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Updated: 2 hours 12 min ago

Cochrane seeks Head of Governance & Strategy Unit - Flexible location, London based preference

Tue, 08/27/2019 - 14:00

Specifications: Full Time
Salary: £70,000
Location: Flexible, though with a preference for London - based
Application Closing Date: Tuesday 17th September 2019

Cochrane is the world’s most respected producer of high-quality health evidence to inform decision-making by healthcare practitioners, patients and carers, researchers and policymakers. Our global independent network of over 11,000 members and 68,000 supporters analyze and summarize the best evidence from research and publish it in the Cochrane Library (www.cochranelibrary.com). Cochrane is passionate about improving health outcomes for everyone, everywhere by helping them to make informed choices about healthcare issues and we have been doing this for 25 years.

We are looking for someone with exceptional leadership skills and experience to join our Senior Management Team as Head of Governance & Strategy. This is a newly-created role leading a Unit that reports to the Chief Executive Officer, and we will look to you to:

  • Act as Company Secretary of The Cochrane Collaboration, ensuring that all the right support structures are in place to enable our Governing Board to meet its responsibilities and obligations;
  • Lead and oversee high-quality support to the Board, its Sub-Committees, the Cochrane Council and other governance bodies. This will include managing the meeting schedule and the development of agendas and supporting documentation;
  • Lead and support Cochrane’s review and impact of our current organizational Strategy to 2020 and the development of our new strategy from January 2021; 
  • Coordinate and oversee development and implementation of project management norms and standards, including the Unit’s technical support to Cochrane Central Executive Team and Cochrane Group staff;
  • Ensure Cochrane develops a robust organizational and programme monitoring and evaluation (M&E) approach, framework and metrics to measure the success and impact of its present and future activities and outputs, and ensure these are communicated and implemented across the organization;
  • Coordinate our approach to Risk Management and lead on reporting organizational risks to the leadership team and our Governing Board.

If you have experience in a senior role within a government, charity, regulatory, or similar environment; excellent analytical skills; proven strategic planning, project management and organisational reporting skills and a ‘can-do’ attitude then we would like to hear from you.  In return, we can offer you a stimulating, highly collegiate, work environment with plenty of scope to make your own mark.

Thursday, August 29, 2019 Category: Jobs

Visit the Cochrane Community Exhibition Stand at the Colloquium

Mon, 08/26/2019 - 13:41

The Cochrane Community Exhibition Stand has traditionally been a hub of activity and a gathering point for both members, staff, and for those new to Cochrane. Come chat to us, get your questions answered, and learn more about Cochrane!

Our annual event, the Cochrane Colloquium, brings together members of the community, staff, and newcomers to Cochrane. Amongst the wide range of workshops, activities, social events, and support we are offering, we would like to ensure that consumers, students, early career professionals, and first time Colloquium participants have easily identifiable people to ask questions to and the chance to learn about the wide a range of Cochrane activities. At breaks or at lunch, we invite you to visit the Cochrane Community Exhibition Stand and come chat with us!

At the stand you will see people wearing a purple Cochrane sash so that you know who to approach if you have questions. Those with sashes have attended multiple Cochrane Colloquia and have a good awareness of Cochrane and our work – they are there for you to ask questions, have a chat and to network with. See you at the Community Booth!

Name: Dario Sambunjak
Country: Croatia
Languages: English, Croatia
Role: Learning Content Officer, Cochrane Training
Will be at the Community Booth: Tuesday afternoon break, Thursday morning break, and  Thursday afternoon break
I have had many roles in Cochrane - Cochrane Croatia Branch Director, author of several Cochrane Reviews, Co-Chair of Colloquia Workshop Programme, and others. Currently I'm involved in developing and supporting training activities (mostly online, but also face-to-face) across the Cochrane community.

 Name: John Hilton
Country: United Kingdom
Languages: English
Role: Editor
Social Media: Twitter, Instagram
I work in the Editorial and Methods Department in the Cochrane Central Executive. Ask me about the Cochrane Library!

 

 Name: Miranda Cumpston
Country: Australia
Languages: English
Role: Handbook Editor, Cochrane Public Health Editor
Social media: Twitter
I've been involved with Cochrane since 2003, primarily as a trainer for Cochrane authors and also as an editor. Recently I've been involved in editing the new edition of the Cochrane Handbook - ask me about the Handbook or about authoring a review.

Name: Muriah Umoquit
Country: Canada
Languages: English
Role: Communications and Analytics Officer, Knowledge Translation Department
Social Media: Twitter, Facebook, Instagram, LinkedIn
I oversee the many internal and external communication channels that Cochrane uses – from newsletters to Instagram. Lets chat about how you are sharing health evidence and how to best reach your intended audience.

Name: Robin Featherstone
Country:  Canada
Languages:English
Role: Information Specialist
Social media: Twitter
I’m an Information Specialist for the Editorial & Methods Department in the Central Executive. Ask me about Cochrane Library, CENTRAL, Cochrane Register of Studies, anything about searching methods to support Cochrane reviews, or about the role of Information Specialists in Cochrane.

 

 Name: Sabrina Khamissa
Country:  United Kingdom
Languages: English
Role: Events and brand Support Officer, Knowledge Translation Department
I'm the Events and Brand Support Officer for Cochrane. I help Cochrane Group's host the Colloquia and Governance Meetings. I also provide marketing, communications and brand support to the community. This will be my first Colloqium! I can support attendees with general information about every aspect of the Colloquium and venue. I can also point you in the right direct for which group/person to speak to, if you need to make contact with some, need advice or want to find out more about a particular project.

 

More profiles of Cochrane Community members helping at the Colloquium Exhibition Stand to be added!

Monday, August 26, 2019

#BetterPoster templates for Cochrane Colloquium attendees

Fri, 08/23/2019 - 13:13

Cochrane’s Colloquium is our annual flagship event, which brings together Cochrane contributors and stakeholders from around the world to discuss Cochrane research, systematic review methods, important global health questions, and promoting evidence-informed health care. This year our 26th annual event will be hosted in Santiago, Chile on 22-25 October 2019.

One important and highly anticipated element of our Colloquium is our poster sessions. This is a great opportunity to browse the work of important studies and speak directly to some of the lead authors. Many collaborations, partnerships, and learning have happened from these sessions.

This year in Chile we have up to 300 posters being presented. Rows of posters with vast text is difficult for attendees to navigate efficiently. We are also aware that many of our attendees will not have English as their native language, making the poster session even harder to navigate. 

As in the past Colloquiums, we offer all attendees the Cochrane branded traditional academic conference template. In addition to this, we are also providing branded #betterposter templates. These new templates offer posters with less text and a decluttered design with the main finding in plain English as the highlighted feature.


 
We have teamed up with Mike Morrison from the Michigan State University. Applying his expertise on industrial-organizational psychology, Mike has created Cochrane branded #betterposter design to help facilitate information exchange at this year’s colloquium.

Below is a quick introduction to these new templates - there is also a longer version to watch that explains the background and demonstrates why the traditional format is ineffective! We understand these videos go quickly and that even with subtitles added in, it may be difficult for those that are not Native-English speakers to follow. Therefore we will be hosting an free webinar in the next month to go over the design and how to edit the templates to create your own poster.


 
We welcome poster presenters to try out this new format – we will be inviting both the presenters and viewers to participate in a larger evaluation study of these templates after the Colloquium.

 

Wednesday, August 28, 2019

The University of Sydney seeks Senior Evidence Analyst - Sydney, Australia

Thu, 08/22/2019 - 14:46

Closing date: 11:30pm, Thursday 29 August 2019
Type: Fixed Term for 12 months with possible annual extension

The Senior Evidence Analyst provides deep technical knowledge and collaborates with academics and research professionals to support the research requirements for the work area. This includes actively leading and contributing to project activities, designing review protocols, undertaking critical aspects of research work including analysis and key findings. Collates research data, draws insights and analyses, reports information from the research undertaken and work with internal and external stakeholders.

The Senior Evidence Analyst will work with the manager and other staff within the SRHTA team to develop systematic reviews and Health Technology Assessments (HTAs) and conduct evidence reviews for HTAs including: development of search strategies, conducting literature searches, review and selection of citations, extraction of data, quality assessment and critical appraisal and writing of reports. Together with conducting work for NHMRC Health Evidence Advice and Methods Panel; conducting evidence reviews and developing protocols the successful incumbent will have strong interpersonal and communication skills to develop and maintain effective relationships with multiple project clients and key clients.

Thursday, August 22, 2019 Category: Jobs

An Open Letter in Response to the FDA’s Public Comment Request on the Clinical Data Summary Report Pilot

Thu, 08/22/2019 - 13:50

This post was originally posted on the Cochrane Methods website

In January 2018, the FDA announced a pilot aimed at enhancing the transparency of the Agency's drug approval process and decisions. As part of the pilot, sponsors of up to nine drug applications to the FDA were asked, on a voluntary basis, if they would approve the public release of portions of the CSRs, which would be posted within an Action Package for the drug that also includes FDA application review files and letters. The parts of the CSRs made publicly available included information from the study report body, the protocol and amendments, and the statistical analysis plan for each study.

The FDA is calling for comments on this pilot as part of the ‘New Drugs Regulatory Program Modernization: Improving Approval Package Documentation and Communication’ call for public comment (deadline 26 August 2019).

Karla Soares-Weiser, Editor-in-Chief of the Cochrane Library, and members of the Cochrane Clinical Study Report Working Group have submitted a response to this pilot, which is reproduced below as an open letter. The Cochrane Clinical Study Report Working Group is a recently announced, open group that aims to support and facilitate the increased use of CSRs in Cochrane Reviews. 

The Clinical Study Report Working Group also invites, and welcomes, any sponsors or regulators who would like to reach out and initiate discussions with us to help facilitate CSR use in Cochrane Reviews. To date, only two published Cochrane Reviews have used CSRs (here and here) and overcoming challenges with access and terms of use will be key to increasing this number.

If you are interested in joining the Clinical Study Report Working Group, or have any questions or feedback on the project, please email methods@cochrane.org (emails to the attention of Ella Flemyng, Methods Implementation Coordinator). You may also be interested in the recent post ‘Using Clinical Study Reports as a data source for Cochrane Reviews: consultation meeting report and next steps’.

Submitted to the FDA via the online portal:

Covering note: The attached letter was posted on the Cochrane Methods website on 22 August 2019 (https://methods.cochrane.org/news/open-response-FDA-Clinical-Data-Summary-Report-Pilot) in response to the FDA’s invitation for public comment on the Clinical Data Summary Report Pilot program (Docket No. FDA-2019-N-2012 for the “New Drugs Regulatory Program Modernization: Improving Approval Package Documentation and Communication”). We, the undersigned, Editor-in-Chief of the Cochrane Library and members of the Cochrane Clinical Study Report Working Group, are formally submitting our letter as part of the public comment process. Institutional affiliations, for identification purposes, and competing interest statements were current as of 22 August 2019. Submitted by Ella Flemyng on 22 August 2019.

Background

Cochrane exists so that healthcare decisions get better. We produce high-quality, relevant, up-to-date systematic reviews and other synthesized research evidence to inform health decision making. 

Many projects in the field, including a recent Cochrane Methods Innovation Funded project, have highlighted that journal article reporting of randomized controlled trials (RCTs) is often incomplete and can therefore bias results of systematic reviews. Clinical study reports (CSRs) are increasingly recognised as a source of RCT information that can enhance the value of systematic reviews as they are likely to be the most comprehensive and complete single source of information about a RCT, particularly when compared to a journal article. CSRs help systematic reviewers gain a more detailed picture of the methods, and results for under-reported outcomes from a trial, especially adverse effects.

Feedback on the Clinical Data Summary Report Pilot program 

By the end of the FDA Clinical Data Summary Report Pilot, only one sponsor out of a potential nine opted-in and approved the release of this information (in February 2018). 

The released Erleada CSR contains substantially more information than would be available via a journal article, which is of huge benefit for systematic reviewers; the methods are better described, there is more information about the intervention and co-interventions, and the results tables and descriptions of adverse events are relatively comprehensive.  

Redactions in the Erleada CSR are relatively light, but perhaps some are still unnecessary. For example, at the bottom of page 31, information on storage and use of the drug could be important. Redacted participant IDs means information across different tables cannot be linked. However, even with redactions, there is a lot of useful information in the document that would be valuable for researchers and systematic reviewers. 

In addition to releasing information from the main body of the CSR, the protocol and amendments, and the statistical analysis plan for each study, we ask the FDA to provide access to the appendices, such as the complete tables and line listings of adverse events. Members of our CSR Working Group have found these can provide additional valuable information for the assessment of benefit and risk of a treatment. 

We would also like to comment that the information on the ‘Drug Approval Package: ERLEADA (apalutamide)’ page is clearly identified and therefore easy to use, including the CSR, protocol and statistical analysis plan information. However, any integrated review provided by the FDA should be in addition to the individual reviews and materials that are already made publicly available in the FDA Drug Approval Packages, and not replace them. The individual reviews and other documentation in the packages can be used for multiple purposes, including the assessment of the safety and efficacy of medicines and the synthesis of data in systematic reviews. Publicly available CSRs and the full FDA Drug Approval Package can thus complement each other, and neither is a substitute for each other. Whilst a CSR is necessary for transparency, providing both will enhance the ability to independently assess benefit and risk of medicines.

The Erleada CSR and action package does not appear to have clear copyright or reuse information. We assume that by making the CSRs publicly available that there are no restrictions on use and the data presented in the CSR can be used freely within Cochrane Reviews. We encourage the FDA to include positive statements about re-use of data for all available CSRs. 

We urge the FDA to make CSRs publicly available

Given the benefits of using CSRs, Cochrane is exploring how more could be used within relevant Cochrane Reviews. Cochrane held a consultation meeting in May 2019 to identify practical ways forward to facilitate CSR use within Cochrane review teams and we are developing a strategy based on these recommendations (summary post and meeting report can be found here). 

Cochrane has always supported initiatives to improve reporting of, and access to, RCTs and other primary research. The FDA states, “The Agency is.. considering whether to focus its efforts to better communicate the basis for drug approvals on the development of new integrated review documents, rather than on the release of CSRs” [see section ‘Update (6/26/2019)’] and we urge the FDA not to go down this route. For CSR disclosure, we feel that pilots are no longer needed and we urge all sponsors to make CSRs publicly available, not only all new drugs coming onto the market but also for past RCTs that have CSRs.

CSRs are a complete record of a trial. They contain essential information about the benefits and harms of medications, and about the credibility of that information. Independent researchers and systematic reviewers need to be able to access CSRs to verify the presented summary evidence from RCTs and assess how it was generated, and if necessary, to re-evaluate conclusions. Access to CSRs when compared with other sources of data (journal articles, registry records, etc.) reduces the potential for mistakes, misinterpretations, bias, evidence distortion, corruption and fraud. 

We support and applaud the efforts by the FDA to improve the transparency, usability and accessibility of information used in the drug review process. We urge the FDA to make it a mandatory policy to publicly disclose CSRs, not a voluntary choice of the sponsors. We also urge all sponsors with CSRs for new, or previously approved, drugs or biologics to publicly release them to help facilitate their use in systematic reviews and health decisions.  

Signatories:

Karla Soares-Weiser
Editor-in-Chief
Cochrane

Isabelle Boutron
Co-convenor Bias Methods group
Director of Cochrane France
Prof of Epidemiology at Université de Paris 

Yuan Chi
Research Assistant
Centre for Evidence-Based Chinese Medicine
Beijing University of Chinese Medicine, China

Kerry Dwan
Statistical Editor
Cochrane

Ella Flemyng
Methods Implementation Coordinator
Cochrane

Kit Gilchrist
Editorial and Communications Officer
Cochrane

Marius Goldkuhle
Research Associate
Cochrane Haematological Malignancies, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany

Toby Lasserson
Senior Editor (Methods Support and Development)
Cochrane

Carol Lefebvre 
Lead Convenor, Cochrane Information Retrieval Methods Group 
Independent Information Consultant, Lefebvre Associates Ltd, UK

Anne Littlewood
Information Specialist
Cochrane Oral Health, the University of Manchester

Evan Mayo-Wilson, MPA, DPhil
Associate Professor, Department of Epidemiology and Biostatistics
Indiana University School of Public Health-Bloomington

Lorri Puil, MD, PhD
Editor, Cochrane Hypertension
Department of Anesthesiology, Pharmacology & Therapeutics
Faculty of Medicine, University of British Columbia

Teo Quay
Managing Editor (Cochrane Anaesthesia and Cochrane Emergency and Critical Care)
Cochrane

Tarang Sharma
Editorial Officer
Cochrane

Farhad Shokraneh
Information Specialist
Cochrane Schizophrenia Group, Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, UK 

Nicole Skoetz
Senior Editor Cochrane Cancer
Department I of Internal Medicine
University Hospital of Cologne

Professor Lesley Stewart
Director Centre for Reviews and Dissemination (CRD), University of York
Co-convenor of the Cochrane Individual Patient Data Methods Group

Emma Thompson
Advocacy and Partnership Officer
Cochrane

Sheila Wallace
Cochrane Information Specialist
Cochrane Incontinence, Institute of Health & Society, Newcastle University, UK

Competing interests:

Cochrane: Cochrane does not accept commercial or conflicted funding. 

Karla Soares-Weiser: Karla Soares-Weiser is a full-time employee of Cochrane and receives a salary.

Isabelle Boutron: Isabelle Boutron is Prof of Epidemiology at Université de Paris and receives a salary from université de Paris and Assistance Publique de Hôpitaux de Paris. She is a member of the Cochrane CSR Working Group.

Yuan Chi: Yuan Chi has no employment relationship with Cochrane and is a member of the CSR Working Group in Cochrane.

Kerry Dwan: Kerry Dwan is a full-time employee of Cochrane and receives a salary, and is a member of the CSR Working Group in Cochrane.

Ella Flemyng: Ella Flemyng is a full-time employee of Cochrane and receives a salary. She is leading a project in Cochrane that aims to assess how more clinical study reports could be used in Cochrane Reviews and is setting up an open CSR Working Group in Cochrane.  

Kit Gilchrist: Kit Gilchrist is a full-time employee of Cochrane and receives a salary, and is a member of the CSR Working Group in Cochrane.

Marius Goldkuhle: Marius Goldkuhle is not employed by Cochrane. He is a member of Cochrane Haematological Malignancies and the CSR Working Group within Cochrane.

Toby Lasserson: Toby Lasserson is a full-time employee of Cochrane and receives a salary, and is a member of the CSR Working Group in Cochrane.

Carol Lefebvre: Carol Lefebvre serves Cochrane part-time as Lead Convenor, Cochrane Information Retrieval Methods Group but receives no salary. She is an independent information consultant and receives fees for consultancy and teaching in information retrieval for evidence synthesis. She is a member of the CSR Working Group in Cochrane.

Anne Littlewood: Anne Littlewood is a salaried employee of Cochrane Oral Health, the University of Manchester. She is a member of the Cochrane CSR Working Group.

Evan Mayo-Wilson: In the last three years, Evan Mayo-Wilson has received support from the Laura and John Arnold Foundation, Patient Centered Outcomes Research Institute, National Institutes of Health, US Food and Drug Administration, and Robert Wood Johnson Foundation. He has no other interests to declare. He is a member of the Cochrane CSR Working Group.

Lorri Puil: In the last three years, Lorri Puil has received support from the Canadian Institutes of Health Research, the British Columbia Ministry of Health via the Therapeutics Initiative, Faculty of Medicine, University of British Columbia, and a Michael Smith Foundation for Health Research Reach grant. She is also part of a research group receiving funding from the Australian National Health and Medical Research Council, and a member of the CSR Working Group in Cochrane.

Teo Quay: Teo Quay is a full-time employee of Cochrane Anaesthesia and Cochrane Emergency and Critical Care. She is a member of the CSR Working Group in Cochrane.

Tarang Sharma: Tarang Sharma is a full-time employee of Cochrane and receives a salary, and is a member of the CSR Working Group in Cochrane. She has previously undertaken research using CSRs as source documents for reviews.

Farhad Shokraneh: Farhad Shokraneh is a member of the Cochrane CSR Working Group. No other competing interests to declare.

Nicole Skoetz: Nicole Skoetz a member of the Cochrane CSR Working Group. No other competing interests to declare.

Lesley Stewart: Lesley Stewart is employed by the University of York and has no financial conflicts of interest. She advocates data sharing and has previously used data from CSRs in her research. She is a member of the Cochrane CSR Working Group.

Emma Thomson: Emma Thomson is a full-time employee of Cochrane and receives a salary, and is a member of the CSR Working Group in Cochrane.

Sheila Wallace: Sheila Wallace is a full-time employee of Cochrane Incontinence (employed via the Group’s host Newcastle University) and receives a salary, and is a member of the CSR Working Group in Cochrane. The single largest funder of Cochrane Incontinence is the National Institute for Health Research (NIHR).  The views and opinions expressed herein are those of the signatory and do not necessarily reflect those of Newcastle University, the Systematic Reviews Programme, NIHR, NHS or the Department of Health.

Thursday, August 22, 2019

Featured Review: How simple changes to food environments could reduce overconsumption

Thu, 08/22/2019 - 10:24

In this article, lead author Dr Gareth Hollands from the Behaviour and Health Research Unit, University of Cambridge, summarizes some of the key messages from 'Altering the availability or proximity of food, alcohol, and tobacco products to change their selection and consumption'  published by Cochrane Public Health.

Would you be less likely to buy a chocolate bar to eat if there were fewer different chocolate bars on display in the shop and more types of fruit instead? And would you eat fewer snacks from a bowl if you had to walk to the other side of the room to get your hands on them?

We found 24 studies in total: six looked at altering availability and 18 at proximity. These studies provided low-certainty evidence that reducing the number of options of a range of food could reduce the amount selected by 36% (three studies in 154 people) and the amount consumed by 17% (two studies in 150 people). We also found low-certainty evidence from 12 studies in 1098 people that placing food products further away from people could reduce how much they consume by 19%. These findings suggest that overconsumption may be reduced by changing our food environments to reduce the number of options available – such as reducing the range of unhealthy foods on restaurant menus or in vending machines – and move unhealthier products to less convenient locations, such as away from supermarket checkouts.

But some important uncertainties about these results remain, including what they could mean for altering our food environments to reduce overconsumption. For example, relatively few studies have been conducted, and of these, many are of poor quality. Especially few studies tested the effect of these changes in “real world” settings and over the long-term. Most were conducted in scientific laboratories over short time periods. We therefore lack confidence that similar effects would be seen in the environments that matter - supermarkets, shops, cafeterias and restaurants where people buy and eat food. This lack of real-world evidence is consistent with other Cochrane Reviews that look at changing aspects of food environments, such as portion size and nutritional labelling.

This reflects the difficulty public health researchers have in gaining access to real world environments. Most supermarkets and cafeterias are commercial operations that benefit from their products being purchased and consumed. Consequently, they have little incentive to partner with researchers who want to find out how to reduce or change that consumption. But things are slowly changing, as commercial partners understand that the health of their staff and customers is a societal good, or at least is vital to a sustainable business. Important evidence is beginning to emerge from research programmes worldwide that involve commercial partners and research teams focused on changing food environments to benefit population and planetary health, including in the Netherlands, Australia and the UK (with further examples here.)

A stronger evidence base can inform policy actions to make changes to available food options and the position of foods in retail and other settings, in order to reduce overconsumption. Such actions are already beginning to be seen. These include mandating the nutritional composition of certain ranges of foods available within public-sector establishments , and the possibility of legislating to ensure that unhealthier foods are placed in less accessible positions in shops, away from checkouts and aisle ends. While such changes can only ever be part of a range of measures tackling overconsumption, we should not underestimate the influence that the environments that surround us can have in shaping population behaviour and health.

Tuesday, August 27, 2019

World Health Organization's new Science Division has several openings - Geneva, Switzerland

Wed, 08/21/2019 - 16:45

The World Health Organization (WHO) is an official partner of Cochrane. The overall mission of the Science Division at WHO is to harness the power of science and innovation in a systematic way, by ensuring the excellence, relevance and efficiency of WHO's core technical functions, including norms and standards and research. There are currently several vacancies in this Division, more information can be found on the WHO website:

Wednesday, August 21, 2019 Category: Jobs

Cochrane Pregnancy and Childbirth Group support WHO in ‘living guidelines’ approach

Mon, 08/19/2019 - 10:04

 An article highlighting an innovative approach developed by WHO and Cochrane to ensure that global recommendations on maternal and perinatal health are up to date was recently published in BMJ Global Health.

The Cochrane Pregnancy and Childbirth Group has a long-standing collaboration with WHO on the development and updating of Cochrane reviews that inform WHO’s global maternal and perinatal health guidelines.

Now, that close collaboration has gone a step further in the development of a ‘living guidelines’ approach to ensure that the latest evidence in maternal and perinatal health can be translated into practice as quickly as possible.

Updating recommendations

WHO has produced over 400 evidence-based global recommendations on how best to improve health during pregnancy, childbirth and the postpartum period in the last 10 years. Ensuring that all these recommendations stay up to date and reflect the latest evidence is therefore a significant challenge.

Currently, guidelines are typically updated every few years. Yet, when strong new evidence becomes available, not reviewing the updating recommendation in a timely manner could adversely affect people’s health and wellbeing. At the same time, there are recommendations for which the evidence base rarely changes, and so an update does not seem the best use of limited resources.

The ‘living guidelines’ approach

The ‘living guidelines approach’ uses a combination of ongoing literature surveillance to inform prioritization, rapid appraisal of the potential impacts of new evidence on recommendations and accelerated updating of high-priority Cochrane systematic reviews for high-priority questions.

The aim is for the latest evidence and updated recommendations to reach healthcare professionals worldwide as quickly as possible.

So far, 25 WHO maternal and perinatal recommendations have been updated using the ‘living guidelines’ methodology, including on postpartum haemorrhage, one of the leading causes of maternal death worldwide.

Further information:

 

Monday, August 19, 2019

Overview of Cochrane's eight Review Group Networks

Wed, 08/14/2019 - 13:20

Cochrane has created eight new Networks of Cochrane Review Groups responsible for the efficient and timely production of high-quality systematic reviews that address the research questions that are most important to decision makers.

These films introduce the teams, what has happened so far, and the ambitions for what is to come.

In these short films, we focus on:

Cochrane Abdomen and Endocrine Network

Cochrane Cancer Network

Cochrane Children and Families Network

Cochrane Musculoskeletal, Oral, Skin and Sensory Network

Cochrane Circulation and Breathing Network

Cochrane Acute and Emergency Care Network

Cochrane Public Health and Health Systems

Cochrane Mental Health and Neuroscience Network

Wednesday, August 14, 2019

Chris Del Mar update

Tue, 08/13/2019 - 12:56

As many across the Cochrane community may be aware, Professor Chris Del Mar, Co-ordinating Editor of Cochrane Acute Respiratory Infections and long-time Cochrane contributor, was involved in a serious surfing accident earlier this year. During one of his regular early morning surfing sessions on Australia’s Gold Coast, Chris sustained a very high level spinal cord injury and as a result, spent over three months in intensive care. 
 
In recent months Chris has moved to the Brisbane hospital’s spinal injury rehabilitation unit. Arrangements are now being made for home modifications and purchase and installation of equipment that will enable Chris to return home and participate in daily life. Some of the priorities include a hospital bed, power wheelchair, a wheelchair-accessible vehicle, and specialized communication devices.

Despite everything he has been through in recent months, Chris is continuing to do some work. His PhD students and research colleagues visit him at his hospital bedside to discuss projects and papers and Chris plans to return to work next year aided by a wheelchair and voice- or eye-activated computers and other devices. ‘Chris is a very inspiring man and very brave,’ says his wife and fellow Cochrane contributor Professor Tammy Hoffmann. ‘It’s taking a ton of courage to get through this situation.’
 
Concerned friends, colleagues and organizations from around the world have been reaching out to support Chris since his accident, and many have asked how they can best help. Some colleagues have now set up a crowdfunding campaign to make Chris’s home wheelchair-accessible. It is also hoped the funds will enable the purchase of other assistive equipment that he needs, including the specialized computers and input devices needed for him to continue working. If you’d like to support Chris and his family, this recent update on his progress contains links to further information.

Tuesday, August 13, 2019

Cochrane's 30 under 30: Soodabeh Behboodi

Mon, 08/12/2019 - 15:11

Cochrane is made up of 11,000 members and over 67,000 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.

The Cochrane 30 Under 30 series is now closed. However, we are keen to hear from early career professionals about their work with Cochrane for future series. If you would like to be added to our waitlist, please conact lparsonson@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: Soodabeh Behboodi
Age:
25
Occupation:
Dentist and Clinical Lecturer
Program:
Author & Peer Reviewer at Cochrane Oral Health Group

How did you first hear about Cochrane?
In 2012, Iranian Evidence-Based Center held a Cochrane workshop, then I decided that I want to be a clinician who applies trusted up to date evidence in her daily practice and I decided to join Cochrane family.

It didn’t take much reading to realise the importance of Cochrane’s work. So, when the opportunity presented itself, I was keen to work for an organization whose mission – of generating reliable health information which is free from commercial sponsorship – I respect. 

How did you become involved with Cochrane? What is your background?
I filled the 'Getting Involved' form and as I had a presentation titled "Low level laser therapy in orthodontics" for a study club which was awarded as best presentation, I chose Laser as my interested field. Now I am an active member in Oral Health Group of Cochrane and I am participating as Peer reviewer and Author in a Cochrane systematic review titled "Laser therapy for dentine hypersensitivity".

What do you do in Cochrane?
I am involved in updating a Cochrane systematic review titled "Laser therapy for dentine hypersensitivity".

What specifically do you enjoy about working for Cochrane and what have you learnt?
I have developed a passion for practicing evidence based and getting to know Cochrane and using its trainings enabled me to critically appraise the evidence which would lead to make better decision in treatment planning.

What are your future plans?
I am a Clinical Lecturer in Azad University of Tabriz as well as the supervisor of a research team. I want to give the same chance for my students who are at the start of their career, to get to know Cochrane and be able to critically appraise the evidence to apply for their first patients.

In your personal experience, what one thing could Cochrane do better to improve its global profile?
In my opinion, Cochrane is an interconnecting subsets, working as a whole system, in which each region's activity could affect system. In my region, there is a great potential of passionate participants which could contribute to Cochrane, if they have opportunity by getting introduced to Cochrane which could be beneficial for Cochrane and health system. In my region expanding Cochrane credentialed trainings would be of great help in this regard.

What do you hope for Cochrane for the future?
I hope for Cochrane to make links with clinics to assess the obstacles clinicians face in implementing the recommended evidence. This could help decision-making clinicians, guideline developers, which is along with Cochrane's slogan: Trusted evidence, Informed decisions, Better health.

How important is it that young people get involved in Cochrane? Why is this, do you think?
I face many of them in university and I think they have time, which could be managed to be used for Cochrane under supervision of a professional if they get to know the system, because clinicians come up with good questions and ideas during their daily practice but they don’t have enough time to pursue them. If Cochrane could make a system for youngsters to get involved under supervision this could be beneficial for individuals and Cochrane.

Providing better health which is Cochrane's aim is only possible if many participants contribute according to their abilities and conditions. This contribution will be of great help for the healthcare network of each region.

What would your message be to other young people who want to get involved with Cochrane’s work but not sure where to start….?
I want to say this for your readers who are just having a glance, I think they are convinced that evidence based practicing is the future of medical industry, I recommend they get more training with Cochrane's extensive online training programs. Also, I want to outline that donating their time to this system will have a great impact for the healthcare network in the society they're living.

 

Monday, August 12, 2019

Cochrane Skin seeks Cochrane Systematic Review Methodologist - Nottingham, UK

Fri, 08/09/2019 - 16:09
Closing Date: Wednesday, 4th September 2019
Salary: £30395 to £39609 per annum pro-rata depending on skills and experience.
Contact type: Maternity leave cover - fixed-term, part-time. Maximum 27 hours – minimum 18.5 hours per week.

A short-term opportunity (to provide maternity leave cover) has arisen for a Systematic Review Methodologist to join the Cochrane Skin team at its editorial base within the Centre of Evidence Based Dermatology (CEBD), School of Medicine, University of Nottingham. CEBD has an international reputation for independent research into the prevention and treatment of skin disease with a focus on delivering independent clinical research that informs the NHS.

Cochrane Skin (CS) is part of the international Cochrane organisation, and is the editorial base for the preparation and dissemination of Cochrane systematic reviews on the treatment and prevention of skin diseases. It is one of 62 Cochrane review groups worldwide which contribute to Cochrane, and this busy editorial base currently has around 40 review teams preparing protocols or reviews for publication or updating published reviews; please see skin.cochrane.org for more information. In providing maternity leave cover for the Cochrane Systematic Review Methodologist, you will lead on giving support and guidance on all methodological aspects of CS systematic reviews. You will be responsible for working with review teams at all stages of the review-writing and editorial process (from title registration to review publication), and will ensure that relevant methodological procedures are adhered to.

We are seeking an individual with proven knowledge and experience of involvement in systematic review methods e.g. by being the lead author of quality systematic reviews. You should possess a good understanding of statistical and research methodology, including knowledge of the relevant statistical techniques used in meta-analysis along with an ability to critically appraise systematic review methodology with attention to detail. Excellent verbal and written communication skills, including the ability to communicate with clarity on complex and conceptual ideas to those with limited knowledge and understanding as well as to peers, are also essential. We particularly welcome applications from candidates with knowledge of Cochrane systematic review methodology. 

This is a part-time post (maximum 27 hours – minimum 18.5 hours per week – please state your preference on your application) and will be offered on a fixed-term contract until 31 July 2020.

 

Friday, August 9, 2019 Category: Jobs

Podcast: Use of computer or robotic technology to assist surgeons in performing gynaecological surgery

Fri, 08/09/2019 - 13:29

Recent developments allow surgeons to do operations remotely by guiding mechanical arms, rather than needing to be next to the patient. This is called robot-assisted surgery and the Cochrane Review of its use in gynaecological surgery was updated in October 2018. Theresa Lawrie from the Cochrane Gynaecology, Neuro-oncology and Orphan Cancer Group based in Bath in the UK, tells us the latest.

Robot-assisted surgery is used in several countries for gynaecological surgery, particularly for removing the uterus, known as a hysterectomy, and also for other procedures including removal of uterine fibroids, restoring fertility, and repairing vaginal vault prolapse. This last procedure is known as sacrocolopexy. The approach has also been used for the treatment of women with endometrial and cervical cancers.

However, robot-assisted surgery is controversial because of the significant commercial interests involved and because the potential benefits and harms over standard surgical approaches have not been clearly established. Unfortunately, despite our updating of the previous version of this review, which was published in 2014, we’re still not able to fully resolve the uncertainties. Much of the evidence remains low quality, and we cannot be sure whether there is a difference between robot-assisted and conventional laparoscopic, or keyhole, surgery in overall complication rates and other outcomes for the patients.

We now include 12 randomised trials, involving just over a thousand women. Eight studies compared robot-assisted surgery with conventional surgical approaches for hysterectomy, three looked at sacrocolpopexy and the last examined surgical treatment for endometriosis. Among studies of women undergoing hysterectomy, two involved women with endometrial cancer while the others involved women with benign conditions.

For hysterectomies, when robot-assisted and conventional laparascopic surgery were compared, we could not be sure whether there was a difference in complication rates during or after the operation, for either benign disease or cancer. Two studies did show that robot-assisted operations took about 40 minutes longer than conventional approaches, but hospital stays were slightly shorter. However, the evidence for these findings was of very low certainty, partly because of the high risk of bias in the trials. One study compared robot-assisted surgery with open abdominal surgery for hysterectomy; but it was too small, with just 20 women, to be able to detect any possible differences between the two techniques.

For sacrocolpopexy, limited data from three studies suggest that, overall, there may be little or no difference in the rate of complications during the operation between robot-assisted and conventional surgery. However, low-certainty evidence from a single study suggests that post-operative complications might be higher with robot-assisted techniques. With regard to operating time, robot-assisted surgery for sacrocolpopexy might be associated with longer operations than conventional surgery, but the duration of hospital stay was similar for the two procedures.

Finally, the one study of robot-assisted versus conventional surgery for endometriosis, was, once again, too small to show potential differences between these surgical approaches.

In conclusion, low-certainty evidence for hysterectomy and sacrocolpopexy operations suggests that complication rates for robot-assisted surgery might be similar to those for conventional laparoscopic surgery. Things are more uncertain for gynaecological cancer, where we found no comparative evidence on cancer recurrence or survival after the surgery. As robot-assisted surgery depends on the skill and experience of the surgeon and is expensive, evaluating its effectiveness and safety continues to present a challenge; but this needs to be met if we are to have reliable evidence on its potential benefits and harms.

Friday, August 9, 2019

Making what can’t be counted count: Cochrane-WHO collaboration on qualitative evidence syntheses in guidelines showcased in new articles

Thu, 08/08/2019 - 14:58

A series of papers highlighting innovative work carried out by the Cochrane Effective Practice and Organisation of Care Group and the World Health Organization on using reviews of qualitative research in guideline development processes has been published in Health Research Policy and Systems.

Cochrane is a non-governmental organization in official relations with WHO. The Cochrane Effective Practice and Organisation of Care (EPOC) Group, as well as other Cochrane contributors, has a long-standing relationship with WHO and works closely with them on guideline development. This fruitful collaboration had led to several innovations, such as the inclusion of qualitative evidence syntheses in WHO guideline processes and the development of GRADE-CERQual, an approach to assess the confidence of evidence from reviews of qualitative research.

EPOC produced Cochrane’s first qualitative evidence synthesis review, Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health, in 2013. This review was used in a WHO guideline on health worker task shifting, providing the panel with important information about the acceptability and feasibility of lay health worker programmes and complementing another review that focused on the effectiveness of these programmes.

Since then, WHO and Cochrane EPOC have continued to collaborate. Several WHO guidelines now include evidence from Cochrane qualitative evidence syntheses, and Cochrane EPOC is working closely with WHO to improve methods for this approach.  

Now, a series of papers detailing this work has been published in Health Research Policy and Systems. The articles were commissioned by WHO in response to requests for direction on how to use qualitative evidence syntheses in guidelines and were authored by a team from WHO, Cochrane staff at the Norwegian Public Health Institute and the University of Central Lancashire.

Evidence-based guidelines, such as those produced by WHO, have traditionally focused on quantitative evidence from reviews of effectiveness. However, guideline panels also discuss issues such as the cost, acceptability and feasibility of an intervention and its potential implications for equity – though this has often been done in an unsystematic way. Reviews of qualitative research can help look at these more systematically.

The three new articles, each led by a different Cochrane EPOC editor, highlight different ways that using qualitative evidence synthesis can benefit guideline development.

“The papers discuss how qualitative evidence syntheses can be a powerful means of improving the relevance of guidelines, how they can help to integrate the views and experiences of all types of stakeholders – including groups who may not be otherwise represented in the decision-making process – and how they are also a useful source of information for implementation,” explains Claire Glenton, a Cochrane EPOC editor who led one of the papers. “They also highlight a number of issues for further development.”

The series showcases several Cochrane qualitative evidence syntheses and offers practical advice to others who want to include this type of evidence in guidelines, providing examples of what was done well, and the lessons learnt. The authors also highlight knowledge gaps for further research and practice.

Soo Downe, another EPOC editor who led one of the papers, emphasises the value of qualitative evidence synthesis for guidelines: “Health care is only useful if it meets the needs, values and beliefs of those it is designed for, and of those who have to use it. Qualitative insights are critical for ensuring that care is not only effective clinically, but useful practically.”

“This is a crucial safety issue as well as an issue of high quality, respectful, acceptable and affordable care. For the first time, this series provides guidance on how this essential but previously overlooked component of health care quality can be realised.”

This collaboration between EPOC and WHO has been a useful opportunity to explore how Cochrane reviews and qualitative evidence syntheses can be made as relevant as possible for this key target audience. WHO plans to continue to incorporate qualitative evidence syntheses into their guidelines and will keep working with Cochrane about how best to do this.

Later this year, several of the authors involved in this project are also organizing the QESymposium in Brazil. Simon Lewin, another Cochrane EPOC editor who led a paper in this series, is part of the Scientific Programme Advisory Committee and notes: “The symposium will explore the use of qualitative research in decision making processes tied to the Sustainable Development Goals, and we expect many of the issues raised in these papers to be discussed there.”

Access the papers

 

Thursday, August 8, 2019

Podcast: Assisted reproductive technology: an overview of Cochrane Reviews

Wed, 08/07/2019 - 13:55

Cochrane Overviews bring together the findings from multiple reviews and one of the largest, first published in September 2013, was updated and republished in May 2018. Cindy Farquhar, from the Department of Obstetrics and Gynaecology at the University of Auckland in New Zealand describes this enormous volume of evidence for assisted reproduction.

"Infertility is defined as failure to conceive after one year of trying. Up to one in six couples will experience this at some point in their lives and many will seek fertility treatment in the form of assisted reproduction. When they do so, they will hope that they are getting the best available care, and this Overview of a wide breadth of research should help to achieve this.

Fertility treatments are complex and costly, and the stakes are high. A cycle of assisted reproduction includes several steps which start with down regulation, ovulation induction, triggering of ovulation, oocyte retrieval, fertilization, embryo transfer and luteal phase support. 

With this in mind, it is important that each step in assisted reproduction, or ART, is supported by good evidence from well-designed studies. With this aim, the Cochrane Gynaecology and Fertility Group has considered the evidence from all Cochrane systematic reviews of ART published on the Cochrane Library.

We included 68 Cochrane Reviews of various stages in the ART cycle. All the reviews were assessed for quality, all were found to be high quality and this overview provides the most up to date evidence from randomised trials for ART cycles.

Reviews of in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) were included in the overview, but reviews of intrauterine insemination and ovulation induction were not included.

Thirty-eight of the reviews identified interventions that were effective or promising, 19 reviews identified interventions that were ineffective or possibly ineffective, and 15 reviews were unable to draw conclusions due to lack of evidence.

Use of the evidence from this overview to guide clinical practice should help to improve live birth rates and reduce rates of multiple pregnancy, cycle cancellation and ovarian hyperstimulation syndrome.

As with the previous version of this overview, we hope that medical societies and guideline groups will find it useful it in their efforts to guide their clinical practice."

Wednesday, August 7, 2019

Cochrane's 30 under 30: Audrey Tan and Eve Tomlinson

Mon, 08/05/2019 - 12:17

Cochrane is made up of 11,000 members and over 67,000 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.

The Cochrane 30 Under 30 series is now closed. However, we are keen to hear from early career professionals about their work with Cochrane for future series. If you would like to be added to our waitlist, please conact lparsonson@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: Eve Tomlinson and Audrey Tan
Age: 26 and 24
Occupation: NIHR Network Support Fellows for the Cancer Network and Circulation and Breathing Network

How did you first hear about Cochrane?
Eve: I first found out about Cochrane during my BSc in Psychology. I came across a Cochrane review whilst searching for literature for one of my research projects and found it to be such a useful resource giving a thorough overview of the studies in the topic area I was exploring. I was struck by how robust the methods for the review were and found it a great base to work from to then delve into the individual studies further.

Audrey: I first heard about Cochrane during my MSc in Evidence-Based Social Intervention and Policy Evaluation. Cochrane was introduced to us as the gold-standard for evidence synthesis and the pre-eminent organisation for synthesis methodology.

How did you become involved with Cochrane? What is your background?
Eve: Prior to becoming involved with Cochrane I worked as a Clinical Trial Coordinator at the Royal United Hospital, Bath, in the Oncology and Haematology Department. I think it is the combination of my experience in Cancer clinical trials and in health research from my degrees that means I’m well placed in the role of Network Support Fellow for the Cancer Network.

Audrey: While my undergraduate background is in qualitative research methods, after my MSc I started working for the Royal College of Obstetricians and Gynaecologists as a Systematic Reviewer writing systematic reviews for NICE clinical guidelines. I jumped at the opportunity to work for Cochrane as a Network Support Fellow; having the chance to work for this pre-eminent organization in the field of evidence-based medicine at an early stage in my career seemed too good to pass up.

What do you do in Cochrane?
Eve: I am the Network Support Fellow for the Cancer Network. I am working alongside the Network Senior Editor and Associate Editor to aid the delivery of our Network Strategic Plan. One of my main focuses is to support the six Cancer Cochrane Review Groups with review prioritisation activities, in order to ensure that Groups are producing reviews relevant to end users such as patients, carers, health care professionals and decision makers. I am also working to improve collaboration and shared learning in the Cancer Network, recently setting up the Cancer Network Newsletter to facilitate this.

Audrey: Similar to Eve, I’ve been helping my Groups develop prioritisation plans. I’ve also undertaken a stakeholder mapping exercise to identify groups and organisations that can facilitate research dissemination, conducted a member profile survey of people within the Network to identify opportunities for collaboration, and joined the author team on several reviews. Another main component that’s unique to my role is increasing Groups’ capacities to perform network meta-analyses.

What specifically do you enjoy about working for Cochrane and what have you learnt?
Cochrane is a global organisation and between our Networks (Cancer and Circulation and Breathing) there are Review Groups based in the UK, France, The Netherlands, Germany, Australia, Canada, and America. We enjoy being able to work with people from all over the world that care about making a difference to health care. We’ve learnt early on that although the Review Groups are different geographically, with differing personnel structure, funders and resources, they are all exerting enormous effort to achieve the same overarching goal: to produce high-quality, accessible reviews of evidence to allow people to make accurate and informed decisions about their health and health care generally.

 What are your future plans?
Eve: I look forward to working more with the Review Groups in the Cancer Network on review prioritization, dissemination and the identification and development of stakeholder partnerships. I plan to learn more about the process of conducting a Cochrane review by joining a priority review author team.  

Audrey: My long-term goal is to transition my career into working in health policy so gaining the experience now “on the ground” in evidence-based research is an ideal starting place.

In your personal experience, what one thing could Cochrane do better to improve its global profile?
Cochrane should improve the ways it disseminates research in order to make sure it is being accessed and understood by those who need it most. Cochrane reviews are a robust and comprehensive source of knowledge, but a lot of people just don’t know about them. The increase in the creation of working links with sites such as Wikipedia will hopefully help with this, as will the use of alternative methods of dissemination such as using BlogShots and social media. Cochrane should work with medical students and registrar doctors to engage them with Cochrane work and translate findings into best practice, to get involved with reviews and recommend Cochrane reviews to patient groups.

What do you hope for Cochrane for the future?
We hope that Cochrane will focus efforts to expand further into lower and middle-income countries, opening up more Centres and Review Groups in these countries to ensure that Cochrane evidence is applicable worldwide.

How important is it that young people get involved in Cochrane? Why is this, do you think?
It is important for Cochrane to have a diverse workforce, including younger voices that bring enthusiasm, new ideas and challenge current practice.

Involving young people in Cochrane’s work has numerous benefits, including improving research and development by introducing young people’s perspectives, facilitating research dissemination and achieving a wider impact, and enabling young people to improve their own research skills.

What would your message be to other young people who want to get involved with Cochrane’s work but not sure where to start….?
There is so much you can be part of in Cochrane at the click of a mouse e.g. through accessing Cochrane TaskExchange and Cochrane Crowd. As there are so many different topics covered by Cochrane and departments within the organisation, it would be a good idea to check out the Cochrane Website to learn more and determine which part you want to get involved with, then contact your local Cochrane Centre for further information. 
 

Monday, August 5, 2019

Maternity Matters: A new special series of blogs and other resources from Cochrane UK

Fri, 08/02/2019 - 18:51

Throughout August, the Cochrane UK team are running a new special series; ‘Maternity Matters’.

Maternity Matters is series of blogs and other resources, including graphics and podcasts, sharing some of the latest evidence on women's and babies' health, from pregnancy through to the early days after birth. 

The series focuses on NHS priorities on maternity and highlights new Cochrane Reviews or research. The blogs look at risk reduction in pregnancy with new Cochrane Reviews on smoking cessation and vitamin D; on women’s experiences and particular needs in pregnancy after recurrent miscarriage and after stillbirth; on continuity of care; and on managing the third stage of labour. 

Professor Catherine Swann (@cjswannPHE), Deputy Director of Maternity and Community at Public Health England, welcomes the series:

See below for a round-up of materials and join in the discussions on Twitter, by following @CochraneUK and using the hashtag #MaternityMatters 

Blogs 

 

Learn more about Cochrane UK, the Cochrane Pregnancy and Childbirth Group, the Cochrane Neonatal Group, the Cochrane Children and Families Network and the Cochrane Child Health Field.

Friday, August 2, 2019

Podcast: Support during pregnancy for women at increased risk of low birthweight babies

Fri, 08/02/2019 - 08:54

The Cochrane Pregnancy and Childbirth Group has produced more than 600 reviews and one of its first from 1995 looked at the effects of providing support during pregnancy for women at increased risk of having a low birthweight baby. The review underwent another update in April 2019 and we asked a new member of the research team, Christine East from Monash University and La Trobe University in Melbourne, Australia to tell us about the importance of the review and its latest findings.

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Some newborn babies are smaller than expected and this can be for a number of reasons. Sometimes they are simply born early. Others may be born at full term but may not have grown well enough in the womb. Whatever the reason, low birthweight babies face more challenges than babies born at a normal weight.

One of the ideas for how to prevent babies being born small is to provide social support to women during their pregnancy. This might be in the form of emotional support, helping women get to appointments, or helping them understand when to let their midwife or doctor know about any concerns they are having.

Our review examines the evidence on these and other such strategies. We looked at the randomised trials that had tested the effects of programmes offering additional social support to women who were at risk of having a low birthweight baby. Some trials involved support from healthcare professionals, while, in others, lay persons provided the support. The main outcomes were babies born preterm, that is, three or more weeks earlier than the usual 40 weeks, or weighing less than 2500 grams at birth.



We included 25 reports, which had data for more than 11,000 mothers and their babies, across 21 different studies. We found that when compared with routine care, programmes that offered additional social support for these at-risk women may slightly reduce the number of babies born weighing under 2500 grams. There was also evidence that social support might decrease the number of babies born preterm, although the potential effect was not large. We also found that additional social support might reduce the number of births by caesarean section and the number of hospital admissions during pregnancy. And the results were consistent whether the support came from healthcare professionals or specially trained lay persons.

In summary, pregnant women need the support of caring family members, friends and health professionals. Programmes that offer additional social support during pregnancy are unlikely to have a large impact on babies being born small or before term. However, these support services may help in reducing the likelihood of caesarean birth and the need for the woman to have to stay in hospital at some point during her pregnancy.

Thursday, August 1, 2019

Keeping Cochrane evidence up-to-date

Wed, 07/31/2019 - 16:17

A recent article in Nature, 'Out of date before it's published', looked at how we are keeping pace with fast-moving research fields. It featured the work of Cochrane to increase the speed and efficiency of Cochrane systematic review production.

Julian Elliott co-leader of Project Transform, discussed the need for the latest health evidence to be available and the idea of living systematic reviews. You can learn more about Project Transform and the work in this short video:

Chris Mavergames, Cochrane’s Head of Informatics & Knowledge Management, touched upon our 'evidence pipeline', Cochrane Crowd, and what's next for technology to make the process faster. You can learn more about our Citizen Scientist platform, Cochrane Crowd, in this short video:

Thursday, August 1, 2019

Cochrane's 30 under 30: Selena Ryan-Vig

Wed, 07/31/2019 - 09:03

Cochrane is made up of 11,000 members and over 67,000 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.

The Cochrane 30 Under 30 series is now closed. However, we are keen to hear from early career professionals about their work with Cochrane for future series. If you would like to be added to our waitlist, please conact lparsonson@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: Selena Ryan-Vig (on Twitter: @CochraneUK)
Age: 26
Occupation: Communications & Engagement Officer, Cochrane UK

How did you first hear about Cochrane?
I have to admit that it was only in my final year at university that I became familiar with Cochrane. I was studying a module about ‘the psychology of pain’ and my lecturer was an author on Cochrane Reviews assessing interventions for the treatment and prevention of pain. He asked the class whether we’d heard of Cochrane Reviews and, if not, why not. I made sure to brush up at that point.

It didn’t take much reading to realise the importance of Cochrane’s work. So, when the opportunity presented itself, I was keen to work for an organization whose mission – of generating reliable health information which is free from commercial sponsorship – I respect. 

How did you become involved with Cochrane? What is your background?
I studied psychology at the University of Bath, with a placement year spent working in a national mental health charity for women. After graduating, I wasn’t entirely sure what kind of job I was looking for, but I was interested in research and I knew I’d like to work within the charity or public sector. When I saw an opening at Cochrane UK on the NHS jobs website, it felt like a good fit. I began working at Cochrane UK as an information and administration assistant and moved into my current role about a year and a half later.

What do you do in Cochrane?
My role primarily involves sharing information about Cochrane and Cochrane Reviews with different audiences, such as researchers, healthcare professionals and the public. For example, I make video summaries and ‘blogshots’ (a kind of infographic) to share the key messages from Cochrane Reviews in ways which can be easily and quickly accessed and understood. I also produce our newsletters, curate Cochrane UK's website and social media accounts and monitor the analytics on these.    

Additionally, with a colleague, I run interactive sessions in schools with students aged 15-18. We give an overview of evidence-based health care and why it’s important, and encourage students to think critically, particularly around health claims they may see in the media (such as ‘bacon causes cancer’). I also give occasional talks in universities or at conferences to raise awareness of Cochrane’s work.

What specifically do you enjoy about working for Cochrane and what have you learnt?
The global nature of Cochrane is amazing and something which I only really appreciated when I was fortunate to attend my first Cochrane Colloquium in Seoul in 2016. Everyone has to make decisions about health, and when we do it’s important that those decisions are informed by the best available research evidence. It’s inspiring to be part of an organization made up of so many people from around the world who are driven by that ethos. I enjoy the variety of my role at Cochrane UK. I’ve been given many different opportunities and feel lucky to be part of a team so generous with their support and time.

 

What are your future plans?
To be decided! I’m interested in science communication; particularly how nuanced and complex research findings can be conveyed accurately but accessibly to different audiences. Equally, it’s been really rewarding working with young people to hone their critical thinking skills about some of the (mis)information about health we’re bombarded with every day. Both are potential avenues I’d be keen to gain more training in and explore further.

In your personal experience, what one thing could Cochrane do better to improve its global profile?
I’m bound to be biased given my role in communications, but I would love to see even more resources in Cochrane being allocated towards the dissemination of Cochrane Reviews. So much work goes into conducting a Cochrane Review, but if the target audiences of that review don’t know it exists – or are unsure how to access it – a lot of that effort is undermined.  We’re fortunate at Cochrane UK to have two full time members whose primary focus is on disseminating Cochrane evidence, but not every centre or group has this luxury.

What do you hope for Cochrane for the future?
Making decisions about health that are informed by the best available evidence seems like such a no-brainer, that it’s scary to think that – globally - this is often far from the current reality. With so much misleading and sensationalised health information in circulation, I hope that Cochrane – and other organizations like it – can be ‘louder’. It would be great to see Cochrane doing more outreach work to help better equip individuals to distinguish between reliable, and less reliable, sources of evidence.

How important is it that young people get involved in Cochrane? Why is this, do you think?
It’s really important that young people get involved with, and become more aware of, the importance of evidence-based decision-making and Cochrane’s role in that. This is particularly true of early career researchers or health professionals but more broadly than that too. That’s because everyone needs to make decisions about health at some stage in their lives and being aware of reliable, trust-worthy sources of information is a key part of that.

What would your message be to other young people who want to get involved with Cochrane’s work but not sure where to start….?
Students could look up Students 4 Best Evidence; a blogging website for, and by, students interested in evidence-based practice for introductions to some of the fundamentals of evidence-based practice. TaskExchange is also good if you’d like to get stuck in contributing to some of the tasks involved in producing a systematic review; from data extraction to translation. There’s lots more information about getting involved here too.
 

Tuesday, July 30, 2019

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