Keeping up with evidence a new system for WHO's evidence-based family planning guidance

The World Health Organization (WHO) is responsible for providing evidence-based family planning guidance for use worldwide. WHO currently has two such guidelines, Medical Eligibility Criteria for Contraceptive Use and Selected Practice Recommendations for Contraceptive Use, which are widely used globally and often incorporated into national family planning standards and guidelines. To ensure that these guidelines remain up-to-date, WHO, in collaboration with the Centers for Disease Control and Prevention and the Information and Knowledge for Optimal Health (INFO) Project at the Johns Hopkins Bloomberg School of Public Health's Center for Communication Programs, has developed the Continuous Identification of Research Evidence (CIRE) system to identify, synthesize, and evaluate new scientific evidence as it becomes available. The CIRE system identifies new evidence that is relevant to current WHO family planning recommendations through ongoing review of the input to the POPulation information onLINE (POPLINE) database. Using the Meta-Analysis of Observational Studies in Epidemiology guidelines and standardized abstract forms, systematic reviews are conducted, peer-reviewed, and sent to WHO for further action. Since the system began in October 2002, 90 relevant new articles have been identified, leading to 43 systematic reviews, which were used during the 2003-2004 revisions of WHO's family planning guidelines. The partnership developed to create and manage the CIRE system has pooled existing resources; scaled up the methodology for evaluating and synthesizing evidence, including a peer-review process; and provided WHO with finger-on-the-pulse capability to ensure that its family planning guidelines remain up-to-date and based on the best available evidence.