Cochrane News

Subscribe to Cochrane News feed
Updated: 8 hours 47 min ago

Author Q&A: Does treatment for gum disease help people with diabetes control blood sugar levels?

Thu, 06/16/2022 - 13:41

We spoke to Cochrane Oral Health Author Terry Simpson about the updated review Treatment of periodontitis for glycaemic control in people with diabetes mellitus. He explains the results of this review and what it means for the research community as well as medical, nursing, and dental professionals - with thanks also to Josh Twigg, Ambrina Qureshi, Sarah Wild, Ian Needleman and Laura MacDonald.

Terry, can you tell us about this updated Cochrane Review?
Our review of studies evaluating the impact of treatment of periodontitis (gum disease) on glycaemic control in people with diabetes was originally published in 2010 (based on a protocol published in 2004) and first updated in 2015. For the 2022 update, we divided the review in two due to the sheer volume of studies on this topic and to account for the clear divide that has emerged in the research, focusing on two different key questions. This update answers the question: how does treatment of periodontitis compare to usual care or no treatment for improving glycaemic control in people with diabetes; the second part of the update will compare different approaches to treatment of periodontitis against one another, to assess if there is a gold standard for treatment.

This first part of our update found that glycaemic (blood sugar) control in people with diabetes can be improved with treatment of periodontitis. The improvement in diabetic control from treating any periodontitis appears to be approximately equivalent to the threshold for determining effectiveness of an additional diabetes drug - but without the side effects.



What does it mean for the research community?
For the first time since this review began, we have shown that we do not need to conduct further randomised controlled trials that compare periodontal treatment against no treatment or usual care in people who have both diabetes and periodontitis. Within the population of people with diabetes, there is the potential for individuals to improve glycaemic control through treating their periodontitis and therefore we recommend that research should not withhold periodontal treatment from such people for the purpose of a research study that is highly unlikely to add new information to the evidence base. Trials comparing different approaches to periodontal treatment may still be useful, while qualitative studies and process evaluations will be helpful to establish how best to optimise the provision of effective periodontal treatment in primary care settings and to support patients to improve their periodontal health and oral hygiene practices.

Given the evidence is clear, what needs to change?
As treatment of periodontitis in people who also have diabetes can have a beneficial effect on metabolic control (glycaemic levels), it is important that there is better communication between dental and medical professionals managing patients with diabetes and periodontitis as this will facilitate appropriate treatment to minimise risk of complications of diabetes. Unfortunately, care pathways between diabetes and oral health do not exist for most patients. Therefore, healthcare policy and guidance are needed to establish such funded pathways.

For dental professionals, greater awareness is required regarding effective monitoring and treatment of diabetic patients with periodontitis. Professional development for all relevant healthcare staff (including diabetologists, other medical and nursing teams dealing with diabetic patients and the dental professionals) must be delivered to transfer knowledge, address barriers and support implementation. Partnering with organisations that provide information and support for people with diabetes and oral health would be helpful.

Governments may wish to review how socially funded health schemes are addressing the need for periodontal care, particularly among people with diabetes, where the potential for improvement in health and quality of life may be profound. The role of periodontal specialists in providing training and advice on referral for further management is critical in ensuring the dental workforce is equipped to manage this group of patients to the best standard.  

Groups formulating guidelines on diabetes or periodontitis should incorporate the findings of our review so that appropriate educational resources are available for professionals and patients. In the UK, we are aware that NICE have already undertaken this responsibility.



How can clinicians working in this field change what they do?
Medical and nursing professionals should ask all patients diagnosed with diabetes whether they have had a dental visit to get their gums checked and to emphasise the importance of gum health in diabetes management. They can signpost or refer their patients to dental professionals in the case of any unusual presentation or poor oral health identified during general screening on follow-up visits. Similarly, dental professionals (dentists and hygienists/therapists) can advise all patients with diabetes of their increased risk of gum disease and the benefits of good gum health for their overall health and wellbeing. Regular screening of gum health should continue to be provided to all patients, with detailed assessment for those identified at risk of periodontitis. Most patients will continue to be suitable for treatment under the care of a general dentist. However, for people with more severe gum disease and where gum disease is not responding to treatment, referral to a specialist (periodontist) should be considered where available.

Dental and medical professionals can familiarise themselves with the evidence about the links between periodontitis and diabetes. Both professions can assist in the process of educating patients about this relationship. Dentists can play a role in screening for diabetes, considering the possibility of undiagnosed diabetes in patients with risk factors (such as increasing age, higher BMI, non-white ethnicity, family history of diabetes) and the presence of periodontitis, particularly when the condition is severe. They should be able to inform patients of local options for testing for diabetes.

Where can clinicians find out more?

Thursday, June 16, 2022

World EBHC Day launches campaign to address global health challenges through partnerships for purpose

Wed, 06/15/2022 - 15:44

JBI, Cochrane, Campbell, GIN, the Institute for Evidence-Based Healthcare, the Centre for Evidence-based Health Care, and NICE recently launched the World Evidence-Based Healthcare (EBHC) Day 2022 campaign, ‘Partnerships for Purpose’. 

World EBHC Day is held on 20 October each year. It is a global initiative that raises awareness of the need for better evidence to inform healthcare policy, practice and decision making in order to improve health outcomes globally. It is an opportunity to participate in debate about global trends and challenges, but also to celebrate the impact of individuals and organisations worldwide, recognising the work of dedicated researchers, policymakers and health professionals in improving health outcomes.

The 2022 campaign aims to examine partnerships and practical considerations around establishing different types of partnerships, accelerating innovation, ensuring equity and integrity, overcoming challenges and biases, lessons learned and achieving impact for improved health outcomes globally.

Bianca Pilla, World EBHC Day Committee Chair, explains: 

"The global evidence community has long recognised that collaboration is key to producing trustworthy, pragmatic evidence. The global COVID-19 pandemic has highlighted the importance of evidence-based healthcare and the need for partnerships in developing rapid evidence-informed responses, streamlining global efforts, reducing research waste, and ensuring the best-available evidence is accessible, transparent and understood"

The scale of national and international collaboration triggered by COVID-19 has surpassed all historical precedents. While many partnerships existed before the pandemic, there has been an extraordinary increase in new and innovative partnerships and collaboration between regulators, governments, scientists and researchers, healthcare providers, tech giants and consumer groups – many of which were written about in the blogs published for World EBHC Day 2021.

There is a growing concern, which was heightened during the pandemic, about making partnerships and collaboration equitable for — and beneficial to — all partners. Although willingness to collaborate has increased, vested interests, bureaucracy and inability to change remain limiting factors. Around the globe, organisations have set up networks, task forces and working groups to coordinate efforts and overcome some of these challenges.

Cochrane’s Editor in Chief, Dr Karla Soares-Weiser says, 

"Partnerships are at the heart of evidence-informed healthcare, and I am very proud of the work Cochrane does with our partners. As a global evidence community, we know that we need to work together to coordinate efforts and make the best use of limited resources. Working together is also an opportunity to listen to and learn from other perspectives, ultimately to benefit the health of all worldwide. I look forward to the discussions that this year’s World EBHC Day campaign on partnerships for purpose will generate."

Led by JBI, World EBHC Day 2022 seeks to raise awareness, stimulate debate and shine a light on best practice in the science and art of working in partnership to bridge research, policy and practice, and realise the potential of evidence-based healthcare.

World EBHC Day calls on individuals and organisations around the world to take action as we lead up to World EBHC Day on 20 October. Everyone is invited to  contribute to the global discussion on how to partner for purpose to address global health challenges.

 

Monday, June 20, 2022

Cochrane seeks Statistical Editor

Tue, 06/14/2022 - 14:39

Specifications: Part time 22.5 hours (Permanent/Consultancy role considered)
Salary: £45,000 per annum full time equivalent
Location: Flexible
Application Closing Date:  27 June 2022

The Evidence Production and Methods Directorate in Cochrane is made up of three departments that are responsible for the efficient and timely publication of high-quality systematic reviews in the Cochrane Library. One of the three departments is the Methods and Evidence Synthesis Development team.

The Methods Support Unit (MSU) sits in the Methods and Evidence Synthesis Development team. The MSU provides hands on statistical and methods support to people preparing Cochrane systematic reviews. As Statistical Editor, you will provide advanced methods support and advice as requested by the Methods Support Unit Manager, from members of the Cochrane community directly or via  the Community Support Team as needed. The post holder will also provide independent methods review of high-profile reviews, including those intended for press release. In addition to this you will support the implementation of established and more complex methods in Cochrane reviews and work on monitoring the quality of statistical methods and analysis in Cochrane reviews to inform priorities for training and guidance. The role will require a formal qualification in epidemiology or biomedical statistics, and a good understanding of methods used in meta-analysis.

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. An understanding of Cochrane’s work and health research more generally is an advantage, but not essential.

The majority of Cochrane Central Executive staff are located in London, UK, however flexible location or a part-time appointment are possible for the right candidate.

How to apply

  • For further information on the role and how to apply, please click here
  • The deadline to receive your application is by 27 June 2022. 
  • The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples.
  • Note that we will assess applications as they are received, and therefore may fill the post before the deadline.
  • Interviews to be held on: w/c 11 July 2022
Tuesday, June 14, 2022 Category: Jobs

Cochrane seeks Methods Support Unit Manager

Tue, 06/14/2022 - 14:33

Specifications: Permanent
Salary: £52,000 per annum
Location: UK
Application Closing Date:  27 June 2022

The Evidence Production and Methods Directorate in Cochrane is made up of three departments that are responsible for the efficient and timely publication of high-quality systematic reviews in the Cochrane Library. One of the three departments is the Methods and Evidence Synthesis Development team.

The Methods Support Unit (MSU) sits in the Methods and Evidence Synthesis Development team. The MSU provides hands on statistical and methods support to people preparing Cochrane systematic reviews. As lead for the Methods Support Unit, you will be responsible for ensuring that people preparing reviews for publication in the Cochrane Library have access to current advice about the implementation of systematic review methods, including searching, statistical analysis, and bias assessment. The team comprises a Systematic Review Methodology Editor, a Statistical Editor and an Information Specialist. Additional budget will be made available to fund additional methods expertise as may be required.

The Methods Support Unit Manager will be responsible for ensuring that methodological and statistical queries from the Evidence Synthesis Development Editors, Editorial Service or Community Support Team are addressed. The role will require a formal qualification related to systematic review methods.

How to apply

  • For further information on the role and how to apply, please click here
  • The deadline to receive your application is by 27 June 2022. 
  • The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples.
  • Note that we will assess applications as they are received, and therefore may fill the post before the deadline.
Tuesday, June 14, 2022 Category: Jobs

Cochrane International Mobility - Filip Wikström

Mon, 06/13/2022 - 10:36

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.

Getting involved in Cochrane’s work means becoming part of a global community. The Cochrane International Mobility programme connects successful applicants with a placement in a host Cochrane Group, learning more about the production, use, and knowledge translation of Cochrane reviews. The prgramme offers opportunities for learning and training not only for participants but also for host staff.

In this series, we profile those that have participated in the Cochrane International Mobility Program and learn more about their experiences.

Name: Filip Wikström
Location:
Lund, Cochrane Sweden
CIM location:
Barcelona, Cochrane Iberoamerica


How did you first learn about Cochrane?
The Cochrane Learning Modules are integrated into the Medicine Programme in Lund University, so I was gradually exposed to the Cochrane Methodology over several semesters. I think reading and assessing past research is an invaluable skill to have, so I was very glad to get the opportunity to do my Master’s Thesis with Cochrane.

What was your experience with Cochrane International Mobility?
My experience with the international mobility program was fantastic. The researchers at Cochrane Iberoamerica were very welcoming and I look back very fondly to the weeks I spent there. I learned a lot about systematic reviews but I also got to know amazing researchers and the projects they were working on.

What are you doing now in relation to your Cochrane International Mobility experience?
Currently I am contributing to a Cochrane Review on Tumor Necrosis Factor alpha inhibitors, under the supervision of Michele Compagno and Matteo Bruschettini (both based at Lund University). In the future I aspire to collaborate on more Cochrane projects.

Do you have any words of advice to anyone considering a Cochrane International Mobility experience?
Based on my own experience, I would advise anyone who likes systematic reviews to consider the program. It is a great opportunity to meet passionate researchers and work in an international environment. I got new perspectives on Cochrane methodology but also experiences that I think are important on a personal level.

 

 

Monday, June 20, 2022

Cochrane International Mobility - Agata Stróżyk

Mon, 06/13/2022 - 10:26

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.

Getting involved in Cochrane’s work means becoming part of a global community. The Cochrane International Mobility programme connects successful applicants with a placement in a host Cochrane Group, learning more about the production, use, and knowledge translation of Cochrane reviews. The prgramme offers opportunities for learning and training not only for participants but also for host staff.

In this series, we profile those that have participated in the Cochrane International Mobility Program and learn more about their experiences.

Name: Agata Stróżyk
Location:
Warsaw, Poland
CIM location:
Lund, Cochrane Sweden


How did you first learn about Cochrane?
I first got a chance to better know what systematic reviews are and what the role of Cochrane is when I was participating in the Evidence-Based Medicine faculty at my university. Systematic reviews are critical in summarizing clinical evidence, and Cochrane is the most methodologically rigorous at doing it! In Poland, we call the Cochrane Handbook, our Bible for systematic reviews.

What was your experience with your virtual Cochrane International Mobility?
To be a part of a Cochrane systematic review was definitely on my to-do list. I was looking for any opportunity to be involved in Cochrane for about two years. I was a supporter at Cochrane TaskExchange and Cochrane Crowd. Finally, I contacted Matteo at Cochrane Sweden, who involved me in a systematic review that was already ongoing. Thus, I didn’t have to go through all process, but from the beginning of my traineeship, I had to do specific tasks. Matteo and Giovanni Cagnotto (also based at Lund University) were my supervisors and are very friendly, kind, patient, and supportive at each step, but also very motivating and fast-working – that was a great experience!

What are you doing now in relation to your Cochrane International Mobility experience?
At the moment, we hope to complete our systematic review, “Tumor necrosis factor (TNF) inhibitors for the treatment of psoriatic arthritis”, in a couple of weeks. For sure, I will use what I’ve learned to do methodologically better systematic reviews in the future. Moreover, I will still look for other opportunities to be a part of the Cochrane community, and maybe one day to prepare a new Cochrane systematic review within my area of expertise.

Do you have any words of advice to anyone considering a Cochrane International Mobility experience?
If you are interested in systematic reviews, I think it is a highly desirable step to participate in any kind of traineeship supervised by Cochrane. However, also for any medical practitioners and researchers who would like to better understand the critical appraisal of evidence and its translation into practice, I think it’s a great option. My personal advice: do not give up, if you do not get any response for the first time! Be persistent in chasing your dreams

 

Monday, June 13, 2022

Featured Review: Digital technologies to help people with asthma take their medication as prescribed

Wed, 06/08/2022 - 09:22

New Review published: Digital technologies to help people with asthma take their medication as prescribed

Asthma is one of the most common long-term conditions worldwide. There are effective medicines available to treat symptoms, such as inhalers containing steroids. However, for best effect, maintenance medication need to be taken as prescribed. Many people do not take their medication, due to busy schedules and the belief that medication is only needed short-term. This is known as 'non-adherence', which can lead to more symptoms and attacks. Non-adherence is a major health problem; achieving adherence is very important to prevent attacks and reduce the risk of death. In healthcare there is increasing use of digital interventions such as mobile phones, text messages, and 'smart' inhalers that can feed back information about medication-taking. However, there is limited evidence on whether these technologies work to improve asthma medication-taking or improve symptoms.

This review aimed to find out whether digital technologies really work to improve asthma medication-taking, and whether this improved adherence leads to improvements in asthma symptoms and other benefits.

Study characteristics

We found 40 studies including more than 15,000 adults and children with asthma. Studies ranged from about 2 weeks to 24 months' duration, so we cannot say whether these methods are effective in the long term (a long period of years). We searched multiple information sources to identify relevant studies. This review is current as of June 2020. Looking at the data, we aimed to find out whether digital technologies helped people with asthma to take their medication as prescribed, and whether people who used the technology had better asthma control, and fewer asthma attacks, than those who did not use the technology.

Key results

People with asthma who were given the digital technology to support asthma medication-taking were better at taking their medication as prescribed compared to people who did not get the technology; 15% more people (likely to be somewhere between 8% and 22%) took their medication as prescribed when they received the digital technology, compared to those who did not (who took their medication on average 45% of the amount prescribed).

Importantly, people who got the digital technology had much better asthma control and half the risk of asthma attacks (likely somewhere between 32% and 91%), which has direct benefits for reducing the risk of asthma-related deaths. We saw improvements in quality of life and lung function, but the effect on lung function was small and may be of limited clinical relevance.

No improvements were seen in unscheduled healthcare visits. There was not enough information to tell us about the effect of digital technologies on time off work or school or the cost-benefits, nor whether there are any harms. Technologies were generally acceptable to patients. Certain types of technologies such as 'smart' inhalers and text messages seemed to be better for improving medication-taking than other technology types, although the small number of studies means we cannot be certain that these technologies definitely work better than others.

Quality of the information

There is some uncertainty about our results because the studies were quite different from each other. These differences mean that we cannot be completely sure what the real benefit is, as the benefits may be due to other factors not directly related to the technology - for example, being involved in a study can improve medication-taking. Sometimes the studies did not give us enough information for us to include them with the other studies to work out their effectiveness. We had concerns about a quarter of the studies where people did not finish the study, and we were uncertain whether studies reported everything they measured.

Practising GPs and authors on this Cochrane review Anna De Simoni and Chris Griffiths discuss using apps and digital tools with patients with asthma, they explain,

"The evidence in this review gives us more confidence to discuss their use. From this review we know electronic adherence monitors and text messages can help patients make more informed choices."

Key message

The studies we found suggest that digital technologies may help people with asthma take their medication better, improve their asthma control, and potentially halve their risk of asthma attacks, compared with people who did not get the technology. Certain types of digital technologies, such as text-message interventions, may work better than others. However, we have some uncertainties about the quality of the information reported in some studies, and the small number of studies for the different technology types, which means we cannot be 100% certain of their benefits.

Author Amy Chan explains,

 “Digital technologies that aim to improve medication taking can increase people taking their medication in way it has been prescribed by 15%, and improve asthma control and quality of life. Technologies that use text messages or electronic adherence monitors appear to be particularly effective for improving people taking their medication as prescribed.”

Wednesday, June 8, 2022

Which is the best treatment for heavy menstrual bleeding?

Mon, 06/06/2022 - 14:00
Monday, June 6, 2022

Cochrane Sweden celebrates its 5th anniversary

Tue, 05/31/2022 - 19:51

2022 marks the 5 year anniversary of  Cochrane Sweden. The center was established on the 17th of May 2017, in the city of Lund. For this milestone, Cochrane Sweden shares some of their many highlights. 

Over the past five years, Cochrane Sweden has been busy promoting evidence-based decision-making in healthcare in Sweden. Some accomplishments have been providing learning tools on how to conduct, edit and read systematic reviews. Cochrane Sweden launched Cochrane Interactive Learning as part of the curriculum for medical students at Lund University to support training in evidence-based health care. Cochrane Sweden is also the first Cochrane group to get unlimited access to Cochrane Interactive Learning. This has led to Sweden having the highest number of users per inhabitant in the world. Moreover, the strategic and fruitful collaboration with Lund University has provided unlimited access to Covidence and, in the coming days, to RevMan Web.

Each year Cochrane Sweden also provides many workshops, courses, and lectures about Cochrane, systematic reviews, evidence-based medicine, and more specialized topics, such as reviews of non-randomized studies, diagnostic test accuracy reviews and complex meta-analyses. We have trained hundreds of PhD students in the Cochrane methodology, and some of them have become Cochrane authors. Eleven master medical students have prepared their master theses at our centre. In 2017, Cochrane Sweden launched the Cochrane International Mobility program. Since then, more than 20 people have participated in this international exchange program to learn more about evidence-based medicine through collaborations between Cochrane Sweden and other Cochrane centers. You can read some examples of the researchers experience with the program here. We are much grateful to all members of our Advisory Board, which includes Swedish health professionals and Cochrane staff from six different groups, for their generous and qualified guidance.

For the past five years, Cochrane Sweden has been busy producing new research. So far, researchers affiliated to our center have completed 22 new or updated Cochrane Reviews, published 25 new Cochrane protocols and 38 other journal articles and reports. This has led to us often being mentioned in international and Swedish media. Currently, we also have 19 protocols and reviews in preparation. Several of these reviews have been commissioned by national and international stakeholders, including the World Health Organization.

 Cochrane Sweden has also collaborated with other centers through the Scandinavian GRADE Network. In 2022, we led the establishment of the network together with Cochrane Denmark, Cochrane Norway, SBU, the Danish Health Authority and the Norwegian Institute of Public Health.  

Our team has also grown up! In 2020, Martin joined as project coordinator, and indeed is coordinating lots of projects, from training to research and dissemination; Katarina is brilliantly delivering administrative support to our activities and contributing to develop new projects; in 2022, also Lea became part of the staff: she contributes to daily operations and ongoing research, such as the Swedish trial transparency report.

We have also produced a lot of content on social media. You can follow us on TwitterLinkedIn, and Instagram, or register to our monthly newsletter

Visit the Cochrane Sweden website here, or drop-in at our office!

Vi ses!

Lea, Martin, Katarina, and Matteo

Tuesday, May 31, 2022

Cochrane’s Governing Board seeks new Treasurer

Tue, 05/31/2022 - 11:20

Candidates with experience in accounting and financial management are encouraged to apply

Cochrane is a diverse, global organization committed to informing healthcare decisions with the best available evidence from research. Organizationally, we are an international network of autonomously funded groups and a registered charity in the United Kingdom. Members of the Governing Board come from around the world and provide strategic leadership for the whole organization, as well as acting as Trustees of the UK charity.
 
Governing Board members work as a team, with complementary skills and backgrounds. They are a mix of elected members - who must be Cochrane Members - and appointed members, who bring an external perspective to the Board. Appointed members can be anyone with the relevant skills and experience and will not normally be Cochrane Members.

The Treasurer is a member of the Governing Board who supports their fellow Trustees to fulfil their obligation to provide financial oversight for the organization. Our current Treasurer, Karen Kelly, will step down from her position at the end of August 2023. To ensure a smooth handover and to increase the number of Board members with financial expertise, we are looking to appoint a new Board member who can act as Deputy Treasurer until August 2023, taking over as Treasurer from September 2023.

This is an exciting opportunity to join the board of an internationally renowned healthcare organization as we embark on a program of substantial change in how we are organized as a global collaboration, and seek to complete our transition to become a fully Open Access source of health evidence.

Appointed members serve an initial three-year term and may be reappointed. Board membership is a voluntary, unpaid role, although expenses will be paid.
 
The deadline for applications is 15 July 2022. To find out how to stand for appointment, please visit elections.cochrane.org.

 

Tuesday, May 31, 2022

Cochrane’s Governing Board seeks to appoint two new members

Tue, 05/31/2022 - 11:20

Candidates with experience in digital product development, business development, or publishing are encouraged to apply

Cochrane is a diverse, global organization committed to informing healthcare decisions with the best available evidence from research. Organizationally, we are an international network of autonomously funded groups and a registered charity in the United Kingdom. Members of the Governing Board come from around the world and provide strategic leadership for the whole organization, as well as acting as Trustees of the UK charity.
 
Governing Board members work as a team, with complementary skills and backgrounds. They are a mix of elected members - who must be Cochrane Members - and appointed members, who bring an external perspective to the Board. Appointed members can be anyone with the relevant skills and experience and will not normally be Cochrane Members.
 
To replace current Board members retiring this year, we’re looking for two new appointed members with experience and expertise in one or more of the following areas:

  • Digital product development
  • Fundraising and business development
  • Publishing and Open Access

The Board is running a separate appointments process for a new Treasurer. If you have expertise in accounting or financial management, particularly in a UK context, you should consider applying for the role of Treasurer instead. More information is available here.

This is an exciting opportunity to join the board of an internationally renowned healthcare organization as we embark on a program of substantial change in how we are organized as a global collaboration, and seek to complete our transition to become a fully Open Access source of health evidence.

Appointed members serve an initial three-year term and may be reappointed. Board membership is a voluntary, unpaid role, although expenses will be paid.
 
The deadline for applications is 15 July 2022. To find out how to stand for appointment, please visit elections.cochrane.org.

 

Tuesday, May 31, 2022

Cochrane Library Editorial: Appraising pay‐for‐performance in healthcare in low‐ and middle‐income countries through systematic reviews

Fri, 05/20/2022 - 14:40

Pay-for-performance (P4P) is an approach whereby individuals, teams or facilities within the health system are given money or other rewards for meeting service‐related targets, carrying out specific tasks or for meeting specific quality or health outcome thresholds. P4P has been one of the most ideologically charged topics in recent years in global health. It has attracted considerable investment, promotion, innovation, and assessment, but the issue of its effectiveness, efficiency and long‐term effects remains controversial.

A newly published Cochrane Library Editorial explores the challenges encountered by those who have conducted P4P systematic reviews and offers suggestions for future reviews and research on P4P. Karin Diaconu, lead author from Queen Margaret University in Edinburgh, says:

“This editorial offers an overview of 4 challenges we met with when evaluating 171 studies on pay-for-performance for systematic reviews. It also provides our reflections on the priorities for future evidence syntheses. We hope this editorial will help guide future studies and evidence synthesis projects about P4P.” 

Thursday, May 26, 2022

Join our World Health Assembly side-event on using evidence to address health challenges

Tue, 05/10/2022 - 17:51

Now is the time to ‘up our game’ in using evidence to address health challenges

The COVID-19 pandemic created a once-in-a-generation focus on evidence. We now have the opportunity to systematize the aspects of evidence use that are going well and to address the many gaps.

Alongside the upcoming 75th World Health Assembly, Cochrane and the Global Commission on Evidence to Address Societal Challenges are co-organising a virtual side event which will bring together a global panel to discuss some of these issues. The event will be chaired by the World Health Organization’s Chief Scientist.

Roundtable participants:

  •  Fitsum Assefa Adela, Ministry of Planning and Development, Ethiopia
  •  María Begoña Yarza, Minister of Health, Chile
  • Budi Gunadi Sadikin, Minister of Health, Indonesia (TBC)

Chair: Dr Soumya Swaminathan, Chief Scientist, WHO

About the session

During the roundtable, leaders from WHO Member States who use evidence to guide national decision-making will be encouraged to reflect on their work – and share what they need from evidence producers, evidence intermediaries, and multilateral organizations. Cochrane, the WHO Evidence-informed Policy Network and the Evidence Commission will then discuss their shared vision and recommendations.

The session will be a dialogue between both the demand and supply side of evidence – highlighting the key priorities for the evidence-informed future we want and need, and the conditions needed to get us there.

Tuesday, May 10, 2022

Featured review: Music therapy for autistic people

Tue, 05/10/2022 - 07:45
Tuesday, May 10, 2022

COVID-19: Interventions to reduce the risk of coronavirus infection among workers outside healthcare settings

Mon, 05/09/2022 - 13:18

'Interventions to reduce the risk of coronavirus SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus‐2) infection among workers outside healthcare settings'

What is the aim of this review?

Coronavirus (COVID‐19) is a respiratory infectious disease that has spread globally. People infected with SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus‐2) can develop critical illnesses and may die, particularly older people, and those with underlying medical problems. Different interventions that attempt to prevent or reduce workers' exposure to SARS‐CoV‐2 in the workplace have been implemented during the pandemic. This Cochrane Review evaluated the effects of these interventions on the COVID‐19 infection‐rate, absenteeism, COVID‐19‐related mortality, and adverse events.  

What was studied in this review?

The authors searched for studies that examined interventions according to the following four categories: 1) elimination (for example self‐isolation strategies); 2) engineering controls (for example barriers to separate or distance co‐workers, and workers from members of the public); 3) administrative controls (for example working from home); 4) personal protective equipment (for example use of face masks or other types of face covering). We included studies of any worker outside the healthcare setting. We searched for studies without language or time restrictions. 

What are the main findings of this review?

The author team screened more than 13 thousand reports, and included one study, conducted in 162 secondary and post‐secondary schools in England, from March to June 2021. The study enrolled more than 24 thousand workers. In the 86 schools in the control group (standard isolation), staff who were considered COVID‐19 contacts through contact tracing were required to self‐isolate at home for 10 days. In the 76 schools in the intervention group (test‐based attendance), staff who were considered COVID‐19 contacts through contact tracing were not required to isolate. Instead, they took a daily rapid test (lateral flow antigen test) for seven days. If the rapid test was negative, the staff member could go to work. If the rapid test was positive, the staff member would self‐isolate. The researchers wanted to know if there was a difference in COVID‐related absence between the two methods. 

The author team are uncertain whether a strategy of test‐based attendance changes COVID‐19 infection rates (any infection; symptomatic infection) compared with routine isolation after contact with a person with COVID‐19. COVID‐related absence may be lower or similar in the test‐based attendance group. 

However, they were uncertain about these findings, because the number of infections was very low among the participants. Mortality, adverse events, quality of life, and hospitalisation were not measured. Seventy‐one per cent of the test‐based attendance group followed the strategy; the researchers did not report on compliance for the standard isolation group. 

The team identified one ongoing study that also addressed the effects of screening in schools.

Another ongoing study is evaluating the effects of using a face shield to prevent COVID‐19 transmission. 

The authors did not find any studies that studied engineering or administrative controls.

Matteo Bruschettini, Director of Cochrane Sweden, who led the review explains, 

“Millions of scientific papers are published every year, and during the pandemic there were many about covid-19. It is not an easy task to keep up to date with the results of all these. Systematic reviews are one way of weighing up all the studies carried out in a specific field and providing an overview of the results of these studies.  This review investigating how workplace interventions reduced the spread of covid-19 assessed 13, 000 scientific articles published on the subject, however only one study could be included in the review. 

Almost none of the studies had the study design required to answer the question of whether the effects of the intervention reduced the risk of SARS-CoV-2 infection in non-healthcare workplaces. This surprised us. These systematic reviews are important because they can provide answers to questions that are of extreme concern to millions of people in workplaces around the world. 

We were able to identify two studies that had not been completed by September 2021 that may be included in the future. One assesses the benefit of face shields in preventing covid infection and the other looks at covid-19 screening in schools.”

How up‐to‐date is this review?

The author team searched for studies that were available up to 14 September 2021.

 

Monday, May 9, 2022

Featured review: Antioxidants for male subfertility

Mon, 05/09/2022 - 09:29
Monday, May 9, 2022

Pages