Cochrane News
Cochrane's 30 under 30: Javier Ortiz Orendain
Cochrane is made up of 13,000 members and over 50,000 supporters come from more than 130 countries, worldwide. Our volunteers and contributors are researchers, health professionals, patients, carers, people passionate about improving health outcomes for everyone, everywhere.
Cochrane is an incredible community of people who all play their part in improving health and healthcare globally. We believe that by putting trusted evidence at the heart of health decisions we can achieve a world of improved health for all.
Many of our contributors are young people working with Cochrane as researchers, citizen scientists, medical students, and volunteer language translators and we want to recognize the work of this generation of contributors as part of this series called, Cochrane’s “30 under 30."
In this series, we will interview 30 young people, 30 years old or younger who are contributing to Cochrane activities in a range of ways, all promoting evidence-informed health decision making across the world.
We will be hearing from them in a series of interviewees published over the coming months.
We're keen to hear from you. Would you like to take part in this series? Do you know someone you'd like to see interviewed? Contact kabbotts@cochrane.org. Or if you want to know more about Cochrane’s work contact membership@cochrane.org where our community support team will be happy to answer your questions.
Name: Javier Ortiz Orendain
Age: 27
Occupation: First year Resident Psychiatrist
Program: Mayo Clinic Psychiatry Residency Program
How did you first hear about Cochrane?
It was 2014; I just had finished my board exam on basic sciences of medicine, and I was about to start meeting patients for the first time. After some weeks of experience in the clinical setting, I was faced with uncertain territories given that my basic science knowledge was insufficient to provide patient care. Fortunately, my school had a class on evidence-based medicine, which was given by Netzahuapilli Delgado, at the time teacher, but now also friend and colleague. He was at the time one of the members of the local branch of Cochrane Mexico. He showed me the principles of EBM and during his lectures, he talked about Cochrane with much passion.
How did you become involved with Cochrane? What is your background?
Netzahuapilli Delgado invited me to become part of the local Cochrane branch. The local branch in the Hospital Civil de Guadalajara was run by young doctors who despite having busy clinical lives were all enthusiastic and helpful with young students. I was encouraged to reach out to the groups of my interest, Schizophrenia had been a long passion of mine, so I contacted Cochrane Schizophrenia. After exchanging many emails with the managing editor of Cochrane Schizophrenia, she trusted me with one systematic review and I started to embark on this journey with Cochrane.
I am a medical doctor training to become a psychiatrist in the United States. I have the fortune of having experience in clinical trials and in doing systematic reviews.
What do you do in Cochrane?
When I am in Mexico, my group and I am in charge of giving talks about Cochrane and EBM in general. Also, we translate articles in Spanish for the authors.
I participate with the Cochrane Schizophrenia group doing systematic reviews, and after visiting the Editor Base of Cochrane Schizophrenia in Nottingham, Professor Clive Adams decided to invite me to become part of the editorial base.
What specifically do you enjoy about working for Cochrane and what have you learnt?
Working in Cochrane has brought me friendships and contacts throughout the world. For example, a couple of years ago we were organizing a conference on evidence-based medicine, and through our contacts in Cochrane, we were able to bring a great researcher and entrepreneur to Mexico. Since her visit to Mexico, we have been good friends even though we live oceans apart. The sense of community and the shared goal of systematizing evidence to deliver better care to patients is what makes me proud of being part of Cochrane.
What are your plans?
I will finish my training as a psychiatrist in about three years. After my training as a general psychiatrist, I will pursue more training in psychosis research. I also plan to work towards the goal of the Cochrane Schizophrenia group of systematizing the evidence for the care of people with psychosis or other severe mental illnesses.
In your personal experience, what one thing could Cochrane do better to improve its global profile?
I have met many enthusiastic people from many parts of the world during my time with Cochrane. Many young people are interested and willing to give their time to Cochrane due to their innate passion. Supporting visits to their Cochrane groups of interest would help them understand the groups' vision better, learn about systematic reviews and it will help them make connections and relationships that are otherwise impossible to be made online.
What do you hope for Cochrane for the future?
Continuing with the traditional model of giving independence to groups to develop their systematic reviews with their own expertise. I would like to see Cochrane Thematic Groups establishing more communication with the regional groups, this way the network will expand. Also, allocating resources to librarians so that the process of systematic reviews is optimized.
How important is it that young people get involved in Cochrane, why is this, do you think?
It is one of the most important things for long-term sustainability. Building on the enthusiasm of young individuals is essential to maintain the innovative character of Cochrane. They have always been an important motor of Cochrane's way.
What would your message be to other young people who want to get involved with Cochrane’s work but not sure where to start….?
Reach out to your local community of Cochrane and become involved in local projects. If someone from your regional group is doing a review, join them in the process. Doing systematic reviews is the best way to learn how to do them. After getting initialized in Cochrane, reach out to your group of interest and be specific about your skills and how can you be helpful.
Cochrane's 30 under 30: Theresa Schmalfuß
Cochrane is made up of 13,000 members and over 50,000 supporters come from more than 130 countries, worldwide. Our volunteers and contributors are researchers, health professionals, patients, carers, people passionate about improving health outcomes for everyone, everywhere.
Cochrane is an incredible community of people who all play their part in improving health and healthcare globally. We believe that by putting trusted evidence at the heart of health decisions we can achieve a world of improved health for all.
Many of our contributors are young people working with Cochrane as researchers, citizen scientists, medical students, and volunteer language translators and we want to recognize the work of this generation of contributors as part of this series called, Cochrane’s “30 under 30."
In this series, we will interview 30 young people, 30 years old or younger who are contributing to Cochrane activities in a range of ways, all promoting evidence-informed health decision making across the world.
We will be hearing from them in a series of interviewees published over the coming months.
We're keen to hear from you. Would you like to take part in this series? Do you know someone you'd like to see interviewed? Contact kabbotts@cochrane.org. Or if you want to know more about Cochrane’s work contact membership@cochrane.org where our community support team will be happy to answer your questions.
Name: Theresa Schmalfuß
Age: 26
Occupation: Medical Student (Year 5)
Program: Student Researcher at the Department of Evidence Evidence-based Medicine and Clinical Epidemiology at Danube University Krems, Cochrane Austria. Assistant Project Manager at the “doctors information centre” www.ebminfo.at
How did you first hear about Cochrane?
I first heard about Cochrane whilst studying in the UK. In my second year as a medical student there I underwent a schooling as “learning resource leader”, where I was taught to effectively search various databases for high quality evidence. Through this work, I read many Cochrane reviews and soon became a big fan of the Cochrane Collaboration as an excellent source for high quality evidence-based medicine.
How did you become involved with Cochrane? What is your background?
Cochrane Austria is involved in teaching medical students at my University in Austria at a very early stage in their degree about Epidemiology. During my studies, I chose the elective “evidence-based medicine” which is taught by members of staff of Cochrane Austria. This allowed me to get some firsthand information on their work and I quickly grew fond of their projects. After successful completion of the elective, I applied as a student researcher and shortly after got involved in my very first project.
My background is medicine. I studied for 3 years in the UK and switched University to Austria. Prior to my work with Cochrane I have worked with international organizations, such as “Médecins du Monde” (Doctors of the World), “Oxfam” and “HOPE International” and thus really enjoy working together with motivated people that try to make a difference – even if it's just a small one.
What do you do in Cochrane?
At Cochrane I am involved in various research tasks throughout various projects. However, my main focus lies in the “Evidence Based Medicine, Medical Information Centre”; a project which creates rapid reviews to various medical queries. Each review is published on the project’s website (www.ebminfo.at) and can be freely accessed. The great thing about rapid reviews is that evidence is synthesized more quickly than a systematic review, since certain methodological aspects of systematic reviews are abbreviated, and all the important knowledge is compressed in a short and understandable matter. I am also writing my doctoral thesis under the supervision of the director of Cochrane Austria.
What specifically do you enjoy about working for Cochrane and what have you learnt?
Specifically, in my work, I enjoy the fact that I am confronted with so many various medical topics (rare diseases, new procedures and new drugs) that I would normally not encounter throughout my studies. I love how at Cochrane Austria my collogues are very passionate about their work and their mission. I work alongside very inspiring people that think outside the box and critically assess the research and evidence that is presented to them.
Throughout my career, I have noticed that either as medical professional or patient it can be very challenging to find good and solid evidence in a myriad of research in today's society that is pressured to constantly publish new data and information. Cochrane brings light into the dark and stands for trusted evidence that allows anyone searching for guidance to make informed decisions.
What are your future plans?
After graduating medicine, I hope to continue my passion for evidence-based medicine and continue to be involved in research projects. As a medical professional, Cochrane has taught me how to integrate clinical experience, patient values and the best research information in my decision making.
In your personal experience, what one thing could Cochrane do better to improve its global profile?
I feel that Cochrane should try to motivate students more to have an interest in evidence-based medicine. Many students feel that it can be very “dry”. However, if more students had the chance to participate in projects, colloquiums or workshops their perception on Epidemiology might change.
What do you hope for Cochrane for the future?
I hope that the Cochrane Network will constantly grow and that more and more people, especially students, contribute to promoting good and trustworthy evidence. I also think it is very important to make complex knowledge more understandable. Cochrane should continue its great work in breaking down research into plain and simple statements and making these accessible to the public.
How important is it that young people get involved in Cochrane?
I think this is very important!
Why is this, do you think?
Young people are the future, and it is extremely important for an Organization like Cochrane, that promotes independent research and trustworthy evidence, to further exist. Any young person interested in being part of a fantastic international network of inspiring people that all promote trusting and accessible evidence should consider getting involved with Cochrane’s Projects. This might be a great opportunity, especially for someone interested in working in the field of Epidemiology, Medicine or Public Health, to get some great work experience.
What would your message be to other young people who want to get involved with Cochrane’s work but not sure where to start….?
Don’t be shy and contact your local Cochrane Centre and ask how you can get involved. Everyone who is motivated is welcome to join. It might be a good Idea to start by becoming a Cochrane Citizen Scientist or to visit Cochrane Task Exchange and contribute to tasks that interest you.
Podcast: Routine scale and polish for periodontal health in adults
Many adults in high-income countries will have had a ‘scale and polish’ when they go to the dentist, and some will be offered this routinely. But, is it worthwhile? The latest evidence is in the third update of the Cochrane Review, published in December 2018 and lead author, Thomas Lamont from the University of Dundee in Scotland tells us more.
"A ‘scale and polish’, or ‘professional mechanical plaque removal’, is done with specially designed dental instruments or ultrasonic scalers, followed by polishing with special pastes. It’s intended as a supplementary form of plaque removal to the oral hygiene that patients do at home. The aim is to reduce the risk of gum disease and many dentists or hygienists provide scaling and polishing for most patients at regular intervals, even if the patients are considered to be at low risk of developing gum disease.
However, there is debate about whether scaling and polishing treatment is effective and how often it should be done. Scaling can be an invasive procedure and has been associated with negative side effects, including damage to tooth surfaces and tooth sensitivity. We’ve updated the Cochrane Review, which was last published in 2013, and now have high certainty evidence that routine scaling and polishing does not, in fact, reduce gum disease in low-risk adults.
We included two studies, with a total of just over 1700 participants. Both studies involved adults without severe gum disease who were regular attenders at general practices in the UK. These types of practices are the most appropriate setting for evaluating 'routine scale and polish' treatments; and although both included studies were done in the UK, it would be reasonable to assume that the findings would be the same in other high-income countries.
One study measured outcomes at 2 years, and the other at 3 years. Both found that regular planned scale and polish treatments did not reduce the early signs of gum disease more than scale and polish delivered only when the dental professional judged it necessary or it was requested by the patient. The tartar levels were slightly more reduced with scheduled treatments, but it’s uncertain if this small difference would be considered important by patients or their dentists.
Participants in the trials who had scale and polish treatments at 6 and 12 month intervals reported feeling that their teeth were cleaner than those not scheduled to receive treatment, but this evidence is of low quality, and the studies didn’t find any benefits on quality of life. Neither study measured side effects, such as damage to tooth surfaces or tooth sensitivity, changes in attachment level, tooth loss or bad breath, and the available evidence on the costs of the treatments is uncertain.
In summary, our review casts doubt on whether it is necessary for scale and polish to be delivered routinely, on a standard schedule of every 6 or 12 months. Many people like the clean feeling that they get from a scale and polish treatment, but it’s not clear that there is any real clinical benefit on gum disease. The updated review shows that providing scale and polish treatment only when the dentist deems it appropriate or the patient requests it, does not result in poorer oral health outcomes after 2 to 3 years than doing it on a predetermined 6- or 12-monthly schedule.”
Monday, March 18, 2019Cochrane in Everyday Life - Round Up
Cochrane does not make clinical recommendations, instead it provides unbiased and high-quality health evidence so that health decisions, policies, and clinical guidelines can be informed by the best available evidence. ‘Cochrane Evidence in Everyday Life’ series collects stories about individuals, families, and carers making health decisions based on Cochrane evidence. Each piece in the series collects stories around the personal impact that one Cochrane Review has made.
Would you like to add your story about using Cochrane evidence for in 'everyday life'? Please contact mumoquit@cochrane.org to share your story!
Click on the images below to read stories of how Cochrane Evidence is being used in everyday life:
Coming soon - contact us to ad your story
Coming soon - contact us to add your story
Cochrane in Everyday Life - Compression stockings for preventing deep vein thrombosis in airline passengers
Cochrane does not make clinical recommendations, instead it provides unbiased and high-quality health evidence so that health decisions, policies, and clinical guidelines can be informed by the best available evidence. ‘Cochrane Evidence in Everyday Life’ series collects stories about individuals, families, and carers making health decisions based on Cochrane evidence. Each piece in the series collects stories around the personal impact that one Cochrane Review has made.
Review: Compression stockings for preventing deep vein thrombosis in airline passengers
Year published: 2016
Review Group: Cochrane Vascular
Conclusions: High‐quality evidence shows that airline passengers similar to those in the trials in this review can expect a substantial reduction in their risk of a symptomless deep vein thrombosis (DVT) if they wear compression stockings. Wearing stockings might reduce the incidence of this outcome from a few tens per thousand passengers, to two or three per thousand. There is moderate‐quality evidence that superficial vein thrombosis may be reduced if passengers wear compression stockings. Low‐quality evidence shows that passengers who wear stockings will also experience less oedema in their legs. However, this review is unable to identify whether these effects of wearing stockings translate into effects on outcomes such as death, pulmonary embolism and symptomatic DVT.
Plain language summary: available in English, Deutsch, Hrvatski, Polski, Português, and Русский
Note worthy mentions: Wikipedia entry on compression socks
User story:
"My name is Ciara from Ireland. I’m the founder and Editor of Meta-Evidence, which helps promote the work of the Campbell Collaboration across the UK and Ireland. After reading the Cochrane Review on compression socks, I made sure to wear my flight socks on a recent trip to Campbell's summit, GEIS, in Melbourne Australia. Normally my ankles swell up after a long flight and I was worried about the possibility of blood clots; I was so happy to see strong Cochrane-evidence on a practical solution to help safe guard against this! Given Cochrane Evidence, I will now wear my compression socks on every flight!” @MetaEvidence
Would you like to add your story of using this review? Please contact mumoquit@cochrane.org to share your story.
Tuesday, March 19, 2019 Category: The difference we makeGet Social with Cochrane!
Our Strategy to 2020 aims to put Cochrane evidence at the heart of health decision-making all over the world. This not only means making our producing high-quality and relevant systematic review but making sure that our evidence is accessible and advocating for evidence. We aim to make Cochrane the ‘home of evidence’ to inform health decision making, build greater recognition of our work, and become the leading advocate for evidence-informed health care.
You can access Cochrane evidence in news on your favourite social media platform! Follow us on:
Friday, March 29, 2019Cochrane-REWARD prize - 2017 Award Winner: SYRCLE
When it received the joint second Cochrane-REWARD prize in 2017, SYRCLE (the SYstematic Review Center for Laboratory animal Experimentation) was focused on encouraging the use of systematic reviews of animal studies to reduce waste and improve quality. Since then, SYRCLE has evolved, and here Merel Ritskes-Hoitinga gives an overview of how things have developed.
SYRCLE started in the Netherlands with the aim of improving the reliability of laboratory animal research and its relevance for patients by using systematic reviews. Systematic reviews have not been commonly used for animal studies, yet we saw the potential of implementing them to identify knowledge gaps, reduce duplication and improve the design of future animal and clinical studies.
We have developed an education programme designed to support researchers to conduct high-quality systematic reviews of animal studies. ZonMw (the Netherlands Organisation for Health Research and Development) funding has helped us to offer workshops and coaching. We have also set up a global SYRCLE ambassador network who can help to spread the messages locally.
Many of our systematic reviews of animal studies show that publication quality is quite low. They also show that the translation of findings from animal to human studies is quite poor. We think it is important to create transparency about this, in order to promote quality and translation of primary studies, as well as help speed up more use of replacement alternatives, such as human-based model systems.
We have already seen that participants from our workshops are getting good publications and citations, and people are accepting the idea. Our work has since grown, and we are now focussing on preclinical studies in general, including, for example, in vitro studies.
Impact of the prize
Receiving the second Cochrane-REWARD prize in 2017 was very important – it was fantastic to have international recognition from Cochrane and the REWARD alliance, especially for an initiative in a relatively new field.
We used the prize money to identify new ambassadors – our network has doubled from 15 to 30, from 15 countries around the world. Our network is made up of enthusiastic individuals that see the need to set up education in this area, and with more support this work could go even further.
In the coming years, we hope to be able to spread the messages of SYRCLE more quickly and widely, for example, through a train the trainer programme. However, funding is a challenge, especially as this is such a new field.
Collaborating with others on research waste
Through winning the prize, I met Matt Westmore from the UK National Institute for Health Research (NIHR) and Paula Williamson of COMET (Core Outcome Measures in Effectiveness Trials), who were the other recipients that year, and Iain Chalmers and Paul Glasziou. Through these connections I have also become involved in the Ensuring Value in Research (EViR) Funders’ Forum.
EViR has produced 10 guiding principles to work towards increasing the value of health-related research, which are currently being implemented for clinical studies. We are now working together on a set of principles for preclinical studies. Implementing these will lead to higher quality research, improved reporting – and ultimately the better use of resources and protection of animals and humans.
The Cochrane-REWARD prize – 2019 nominations open
The annual Cochrane-REWARD prize recognizes good local or pilot initiatives that have the most potential to reduce research waste if scaled up globally.
Nominations for this year’s prize are open until 5 June 2019.
Thursday, March 14, 2019The Thomas C Chalmers Award - 2018 Award Winner, Adriani Nikolakopoulou
The Thomas C Chalmers Award is awarded to the principal author of the best oral and the best poster presentation addressing methodological issues related to systematic reviews.
Tom Chalmers (1917-1995) was an outspoken advocate of randomised trials, whether at the bedside, at professional meetings, in class or in situations pertaining to his own life. His creativity spanned his entire career, influencing clinicians and methodologists alike. He is perhaps best known for the notion ‘randomise the first patient’, his belief that it is more ethical to randomise patients than to treat them in the absence of good evidence. In his later years, in arguably his most important work, Tom and his colleagues showed that, had information from RCTs been systematically and cumulatively synthesised, important treatments such as thrombolytic therapy for myocardial infarction would have been recognised as useful much earlier.
For more information on the prize eligibilty and criteria, visit the Colloquium Prize page. The call for abstracts is open and the deadline for submission is 12 April 2019. Abstracts for oral presentations and posters are invited in areas relevant to the work of Cochrane as well as evidence-based practice, policy, methodology, and advocacy.
In 2018, the winner of best short oral presentation winner was Adriani Nikolakopoulou for 'The emerging evidence synthesis tools: actively living network meta-analysis'. We spoke to Adriani on what winning the Thomas C Chalmers Award 2018 has meant to her.
"I work as a post-doctoral researcher in the Evidence Synthesis Methods group at the Institute of Social and Preventive Medicine (ISPM) of the University of Bern.
Cochrane’s mission and the life of Thomas C Chalmers are a big inspiration to me and I consider an honour to be able to associate my work with them.
Developing methodology for systematic reviews is a key aspect of my work. Thus, an award for the best oral presentation addressing methodological issues related to systematic reviews seemed like a good fit. Moreover, as an early career researcher, I consider any means to help dissemination of your research to be very important. The process involved in applying for the award was as easy as indicating that you consider yourself eligible for the Thomas C Chalmers Award when submitting an abstract for the Colloquium.
In my presentation, I described the concept of an actively living network meta-analysis, which combines ideas of living systematic reviews, network meta-analysis and evidence-based sample size calculations. Winning the award for this piece of work constitutes a recognition of the potential usefulness and importance of such a framework.
Although it is not that long ago since I was awarded, so I was not able to experience benefits career-wise, I am certain that the award will strengthen significantly future applications for grants and academic positions. Moreover, winning the Award had a huge impact on my moral. The experience was very motivating, and I came out of it with more confidence and sense of responsibility.
To anyone considering applying for this award; apart from any benefits of winning the award, I find that participating is an important motivation to prepare a good presentation and to think whether and how your work meets the criteria for the evaluation of the applications: originality of thought, high quality science, relevance to the advancement of the science of systematic reviews, and clarity of presentation."
For further information on other prizes which are awarded at the Colloquium, please visit https://colloquium2019.cochrane.org/prizes-and-awards
Thursday, March 14, 2019Symposium on using qualitative evidence to inform decisions in the SDG era – 9-11 October 2019, Brasilia, Brazil
Are you interested in qualitative research and the UN Sustainable Development Goals (SDGs)? Are you working within health, education, social welfare, crime and justice, the environment, agriculture or other related sectors?
Researchers, policy makers, research commissioners and other stakeholders from across the world are invited to attend the first Symposium on using qualitative evidence to inform decisions in the SDG era, to be held on 9 -11 October 2019 in Brasilia.
Background
Multisectoral action is needed to achieve the UN Sustainable Development Goals (SDGs). Such action requires a deep and contextualised understanding of the needs, views and experiences of a wide range of stakeholders. It also requires an in-depth understanding of how policies impact on different groups and sectors, and on equity and social inclusion. Qualitative research can play a critical role in providing this type of evidence, and in ensuring the representation of diverse voices.
The Symposium
The Symposium is hosted by the Oswaldo Cruz Foundation in collaboration with the Norwegian Institute of Public Health. It will advance conversations and collaborations on innovative ways of using qualitative evidence to broaden and humanise decision and policy-making processes to achieve the SDGs. The Symposium will also explore the tools and methods needed to support the translation of qualitative evidence into policy and practice, and will examine ways of strengthening capacity in this area, particularly in the global South. Further information and key dates are available on the Symposium website.
Who is invited?
As researchers and research commissioners, policy makers and other evidence users, and other stakeholders from across the world, we hope you will consider participating in this important gathering. The Symposium will provide opportunities to share with a multisectoral community your experiences and ideas on using qualitative evidence to support decision making. A wide range of organisations from across sectors are contributing to developing an exciting and innovative programme for the Symposium.
Help us identify Symposium themes!
You can get involved now by helping to identify themes that should be covered in the Symposium – please participate via the website. There, you can also indicate interest in participating in the 'Virtual Symposium' that will include a number of online activities such as plenary sessions webcasts and online group discussions.
Covidence seeks Community Manager(s) - Flexible location
Specifications: 0.5-1.0 FTE
Salary: AU$60,000 – AU$80,000 pro-rata DOE
Location: Flexible - this is a remote position; preferred locations are UK/EU or AU/NZ, but other options are possible for the right candidate
Application closing date: 25 March 2019
What does a Covidence Community Manager do?
You will work to understand user needs, support users in their experience using Covidence, manage major institutional accounts, and contribute to the design and development of Covidence. Working with researchers from around the world, you will collaborate to build a new way of making sense of research data, transforming the impact that research can have on health and wellbeing.
For more information and to apply, please see the full ad at: https://www.linkedin.com/jobs/view/1126645476/
Thursday, March 7, 2019 Category: JobsSalt Awareness Week
'World Salt Awareness Week' is a global event t o bring attention to salt intake and the risks to health it can bring, including high blood pressure and increased risk of stroke and heart disease. This year, the awareness week is being observed 4-10 March, 2019.
Cochrane Nutrition Field's aim is to support and enable evidence-informed decision-making for nutrition policy and practice by advancing the preparation and use of high-quality, globally relevant nutrition-related Cochrane reviews. Cochrane Nutrition covers a wide spectrum of nutrition-related issues and questions, ranging from clinical to public health nutrition.
To mark World Salt Awareness Week, we have collated a selection of Cochrane Reviews on salt intake:
- Advice to reduce dietary salt for prevention of cardiovascular disease
- Altered dietary salt for preventing pre‐eclampsia, and its complications
- Altered dietary salt intake for people with chronic kidney disease
- Altered dietary salt intake for preventing and treating diabetic kidney disease
- Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride
- Iodised salt for preventing iodine deficiency disorders
- Reduced dietary salt for the prevention of cardiovascular disease
- Reduced salt intake compared to normal dietary salt, or high intake, in pregnancy
Wednesday, March 6, 2019
Relaunch of Cochrane Ireland
We are delighted to announce the recent relaunch of Cochrane Ireland and its establishment as an Associate Centre. The official launch will take place at the upcoming joint Cochrane UK and Cochrane Ireland Symposium in Oxford in March 2019.
Cochrane Ireland will be hosted within the newly-established Evidence Synthesis Ireland (ESI), based at the National University of Ireland Galway. ESI is supported by funding from the Health Research Board of Ireland and the Health and Social Care Research and Development Division, Northern Ireland and aims to build evidence synthesis knowledge, awareness and capacity among the public, health care institutions and policymakers, clinicians and researchers on the Island of Ireland. A key goal of ESI is to re-establish the activities of Cochrane Ireland; these include the development of an extensive programme of Cochrane training events and Cochrane fellowship and studentship schemes.
Cochrane Ireland will be led by Professor Declan Devane as Director of Cochrane Ireland and Evidence Synthesis Ireland, and the Cochrane Ireland team; Dr Elaine Toomey (Associate Director of Cochrane Ireland), Dr Patricia Healy (Programme Manager of Evidence Synthesis Ireland) and Sheena Connolly (Administrator of Evidence Synthesis Ireland). Speaking about the relaunch of Cochrane Ireland, Professor Devane said: “We are delighted to be part of Cochrane’s work across the Island of Ireland and are excited by the potential it has to make a difference to health care decisions across the Island. Health care decisions should be based on the full range of information that is available on a topic; it can't rely on one or more individual pieces of information, or studies. Together with our friends in Cochrane UK and our wider team of collaborators, we look forward to helping build capacity to conduct syntheses of evidence for which Cochrane is a global leader”.
Cochrane CEO Mark Wilson commented: “I’m thrilled with the re-launch of Cochrane Ireland and the appointment of Professor Declan Devane as its new Director. Declan is a highly experienced systematic reviewer and trainer, and we look forward to working together. Given the passion and generosity Declan brings to everything he does, I am sure that he and the new team will expand the reach and impact of Cochrane evidence in health decision making in Ireland in the coming years.”
Cochrane Ireland will join its international Cochrane colleagues to represent and promote Cochrane on the island of Ireland, facilitate engagement with regional stakeholders to improve knowledge translation and dissemination of Cochrane reviews, and build capacity for review production and use.
Professor Martin Burton, Director of Cochrane UK, commented: “All of us at Cochrane UK have enjoyed working with our friends and colleagues on the island of Ireland. We are delighted that Cochrane Ireland is re-launching itself under the auspices of Professor Declan Devane and his team in Galway. We wish them every success and look forward to meeting them at the joint Cochrane UK and Cochrane Ireland Symposium in Oxford in March”.
A full list of the Cochrane Ireland training events is available here, and more information on the Cochrane Ireland fellowship and studentship schemes is available here. For more information or to get in touch, contact us on esi@nuigalway.ie, follow us on Twitter at @CochraneIreland or visit our website at https://ireland.cochrane.org.
Friday, March 8, 2019Podcast: Sedation of children undergoing dental treatment
Fear associated with going to the dentist is common and, among children especially it can make it difficult to deliver the treatment they need. Therefore, among their many reviews of the effects of dental treatments, the Cochrane Oral Health Group maintains a review of the effects of sedation on children undergoing such treatment. The review’s third update was published in December 2018 and lead author, Paul Ashley, from the UCL Eastman Dental Institute in London England tells us where things now stand in this podcast.
"Children who are scared of the dentist will often express this as uncooperative or difficult behaviour during their visit. If this prevents effective treatment, it can result in a child's tooth decay going untreated. Behaviour management techniques might help but aren’t always enough. For children who can’t manage, dentists may consider using sedation and we examined the effectiveness of drugs to sedate a child whilst keeping them conscious in order to carry out dental treatment; but found that there are many more holes than fillings in the evidence.
We did identify a total of 50 randomised trials involving more than 3,700 children, from countries across the world; but most of these studies were at high risk of bias. It was also difficult to combine their data because of reasons such as the variety of outcomes reported, the mixture of dosage and delivery methods used for the drugs, and the large number of different drugs and drug combinations that were tested. In fact, we recorded 34 different combinations in the review and of all the interventions assessed, we could only do one meta-analysis, which combined the results of the six small trials comparing oral midazolam to placebo. This did show that oral midazolam is probably effective, but it means we can say little about the effects of treatments, but lots about the need for future research.
We made several recommendations for new studies in order to deal with some of the issues we encountered. In general, there are the problems seen in many other Cochrane Reviews around poor quality reporting, randomization, studies being too small, and so on. But there were some issues specific to our review and these included the need for greater consistency in the outcome measures used; better consideration of the age ranges assessed, since sedative techniques appropriate for a 3-year old may be different to those for a 12-year old; and more studies of the same drug and drug combinations to allow better assessment of overall effectiveness.
In summary, although our review shows moderate‐certainty evidence that oral midazolam is an effective sedative agent for children undergoing dental treatment, there is a need for further well‐designed and well‐reported clinical trials to evaluate other potential sedation agents. This research should also consider evaluating experimental regimens against oral midazolam or inhaled nitrous oxide."
Wednesday, March 6, 2019Cochrane Infectious Disease Group works with WHO on latest guidelines for malaria vector control
The World Health Organization published Guidelines for malaria vector control, drawing on seven Cochrane reviews specially prepared for them by the Cochrane Infectious Diseases Group (CIDG).
With its editorial base at Liverpool School of Tropical Medicine (LSTM), CIDG was asked to review all of the evidence that was used in bringing together what WHO have described as a “one-stop shop” for countries and partners working to implement effective malaria vector control measures. Consolidating more than 20 sets of WHO recommendations and good practice statements into one user friendly document, the guidelines support each country to select and implement the most effective interventions for its own unique malaria landscape.
LSTM’s Professor Paul Garner is Coordinating Editor of CIDG. He said: “These guidelines are based on a complete and thorough review of all of the existing evidence regarding various insecticide-treated nets, insecticide residual spraying, space spraying, larviciding, larvivorous fish and repellents. Systematic reviews are at the heart of the guidelines and the work was carried out by a number of Cochrane authors, including a group of early career researchers who brought to the table enthusiasm and commitment to understanding the evidence and identifying best practice throughout, and completed this momentous task in time for the panel”.
The intensive process of reviewing the evidence base for the guidelines enabled WHO to identify where gaps exist, which they describe as critical to refining the research agenda for the ongoing development of the guidelines. WHO also believes that the new guidelines will support malaria control by increasing the level of transparency around the evidence that underpins WHO’s vector control recommendations.
Dr Jan Kolaczinski, Coordinator of the Entomology and Vector Control unit of the WHO Global Malaria Programme, said: “Through greater transparency, we hope that innovators and research partners will understand why new tools and interventions need to be fully evaluated. We really want all malaria stakeholders to recognise the benefits of conducting solid research which, in turn, generates an evidence base from which WHO can develop recommendations.”
- This news article was first published on the LSTM website
- Visit the Cochrane Infectious Diseases website
Launch of Cochrane Colombia to support the use of high quality, trusted health information
Cochrane, a global independent network of researchers, professionals, patients, carers and people interested in health, is proud to announce its newest Centre, ‘Cochrane Colombia’.
Cochrane Colombia will promote evidence-based decision making in healthcare in Colombia by supporting and training authors of Cochrane Reviews, as well as working with clinicians, professional associations, policy-makers, patients, and the media to encourage the dissemination and use of Cochrane evidence.
Cochrane works with collaborators from more than 130 countries to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. Cochrane’s work is recognized as representing an international gold standard for high quality, trusted information. Institutions from Colombia have been involved in the Cochrane Iberoamerica Network for many years. Establishing Cochrane Colombia as a full Centre is a next step in its development. The Centre brings together three institutions – the Pontifical Xavierian University, through the Department of Clinical Epidemiology and Biostatistics; the National University of Colombia through the Institute of Clinical Research; and, the University of Antioquia thorough the Faculty of Medicine– that will jointly manage the activities of Cochrane Colombia. In addition, five institutions will join as Cochrane Affiliates.
In its first phase, Cochrane Colombia will be coordinated and led by Professor Maria Ximena Rojas-Reyes from the Pontifical Xaverian University: “The launch of Cochrane Colombia is a recognition to the voluntary work done for years by different Colombian professors, students and health care professionals that believe in evidence based health care. Producing and increasing the dissemination of the best available information on healthcare is critical for clinicians and patients everywhere in the world. The centers that today give life to Cochrane Colombia have been working hard for more than 20 years in promoting the use of evidence in health care and policy decisions in our country. With the establishment of Cochrane Colombia as a formal Centre, we can expand our work, to support the synthesis of evidence according with Colombia´s needs for health decision making, while continuing the training people in the use of evidence and particularly the Cochrane evidence”
Hernando G Gaitán, Coordinating Editor of the Cochrane Sexually Transmitted Infections Group: "The Cochrane Colombia Centre will strengthen the leadership that Colombian researchers have in knowledge translation products such as Clinical Practice Guidelines and Health Technology assessment reports. Also with the new Center different opportunities for training and participation in Systematic Reviews will come up and we are sure the Groups, and authors, located in Colombia will improve their performance."
Xavier Bonfill, director of the Iberoamerican Cochrane Center and Network, expresses his congratulations: “The launch of Cochrane Colombia is a culmination of many years of Colombian participation in the Cochrane Collaboration and, specifically, in the Iberoamerican Network. Progressively, a variety of people working in different institutions have been involved as authors, trainers or have contributed in other important tasks such as trials identification, as it is reflected in the corresponding data. Now there are the necessary conditions for assuming the challenges of being a national Centre, which should bring more opportunities for working together and making more significant contributions to Cochrane and to their country”.
Cochrane’s Chief Executive Officer, Mark Wilson, warmly welcomed today’s news: “I am delighted we are announcing the launch of Cochrane Colombia, which I’m confident will deepen and expand the reach and impact of Cochrane activities on health and healthcare decision-making across Colombia and therefore improve health outcomes for its 50 million citizens.”
Cochrane Colombia will remain closely connected to the Cochrane Iberoamerican Network, through which methodological support, mentoring, and supervision will be provided.
- For more information on the work of the Cochrane Colombia, please visit the Cochrane Colombia website.
- On the website, you will also find more information about the First symposium of Cochrane Colombia, taking in place in Bogota, on March 4 & 5, 2019.
The Thomas C Chalmers Award - 2018 Award Winner, Leonie Van Grootel
The Thomas C Chalmers Award is awarded to the principal author of the best oral and the best poster presentation addressing methodological issues related to systematic reviews.
Tom Chalmers (1917-1995) was an outspoken advocate of randomised trials, whether at the bedside, at professional meetings, in class or in situations pertaining to his own life. His creativity spanned his entire career, influencing clinicians and methodologists alike. He is perhaps best known for the notion ‘randomise the first patient’, his belief that it is more ethical to randomise patients than to treat them in the absence of good evidence. In his later years, in arguably his most important work, Tom and his colleagues showed that, had information from RCTs been systematically and cumulatively synthesised, important treatments such as thrombolytic therapy for myocardial infarction would have been recognised as useful much earlier.
For more information on the prize eligibilty and criteria, visit the Colloquium Prize page. The call for abstracts is open and the deadline for submission is 12 April 2019. Abstracts for oral presentations and posters are invited in areas relevant to the work of Cochrane as well as evidence-based practice, policy, methodology, and advocacy.
In 2018, the winner of best short oral presentation winner was Leonie Van Grootel for 'Using Bayesian information for matchinig qualitative and quantative sources in a mixed studies review'. We spoke to Leonie on what winning the Thomas C Chalmers Award 2018 has meant to her.
"I am an assistant professor at the department of Methodology & Statistics, Faculty of Social Sciences, Tilburg University., the Netherlands. In addition, I also have relations with the EPPI-Centre at University College London, for we are working on several short-time appointments as a visiting fellow.
I was planning to go to the Cochrane Edinburgh Colloquium and talk about my research on mixed studies reviewing methodology. When checking the program, I never imagined that would have any chance at winning such a prestigious award. However, when reading the description of what the award stood for, I was triggered by the aspect of methodological innovation. Since I consider methodological innovation in reviews a central aspect in my work, I decided to give it a try.
First of all, a great honour to receive at the start of my academic career. The fact that a leading organization as Cochrane welcomes my ideas is very flattering. In addition to that, I very much appreciate the recognition of Cochrane for the potential of incorporation of qualitative research for systematic reviews - which is the main issue discussed in my presentation and paper. Qualitative research will, I believe, becoming increasingly important for systematic reviews in medical and health sciences, and the potential of mixed studies reviews has not yet been reached. Thanks to the recognition of Cochrane for this topic, I am confident that further pursuing research in this field is worthwhile and can possibly aid evidence-based medicine and clinical practice. I am currently even applying for research funding for research on this very topic; and the Cochrane prize on my CV will definitely increase my chances of getting it.
My message to other colleagues or Cochrane collaborators who are considering applying for this award is to keep believing in doing the research that you feel is important for evidence practice. Even if the topic might not be popular or at the top of the agenda of the big institutions or funding agencies; do not let your research agenda be determined by what is expected from you or what happen to be ‘hot topics’ but stand for what you really think is important. Your audience will notice your genuine dedication to your work and will appreciate it."
For further information on other prizes which are awarded at the Colloquium, please visit https://colloquium2019.cochrane.org/prizes-and-awards
Wednesday, March 6, 2019Featured Review: Mediterranean-style diet for the prevention of cardiovascular disease
What happened with this trial and do you think we can still trust its findings?The original trial (Estruch 2013) was retracted and re-analysed when methodological issues concerning randomisation came to light for 2 sites, and the inclusion of non-randomised second household members. The new publication (Estruch 2018) controlled for these in the analyses and conducted a series of sensitivity analyses excluding these sites. The re-analysed paper also reports clinical endpoints separately where there was low quality evidence of little or no effect of the PREDIMED intervention compared to a low fat diet on total mortality, CVD mortality, or MI, but moderate quality evidence of a reduction in the number of strokes was seen with the intervention.
Overall, we should treat findings from this trial with extreme caution, given the number of methodological issues flagged, as also clearly outlined by Hilda Bastian’s piece. There are other studies in the review that you had concerns over. Does this reflect problems in running studies or could misconduct be the problem here?Both issues are possible indeed. Concerns have been publicly raised about potential scientific misconduct and data fabrication, as well as about the integrity and reliability of the published data for a few secondary preventions trials (Singh 1992; Singh 2002). The review includes a large number of studies yet provides only low or very low certainty evidence. Can you explain why this is? Overall, there were limited data on clinical endpoints, our primary outcome. Two studies were excluded from all main analyses in sensitivity analyses due to published concerns regarding the reliability of the data (Singh 1992; Singh 2002). Only one trial reported clinical endpoints for primary prevention and this study experienced methodological issues regarding randomisation with the report subsequently being retracted and re-analysed (PREDIMED). The findings in secondary prevention are based on one older trial reporting very large effect estimates (The Lyon Diet Heart Study) using a modified Zelan design. In addition, both the PREDIMED trial and The Lyon Diet Heart Study supplied supplemental foods as well as dietary advice to follow a Mediterranean-style diet so the policy implications of the findings of these trials are unclear (Appel 2013). The majority of studies included in this review were at unclear risk of bias for many of the risk of bias domains so results should be interpreted cautiously. High risk of bias was noted for differential attrition rates between the intervention and control groups in two trials (Djuric 2009; Vincent-Baudry 2005), and high risk of other bias in two trials where there are published concerns regarding the reliability of the data (Singh 1992; Singh 2002). These two studies have been excluded from the main analyses. What sort of studies do we need now to address the uncertainties that the review has identified?Several ongoing trials have been identified, particularly reporting clinical endpoints in secondary prevention, which will add to the evidence base. Further adequately powered primary prevention trials are needed to confirm findings on clinical endpoints to date. With the accrual of further evidence, the heterogeneity observed between trials in terms of both the nature and duration of the intervention, comparators, and the range of participants recruited can be explored further and its impact on outcomes examined. The ongoing studies may help reduce the uncertainty. Wednesday, March 13, 2019
Podcast: Laparoscopy versus laparotomy for the management of presumed early stage endometrial cancer
Recent decades have seen greater and greater use of laparoscopy, or keyhole surgery, when people need an operation on their abdomen. There are now dozens of Cochrane Reviews of this, for a wide variety of conditions and, in October 2018, the one for laparoscopy versus laparotomy, or open surgery, for women with early stage endometrial cancer was updated. The review is led by Khadra Galaal from the Royal Cornwall Hospital in Truro in the UK and she tells us the latest findings in this podcast.
"Worldwide, cancer of the womb or 'endometrial cancer' is the fifth most common cancer among women under 65 years of age, with a higher incidence in high income countries than in low and middle income countries. The current standard treatment is a hysterectomy to remove the woman’s womb and removal of her fallopian tubes and ovaries. Other treatments include radiotherapy and chemotherapy. Traditionally, the surgery has been done as a laparotomy, through an open cut in the abdomen, and our review compares this technique against laparoscopic or keyhole surgery.
We looked at the effects of the two types of surgery on how long women remained alive after the diagnosis of their cancer and the length of time that they remained disease‐free. We were able to use results from six randomised trials that had analysed data for nearly 4000 participants with early stage endometrial cancer. We found no significant difference in the risk of death between the women who underwent laparoscopy and those who underwent laparotomy. In addition, results from five randomised trials confirmed no difference in the risk of cancer recurrence if women had laparoscopy or laparotomy. Notably, laparoscopy was associated with less blood loss and earlier discharge from hospital.
In summary, this update confirms the findings of our previous review from six years ago, that laparoscopy is an effective and viable alternative to laparotomy for the treatment of women with early stage endometrial cancer. With regards to long term survival, outcomes for laparoscopy are comparable to laparotomy."
Tuesday, February 26, 2019Apply now: the Cochrane-REWARD prize for reducing waste in research
Nominations are open for the 2019 Cochrane-REWARD prize, which recognizes initiatives that have potential to reduce research waste.
An estimated $170 billion of research funding is wasted each year because its outcomes cannot be used [1]. The waste occurs during 5 stages of research production: question selection, study design, research conduct, publication, and reporting [2,3]. Much of this waste appears to be avoidable or remediable, but there are few proposed solutions.
The Cochrane-REWARD prize was established in 2017 to stimulate and promote research in this area.
Cochrane is now calling for nominations for the 2019 prize
All nominations will be assessed using the following criteria:
1. The nominee has addressed at least one of the 5 stages of waste (questions, design, conduct, publication, reporting) in health research;
2. The nominee has pilot or more definitive data showing the initiative can lower waste;
3. The initiative can be scaled up;
4. The estimated potential reduction in research waste that the initiative might achieve.
Nominations for the 2019 prize should be submitted by 5 June 2019. Two prizes will be awarded (a 1st prize of £1500 and a 2nd prize of £1000), but other shortlisted candidates will also be highlighted to help disseminate good ideas.
The winners of the 2019 prize will be announced at the 5th International Clinical Trials Methodology Conference, which will take place in Brighton, UK on 6-9 October 2019.
More information on the prize and how to submit a nomination
Read about the previous winners of the Cochrane-REWARD prize
Deadline for submissions: 5 June
References:
- Chalmers I, Glasziou P. Avoidable waste in the production and reporting of research evidence. Lancet. 2009 Jul 4;374(9683):86-9.
- Macleod MR, Michie S, Roberts I, et al. Biomedical research: increasing value, reducing waste. Lancet. 2014 Jan 11;383(9912):101-4.
- Glasziou P, Altman DG, Bossuyt P, et al. Reducing waste from incomplete or unusable reports of biomedical research. Lancet. 2014 Jan 18;383(9913):267-76.
- Glasziou, P and Chalmers, I. Research waste is still a scandal—an essay by Paul Glasziou and Iain Chalmers. BMJ. 2018 Nov 12;363:k4645
Friday, February 22, 2019
Elections to the Cochrane Consumer Executive open
Are you interested in taking a leadership role in the Cochrane consumer community? Cochrane’s Consumer Engagement Officer; Richard Morley, and Consumer Executive member; Nancy Fitton explain what’s involved and how to apply.
"Cochrane is an amazing movement to change the way that evidence is produced and used. It is a global community of over 63,000 supporters and members who use and create new knowledge so that healthcare decisions can be made using reliable evidence.
A feature of its work since 1994 has been to support a global network of healthcare consumers (patients, care-givers, and family members) of over 1550 people who help produce Cochrane evidence by setting priorities for future research, defining outcomes in reviews, working alongside researchers, peer reviewing abstracts and reviews, and helping to disseminate evidence. They work with Cochrane’s network of Review Groups, Centres and Fields. And they are part of the governance of the organisation.
One of the ways in which consumers do this latter role is by being part of the Consumer Network Executive. This group of consumers has an important role to play in representing the voice of consumers, they help to take forward work that improves the way that Cochrane works with consumers, and make its evidence accessible to its non-scientist users.
Over recent years the Consumers Executive has helped produce the Consumer Structure and Function Review (2015) and Consumer Delivery Plan (2016), setting out the ways in which consumer involvement will be improved. It formed a group that developed the Statement of Principles for Consumer Involvement in Cochrane (2017). The Executive has supported many consumers at Colloquia, Cochrane’s annual meeting. It has commented on a range of policy documents like the recent Peer Review policy that now makes it mandatory to seek consumer peer review on protocols and reviews. Presently it is working with the network of Cochrane Centres to spread consumer involvement and engagement across our global organisation.
Nancy Fitton, member of the present Consumers Executive, shares her experience of being a member of the group.
It has been a privilege to serve on the Consumer Executive for the last five years. Each member of the CE has their unique skill set, point of view, and experience with Cochrane. We are all from different countries. These differences provide a rich mix of input for the tasks that we undertake.
The work of Cochrane is very important to us. Of course, the participation of consumers in that work is of utmost importance. We work, through various channels, to improve the experience of consumers involved in Cochrane, and to help Cochrane groups embrace consumers as members of the team. This has been a very rewarding endeavour for me. Additionally, the other members of the CE are excellent co-workers in this task. We have an outstanding champion in our Consumer Engagement Officer, Richard Morley.
If you have wished that you had more input into “how things are done,” and would like to build on your involvement with Cochrane by contributing to the consumer experience, you might consider running for a spot on the Consumer Executive."
Members of the Consumers Executive are elected by the whole membership of the consumer community, for a period of three years, with an option to stand for a further period. Elected members are asked to attend monthly online or telephone meetings, to undertake some work in between meetings, and to come to the Mid-year business gathering that takes place in April each year, and the Colloquium (where funding allows). This is not a paid post, but all expenses are met by Cochrane. The Consumers Executive also appoints two people to serve on the Cochrane Council. Members of the Executive are supported by Cochrane’s Consumer Engagement Officer.
This year there are two vacancies to be filled and one of those positions is kept for someone from a Low and Middle-income country. We are particularly keen to encourage people to come forward who can provide leadership to the network, can represent the consumer voice to the wider Cochrane community, support the wider network in its ambition to involve consumers, and actively contribute to the debate about the best ways to involve consumers in the organisation. It’s important to know that the function of all Cochrane’s Executive groups is being reviewed.
If you are still interested, you can download the document that explains how to apply.
Nominations close Friday 29th March 2019
Thursday, February 21, 2019