Transcript PPT - Cochrane Consumer Network

The Cochrane Collaboration
www.cochrane.org
Introduction to The Cochrane
Collaboration
 Janet Wale (Cochrane Consumer Network)
mission
Cochrane reviews and The Cochrane Library
structure of the Collaboration
 Jordi Pardo Pardo (Iberoamerican Cochrane Centre)
diversity
 Maryann Napoli (Consumer)
efficacy and adverse events in systematic reviews
 Jane Cracknell (Review Group Coordinator)
editorial base perspective
 Andy Oxman (Review Author)
types of studies, bias, grading of evidence
 Arne Ohlsson (Centre Director)
where to from here
The Cochrane Collaboration
“It is surely a great criticism of our
profession that we have not
organised a critical summary, by
specialty or subspecialty, adapted
periodically, of all relevant
randomized controlled trials”.
Archie Cochrane, 1979
The Cochrane Collaboration
The Cochrane Collaboration is an international
organization that aims to help people make well-informed
decisions about health care by preparing, maintaining,
and promoting the accessibility of systematic reviews of
the effects of healthcare interventions.
ie synthesising healthcare evidence (since 1993)
The Cochrane Library
Issue 3, 2004
Cochrane Database of Systematic Reviews
Full text systematic reviews - ongoing and completed
(currently 3,559 reviews and protocols)
Database of Abstracts of Reviews of Effects
Assessments of reviews
(currently 4,795 abstracts of non-Cochrane reviews)
Cochrane Central Register of Controlled Trials
Bibliographic references of reports of trials
(currently 415,918 citations of trials)
Cochrane Database of Methodology Reviews
Systematic reviews of methodology issues
(currently 18 reviews and protocols)
The Cochrane Methodology Register
References to methodology studies
(currently 5,668 theory and methods related citations)
The Cochrane Library
EFFECT OF LONGER-TERM MODEST SALT
REDUCTION ON BLOOD PRESSURE
He FJ, MacGregor GA
Date of most recent amendment: 04 February 2004
Date of most recent substantive amendment: 06 October 2003
This review should be cited as: He FJ, MacGregor GA. Effect of longer-term
modest salt reduction on blood pressure (Cochrane Review). In: The
Cochrane Library, Issue 3, 2004. Chichester, UK: John Wiley & Sons, Ltd.
The Cochrane Collaboration
Vitamin D and vitamin D analogues for preventing fractures
associated with involutional and post-menopausal osteoporosis
Gillespie WJ, Avenell A, Henry DA, O’Connell DL, Robertson J
This Review should be cited as: Gillespie WJ, Avenell A, Henry DA, O’Connell DL, Robertson J. Vitamin D and
vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. The
Cochrane Database of Systematic Reviews 2001, Issue 1. This version first published online: 22 January 2001 in
Issue 1, 2001.
ABSTRACT
Background
Due to their known effects on bone metabolism, vitamin D and related
compounds have been proposed for the prevention of osteoporosis and
fractures.
Objectives
To determine the effects of supplementation with Vitamin D or a Vitamin D
analogue in the prevention of fractures of the axial and appendicular skeleton
in elderly men or women with involutional or post-menopausal osteoporosis.
Cochrane Wounds Group
Some review titles
• Water for wound cleansing
• Therapeutic touch for healing acute wounds
• Removal of nail polish and finger rings to prevent surgical infection
• Preoperative fasting for adults to prevent perioperative complications
• Gauze and tape and transparent polyurethane dressings for central venous catheters
• Topical negative pressure for treating chronic wounds
• Beds, mattresses and cushions for pressure sore prevention and treatment
• Nutritional interventions for preventing and treating pressure ulcers
• Therapeutic ultrasound for pressure sores
• Compression for venous leg ulcers
• Electromagnetic therapy for treating venous leg ulcers
• Intermittent pneumatic compression for treating venous leg ulcers
• Laser therapy for venous leg ulcers
• Oral zinc for arterial and venous leg ulcers
• Pentoxifylline for treating venous leg ulcers
• Topical agents or dressings for pain in venous leg ulcers
• Patient education for preventing diabetic foot ulceration
• Pressure relieving interventions for preventing and treating diabetic foot ulcers
The Cochrane Collaboration
Review
Groups
Fields
Steering
Group
Consumer
Network
Centres
Methods
Groups
The Steering Group is supported
by the Secretariat
Jini Hetherington
Administrator and
Company Secretary
Louise Kitchener
Administrative Assistant
Nick Royle
Chief Executive
Officer
Claire Allen
Deputy Administrator
Collaborative Review Groups
Review Groups are composed of persons
from around the world who share an interest
in developing and maintaining systematic
reviews relevant to a particular health area.
 coordinated by an editorial team who edit and
assemble completed reviews into modules for
inclusion in The Cochrane Library.
Collaborative Review Groups (50)
Acute Respiratory Infections Group Airways
Anaesthesia
Back
Breast Cancer
Colorectal Cancer
Consumers and Communication
Dementia and Cognitive Improvement
Depression, Anxiety and Neurosis
Developmental, Psychosocial and Learning
Problems
Drugs and Alcohol
Ear, Nose and Throat Disorders
Effective Practice and Organisation of Care
Epilepsy
Eyes and Vision
Fertility Regulation
Gynaecological Cancer
Haematological Malignancies
Heart
Hepato-Biliary
HIV/AIDS
Hypertension
Incontinence
Infectious Diseases
Inflammatory Bowel Disease
Injuries
Lung Cancer
Menstrual Disorders and Subfertility
Metabolic and Endocrine Disorders
Methodology
Movement Disorders
Multiple Sclerosis
Musculoskeletal
Musculoskeletal Injuries
Neonatal
Neuromuscular Disease
Oral Health
Pain, Palliative and Supportive Care
Peripheral Vascular Diseases
Pregnancy and Childbirth
Prostatic and Urologic Cancers
Renal
Schizophrenia
Sexually Transmitted Diseases
Skin
Stroke
Tobacco Addiction
Upper Gastrointestinal & Pancreatic
Diseases
Wounds
The Cochrane Collaboration
•
There should be a clear barrier between the production
of Cochrane reviews and any funding from commercial
sources with financial interests in the conclusions of
Cochrane reviews.
•
Thus, sponsorship of a Cochrane review by any
commercial source or sources (as defined above) is
prohibited.
Policy on Commercial Sponsorship
Fields and Networks (12)
 areas of interest which extend across a number of health problems/specific population
ensure that their priorities are reflected in the work of existing CRGs
compile specialized databases to serve their specific needs
Cancer Network
Child Health
Complementary Medicine
Consumer Network
Health Care of Older People
Health Promotion and Public Health
Neurological Network
Occupational Health
Pre-hospital and Emergency Health
Primary Health Care
Rehabilitation and Related Therapies
Vaccines
from: http://www.cochrane.org
Methods Groups (10)
composed of individuals with an interest and expertise in the
science of systematic reviews
provide advice and support in the development of the methods of
systematic reviews
Applicability and Recommendations
Campbell-Cochrane Health Economics
Health-Related Quality of Life
Individual Patient Data Meta-analysis
Non-Randomised Studies
Prospective Meta-Analysis
Qualitative
Reporting Bias
Screening and Diagnostic Tests
Statistical Methods Group
from: http://www.cochrane.org
What is evidence-based medicine?
EBM
Clinical
expertise
Best research
evidence
Patient values
Sackett DL, Strauss SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-Based Medicine. Second
Edition 2000 - Churchill Livingstone
Slide provided by Bernd Richter
The Consumer Network works to ensure that the consumer
perspective is incorporated into Cochrane systematic reviews
www.cochrane.org/consumers
Cochrane Reviews in healthcare decision making
“…a good systematic review of
whatever evidence is available,
even in highly uncertain situations,
helps make the policymaking process more transparent
and
the political or commercial considerations more visible.”
Moynihan R. Evaluating Health Services: A Reporter Covers the Science of Research Synthesis,
Milbank Memorial Trust 2004;p31.
and identifies context, research needs
The Cochrane Collaboration
The Guiding Principles
•Collaboration
•Building on enthusiasm of individuals
•Avoiding duplication
•Minimizing bias
•Keeping up to date
•Ensuring relevance
•Ensuring access
•Continuous quality improvement
•Continuity
•Enabling wide participation
The 12th Cochrane Colloqium Ottawa