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Updated: 9 hours 39 min ago

Vivli to use Cochrane vocabulary to power Vivli’s search

Wed, 10/31/2018 - 10:19

Cochrane and Vivli formalise partnership aimed at accelerating global medical research

Cochrane and Vivli are pleased to announce their partnership aimed at helping health researchers move faster toward new treatments and cures. The first phase of the partnership has been to work together to use the Cochrane ontology to power the Vivli search. Clinical trials included or cited on the Vivli platform are annotated using the Cochrane PICO ontology and vocabulary.  

Vivli is a non-profit organization that promotes clinical trial data sharing via a platform designed to serve all elements of the international research community. Cochrane members were invited to try out the Vivli beta website prior to its launch in July. 

 “This partnership will make it easier to discover and access clinical trial data on the Vivli platform,” said Julie Wood, Vivli’s Director of Strategy and Operations. “Cochrane’s ontology will improve discoverability of data on the Vivli platform and advance quality research. We hope this relationship will continue to grow as we work to make it easier for Cochrane researchers to access clinical trial data. This new partnership will further promote Cochrane’s mission of promoting evidence-informed health decision-making by producing high-quality, relevant, accessible systematic reviews and other synthesized research evidence.”

Chris Mavergames, Head of Informatics & Technology (IT) Services said, “Cochrane is delighted to be working with Vivli to improve access to clinical trial data, and to put our pioneering work in Linked Data into practice for the benefit of the research community worldwide.”

The Vivli platform helps researchers worldwide to discover, share and analyze data from clinical trials, regardless of who sponsored the research or where the research took place.

About Vivli

Vivli is a non-profit organization working to advance human health through the insights and discoveries gained by sharing and analyzing data. It is home to an independent global data-sharing and analytics platform which serves all elements of the international research community. The platform includes a data repository, in-depth search engine and cloud-based analytics, and harmonizes governance, policy and processes to make sharing data easier. Vivli acts as a neutral broker between data contributor and data user and the wider data sharing community. For more information, visit www.vivli.org and follow us on Twitter @VivliCenter.

Wednesday, October 31, 2018

Cochrane's multi-language project

Tue, 10/30/2018 - 20:48

Only about 6% of the world are native English speakers while 75% don’t speak English at all. Clearly English alone isn’t enough when it comes to making evidence accessible to our target audience: the entire world.

This is why translation teams and geographical centres play a key role in Cochrane’s knowledge translation strategy. During the 25th Cochrane Colloquium in Edinburgh some of the members of the Cochrane Community shared with us their goals and achievements in different language settings.

 

Thursday, November 15, 2018

Cochrane seeks Finance Assistant - London, UK

Fri, 10/26/2018 - 16:18

Specifications: Full Time 37.5 hours per week
Salary: £25,000 - £28,000 DOE
Location: London
Benefits: 27 days annual leave plus bank holidays, 6% employer pension contributions & Cycle to work
Application Closing Date: 9 November 2018

We have an exciting opportunity for an enthusiastic, confident, motivated and committed individual looking to work within a progressive, dynamic and exceptional Finance team and make a difference in the field of health care research.

The successful candidate will receive a completive salary with an excellent benefits package, working for a fantastic charity based in Central London.

The Finance Assistant will maintain the sales and purchase ledgers for Cochrane, Collaboration Trading and Cochrane Innovations, including processing expenses for CET members, facilitating payments and reconciling bank statements.

Key Tasks:

Purchase Ledger

  • Process all purchase ledger items including supplier invoices in line with standard operating procedures
  •  Reconcile all supplier statements on a monthly basis.
  • Produce aged creditor reports for review
  • Input payment runs to the bank and overseas payment provider.
  • Post payment run information into Xero.
  • Complete bank reconciliations in Xero for Cochrane, Collaboration Trading and Cochrane Innovations.
  • Work with the Finance Officer to ensure monthly reconciliations are completed efficiently and accurately
  • Respond in a timely manner to all invoice queries ensuring high levels of service are maintained to all parts of Cochrane.

Concur and Expenses

  • Support the Finance Officer in processing expense claims received within Concur, checking transfer to Xero and coding is correct when downloade
  • Respond in a timely manner to all expense queries ensuring high levels of service are maintained to all parts of Cochrane.

Sales Ledger

  • Process sales invoices for customers and enter into Xero
  • Produce and send statements
  • Follow up unpaid invoices with customers

Other

  • Provide support to the Finance Officers
  • Ensure all Finance filing and record keeping is up to date and easily accessible both electronically and in hard copy form
  • Support the Finance team during the annual audit process
  • Support the Finance team during the annual budgeting process
  • Support the development of the Finance function, implementing standard operating procedures alongside improvements to controls making full use of IT wherever possible.
  • Ensure compliance of all financial matters with that of statutory bodies and relevant regulations by integrated in standard operating procedures.

We are looking for a self-motivated and highly organised individual who is able to work effectively and collaboratively with a diverse range of contacts across the world.  The successful candidate will also have:

  • Demonstrable experience in all aspects of purchase ledger
  • Confident IT user with experience in various programmes including intermediate Microsoft Excel skills
  • Excellent communication skills with the ability to build relationships across the team and organisation
  • Ability to work both independently and as part of a team
  • Ability to work to tight deadlines
  • Analytical problem solving skills and a practical approach to dealing with day-to-day issues
  • Ability to communicate clearly with non-finance employees about financial matters
  • Commitment to Cochrane’s mission and values

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.

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with “Finance Assistant” in the subject line.  The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples.  List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

For further information, please download the full job description.
Deadline for applications: 9 November 2018 (12 midnight GMT)
Interviews to be held on: (TBC)

Friday, October 26, 2018 Category: Jobs

Invitation to stand for election to the Governing Board

Thu, 10/25/2018 - 15:00

Cochrane’s Governing Board is seeking to elect 4 new members

We are looking for candidates with a passion for Cochrane, a belief in its power to improve healthcare decision making worldwide, and the ability to support the management of the organization.

Cochrane is an international organization and a registered charity in the UK, and members of the Governing Board from around the world are ‘Trustees’ of the charity. The Trustees carry ultimate responsibility for Cochrane and this is a critically important role.

The Board works as a team, including members with complementary skills and backgrounds. Candidates standing for election must be Cochrane Members but do not have to be a leader of a Cochrane Group. We are looking for a diverse and international range of candidates, and welcome nominations from people with the skills required to fulfil the responsibilities of a Trustee.

In this election, we are especially seeking candidates who have one or more of the following areas of expertise, in order to complement those of existing Board members:

  • Charity Governance (in any charitable organization around the world)
  • Organizational Finance and Resource Management
  • People Management (often called ‘Human Resources’ in English) and Organizational Development
  • Knowledge of the importance of Consumer involvement in Evidence Production and Health Policy
  • Advocating for Evidence
  • Widening Access, Participation, Reach and Impact of research 
  • Fundraising and Development

This is an exciting opportunity to join the team providing strategic oversight to Cochrane, making sure the organization’s work is effective and innovative, and that it delivers on its mission to promote evidence-informed health decision making by producing high-quality, relevant, accessible systematic reviews and other synthesized research evidence.

In line with the usual requirements for UK charity Trustees, these are voluntary, unpaid roles. Each year you will need to commit to attending at least three face-to-face meetings at different locations internationally, and at least two teleconferences. You will be expected to be a member of one or more Board Sub-Committees. Your expenses will be paid to attend meetings. The term of appointment is three years, from December 2018 to December 2021. In 2019, you should be available to travel to London, UK, 19-20 January; Krakow, Poland, 1-5 April; and Santiago, Chile, 22-25 October.

The deadline for nominations is Wednesday 14 November 2018. To find out how to stand for election, please visit elections.cochrane.org.

With best wishes,

Cochrane Governing Board

Thursday, October 25, 2018

Dr Matthew Page on winning the 2018 Bill Silverman Prize

Tue, 10/23/2018 - 15:47

Cochrane Australia Research Fellow and Co-Convenor of the Cochrane Bias Methods Group Matthew Page recently took out this year’s Bill Silverman Prize, which recognises and celebrates the role of constructive criticism of Cochrane and its work. Here we catch up with Matthew about who and what inspired him to research and publish his prize-winning paper on common statistical flaws in systematic reviews. (Originally posted on the Cochrane Australia website)

Just under a decade ago, Matthew Page was a newcomer to Cochrane. Attending his first Colloquium in Singapore in 2009, he watched Dr David Moher take out the Bill Silverman Prize and as a result, first discovered methodological research. ‘You could say that was  kind of a lightbulb moment that led to all my future research interests,’ Matthew says. ‘I listened to David at the Colloquium and immediately went home, read his paper and realised there’s a whole community out there, a whole field that’s actually all about trying to improve research. Since then, David has become my mentor/methodological hero and we’ve been working together on all kinds of fascinating areas. So it seems really fitting to receive this award for a paper I worked on with both David and the late Doug Altman – another extremely inspiring and brilliant statistician who’s influenced my thinking about methods and meta-analysis.’ 

‘This particular paper was actually Doug’s brainchild. He - like Bill Silverman himself - often bemoaned the poor quality of published medical research. He strongly believed self-criticism can help drive progress, which is what this award is all about,’ Matthew explains. ‘Following a paper we published on reporting quality of systematic reviews in PLOS Medicine in 2016, Doug guided us to conduct this comprehensive analysis of the misuse of statistics in systematic reviews. We looked at a range of different statistical methods which could be used in systematic reviews and assessed whether they were applied and interpreted correctly in 32 Cochrane and 78 non-Cochrane reviews. Using a 61-item checklist, we discovered that there were common flaws in many Cochrane and non-Cochrane reviews. Our findings suggest many areas where Cochrane review authors can lift their game.’ 

‘By identifying these flaws, we can gain a much better idea of which statistical methods need checking in submitted Cochrane reviews. We’re hoping to address the issues we identify by developing a checklist that can be used by editors to evaluate the statistics in submitted Cochrane reviews. Once errors are spotted, these can be fed back to the review authors and corrected, which we hope will ultimately lead to higher quality reviews. You could say that these findings probably confirm suspicions that the involvement of statisticians on review teams can really help to address a lot of methodological shortcomings.’

‘So for me personally it was great to be able to identify and address areas for improvement in the future and ultimately receive the honour of this award for doing so,’ Matthew concludes. ‘I think the prize is also further recognition of Doug Altman’s phenomenal contribution to Cochrane and evidence-based medicine. And it also gave us yet another reason to celebrate David Moher, whose work was recognised in a half day symposium at the Colloquium this year. We are both looking forward to doing further work in this area to help authors and editors wrangling with all sorts of methodological questions and approaches.’   

For more on Matthew’s work into systematic review methods, read his interview with Cochrane Senior Editor Toby Lasserson on Assessing the current state of systematic reviews, his Epidemiology and Reporting Characteristics of Systematic Reviews of Biomedical Research: A Cross-Sectional Study in PLOS Medicine or follow him on twitter @mjpages

Top Image: Prof David Henry (left) presents Matthew with this year's Bill Silverman Prize at the Cochrane Colloquium in Edinburgh

Tuesday, October 23, 2018

Cochrane Interactive Learning

Mon, 10/22/2018 - 17:52

Cochrane Interactive Learning is a series of high quality, online learning modules for conducting intervention reviews following Cochrane review methodology. Useful for both introductory-level and more experienced learners, the modules are designed for both individual distance learners and for trainers looking to create blended online and face-to-face learning.  We have created this video to promote how Cochrane Interactive Learning is being used as a fantastic addition to courses for students as part of a blended learning approach.

Cochrane Interactive Learning is available to purchase as part of an institutional license, and you can contact Richard Hollis on CILsubscriptions@cochrane.org to discuss your requirements.

If you are a Cochrane Author (or hold an eligible Cochrane role) you have free access to Cochrane Interactive Learning and can register to use it at interactivelearning.cochrane.org.  The course is also made freely available to registered users who are resident in HINARI countries. If you need any further help with accessing Cochrane Interactive Learning, please contact support@cochrane.org

Monday, October 22, 2018

Cochrane Crowd webinar - 30 Oct 2018

Mon, 10/22/2018 - 16:47

Help Cochrane curate and deliver health evidence

Cochrane Crowd is an online citizen science platform that enables anyone with an interest in health to contribute to health evidence. Our volunteers make it easier for health researchers to find the latest, high-quality evidence on what treatments work and don’t work. This means health practitioners can more easily access current evidence to inform the treatments they provide. Just a few minutes each day makes a huge difference.

This webinar introduces Cochrane Crowd and how you can get involved. This webinar is scheduled for an Australasian audience. If you can’t make it at the scheduled time, feel free to register and you will be sent a copy of the recording.

 

Tuesday October 30th 12.30-1.30pm AEDT

crowd.cochrane.org

Support for Project Transform was provided by Cochrane and the National Health and Medical Research Counc12/12/1996il of Australia (APP1114605). The contents of the published material are solely the responsibility of the Administering Institution, a Participating Institution or individual authors and do not reflect the views of the NHMRC.


Monday, October 22, 2018

Cochrane seeks Advocacy & Partnership Officer -Flexible location

Fri, 10/19/2018 - 17:51

Specifications: Full Time
Salary: £35,000 - £40,000 DOE
Location: Flexible
Application Closing Date: 16 November 2018

This role is an exciting opportunity to use your experience as an Advocacy & Partnership Officer to make a difference in the field of health care research. 

The Advocacy & Partnership Officer will support Cochrane, the Editor in Chief, the Head of Knowledge Translation, and the Senior Advisor (Centres, Partnerships and Fundraising) in developing and managing strategic partnerships and in preparing advocacy positions. This new role will support the organization’s growth through the proactive management of strategic partnerships, the development and delivery of advocacy positions and will thus help build the profile of Cochrane as global advocate for evidence informed health care and decision making.

We are looking for a self-motivated and highly organised individual who is able to work effectively and collaboratively with a diverse range of contacts across the world.  The successful candidate will also have:

  • Master degree in communications; journalism; health sciences or a related discipline relevant to this position.
  • Experience of presenting complex information clearly and simply.
  • Experience in preparing advocacy campaigns and statements.
  • Demonstrable experience in working with various partner organizations.
  •  Cultural sensitivity and the ability to work with diverse groups
  • Ability to work independently under general direction, willing and able to work in a self-directed way, and able to provide sound advice to contributors and staff members of Cochrane.
  • Excellent interpersonal and communication skills, with a natural flair for networking, including the ability to produce written material appropriate to policy-makers and partners.
  • Experience with using influencing strategies to gain genuine engagement with Cochrane’s mission to achieve organisational goals.
  • Time management skills and ability to work flexible hours as needed.
  • Experience related to all aspects of the planning and organising of meetings, workshops and conferences.
  • Experience of working in an international context.
  • Willingness to travel internationally when required.

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

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with Advocacy & Partnership Officer in the subject line.  The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples.  List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

For further information, please download the full job description.

Deadline for applications: 16 November 2018 (12 midnight GMT)
Interviews to be held on: (TBC)

Friday, October 19, 2018 Category: Jobs

Cochrane seeks Events and Brand Support Officer - flexible, London, UK preferred

Thu, 10/18/2018 - 16:59

Salary: Competitive
Location: Flexible, London preferred
Position: Permanent, full time

This role will lead on supporting, developing and implementing Cochrane’s annual events calendar, to help co-ordinate our Colloquium and Governance Meetings, along with supporting event activities of Cochrane Groups.

The role also supports the work of our Knowledge Translation Department including marketing, brand communications and graphic design on behalf of the Central Executive Team (CET).

We are looking for a self-motivated and highly organised individual who is able to work effectively and collaboratively with a diverse range of contacts across the world.  The successful candidate will also have:

  • A degree or equivalent experience working within events support and co-ordination; project management experience would be highly advantageous, and/or in a similar role
  • Ability to manage multiple projects and work assignment
  • Ability to work alongside varied teams in different cultural and linguistic settings
  • Exceptional IT skills, including: styles and formating in Word, PowerPoint and Excel with the ability to understand Drupal web editing and registration systems
  • Exceptional Adobe Creative Suite (especially Illustrator, InDesign and Acrobat) skills
  • Impressive interpersonal skills both in person and by teleconference/Skype
  • Strong written and verbal communication skills
  • Willingness to work flexibly including outside normal working hours and international travel
  • Proven experience of budget planning
  • Commitment to Cochrane’s mission and values

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

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with “Events and Brand Support Officer” in the subject line.  The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples.  List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

For further information, please see the full job description.

Deadline for applications: Monday 5 November 2018 (12 midnight GMT)

Interviews to be held on: week of 12 November

 

Thursday, October 18, 2018 Category: Jobs

World Menopause Day

Thu, 10/18/2018 - 15:28

18 October 2018  is World Menopause Day and October is World Menopause Month. Cochrane Gynaecology and Fertility Group has published multiple reviews assessing the effectiveness and safety of interventions in menopausal women, including peri and postmenopausal women. To celebrate World Menopause Day we have collated a special selection of reviews investigating various treatments for menopausal symptoms such as hormone therapy, tibolone, relaxation, exercise, and alternative therapy.

Thursday, October 18, 2018

Cochrane Library Special Collection: Preventing falls and fall-related injuries in older people

Wed, 10/17/2018 - 15:18

Free access to all included Cochrane Reviews for 30 days

Falling is a common problem and is an often-overlooked cause of injury in the elderly. Falls increase in frequency with advancing age and increasing frailty. Falls should not be considered an inevitable consequence of ageing. The Cochrane Reviews in this Special Collection focus on the prevention of falls and fall-related injuries in older people, and they provide evidence of effective interventions. The collection includes reviews on the prevention of falls caused by visual impairment, prevention of falls in the community and falls in care settings, and the prevention of falls following major illness. All reviews included in the Special Collection are free to access for the next 30 days (until 17 November), afterwards reviews over 1 year are free to access.

 

Wednesday, October 17, 2018

Cochrane Taiwan is expanding its reach through a new Cochrane Affiliate

Mon, 10/15/2018 - 19:08

Cochrane Taiwan aims to promote evidence informed health care in Taiwan, and develops partnerships with institutions in the country to achieve this aim. One of these institutions is the Chang Gung University of Science and Technology (CGUST). CGUST has now been given Cochrane Affiliate status.

CGUST is committed to training healthcare personnel, and promotes evidence informed health care actively. This is the first affiliate of Cochrane Taiwan. Cochrane Taiwan and President Ying-Tung Lau of CGUST signed a memorandum of cooperation in the presence of Taipei Medical University (TMU) President Chien-Huang Lin. It is expected that the Cochrane Taiwan and CGUST will collaborate in teaching, research, promoting evidence informed health care and enhancing knowledge translation to raise awareness of synthesized health evidence in Taiwan.

Cochrane Taiwan, hosted by TMU, was established in 2015 as a Cochrane Associate Centre. Cochrane Taiwan is striving to promote Cochrane’s mission to “promote evidence-informed health decision-making by producing high-quality, relevant, accessible systematic reviews and other synthesized research evidence”. Cochrane Taiwan focuses on establishing a domestic cooperation network to encourage domestic communication and promotion of evidence informed health care.

Tuesday, October 16, 2018

2018 winner of the prestigious Aubrey Sheiham Leadership Award for Evidence-Based Healthcare in Africa announced

Mon, 10/15/2018 - 17:42

Dr Chikwendu J. Ede has been announced as the 2018 winner of the prestigious Aubrey Sheiham Leadership Award by Cochrane.

The award is managed by Cochrane South Africa (SA) and presented annually to an African researcher to support the conduct of a Cochrane Review focusing on a priority topic with impact on the health of people living in low- and middle-income countries. The winner is also expected to mentor a novice author from Africa during the review process and, in so doing, develop capacity in research synthesis on the continent.

The award includes attendance at an annual Cochrane Colloquium; costs of face-to-face meetings for the awardee and mentee; costs of travel for periods of dedicated work time; and a period of stay at Cochrane SA or another appropriate site to work on the review.

 Dr Ede is a specialist surgeon and a lecturer at University of the Witwatersrand. The award will be used to undertake a review already registered with the Cochrane Hepato-biliary, titled: Nonselective shunts versus selective shunts for preventing and treating variceal rebleeding in people with portal hypertension.

“Variceal bleeding is a lethal complication of portal hypertension. A third of people living in Africa will bleed from oesophagogastric varices and mortality from this bleed is estimated at 30%,” said Dr Ede. “It’s important to stop such bleeding to reduce morbidity and mortality. This new review will address a gap in knowledge identified by my previous review.”

“As variceal bleeding is a significant health and economic burden in developing countries, there is need for an in-depth study of measures to prevent and treat this condition,” he continued. “This review will provide evidence to show which type of shunt works best for preventing and treating oesophagogastric variceal rebleeding.”

Dr Roseline Ede, a registrar at University of the Witwatersrand, has been included as an author in this review as a mentee.

About the Aubrey Sheiham award

Aubrey Sheiham was a dental epidemiologist who was inspired and encouraged by Archie Cochrane to question many of the practices in medicine and dentistry. His commitment was to improving the health of populations in underdeveloped countries and challenging dental establishments to be far more critical. The misuse of healthcare resources has more serious ethical and health implications in underdeveloped countries because resources for health are generally inadequate. Prof. Sheiham believed that supporting and training key health personnel in the concepts of Cochrane would improve the effectiveness and efficiency of health care. Since 2001, through Prof. Sheiham’s generosity, Cochrane researchers from low- and middle-income countries have been funded and supported to complete a Cochrane Review on a topic of relevance to their region, and to cascade knowledge about Cochrane and evidence-based health care to their local networks.

The evaluation panel for the award consists of the Senior Management Team of Cochrane South Africa.

Unfortunately Dr Sheiham passed away in November 2015.

Tuesday, October 16, 2018

Patients and consumers at Cochrane's Edinburgh Colloquium

Fri, 10/12/2018 - 15:19

Our Colloquium is Cochrane's annual flagship event, bringing people together from around the world to discuss putting research into important global health questions and promoting evidence-informed health care.  This year, almost 1300 people from 57 countries attended our Colloquium in Edinburgh, UK. The theme was ‘Cochrane for all - better evidence for better health decisions.’  It was a Patients Included event, co-designed, co-produced and co-presented by healthcare consumers, where everyone’s input is valued equally. It focused on key goals of Cochrane’s Strategy to 2020: producing evidence, making evidence accessible, and advocating for evidence.

We spoke to several consumers and patients attending the Cochrane Colloquium in Edinburgh – here are some of their highlights from the event:

 

Friday, October 12, 2018 Category: The difference we make

Cochrane Library Editorial - Implementing systematic reviews of prognosis studies in Cochrane

Thu, 10/11/2018 - 16:12

Over the last 30 years Cochrane has strived to advance the importance of conducting systematic reviews of therapeutic strategies, diagnostic tests, and risk factors. Now, the Cochrane community embarks on systematic reviews of prognosis studies in the Cochrane Database of Systematic Reviews.

Prognosis research has escalated in the last two decades. Today, frequently echoed terms are ‘personalized medicine’, ‘precision medicine’, or ‘risk‐based medicine’, often used as synonyms.

Read a new Cochrane Library Editorial on the work Cochrane Prognosis Methods is doing produce systematic reviews that summarize the huge amount of data and evidence emerging from primary prognosis studies, to enable stakeholders to make appropriate healthcare decisions.

Thursday, October 11, 2018

Featured Review: Progestogen for preventing miscarriage

Thu, 10/11/2018 - 11:02

Can progestogen help prevent miscarriage?

 Early pregnancy loss, also known as miscarriage, generally occurs in the first trimester. For some women and their partners, miscarriages can happen several times, also known as recurrent miscarriages. While there are sometimes causes for miscarriages that are found, often no clear reasons can be discovered. The hormone called progesterone prepares the womb (uterus) to receive and support the newly fertilized egg during the early part of pregnancy. It has been suggested that some women who miscarry may not make enough progesterone in the early part of pregnancy. Supplementing these women with medications that act like progesterone (these are called progestogens) has been suggested as a possible way to prevent recurrent miscarriage.

This updated Cochrane Review identified a total of 13 trials that enrolled a total of 2556 women with a history of recurrent miscarriages. 

David Haas, Cochrane Pregnancy and Childbirth Group Editor said, 

“We found evidence from randomized controlled trials that giving progestogen medication can probably prevent miscarriage for many women with recurrent previous miscarriages. The trials included in this study found that giving progestogen medication to women with recurrent miscarriages early in their pregnancy may help lower the rates of miscarriage in that pregnancy from 26.3% to 19.4%. We believe that these findings are based on evidence of only moderate quality, so we cannot be certain about the results – but can confidently say giving progestogen medication can probably prevent miscarriage. 

“Having miscarriages can be both physically and emotionally difficult for women and their partners. Finding a therapy to help reduce recurrent miscarriages could help women and their partners avoid this and go on to successfully have a baby.”

Monday, October 15, 2018

Featured Review: Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women

Tue, 10/09/2018 - 18:09

Chantal Dumoulin and Licia P Cacciari from Cochrane Incontinence  wanted to find out if pelvic floor muscle training (PFMT) helps women with urinary incontinence problems. They did this by comparing the effects of this training with no treatment, or with any inactive treatment (for example, advice on management with pads). We asked Chantal and Lucia questions about this recent Cochrane Review.

1. Please can you describe yourself and your Cochrane Group?

Since 2012 I have held a Canada Research Chair in Urogyneacoogical health and Aging. Our research program's overarching goal is to Improve continence care in older Canadian women. With this goal in mind, I partnered with a New Zealand expert in pelvic floor rehabilitation reviews; Dr. J. Hay Smith and a post-doctoral fellow and physiotherapist from Brazil, Dr Licia Carciari, to update our knowledge of the effectiveness of pelvic floor rehabilitation for urinary incontinence, in women. Conducting this review update will help inform my research program but most importantly will transfer the evidence to patients, clinicians and researchers with the overall goal to improve continence care, in women.

2. What was the background to the Review? 

Stress incontinence is leaking of urine which cannot be easily controlled (if at all) when performing a physical activity. Physical activities could include coughing, sneezing, sporting activities or suddenly changing position. Urgency incontinence happens with a sudden, strong need to urinate. This can often lead to not making it to the toilet in time to urinate, resulting in leakage. Mixed incontinence is where someone has both stress and urgency incontinence.

A wide range of treatments have been used in the management of urinary incontinence, including conservative interventions (such as physical therapy, lifestyle intervention, behavioural training and anti-incontinence devices), pharmaceutical intervention and surgery. This review focus on one of the physical therapies, specifically pelvic floor muscle training (PFMT). 

Pelvic floor muscle training is a program of exercises to improve pelvic floor muscle strength, endurance, power, relaxation or a combination of these. It is a widely used treatment for women with stress, urgency and mixed incontinence.

We wanted to find out if PFMT helps women with urinary incontinence problems. We did this by comparing the effects of this training with no treatment, or with any inactive treatment (for example, advice on management with pads). We also summarized findings on costs and cost-effectiveness.

3. What has changed in this update? 

In this update we included ten new trials, which did not change the essential findings of the prior review. However, the wider range of populations, countries and secondary outcomes within these new trials emphasized the strength of recommendation of PFMT for women with urinary incontinence. There is now one report of reduction of urinary leakage episodes for women with urgency urinary incontinence treated with PFMT and one report of better quality of life for women with mixed urinary incontinence treated with PFMT.

Of note, in almost all new included trials, the PFMT protocols were described in more details, with progressive training based on exercise physiology. Grade A patient reported symptoms and quality of life outcomes were used more often, in line with recent international guidelines recommendations. Finally, we are starting to gather data supporting PFMT cost-effectiveness and the results look promising.

4.  Why was it important to conduct this Review?

Earlier Cochrane Reviews of PFMT are outdated as new trials have been published. There is sufficient uncertainty about the effects of PFMT to suggest that continuing to update earlier Cochrane reviews is warranted.

5. What are the main implications of this research?

This review is important for clinicians and consumers.  Based on the data available, we can be confident that PFMT can cure or improve symptoms of stress urinary and all other types of UI. It’s also important to note that negative side effects of performing PFMT were rare and, in the two trials that did report them, the side effects were minor.

This review is also important for researches, since it highlights the need for more pragmatic, well-conducted and explicitly reported trials comparing PFMT with control to investigate the longer-term clinical effectiveness and cost-effectiveness of PFMT for women with symptoms of stress, urgency and mixed urinary incontinence.

6.  What would you like to see happen as a result of publishing this review?  

The findings of the review suggest that PFMT could be included in first-line conservative management programs for women with urinary incontinence. Clinicians and health care providers should be aware of these evidences.  

Wednesday, October 10, 2018

Featured Review: Individual, family, and school-level interventions targeting multiple risk behaviours in young people

Thu, 10/04/2018 - 15:55

Findings suggest that school-based interventions may have a role to play in preventing risk behaviours

Health risk behaviours, such as smoking and drug use, can group together during the teenage years, and engagement in these multiple risk behaviours can lead to health problems such as injury and substance abuse during childhood and adolescence, as well as non-communicable diseases later in life. 

The Cochrane Public Health review team carried out thorough searches of multiple scientific databases and identified 70 studies that looked at ways of preventing or decreasing engagement in two or more risk behaviours, among young people aged eight to 25 years. The studies were divided into groups of individual-level, family-level, and school-level studies and most were conducted in the USA or in high-income countries.

Risk behaviours include:

  • tobacco use 
  • alcohol use 
  • illicit drug use 
  • gambling
  • self-harm 
  • sexual risk behaviour
  • antisocial behaviour 
  • vehicle-risk behaviour 
  • physical inactivity
  • poor nutrition

Lead author Georgie MacArthur from the Cochrane Public Health Group summarises, “The findings suggest that school-based interventions offered to children may have a role to play in preventing tobacco use, alcohol use, illicit drug use, and antisocial behaviour. We did not find strong evidence of benefit of interventions for families or individuals, although fewer such interventions were identified. 

Nevertheless, concerns around reporting of studies and study quality highlight the need for additional robust, high-quality studies to further strengthen the evidence base in this field.”

Friday, October 5, 2018

Featured Review: Non-clinical interventions for reducing unnecessary caesarean section

Thu, 10/04/2018 - 14:35

With numbers of caesarean sections increasing world wide this review looks at non-clinical interventions for reducing caesarean sections.

Caesarean section is an operation used to prevent and reduce complications of childbirth. While it can be a life‐saving procedure for both the mother and baby, caesarean section is not without harm and should only be carried out when necessary. The number of caesarean sections performed has been increasing worldwide. The aim of this updated Cochrane Review was to find out whether non-clinical interventions, which aim to reduce unnecessary caesarean sections, such as providing education to healthcare workers and mothers, are safe and effective. 

The review team from Cochrane Effective Practice and Organisation of Care  studied a wide range of non-clinical interventions drawn from 29 studies, mostly in high-income countries. 

Based on high‐quality evidence, they found the following interventions reduce caesarean section rates without adverse effects on maternal or neonatal outcomes. These interventions are mainly aimed at healthcare professionals (nurses, midwives, physicians) and involve using: clinical guidelines combined with mandatory second opinion for caesarean section indication; clinical guidelines combined with audit and feedback about caesarean section practices; and opinion leaders (obstetrician/gynaecologist) to provide education to healthcare professionals.

Thursday, October 4, 2018

The Recommended Dose podcast: long-time Cochrane luminary Jeremy Grimshaw

Thu, 10/04/2018 - 09:42

President, Campbell Collaboration & long-time Cochrane luminary

Named by Reuters as one of the most influential scientific minds of our time, this week’s guest wears many hats and pursues all kinds of surprising interests. Jeremy Grimshaw has earned a global reputation for translating evidence into genuine changes that improve human health. He’s a Professor of Medicine at the University of Ottawa, President of the global Campbell Collaboration and a long-time Cochrane luminary. And as Ray discovers, he can make complex behavioural science, obscure music festivals and Formula 1 racing the most comfortable of companions in the course of just one lively conversation. Here, Jeremy closes out series 2 of the Recommended Dose with his original insights into health and social sciences research, and throws in some top musical tips for good measure.

Listen to Recommended Dose podcasts on SoundCloud, iTunes, Stitcher  or wherever you listen to your favourite podcasts. 

Find more details and our show notes the podcast page or follow on twitter  or facebook.

The Recommended Dose is produced by Cochrane Australia and co-published with The BMJ.

Thursday, October 4, 2018

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