Systematic reviews do not comment on applicability for primary care

Objectives: How often authors comment on applicability for primary care in systematic reviews of clinical trials.

Study design and setting: We selected 4% of the Cochrane Database for Systematic Reviews (CDSRs; January 2008 to October 2013). We excluded reviews when primary care trials were not eligible. We extracted whether authors explicitly reported in methods that primary care trials were eligible or this was unclear/missing. Reporting any comment on applicability for primary care in discussion was considered as primary outcome.

Results: Of the 163 reviews, 30 (18.4%) stated that primary care trials were eligible, whereas 133 (81.6%) provided no data. Of the 30 reviews, 19 (63.0%) reported in discussion that results might be applicable for primary care and one (4.0%) that were feasible in nonspecialized settings. Of the 133 reviews, 6 (4.5%) mentioned in discussion that results might be applicable for primary care and 12 (9.0%) that were applicable in specialized care only. Commenting on applicability for primary care in discussion was significantly associated with reporting in methods that primary care trials were eligible (odds ratio 6.7, 95% confidence interval 2.6-17.4; P-value <0.001).

Conclusions: Authors usually do not comment on the applicability of results for primary care.