: 33523610 Free Books & Documents. Review.
-
The future of Cochrane Neonatal.Early Hum Dev. 2020 Nov;150:105191. doi: 10.1016/j.earlhumdev.2020.105191. Epub 2020 Sep 12. Early Hum Dev. 2020. PMID: 33036834
-
Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: An Updated Systematic Review for the U.S. Preventive Services Task Force [Internet].Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Sep. Report No.: 18-05239-EF-1. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Sep. Report No.: 18-05239-EF-1. PMID: 30354042 Free Books & Documents. Review.
-
Neonatal interventions for preventing cerebral palsy: an overview of Cochrane Systematic Reviews.Cochrane Database Syst Rev. 2018 Jun 20;6(6):CD012409. doi: 10.1002/14651858.CD012409.pub2. Cochrane Database Syst Rev. 2018. PMID: 29926474 Free PMC article.
-
Bias due to selective inclusion and reporting of outcomes and analyses in systematic reviews of randomised trials of healthcare interventions.Cochrane Database Syst Rev. 2014 Oct 1;2014(10):MR000035. doi: 10.1002/14651858.MR000035.pub2. Cochrane Database Syst Rev. 2014. PMID: 25271098 Free PMC article.
Cited by
-
Creating and Validating a Questionnaire for Assessing Dentists' Self-Perception on Oral Healthcare Management-A Pilot Study.Healthcare (Basel). 2024 May 1;12(9):933. doi: 10.3390/healthcare12090933. Healthcare (Basel). 2024. PMID: 38727490 Free PMC article.
-
Availability of evidence and comparative effectiveness for surgical versus drug interventions: an overview of systematic reviews and meta-analyses.BMJ Open. 2024 Jan 9;14(1):e076675. doi: 10.1136/bmjopen-2023-076675. BMJ Open. 2024. PMID: 38195174 Free PMC article.
-
Effectiveness of a multidisciplinary treatment with youth-initiated mentoring for youths with mental health needs from multi-problem families: a quasi-experimental study.BMC Public Health. 2024 Jan 2;24(1):1. doi: 10.1186/s12889-023-17506-6. BMC Public Health. 2024. PMID: 38166901 Free PMC article.
-
Neurophysiology, Neuro-Immune Interactions, and Mechanobiology in Osteopathy in the Cranial Field: An Evidence-Informed Perspective for a Scientific Rationale.Healthcare (Basel). 2023 Nov 28;11(23):3058. doi: 10.3390/healthcare11233058. Healthcare (Basel). 2023. PMID: 38063626 Free PMC article.
-
Clinical Practice Guideline for Best Practice Management of Pediatric Patients by Chiropractors: Results of a Delphi Consensus Process.J Integr Complement Med. 2024 Mar;30(3):216-232. doi: 10.1089/jicm.2023.0010. Epub 2023 Oct 30. J Integr Complement Med. 2024. PMID: 37902954 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical