In this interview, we learn more about a series of reviews on hip fractures published on the Cochrane Library and talk to some of the authors behind this work Prof Xavier Griffin and orthopaedic surgeons Mr William Eardley and Mr Martyn Parker.

Tell us how did these reviews come about?
This work was funded by the National Institute of Health Research Systematic Reviews programme, as a joint application from Oxford University and Cochrane’s Bone, Joint and Muscle Trauma Group. The underlying concept was that there is diverse, congested and complex literature of varying quality around hip fracture and it can be hard to interpret. We wanted to improve on that and provide useful, actionable statements of the evidence for patients, clinicians and researchers.

Studies are being accumulated very quickly in this field compared to other areas of orthopaedics and the reviews that were in the Cochrane Library were out of date and had various limitations. We were aware that NICE would be reviewing and updating its guidance on the management of hip fracture in adults in 2022 so this was a timely piece of work that would link closely with work at NICE. We were in touch with them along the process sharing the questions for which patients and clinicians wanted answers, as well as sharing findings with them.

Were patients involved?
We carried out scoping work with patients and experts in this field to work out what the priority review topics would be - there could have been a hundred, but we worked together to reduce it down to what was most important. We shared this with NICE to help shape their update. This involvement of patients and their views was not happening when we all started out in this field, it is now so much more patient influenced, which is a good thing for those giving and those receiving treatment and care.

We approached these reviews as informative pieces of work giving direction to guidelines, clinical practice and research rather than being static sources of information - they feed into knowledge and then clinical practice.

Who will find these studies most useful?
Clinicians, surgeons, and trainee surgeons will find these reviews most useful as they provide the gold standard answers to questions they want answered.

The studies are also an important part of the puzzle in terms of informing what might be commissioned for research later.

We hope patients will see an improvement in their care as a result of these reviews as they give an evidence-based anchors for clinician’s recommendations.  NICE will also have these studies available to them when they update their guidance on this topic.

In the UK we have something called the National Hip Fracture Database, it audits treatment in this area, how many hip replacements take place in the UK for example. With these reviews they can report practice against best evidence which is good for patients, good for commissioners and good for people planning service delivery in their hospitals.

Who was involved?
Our success in securing this grant and the reviews done to date builds on very strong networks,
we've got a pretty research active and research savvy community partly through the work of Orthopaedic Trauma Society and the Fragility Fracture Network – we drew on this network to pull this work together. This research collaboration is what we’d like to see fostered going forwards.

These reviews were synchronised with current large trials and NICE updating their guidelines and as such they are an important piece of work to inform the wider picture and influence practice; not only in terms of influencing what treatment is given but influencing how best to study a topic – this is a shift in culture. These reviews should stand the test of time for the next ten years because they have been performed with methodological rigour and include the latest trial data.

You included very recent large landmark trials, how?
We did not want to publish Cochrane reviews that were out of date quickly. We were able to include a very large landmark new trial (WHITE5) in two of these reviews because we were aware of what each other was doing – we were in touch with each other - and we were able to access trial data prior to publication. We don’t work in a siloed way, and this has great benefit.

What value do these studies have for funders?
This body of work will help funders know where to place their funding to get maximum benefit on that spend – there are certain surgeries we can say should no longer happen and those areas no longer need to be studied.

• Visit the Cochrane Bone, Joint and Muscle Trauma Group here
• View each review here:
  • Internal fixation implants for intracapsular hip fractures in older adults
  • Arthroplasties for hip fracture in adults
  • Cephalomedullary nails versus extramedullary implants for extracapsular hip fractures in older adults
  • Surgical interventions for treating intracapsular hip fractures in older adults: a network meta-analysis
  • Surgical interventions for treating extracapsular hip fractures in older adults: a network meta-analysis
    
    

Monday, February 14, 2022

Location: Flexible location (remote working) in the UK.
Specifications: Permanent contract.
Hours: Full-time week (flexible working considered) – 37.5 hours.
Salary: £42,000 per annum.
Application Closing Date: 07 April (Midnight GMT Time)

This role is an exciting opportunity to use your financial knowledge and problem-solving skills to make a difference in the field of health care research.  

The Financial Accountant is responsible for supporting the day-to-day management and the smooth running of the financial accounting operations of Cochrane, which includes leading on financial accounting processes, balance sheet reconciliations and supporting the international payroll.  The jobholder will have an important role to create and shape the financial procedures, improve processes, outputs, and analysis for stakeholders.

You will have a minimum of 3-5 years’ experience in a similar finance role with a recognised qualification. Part-qualified candidates with particularly strong experience will be considered and supported.

Cochrane is a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesizing research findings to produce the best available evidence on what can work, what might harm and where more research is needed. Our work is recognised as the international gold standard for high quality, trusted information.

• For further information on the job description and how to apply, please click here 
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples. Note that we will assess applications as they are received, and therefore may fill the post before the deadline.
• Deadline for applications: 07 April 2022 (Midnight GMT).

Friday, March 25, 2022 Category: Jobs

Ortoze za stopala za liječenje ravnih stopala u djece Istraživačko pitanje Koje su prednosti i nedostatci korištenja ortoza za stopala (uložaka za cipele) za liječenje ravnih stopala u djece? Dosadašnje spoznaje Djeca s ravnim stopalima imaju spušteni svod stopala. U stojećoj poziciji svod stopala je ravan, unutarnji rub stopala može padati prema unutra te čak i dodirivati pod. Ponekad ravna stopala mogu uzrokovati bol ili promijeniti način hoda djeteta. Postoje razne nekirurške metode liječenja, no ukoliko nema boli, većini djece nije potrebno liječenje. Ortoze za stopala ili ulošci za...

Low‐carbohydrate versus balanced‐carbohydrate diets for reducing weight and cardiovascular risk

Key messages

• There is probably little to no difference in the weight lost by people following low-carbohydrate weight-reducing diets (also known as 'low-carb diets') compared to the weight lost by people following balanced-carbohydrate weight-reducing diets, for up to two years.
• Similarly, there is probably little to no difference between the diets for changes in heart disease risks, like diastolic blood pressure, glycosylated haemoglobin (HbA1c, a measure of blood sugar levels over 2-3 months) and LDL cholesterol (‘unhealthy’ cholesterol) up to two years.
• This was the case in people with and without type 2 diabetes.

What are low-carbohydrate and balanced-carbohydrate weight-reducing diets?
People spend lots of money on trying to lose weight using diets, products, foods and books, and continue to debate about which diets are effective and safe. So, examining the scientific evidence behind claims made is important. Low-carbohydrate diets are a broad category of weight-reducing diets that manipulate and restrict carbohydrates, protein and fat in diets. There are no consistent, widely-accepted definitions of these diets and different descriptions are used (e.g. 'low-carbohydrate, high-protein’, 'low-carbohydrate, high-fat', or ‘very low-carbohydrate’).

Low-carbohydrate diets are implemented in different ways, but they restrict grains, cereals and legumes, and other carbohydrate-containing foods; such as dairy, most fruit and certain vegetables. These foods are then typically replaced with foods higher in fat and protein; such as meats, eggs, cheese, butter, cream, oils. Some low-carbohydrate diets recommend eating as desired, while others recommend restricting the amount of energy eaten.

Balanced-carbohydrate diets contain more moderate amounts of carbohydrates, protein and fats, in line with current healthy eating advice from health authorities. When used for weight reduction, balanced diets recommend restricting the amount of energy eaten by guiding people to reduce their portion sizes and choose healthier foods (e.g. lean instead of fatty meat).

Low-carbohydrate weight-reducing diets are widely promoted, marketed and commercialised as being more effective for weight loss, and healthier, than 'balanced'-carbohydrate weight-reducing diets.

Professor Celeste Naude explains, "The weight lost by people on low-carbohydrate weight-reducing diets was similar to the weight lost by those on balanced-carbohydrate weight-reducing diets, for up to two years. Changes in heart disease risk factors were also similar in people following these diets for between one and two years. This was the case in people with and without type 2 diabetes.

"The longest of the trials lasted for two years, so we do not know if there are differences between the effects and safety of these diets beyond two years, which would be especially important for heart disease risk factors.

Most of the people in the trials did not have heart disease or related risks at the start of the studies, so we do not know if there are differences between the effects and safety of these diets in people with heart disease or risk factors, such as conditions that cause abnormal levels of fats in the blood.

Our review did not compare type or quality of carbohydrates, fats or proteins between the diets, or costs between the diets.”

What did the review authors want to find out?
They wanted to find out if low-carbohydrate weight-reducing diets were better for weight loss and heart disease risk factors than balanced-carbohydrate weight-reducing diets in adults who were overweight or living with obesity.

They wanted to find this out for people with and without type 2 diabetes.

What did they do?
They searched six electronic databases and trial registries for all trials* that compared low-carbohydrate weight-reducing diets with balanced-carbohydrate weight-reducing diets in adults who were overweight or living with obesity. The trials had to last for at least three months. The authors compared and summarised the results of the trials and rated the confidence in the combined evidence, based on factors such as study methods and sizes.

*A trial is a type of study in which participants are assigned randomly to two or more treatment groups. This is the best way to ensure similar groups of participants.

What did they find?
The authors found 61 trials involving 6925 people who were overweight or living with obesity. The biggest trial was in 419 people and the smallest was in 20 people. All except one of the trials were conducted in high-income countries worldwide, and nearly half were undertaken in the US (n=26).

Most trials were undertaken in people who did not have heart disease or risk factors (n = 36). Most people (n = 5118) did not have type 2 diabetes.

The average starting weight of people across the trials was 95 kg. Most studies lasted for six months or less (n = 37); and the longest studies (n = 6) lasted for two years.

Main results
Low-carbohydrate weight-reducing diets probably result in little to no difference in weight loss over the short term (trials lasting 3 to 8.5 months) and long term (trials lasting one to two years) compared to balanced-carbohydrate weight-reducing diets, in people with and without type 2 diabetes.

In the short term, the average difference in weight loss was about 1 kg and in the long term, the average difference was less than 1 kg.

People lost weight on both diets in some trials. The amount of weight lost on average varied greatly with both diets across the trials from less than 1 kg in some trials and up to about 12 kg in others in the short term and long term.

Similarly, low-carbohydrate weight-reducing diets probably result in little to no difference in diastolic blood pressure, glycosylated haemoglobin (HbA1c) and LDL cholesterol (‘unhealthy’ cholesterol) for up to two years.

The authors could not draw any conclusions about side effects reported by participants because very few trials reported these.

What are the limitations of the evidence?
The authors are moderately confident in the evidence. Confidence was lowered mainly because of concerns about how some the trials were conducted, which included that many trials did not report all their results. Further research may change these results.

How up to date is this evidence?
The evidence is up-to-date to June 2021.

What gaps did the authors identify?
They do not know if there are differences between the effects and safety of these diets beyond two years.

Since most of the people in the trials did not have heart disease or heart disease risks when they were recruited, the authors do not know if there are differences between the effects and safety of these diets in people with heart disease or risk factors, such as conditions that cause abnormal levels of fats in the blood.

What important related questions were not addressed in this review?
The author team did not compare type or quality of carbohydrates, fats or proteins between the diets. They also did not examine differences in costs between the diets.

• Read the full review here
• Visit the Cochrane Public Health Group website
• Visit the Cochrane Heart Group website 

Friday, January 28, 2022

Wednesday, January 26, 2022

In this free Lifeology course, learn what an infodemic is and what you can do to slow and prevent the spread of misinformation. 

Lifeology’s tagline is ‘The place where science and art converge’. They offer a platform that brings together scientists, artists, and storytellers to help people better understand and engage with science and health information and research. One of the main ways they meet their objectives is through beautifully illustrated, science-backed, bite-sized ‘flashcard’ courses about science and health-related topics aimed at the general public and students.

Image from the Lifeology's 'What is an infodemic and how can we prevent it?' course

For World Evidence-Based Healthcare (EBHC) Day, they collaborated with Cochrane to create a free course. The 41 slides walk the user through the  story of Ronald who has been misguided by misinformation and teaches what an infodemic is and how to slow the spread of misinformation.

Image from the Lifeology's 'What is an infodemic and how can we prevent it?' course

Paige Jarreau, co-founder of Lifeology, said "At Lifeology, we believe that science communication in any format, including our flashcard courses, is far better when it is the product of collaboration between scientists and professional creatives like storytellers and artists. We were pleased to be able to work closely with people from Cochrane to create this course on infodemics. We've produced a beautifully illustrated free course that is practical in its tips to combat misinformation and accessible through its plain language, empathetic storytelling and relatable imagery  - it's also available in English, French, German, Malay, Simplified Chinese, and Spanish !"

Image from the Lifeology's 'What is an infodemic and how can we prevent it?' course

Jordan Collver, the illustrator of the Lifeology course, said "This was an exciting project to work on. We had some fun with metaphors and with well known memes in this course while keeping the story empathic and relatable in a global context.'

View the Lifeology course 'what is an infodemic and how we can prevent it?' in:

•  English
• French
• German
• Malay
• Simplified Chinese
• Spanish

Learn more about Lifeology: 

• Interview with Lifeology
• Lifeology website
• Lifeology on Twitter
• Lifeology on Instagram
• Lifeology on Slack

Thursday, June 2, 2022

Oralna kombinacija antihistaminika, dekongestiva i analgetika u simptomatskom liječenju prehlade Istraživačko pitanje Jesu li kombinirane formule koje sadrže antihistaminike (AH), dekongestive (DK) i/ili analgetike (AN), koje se prodaju bez recepta, učinkovite u liječenju simptoma prehlade? Dosadašnje spoznaje U prosjeku mlađa djeca prebole 6-8 prehlada godišnje, a odrasli 2-4. Prehladu uzrokuju virusi, a simptomi prehlade uključuju grlobolju, začepljen nos i iscjedak iz nosa, kihanje i kašljanje. Prehlada obično prolazi sama od sebe unutar jednog do dva tjedna; no to ima veliki utjecaj na...

Tuesday, January 18, 2022

Cochrane Crowd is a citizen science platform  where a global community of volunteers help to classify the research needed to support informed decision-making about healthcare. Cochrane Crowd volunteers review descriptions of research studies to identify and classify clinical trials.

 A new task has just gone live on Cochrane Crowd. It is a citation screening task that we are doing in partnership with The Healthcare Improvement Studies Institute (THIS Institute).

It forms a part of a methodological study that aims to assess the accuracy of crowdsourcing the screening of search results. Unlike some of the previous studies we’ve done, this one is a little bit different. Instead of asking you to assess a record for possible relevance, we want you to assess it for irrelevance! Our hypothesis is that a crowd can still make a big difference in weeding out the obviously irrelevant records, and that by framing the task in this way, we will reduce the chances of possibly relevant records being rejected.

Are you up for joining this task? If so, head to crowd.cochrane.org and log in. On your tasks page you should see a task called: Training for healthcare professionals in electronic fetal monitoring using cardiotocograph.

We are going to run this study as a randomised study. When you click on the training module, you will be randomised to one of three tasks. Each of the three tasks will look exactly the same. The difference between the three tasks is the agreement algorithm in the background. This algorithm provides a ‘final’ classification on a record based on a certain number and order of individual classifications made by contributors. We are testing three different agreement algorithms as part of this methodological study.

There is of course a training module. It should only take around 10-15 minutes to complete. Once done you will be able to screen some ‘real’ records. Do as many as you like. If you manage to do 250 or more, you will get named acknowledgement in any write-ups of this methods study and be able to download a certificate.

As always, this kind of work would not be possible without the help of this fantastic community. If you are able to take part, then thank you very much indeed from the teams at THIS Institute and Cochrane Crowd.

If you have any questions, please don’t hesitate to get in touch with me: anna.noel-storr@rdm.ox.ac.uk

With best wishes to all and happy citation screening!

Anna and Sarah

• Visit Cochrane Crowd here
• Read The THIS-Crowd Exclusion Study FAQ's
• Follow Cochrane Crowd on Twitter

Friday, January 14, 2022

Oralna antitrombocitna terapija za liječenje akutnog ishemijskog moždanog udara Cilj sustavnog pregleda Cilj ovog Cochraneovog sustavnog pregleda bio je analizirati sigurnost i djelotvornost oralne antitrombocitne terapije u usporedbi s placebom ili nikakvim liječenjem kod osoba s akutnim ishemijskim moždanim udarom kako bi se ustanovilo može li oralno uzimanje antitrombocitnih lijekova smanjiti broj smrti i poboljšati dugoročno zdravlje osoba koje prežive takav moždani udar. Dosadašnje spoznaje Većina moždanih udara uzrokovana je iznenadnom blokadom arterije u mozgu koja je obično...

Location: UK based role with occasional global travel
Salary: £110-120,000 per annum
Contract type: Permanent
Date closing: 06/02/2022

Cochrane is a global independent community of more than 100,000 people who search for and summarize the best evidence from health and care research to help our beneficiaries make informed choices about health and care.  

Our members and supporters come from more than 220 countries worldwide including researchers, health professionals, patients, carers, and people passionate about improving health and care outcomes for everyone, everywhere.

Chief Executive
£110, 120,000 per annum
UK based role with occasional global travel

Cochrane’s work providing accessible, credible information to improve global health - has never been more important or relevant than it is today.

This Chief Executive role is an extraordinary opportunity for an inspirational, experienced and authentic leader, passionate about evidence and health care, to join Cochrane and work with a highly committed and engaged Board and talented staff team to lead the development of a new long-term strategy.

We are seeking someone with experience working in a multi-stakeholder environment, ideally in a global context, with exceptional interpersonal and communication skills with proven capacity to develop influential internal and external relationships.  Thoughtful, curious, and with a supportive leadership style; you will bring a strong track record of leading teams; fostering a high-performing culture; driving organisational change and growing income.  Critically, you will share our vision of a world of better health for all people where decisions about health and care are informed by high-quality evidence.

Cochrane is a global community and we value the diverse range of experience that this brings.  We strive to be an equal opportunities employer and welcome application from people from all races, religions, genders, sexual orientation, lived experience or ability.

• For further information, the role and how to apply please download the full appointment brief here  
• Closing Date: Sunday 6th February 2022
• If you require this document in an alternative format, please contact executiveadmin@prospect-us.co.uk or call 020 7691 1920

Thursday, January 13, 2022 Category: Jobs

Senior Research Integrity Editor, Lisa Bero, discusses this subject in a recent Nature article.

Never has it been more important to foster trust in scientific evidence than in the ongoing coronavirus pandemic. Cochrane is committed to independence, transparency, and integrity in healthcare research. The Research Integrity Team works to support and strengthen this commitment through research, policy development and implementation, advocacy and community outreach.

Recently, Senior Research Integrity Editor, Lisa Bero, has written a World View in Nature on the topic of working together to tackle the issue of problematic studies – studies where there are serious concerns about the trustworthiness of the data or findings. In the article she explains the tools and resources Cochrane uses as described in its policy for ‘Managing potentially problematic studies’, to empower reviewers to act when they suspect an issue. 

Research Integrity Editor, Stephanie Boughton, says “It was great to highlight Cochrane’s leading work in this area. We are building upon Cochrane’s strong history of conducting meta-research to detect research integrity problems. I hope all systematic review authors take up Lisa’s call to action and use tools described in Cochrane’s policy for ‘Managing potential problematic studies’ when they suspect an issue.”

• Read the full article by Lisa Bero in Nature
• Find out more about Cochrane’s Research Integrity Team  

Wednesday, January 19, 2022

Tjelovježba za odrasle pacijente na dijalizi Što je proučavano u ovom sustavnom pregledu? Osobe na terapiji dijalizom izložene su većem riziku od kardiovaskularnih bolesti i depresije, imaju nižu kvalitetu života i smanjenu stopu preživljenja u odnosu na opću populaciju. Nadalje, zbog nedostatka fizičkog kapaciteta i snage, mnoge osobe na dijalizi imaju poteškoća pri obavljanju svakodnevnih aktivnosti. Više se istraživanja bavilo procjenom učinka tjelovježbe na poboljšanje stanja pacijenata na dijalizi, ali bez jasnih zaključaka. Kako je proveden ovaj sustavni pregled? Pretražili smo...

Specifications:  Part Time, 1 day per week
Location: UK based (remote)
Application Closing Date: 25 January 2022

Cochrane UK is seeking a dynamic, self-motivated Transition Support Project Manager to lead and manage a support service for UK-based Cochrane Review Groups (CRGs) and those who work with them during a period of transition to a new review production model. 

You will join a small and friendly team at Cochrane UK and will work closely with the UK-based CRGs, Cochrane’s Editorial and Methods Department (EMD) and Cochrane Support Service to develop and operate processes to minimize disruption during the transition period.   

You will have in-depth knowledge and understanding of the existing Cochrane publication model and editorial processes.  You will have experience of the processes involved in conducting and editing systematic reviews and submitting funding bids.  You will have excellent communication and project management skills with the ability to build effective stakeholder relationships.

The role will be for 1 day per week with the potential to increase if, and when,  the requirements of the project change over the next 12 months.   

This role can be arranged either as a secondment (with your employer’s permission) or with you working as a self-employed contractor. 

If you would like more information please contact Therese Docherty, Business & Programme Manager (therese.docherty@cochrane.nhs.uk) for the full job description and person specification.

Deadline for applications: 25 January 2022.

Monday, January 10, 2022 Category: Jobs

Specifications: Full Time
Salary:  £42,000 per annum
Location: UK based (remote)
Application Closing Date: 31 January 2022

Cochrane is a global independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making the vast amounts of evidence generated through research useful for informing decisions about health. We do this by identifying, appraising and synthesizing individual research findings to produce the best available evidence on what can work, what might harm and where more research is needed.

A Project Manager role has become available to support the Evidence Production and Methods Department (EPM), Publishing and Technology department (P&T), Cochrane Library Product Manager and other Central Executive Teams (CET) in delivering on high priority projects: to project manage the highest priority EPM, P&T and other Cochrane projects where appropriate.

• For further information on the role and how to apply, please click here. 
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples.
• Note that we will assess applications as they are received, and therefore may fill the post before the deadline.
• Deadline for applications: Monday 31 January 2022 (12 midnight GMT).

Monday, January 10, 2022 Category: Jobs

Ubrzani ili polagani prestanak liječenja antiepilepticima Dosadašnje spoznaje Epilepsija je poremećaj kojeg karakteriziraju repetitivni napadaji uzrokovani abnormalnim električnim pražnjenjima u mozgu. Antiepileptici se koriste za sprječavanje tih napadaja. Njihovo redovito uzimanje može imati dugotrajne nuspojave. U remisiji bolesti (kada je osoba neko vrijeme bez napadaja) logično je pokušati prestati s liječenjem. Dva su bitna pitanja: kako i kada prestati s liječenjem. Cilj ovog sustavnog pregleda U ovom su se sustavnom pregledu analizirala istraživanja kako bi se pronašli dokazi vezani...

Liječenje inhibitorima protonske pumpe započeto prije endoskopske dijagnostike krvarenja iz gornjeg gastrointestinalnog trakta Dosadašnje spoznaje Krvarenje iz jednjaka (kanala koji povezuje grlo sa želucem), želuca ili dvanaesnika (prvi dio tankog crijeva) je često hitno stanje. Istraživanja su pokazala da smanjenje količine kiseline u želucu može pomoći u kontroli krvarenja, ali nije poznato je li korisno započeti s takvim liječenjem ranije; odnosno prije endoskopije (pregled jednjaka, želuca i dvanaesnika fibrooptičkom kamerom). Istraživačko pitanje Pregledali smo dokaze o učinku...

Location: Flexible location (remote working) – contract type dependent on location.
Specifications: 1 Mar to 1 September 2022. Fixed-term employment contract if successful applicant based in UK, Germany or Denmark. Consultancy contract in other locations.
Hours: Full time 37.5 hours per week.
Salary: £30,000 per annum.
Application Closing Date: Sunday 23 January 2022 (Midnight GMT).

This role is an exciting opportunity to use your communication and problem-solving skills to make a difference in the field of healthcare research and publishing.  

Cochrane recently implemented Editorial Manager as the editorial and production system for Cochrane Reviews. This role has a significant focus on supporting authors, editors and peer reviewers in using Editorial Manager for submission and peer review; and our linked system Convey for managing Declarations of Interest. Applications are particularly welcomed from candidates with experience of using these or similar systems.

The Cochrane Support team provides technical and user support to Cochrane editorial teams and review authors; and handle enquiries from members of the public about Cochrane’s work. We pride ourselves on our timely and coordinated support service, covering a broad range of areas, with a focus on Cochrane review-writing software and editorial processing and publication.
The team works closely with Cochrane’s Central Editorial Service and other related departments, to ensure accurate, consistent responses to queries on Cochrane technology, policies and methods.

Cochrane is a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesizing research findings to produce the best available evidence on what can work, what might harm and where more research is needed. Our work is recognised as the international gold standard for high quality, trusted information.

• For further information on the role and how to apply, please click here  
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples. Note that we will assess applications as they are received, and therefore may fill the post before the deadline
• Deadline for applications: Sunday 23 January 2022 (12 midnight GMT)
• Interviews to be held on: week beginning 31 January (times to be confirmed)

Thursday, January 6, 2022 Category: Jobs

New review from Cochrane Tobacco and Addiction Group

Key messages
Heated tobacco probably exposes people to fewer toxins than cigarettes, but possibly more than not using any tobacco. Falls in cigarette sales appeared to speed up following the launch of heated tobacco in Japan, but the authors are uncertain whether this is caused by people switching from cigarettes to heated tobacco.

The authors need more independently funded research into whether heated tobacco helps people stop smoking, whether it results in unwanted effects, and the impact of rising heated tobacco use on smoking rates. 

What are heated tobacco products?
Heated tobacco products are designed to heat tobacco to a high enough temperature to release vapour, without burning it or producing smoke. They differ from e‐cigarettes because they heat tobacco leaf/sheet rather than a liquid. Many of the harmful chemicals in cigarette smoke are created by burning tobacco. So heating not burning tobacco could reduce the amount of chemicals a user ingests. Some people report stopping smoking cigarettes entirely by switching to using heated tobacco.   Why the team did this Cochrane Review?
Because cigarette smoking is addictive, many people find it difficult to stop despite the harm it causes. The author team aimed to find out whether trying to switch to heated tobacco helps people stop smoking cigarettes, and whether it results in unwanted effects. They also wanted to find out whether rising heated tobacco use has affected smoking rates or cigarette sales.   What did the authors do
They looked for studies that reported on the use of heated tobacco for stopping smoking, and on unwanted effects and toxin exposure in people asked to use heated tobacco. Here they only included randomised controlled trials, where treatments were given to people at random. This type of study is considered the most reliable way of determining if a treatment works. Finally, they searched for studies looking at changes in smoking rates and cigarette sales following the launch of heated tobacco to market. They included studies published up to January 2021.   What they found
Their search found 13 relevant studies. No studies reported whether heated tobacco helps people stop smoking cigarettes. Eleven trials, all funded by tobacco companies and with 2666 adult smokers, compared unwanted effects and toxin levels in people randomly assigned to use heated tobacco or to continue smoking cigarettes or abstain from tobacco use.

Two studies looked at how trends in cigarette sales changed following the launch of heated tobacco in Japan.

What are the results of our review?
The authors do not know whether using heated tobacco helps people to stop smoking cigarettes (no studies measured this).

They are uncertain whether the chances of getting unwanted symptoms from being asked to use heated tobacco are different compared with cigarettes (6 studies, 1713 participants) or no tobacco (2 studies, 237 participants). Serious unwanted symptoms in the short time period studied (average 13 weeks) were rare in all groups, which means we are uncertain about any differences. Toxin levels were probably lower in people using heated tobacco than those smoking cigarettes (10 studies, 1959 participants), but may be higher than in people not using any tobacco products (5 studies, 382 participants).

The launch of heated tobacco products in Japan may have caused the decline in cigarette sales to speed up over time (two studies), but it is unclear whether the fall in the percentage of people who smoke also sped up because no studies looked at this. 

How reliable are these results?
Results are based on data from a small number of studies, most of which were funded by tobacco companies.

Results on unwanted effects are likely to change as more evidence becomes available. However, we are moderately confident that levels of measured toxins are lower in people using heated tobacco than smoking cigarettes, but less confident that levels were higher than in people not using any tobacco. We are also less confident that the launch of heated tobacco caused the fall in cigarette sales to speed up, as results came from a single country.

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Thursday, January 6, 2022

Pomažu li grijani duhanski proizvodi ljudima da prestanu pušiti, jesu li sigurni za tu svrhu i jesu li doveli do pada stope pušenja? Ključne poruke Zagrijani duhan vjerojatno izlaže ljude manjem broju toksina nego cigarete, no vjerojatno nije bolje od prestanka korištenja duhanskih proizvoda. Činilo se da se pad prodaje cigareta ubrzao nakon lansiranja grijanog duhana u Japanu, ali nismo sigurni je li to uzrokovano prelaskom ljudi s cigareta na grijani duhan. Trebamo više neovisno financiranih istraživanja o tome pomaže li grijani duhan ljudima da prestanu pušiti, ima li to neželjene učinke...