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1710d Systematic reviews and evidence-based guidelines, two of a different kind?
  1. Carel T Hulshof
  1. Netherlands Society of Occupational Medicine (NVAB), Centre of Excellence, Utrecht, the Netherlands; Academic Medical Centre, dept. Coronel Institute of Occupational Health, Amsterdam, the Netherlands


In improving the quality and professional independence of Occupational Safety and Health (OSH) professionals, the development of an evidence-based practice plays a pivotal role. OSH professionals should strive to use scientific evidence as much as possible to support their decisions in daily practice and policy. However, in many situations, still a gap between evidence from research and decision-making in daily practice occurs. In attempts to bridge this gap, high-quality, relevant and up-to-date systematic reviews and evidence-based guidelines are both important tools. The processing of a systematic review and the development of an evidence-based guideline show a lot of similarities in undertaking research syntheses, developing methods for identifying, appraising, and synthesising evidence, and in translating research evidence into practice and policy. International organisations like Cochrane Collaboration and Guidelines International Network (G-I-N) collaborate in the development and adoption of tools like GRADE to rate the quality of evidence and to grade the strength of recommendations.

However, also differences can be identified. While systematic reviews investigate and summarise the scientific literature on effects of exposures, interventions, or diagnostic procedures in a systematic and methodologically rigorous way, it is clear that decision making in the field of OSH will seldom be based on research evidence alone but will incorporate professional expertise of professionals, ethical considerations, preferences and values of workers, and the policies of governments, companies and other stakeholders. Guidelines are defined as ‘documents with recommendations to assist healthcare practitioners and healthcare users, intended to optimise quality of care, based on a systematic review of evidence and an assessment of the benefits and harms of the various care options, supplemented with expertise and experiences of both practitioners and users’. In particular when high quality evidence is not available, contradictory, or inappropriate, experiential and contextual knowledge may help guideline makers to formulate sensible recommendations.

  • systematic review
  • evidence based guideline
  • quality of care
  • contextual knowledge

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