Cochrane News

Subscribe to Cochrane News feed
Updated: 4 hours 39 min ago

My OCD story: evidence-based medicine to the rescue!

Wed, 06/27/2018 - 14:55

Karen Morley blogs about her experience of seeking help for her Obsessive-Compulsive Disorder (OCD) and how finding and using Cochrane evidence was a turning point. This blog post was originally published on Evidently Cochrane.

Without knowing what it was, I had experienced episodes of Obsessive-Compulsive Disorder (OCD) since I was an adolescent, usually when I was particularly stressed. But it was when I was caring full time for my mother, who had multiple conditions including dementia, that I had an unusually distressing episode of contamination-related OCD. When I took to the internet I was amazed to discover that the obsessive checking, washing and acute, abnormal anxiety were symptoms of an illness with a name – and to recognize other symptoms from my past that I now realised were related to it.

I read everything I could find…

I read everything I could find. I knew I should be careful about my sources, but I read fairly indiscriminately from forums, charity websites and a variety of health websites – some sensible, others less so – and that was a mistake.

I had a vague sense of stigma about mental illness and particularly about medication, so I was interested in talking therapies, especially Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention (ERP). What could I expect if I tried it? Unfortunately there were some out-of-date posts in which people described nightmare experiences: someone who had allegedly to sit for two hours with his hands in a toilet; a specialist who made his patients ‘contaminate’ everything in their house including their bedsheets; a popular self-help book with an example of an ERP goal of touching the toilet bowl without washing your hands, then all the ‘clean’ areas in your house, and then preparing a meal! The mere thought of this made my anxiety soar.

Seeking help for OCD

Nevertheless, since the OCD and anxiety were becoming increasingly hard to tolerate and making my carer’s role difficult, with the ongoing and patient support of my brother I made a ten minute appointment with my GP. I told her I thought my OCD was situational and that I understood it was usual to try a talking therapy before medication. I don’t recall that we had much discussion about this, though we did talk about respite care, something I knew my mother would hate. The GP gave me the contact details of the local Increasing Access to Psychological Therapies (IAPT) service and told me to refer myself.

It was a difficult telephone conversation that I had to arrange at a time my mother would not overhear. I described my situation, my symptoms, my feelings, my fears of CBT/ERP, I cried and I felt ashamed. The call handler talked to her supervisor and we agreed that I should try counseling first. The waiting list would be shorter at my GP’s surgery, she said; she would write a letter and I should contact them. They told me that it would take at least six months to get an appointment.

Things didn’t improve

Unsurprisingly, things didn’t improve. My Carer Support Worker arranged for some funding for private counselling: I had to find someone from an online approved register. The support of this kind, sympathetic woman was only of limited relevance, largely because my OCD was quite severe. Unfortunately she didn’t challenge my fear of psychological treatment, saying she felt CBT/ERP seemed ‘cruel’ and when I talked about medication, told me an anecdote about her sister who hadn’t tolerated it well. After ten sessions I called it off. I talked again with my brother and with a friend who had taken fluoxetine and was currently on citalopram. At the time there were confusing debates in the press and social media about the effectiveness of these anti-depressants, some of which denied their effectiveness and suggested tackling the perceived causes of depression and anxiety.

I wanted to see the evidence and know how good it was

And then I searched in the Cochrane Library. I knew what I found there would be evidence based, free from vested interest, recent and reliable.

That was what I needed. I wanted to see the evidence and know how good it was. I wanted to escape the confusion, the emotion (my own included), the forum postings and anecdotes.

I found two Cochrane Reviews:

Selective serotonin re-uptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD)

Psychological treatments versus treatment as usual for obsessive compulsive disorder (OCD)

They told me all the SSRIs in the study were known to be more effective than placebo in reducing symptoms in the short term. So they did work. The effect was described as modest but any improvement would be welcome. There might be unpleasant side effects, which was a worry, but the risk of common side effects for fluoxetine was close to placebo.

Psychological treatments derived from Cognitive/Behavioural models were more effective than ‘treatment as usual’. So they worked, too, although a subgroup analysis suggested that people with more severe symptoms might not benefit as much. Antidepressants, not psychological therapies, were usually the first line of treatment. That was a relief: I had somehow come to think I had a moral duty to slog through a psychological therapy and that taking antidepressants was a sign of weakness, but clearly that was nonsense. ERP was collaborative and the treatment was negotiated with the patient – so no-one was going to make me prepare food after touching the toilet if I didn’t want to – and really, who would?

The second review also referred to this one:

Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents.

I knew I should be wary of this because my eighteenth birthday has long gone. But the study said OCD was similar in children and adults. I was interested in the finding that neither medication nor BT/CBT was superior but there was evidence that medication and BT/CBT combined produced better outcomes than medication alone. It looked as if I was going to have to tackle the Exposure and Response Prevention.

It gave me a feeling of control

I made up my mind to be pro-active, grasp the nettle and discuss treatment with my GP. It gave me a feeling of control I hadn’t had before.

Unable to get a quick appointment with my GP, I asked for the duty doctor to phone me and advise me. I was lucky: psychiatry was his specialism and he was extremely sympathetic, bypassing reception and making me an appointment at his clinic. He asked me what I already knew about OCD and its treatment. ‘I’ve read a couple of Cochrane Reviews,’ I said, casually. I was unprepared for the response. He perked up instantly and looked twice as energetic. It might have been a coincidence – he was an excellent doctor – but for the first time ever I experienced shared decision-making. It was tremendous. I felt like a partner in the consultation. He showed me where I could find information online. We discussed the potential benefits and risks of medication – it was customary to begin with fluoxetine – the dosage, the side effects, what we would do if I couldn’t tolerate the treatment. He turned his computer screen towards me so I could share the information and talked me through things as he looked them up. We discussed my circumstances, too, and what positive steps could be taken to help my mother and me.

Cochrane was a turning point for me

Then he asked me, ‘Do you think you’re depressed?’ I was surprised. I knew I was anxious. But as I went through a list of depressive symptoms, I realised I was. He already thought so, of course, but he didn’t tell me: he asked me. He was listening to me. I felt valued; I could be active and exercise control, which I found particularly encouraging in my situation. This persisted through subsequent appointments when we discussed whether and when to increase the dosage. I made another call to IAPT to ask for CBT/ERP and (after several months) had some therapy via telephone: I felt much braver once the medication had begun to take effect. And yes, the whole process was negotiated and graded.

If I hadn’t taken this route – if I had carried on with counseling – I am sure I would have had to give up my caring role, and I wouldn’t be recovering now. Cochrane was a turning point for me, and I am utterly convinced of the value of evidence based medicine.

But you don’t have to take my word for it. Try it for yourself.

Join in the conversation on Twitter with @CochraneUK or leave a comment on the Evidently Cochrane blog postfor Karen.

References can be found here.

Tuesday, July 3, 2018 Category: The difference we make

The Recommended Dose with Ray Moynihan – series 2 podcast kicks off this week with one of the most influential scientists on the planet

Wed, 06/27/2018 - 13:50

Series two of The Recommended Dose kicks off this week with polymath and poet, Dr John Ioannidis. Recognised by The Atlantic as one the most influential scientists alive today, he’s a global authority on genetics, medical research and the nature of scientific inquiry itself – among many other things.

A professor at Stanford University, John has authored close to 1,000 academic papers and served on the editorial boards of 30 of the world's top journals. He is best known for seriously challenging the status quo. His trailblazing 2005 paper Why Most Published Research Findings Are False has been viewed over 2.5 million times and is the most cited article in the history of PLoS Medicine. In it, he argues that much medical research is biased, overblown or simply wrong. Here, he talks to Ray about the far-reaching implications of these findings for people both inside and outside the world of health.

While most closely associated with exploring cutting-edge conundrums across science, genomics and even economics, John is also something of a humanist. He’d be right at home with the philosophers of ancient Greece, seeking as he does to find answers to the big questions of the day in science and medicine, as well as in nature and narratives. 

A voracious reader himself, John has a lifelong love of ‘swimming in books’ and has penned seven literary works of his own in Greek – two of which have been nominated for prestigious literary prizes. And fittingly, he finds inspiration for his myriad of multi-disciplinary pursuits on Antipaxi, one of Greece’s most beautiful and secluded islands. 

He shares some of his distinctive logic, reason - and even a little of his poetry - on this very special episode of The Recommended Dose.

You’ll find the episode on SoundCloud, iTunes, Stitcher or wherever you listen to your favourite podcasts.

Visit australia.cochrane.org/trd for our show notes and a full transcript of the show, or follow us on twitter or facebook.

Thursday, June 28, 2018

The Recommended Dose with Ray Moynihan – series 2 podcast kicks off this week with one of the most influential scientists on the planet

Wed, 06/27/2018 - 13:50

Series two of The Recommended Dose kicks off this week with polymath and poet, Dr John Ioannidis. Recognised by The Atlantic as one the most influential scientists alive today, he’s a global authority on genetics, medical research and the nature of scientific inquiry itself – among many other things.

A professor at Stanford University, John has authored close to 1,000 academic papers and served on the editorial boards of 30 of the world's top journals. He is best known for seriously challenging the status quo. His trailblazing 2005 paper Why Most Published Research Findings Are False has been viewed over 2.5 million times and is the most cited article in the history of PLoS Medicine. In it, he argues that much medical research is biased, overblown or simply wrong. Here, he talks to Ray about the far-reaching implications of these findings for people both inside and outside the world of health.

While most closely associated with exploring cutting-edge conundrums across science, genomics and even economics, John is also something of a humanist. He’d be right at home with the philosophers of ancient Greece, seeking as he does to find answers to the big questions of the day in science and medicine, as well as in nature and narratives. 

A voracious reader himself, John has a lifelong love of ‘swimming in books’ and has penned seven literary works of his own in Greek – two of which have been nominated for prestigious literary prizes. And fittingly, he finds inspiration for his myriad of multi-disciplinary pursuits on Antipaxi, one of Greece’s most beautiful and secluded islands. 

He shares some of his distinctive logic, reason - and even a little of his poetry - on this very special episode of The Recommended Dose.

You’ll find the episode on SoundCloud, iTunes, Stitcher or wherever you listen to your favourite podcasts.

Visit australia.cochrane.org/trd for our show notes and a full transcript of the show, or follow us on twitter or facebook.

Thursday, June 28, 2018

Featured Review: Workplace interventions for reducing time spent sitting at work

Thu, 06/21/2018 - 18:58

Health effects of sit-stand desks and interventions aimed to reduce sitting at work are still unproven.

Millions of people worldwide sit at a desk all day, and over recent years this has led to increased levels of physical inactivity in the work place. Health experts have warned that long periods of sitting can increase the risk of heart disease and obesity. There are a number of different approaches to reduce the amount of time we spend sitting down while at work. One option that is increasing in popularity is the sit-stand desk. These are desks that are designed to allow you to work at your desk sitting down or standing up.

A team of Cochrane Work researchers updated a systematic review that looked at the effects of different strategies to encourage people to reduce the amount of time they spend sitting at work. They looked at 34 studies with a total of 3,397 participants from high income studies. This was an increase from 20 studies when they last updated the Cochrane Review in 2016. They included evidence from both randomized and non-randomized studies.

Although sit-stand desks are popular, their potential health benefits are very uncertain. The researchers found very low-quality evidence that people who used sit-stand desks sat between 84  to 116 minutes less, compared to when they used conventional desks during the working day. Sit-stand desks also reduced total sitting time, both at work and outside work, and the durations of sitting episodes that last 30 minutes or longer. Standing more did not produce harmful effects in the studies, such as musculoskeletal pain, varicose veins, or a decrease in productivity.

Other interventions aimed at reducing inactivity, such as taking a walk during breaks and using treadmill desks had insufficient evidence to draw conclusions. The researchers found a number of limitations in the included studies that reduced their confidence in the validity and applicability of the results from the trials. The quality of evidence was low for most of the interventions looked at, mainly because the studies were poorly designed and recruited small numbers of participants.

The study’s lead author, Nipun Shrestha from the  Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, commented: “This Cochrane Review shows that, at the moment, there is uncertainty over how big an impact sit-stand desks can make on reducing the time spent sitting at work in the short term. There is also low-quality evidence of modest benefits for other types of interventions. Given the popularity of sit-stand desks in particular, we think that people who are considering investing in sit-stand desks and the other interventions covered in this review should be aware of the limitations of the current evidence base in demonstrating health benefits. We need further research to assess the effectiveness of different types of interventions for reducing sitting time in workplaces in both the short and long term. The evidence base would be improved with larger studies, longer follow-up and research from low income countries.”

Co-author Jos Verbeek, from the Cochrane Work Review Group, Kuopio, Finland, said, “It is important that workers who sit at a desk all day take an interest in maintaining and improving their well-being, both at work and at home. However, at present there is not enough high-quality evidence available to determine whether spending more time standing at work can repair the harms of a sedentary lifestyle. Standing instead of sitting hardly increases energy expenditure, so we should not expect a sit-stand desk to help in losing weight. It’s important that workers and employers are aware of this, so that they can make more informed decisions.”


Thursday, June 21, 2018

Announcing the appointment of Marguerite Koster as Governing Board Co-Chair

Wed, 06/20/2018 - 15:54

Cochrane’s Governing Board is delighted to announce it has appointed Marguerite Koster as its new Co-Chair, taking over from Cindy Farquhar, who finishes her term in September 2018.

Marguerite is a Senior Manager at Kaiser Permanente, one of the largest not-for-profit health plans in the U.S., serving 12.2 million members. She oversees the efforts of the Southern California Permanente Medical Group’s Evidence-Based Medicine Services Unit within Kaiser Permanente’s Southern California Region, which provides medical care to 4.5 million members.

She joined Cochrane’s Governing Board in 2016 as one of its first externally appointed members following its transition from a Steering Group, and has since played an active role as a Cochrane Trustee, serving as Treasurer; Chair of the Finance, Audit & Investment Subcommittee; and a member of the Remuneration Subcommittee, and the Cochrane/G-I-N Partnership Advisory Group. In addition, Marguerite brings valuable experience to the Board in clinical practice guideline development, health technology assessment, knowledge translation and evidence-based implementation.

From September she will work alongside fellow Co-Chair, Martin Burton. The Board extends its congratulations to Marguerite, and thanks to Cindy Farquhar for four years of outstanding service as Co-Chair.

Thursday, June 21, 2018

Collaborating with WHO for evidence-informed nutrition guidelines

Tue, 06/19/2018 - 18:42

The World Health Organization (WHO) Department of Nutrition for Health and Development (NHD) develops evidence-informed guidance on effective actions to address all forms of malnutrition; establishes standards and harmonizes methodologies; and increases public awareness about the WHO policy recommendations.  WHO is Cochrane's largest external partner and we have been collaborating with  them to prioritize and produce systematic reviews that contribute to their nutrition-related guidelines.
 
WHO has recently released a document that outlines their continuous quality improvements. This document includes information about the work conducted with Cochrane, including producing or updating systematic reviews for guidelines, training, and providing access to selected reviews. Various Cochrane Review Groups, as well as Cochrane Nutrition continue to contribute to this successful collaboration.

Tuesday, June 19, 2018

World Continence Week

Mon, 06/18/2018 - 14:32

World Continence Week 2018 is held between 18-24 June and is a global initiative run by the World Federation of Incontinence Patients (WFIP), with the approval of the International Continence Society (ICS). The vision is to help improve health, wellness and quality of life for those with continence issues, and to further establish awareness of bladder weakness, pelvic pain and other conditions that impact on the lives of patients and carers.

Cochrane Incontinence works with authors to prepare, maintain and disseminate systematic reviews of the effectiveness of interventions for incontinence, including prevention, treatment and rehabilitation. The scope of these reviews touches on a wide variety of continence issues, including urinary and faecal incontinence, pelvic organ prolapse, the use of urinary catheters, post-operative urinary retention and night-time and daytime wetting in children.

Below are a variety of Cochrane resources related to World Continence Week.

Highlighted Cochrane reviews:

Electrical stimulation with non-implanted devices for stress urinary incontinence in women.

Pelvic floor muscle training for prevention and treatment or urinary and faecal incontinence in antenatal and postnatal women.

Podcast: How effective are pelvic floor muscle exercises undertaken during pregnancy or after birth for preventing or treating incontinence?

Washout policies in long-term indwelling urinary catheterisation in adults.

Yoga for treatment of urinary incontinence in women (protocol).

Take a look at these Evidently Cochrane blog posts featuring Cochrane Incontinence evidence:Brief Economic Commentaries added to eight Cochrane Incontinence reviews

Brief Economic Commentaries (BECs) have been added to eight existing Cochrane Incontinence reviews. The reviews all focus on different surgical approaches to stress urinary incontinence in women, and a full list of these reviews can be viewed here.

Find out more about how the BECs were incorporated into the evidence in a blog by Patricia Aluko via the Cochrane Economics Methods website here.

Find all of Cochrane Incontinence’s reviews on the Cochrane Library.

Monday, June 18, 2018

Cochrane seeks Senior Office Administrator - London, UK

Fri, 06/15/2018 - 14:53

Specifications: Full Time
Salary: Up to £35,000
Location: London, UK
Application Closing Date: 29/06/2018

About Cochrane
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.

The role
This role is a varied and exciting opportunity to use your experience in administration, facilities and office management, to support colleagues in making a difference in the field of health care research. 

The Senior Office Administrator will provide high-level administrative support to the Central Executive Team (with offices in London, Freiburg and Copenhagen), with focused support for the Head of Finance and Core Services alongside facilities support for the London office.

The Senior Office Administrator will act as the first point of contact at Cochrane’s London Office. S/he will also provide administrative support for the Senior Contracts Specialist, and other project-specific support. S/he will liaise with the landlord and managing agents, and provide facilities management, ensuring that the best value is obtained for all office expenditure.

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

  • Previous senior administration or office/facilities management experience.
  • Excellent typing skills - speed and accuracy essential.
  • Excellent IT skills, including MS Outlook, Word, Excel and PowerPoint.
  • Ability to prioritise and manage own workload amid conflicting demands and busy work periods.
  • Excellent interpersonal skills.
  • Confident in problem solving and using initiative.
  • Excellent communication skills, both verbal and written.
  • Ability to communicate confidently with people at all levels.
  • Proven ability to work under pressure and to tight deadlines.
  • Ability to exercise discretion and diplomacy in dealing with confidential or sensitive matters.
  • Attention to detail/accuracy.
  • Adaptability.

Previous experience within the healthcare sector would be useful.

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

For further information, please see the full job description.

Deadline for applications: 29/06/2018 (12 midnight GMT)

Friday, June 15, 2018 Category: Jobs

Cochrane Epilepsy seeks PhD Student - Europe

Thu, 06/14/2018 - 18:39

In this PhD, Individual Participant Data will be collected from eligible RCTs of add-on treatment in patients with refractory epilepsy. Statistical issues for the analysis of these trials will be explored and a network meta-analysis undertaken using the most efficient and statistically reliable methods. It is anticipated that the characteristics of trials and their participants will have changed over time due to the changing global nature of epilepsy research, the widening population of available AEDs, and changes in the classification and management of epilepsy. Patients within, and across, trials will also differ in the adjunctive AEDs taken alongside the experimental add-on AED or placebo. Such differences are likely to impact upon the underlying assumptions made in a network meta-analysis and the value of having IPD to thoroughly explore such issues will be fully exploited. The research would be completed with support from the Cochrane Epilepsy Group.

  • You should have, or expect to hold an MSc in Statistics or relevant discipline.
  • For European/UK Students only.
  • The English Language Requirement for EU Students is an IELTS score of 6.5 with no band score lower than 5.5.
  • The studentship would be funded for three years at Home/EU rate, with a RCUK Stipend of 14,553 per annum.

The research would be completed with support from the Cochrane Epilepsy Group. 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.

Read the full description and apply.

Thursday, June 14, 2018 Category: Jobs

Cochrane Training Resources in Russian

Wed, 06/13/2018 - 18:21

Cochrane Training is pleased to announce that Cochrane Review production training materials are now available in Russian.

The materials cover essential aspects of a Cochrane Review production based on the Cochrane Handbook for Systematic Reviews of Interventions. The training materials, translated into Russian, consist of records of fourteen Cochrane standard training modules. These modules include subjects and topics required to guide a learner or evidence-user, new to Cochrane, through the steps of a Cochrane intervention Review production; starting from defining a review question to understanding and reporting biases, analysing non-standard data and exploring heterogeneity.  

They will be especially helpful to medical and pharmacy students as well as their teachers by facilitating their way in an increasingly advancing field of health evidence synthesis.

It’s hoped that they will be instrumental in creating learning opportunities for health professionals and practitioners across Russia, contributing largely to Cochrane’s work in knowledge translation within Russian-speaking settings by creating a culture of systematic approach to search for evidence, critical appraisal and evidence synthesis, and ultimately defining research agenda.

These freely available Cochrane training materials will promote Cochrane’s mission of promoting evidence-informed health decision-making by producing high-quality, relevant, accessible systematic reviews and other synthesized research evidence.

Find out more here: Cochrane Training Resources in Russian.

Wednesday, June 13, 2018

Cochrane seeks Project Manager - London, UK

Tue, 06/12/2018 - 15:50

Specifications: Full Time
Salary:
Competitive
Location:
London
Application Closing Date:
06 July 2018

This role is an exciting opportunity to support the Editorial and Methods Department (EMD), Cochrane Library Product Manager and other Central Executive Teams in delivering on high priority projects: by developing an agreed framework for project management and reporting, supporting colleagues to manage their projects efficiently and transparently, and to provide project management services to the highest priority EMD projects, including the implementation of the Cochrane Library roadmap.

The Project Manager will lead on the transformation in relation to managing projects within Cochrane and act as the first point to contact for project management enquiries for Cochrane staff, offering support and guidance for project management methods, tools and processes.

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

  • Proven strategic planning, project management and organisational skills; and the ability to coordinate the work of teams and individuals, ensuring the quality and timeliness of outputs
  • Experience of managing projects, change management and risk management
  • Experience of agile project management methodology
  • Excellent interpersonal and communication skills (spoken, written and presentational) and a collaborative management style
  • High level of technological competence, including the ability to evaluate and use project management software
  • Proven ability to work independently and as part of a team
  • Flexibility and adaptability
  • Experience of strategic planning and budgeting

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

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

For further information, please see the full job description.

Deadline for applications: 06 July 2018 (12 midnight GMT)

Interviews to be held on: TBC

Tuesday, June 12, 2018 Category: Jobs

Australian guideline developers join forces to advance Living Evidence

Mon, 06/11/2018 - 16:57

This news item was orginally posted on Cochrane Australia website.

A new report published heralds an exciting development for evidence-based health care in Australia, with the promise of near real-time incorporation of research into evidence-based guideline recommendations now a step closer to reality. 

The Living Evidence for Australian Health Care report details the outcomes of forum hosted by Cochrane Australia last month which brought together leading experts in evidence synthesis and guideline development across several of Australia’s most pressing chronic diseases to explore opportunities for advancing ‘Living’ models of systematic review and guideline production.

Over the last five years, Cochrane and a number of Australian and international partners have developed the foundations of the Living Evidence model of evidence synthesis and dissemination. This world-leading approach harnesses innovations in data systems, machine learning and citizen science to enable near real-time updating of systematic reviews, evidence-based guideline recommendations and other evidence products. Importantly, the Living Evidence model fast-tracks evidence synthesis without compromising the rigorous, gold standard methods for systematic review that are needed to provide trustworthy recommendations about what works best in health based on the all of the evidence generated to date.

In what represents a world-first effort, leaders from stroke, diabetes, kidney disease and musculoskeletal conditions agreed to work together to drive the development of Living Evidence in Australia, with a shared commitment to achieving the best health outcomes for Australians by enabling consumers, health care providers and governments to access and use the best available evidence based on up-to-the minute research.

Cochrane’s Lead for Evidence Systems, Associate Professor Julian Elliott said 'For far too long, the time lag between publication of a new clinical trial and the incorporation of those results into evidence-based recommendations has been measured in years. We now have the opportunity to reduce that to weeks. We are tremendously excited to be working with such an innovative and committed consortium of partners who really are at the forefront of global development in Living Evidence.'

For more information about the Living Evidence Consortium initiative, please contact:

A/Prof Julian Elliott, Lead, Evidence Systems, Cochrane
Email: julian.elliott@monash.edu

Rhiannon Tate, Program Lead, Evidence Innovation, Cochrane Australia
Email: rhiannon.tate@monash.edu

Early work to develop and test the suite of technical tools and streamlined processes that underpin the Living Evidence model was enabled through Project Transform funded by the National Health and Medical Research Council and the Cochrane Game Changer Initiative.

Monday, June 11, 2018

Cochrane seeks Editor, COI Revision Project - Flexible location

Mon, 06/11/2018 - 13:45

Specifications: 1.0 FTE, Fixed Term (9 months)
Salary: Competitive
Location: Flexible
Application Closing Date: 29/6/18

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

Our work is recognised as the international gold standard for high quality, trusted information. We want to be the leading advocate for evidence-informed health care across the world.

Job Description:
The successful candidate will oversee the revision of Cochrane’s current financial conflict of interest policy and the development of a non-financial conflict of interest policy.  The job will include supporting a literature review of the impact of conflict of interest on systematic review results, convening a management team, running a consultation process, analysing responses and developing a feasible and appropriate policy. Successful conclusion of the project will be that policies presented to the Cochrane Governing Board are approved and implemented.

Requirements: The ideal candidate will have an understanding of Cochrane and its role within evidence synthesis and the potential of conflicting interests (financial and non-financial) to undermine the quality and impact of systematic reviews. Familiarity with how conflict of interest is managed in related organisations (e.g. scientific journals, guidelines bodies) is essential, along with  experience of survey design and analysis and conducting semi-structured interviews.

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

Deadline for applications: 29/06/2018 (12 midnight GMT)

Monday, June 11, 2018 Category: Jobs

Improved learning with Cochrane Training website

Thu, 06/07/2018 - 14:03

Cochrane is pleased to announce that we have re-launched training.cochrane.org with a new design – making the learning resources you need easier to find and use.

All resources are available through new curated collections built around themes or topics. The website highlights the numerous different ways that you can learn with Cochrane - online course, brief individual learning modules, webinars, or searching our database of upcoming workshops and events. You’ll also be able to find out about latest updates, upcoming learning events, and our newest resources.

What to learn about Cochrane and evidence based medicine? Take a look at Cochrane Training today – most of the resources are available free of charge for everyone!

Thursday, June 7, 2018

Cochrane Kidney and Transplant seeks Systematic Reviewer – Sydney, Australia

Thu, 06/07/2018 - 13:44

Specifications: Full-time
Salary: Base salary $82K, plus superannuation
Location: Sydney, Australia
Application closing date: 21 June 2018

We are seeking a full-time Systematic Reviewer to contribute to Cochrane Kidney and Transplant based at the Centre for Kidney Research, The Children’s Hospital at Westmead. The Systematic Reviewer will provide technical knowledge and expertise to the research team to support the development of Cochrane systematic reviews that will inform international clinical practice guidelines on all aspects of kidney disease. This includes conducting literature searches, appraising literature and meta-analysis, and preparing evidence summaries to support the development of clinical practice guidelines on all aspects of kidney disease. The role will also involve a range of other research activities relevant to systematic reviews and guideline development, disseminating systematic review findings, and providing methods support to authors conducting systematic reviews in kidney disease and transplantation.

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

  • tertiary qualifications, likely with Honours, in an appropriate discipline with relevant experience in a related field. May have (or be working towards completing) further studies such as a PhD or have extensive specialist experience in the field of research
  • extensive experience in developing and working on research projects, including expertise in using research protocols, experimental design, ethics submissions and grant applications
  • high-level knowledge and skills in statistical techniques and critical appraisal required for systematic reviews of randomised controlled trials
  • experience in writing of systematic reviews and have published a Cochrane systematic review/s or similar
  • excellent interpersonal, verbal and written communication skills with sound negotiating and conflict resolution skills and a demonstrated level of tact and discretion in dealing with day-to-day operational matters

Intending applicants are welcome to seek further information about the position from A/Professor Allison Tong on allison.tong@sydney.edu.au.

Full job description and application: Research Officer Systematic Reviewer

Closing date for applications: 11.30pm, 21 June 2018 (Australian EST)

Thursday, June 7, 2018 Category: Jobs

Campaigning for Evidence: Sara Yaron - a patient's story

Wed, 06/06/2018 - 18:58

Sara Yaron has been an active consumer’s advocate since 1982, when she was first diagnosed with breast cancer. By profession, she’s a private lawyer in Israel, engaged in medical malpractice lawsuits. After her diagnosis, she became involved with national and international organizations, all regarding health care, patient safety, patients rights to get updated medical information based on evidence, and patients rights.

She recently was re-appointed to the Cochrane Consumer Network (CCNet) Executive for a further period of three years to 2021. Below is her story on how she got involved as a consumer advocate with Cochrane and the changes she has seen. Her blog post was orginally shared on the Cochrane Consumer Network.

I met Cochrane the first time, at an international conference regarding breast cancer, in the late 90’s in Europe. There, I read a brochure, published by CCNet, and fell in love with the idea.  At that time, I was a very young woman diagnosed with breast cancer (grade 3) and a mother of three little children, with one very ill daughter, so I was “thirsty” for any certified, objective written medical information regarding my family’s diseases. I wrote a letter to Hilda Bastian, the then co-ordinator of CCNet, and became an active member of Cochrane’s consumers’ network.

As a lay person, in a paternalistic period within the medical “territory”, it was impossible to get any medical information based on evidence from an objective authority.

As my personal experience was with breast cancer, I’ll tell my story: I was diagnosed in 1983 with breast cancer. The one and only option that was given to me by the medical authorities in my country, was to have a Mastectomy! No other option was even mentioned! All my questions were responded to with contempt. For me it was a feeling of suffocation! I didn’t know where to go for information based on evidence, because all the second opinions in my country, said the same: Mastectomy (!), while in Europe and in the USA there were positive results of Lumpectomy.

When I finished my medical treatment, I joined the Israeli cancer association and the “Reach to recovery” as an advocate on a voluntary basis to help others. One of my main goals was to provide medical information. That work was outside Cochrane.

When I joined CCNet, a new world had been opened for me. I could find qualitative information based on evidence and I become much more confident when facing the medical staff about my, and my family’s, diseases.  The involvement of patients\consumers as an integral part of the process “captured my heart”. I started to help CCNet with hand searching journals, for the Cochrane Breast Cancer, and commenting on reviews and protocols.

I’m not sure that consumer activity was very democratic and transparent back then, but the opportunity existed to become an active consumer which provided a good feeling of becoming part of an important, unique and strong organisation.

Over time, consumers became much more involved in Cochrane, and participated in committees as equal members. Transparency was felt more and more, and consumers’ comments were taken under consideration, with much more sense of equality and respect than before.

I started to write comments on reviews and protocols, mostly for the breast cancer group, as an experienced consumer but also for other groups. Plain language summaries became part of Cochrane reviews, which is very significant for consumers.

CCNet as an organization became bigger, much more democratic and most of the activity, I think, is transparent, with part of the discussions involving most of the members.

Wednesday, June 6, 2018

Cochrane Kidney and Transplant seeks Information Specialist – Sydney, Australia

Wed, 06/06/2018 - 14:14

Specifications: Part-time (0.4 FTE)
Salary
: Base salary $82K p.a. prorate with superannuation
Location:
Sydney, Australia
Application closing date:
18 June 2018

We are seeking an Information Specialist (part-time) to contribute to Cochrane Kidney and Transplant, based at the Centre for Kidney Research, The Children’s Hospital at Westmead. The Information Specialist has an integral role in the production of Cochrane Kidney and Transplant reviews. You will contribute to the maintenance and development of a Specialised Register of randomised controlled trials (RCT) within the scope of Cochrane Kidney and Transplant, provide comprehensive literature and editorial support to authors of systematic reviews, and provide comprehensive literature support for collaborative projects with partner organisations such as KDIGO (Kidney Disease: Improving Global Outcomes) and KHA-CARI (Kidney Health Australia – Caring for Australasians with Renal Impairment).

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

  • tertiary qualifications in librarianship or information science/management. A background or experience in health sciences is an advantage
  • high level attention to detail and the capacity to maintain accurate details (especially in relation to bibliographic control and editorial assessment)
  • demonstrated advanced literature searching expertise
  • excellent interpersonal, verbal and written communication skills with sound negotiating and conflict resolution skills and a demonstrated level of tact and discretion in dealing with day to day operational matters
  • ability to work both independently and as part of a team, taking initiative and exercising sound judgement in resolving matters that may arise as part of normal daily work
  • excellent planning, organisational and time management skills with ability to be systematic in approach to work and possess strong attention to detail
  • excellent computer skills including MS word, MS excel, and MS outlook, while ability and willingness to learn new skills in this area is essential
  • experience in scientific research or information sciences
  • demonstrated knowledge of systematic reviews and medical terminology
  • strong problem solving skills and the ability to use initiative and exercise sound judgement and ability to prioritise workload during busy periods
  • working understanding and current knowledge of relevant aspects of the Work Health and Safety Policy and relevant legislation (including Safe Laboratory Practices for roles based in Laboratory)
  • experience in a research-intensive environment or interest in teaching and working in academia

Intending applicants are welcome to seek further information about the position from Dr. Martin Howell on martin.howell@sydney.edu.au.

Full job description and application: Research Officer Information Specialist

Closing date for applications: 11.30pm, 18 June 2018 (Australian EST)

Wednesday, June 6, 2018 Category: Jobs

Cochrane Crowd celebrates 2nd birthday with 2 million classifications

Tue, 06/05/2018 - 17:57

Cochrane Crowd, Cochrane’s citizen science platform, reached 2 million individual classifications on Tuesday 15th of May at 5.20pm UTC + 1, one day after the platform’s 2nd birthday!

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

In the lead up to the milestone, Crowd ran a #Crowd2million campaign and around 100 people got involved, sharing screenshots and supporting this community to reach our goal. Congratulations to the ten #ShowUsYourScreen-ers who won signed copies of Iain Chalmer's book 'Testing Treatments' for capturing screenshots closest to 2 million and sharing them over Twitter - Paul Manson, Lara Killian, Danial Sayyad, Riccardo Guarise, Richard James, Rachel Playforth, Yudi Hardianto, Hebatullah Abdulazeem, Cindy Beverly, and Patricia Dwyer-Hallquist.

Thank you to everyone who has used Cochrane Crowd - we are looking forward to hitting the next milestone with our amazing community!

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


Tuesday, June 5, 2018

Cochrane seeks Special Advisor to the Editor in Chief - London, UK

Tue, 06/05/2018 - 14:58

Specifications: Full Time
Salary: Competitive
Location: London, UK
Application Closing Date: 14th June 2018

The Special Advisor will support the Editor in Chief by overseeing the management of key projects related to our targets, managing key staff, and by ensuring that there is close co-ordination of projects and work programmes across all the Editorial and Methods Department (EMD) units, and with other groups and individuals where appropriate.

The successful candidate will provide operational input and intelligence to the Editor in Chief, ensure that challenges are addressed or escalated appropriately, and that the work of the EMD is as efficient and effective as possible. She/he will also support the Editor and Deputy Editor in Chief in preparing and managing budgets.

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

  • Experience in critical projects that focus on delivering aspects of the Cochrane Strategy to 2020, improving the Cochrane Library, and delivering better products and services to end users.
  • Detailed knowledge of the mission and vision of Cochrane Library and in-depth understanding of the needs of its users and the processes that underpin its production
  • Significant experience of programme and/or project management
  • Excellent decision making, problem solving, influencing and negotiating skills
  • Proven ability to take senior-level responsibility
  • IT literacy and the ability to gain an understanding of the technological aspects of the product, both in terms of its production and publication
  • Very strong communication and presentation skills, and the ability to translate content deliverables to editorial, content, business and technology focussed colleagues
  • Ability to analyse, pull together and present the key content, business and technology elements to inform sound strategic decisions

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

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

For further information, please see the full job description.

Deadline for applications: 14th June 2018 (12 midnight GMT)
 
Interviews to be held on: (TBC)

Tuesday, June 5, 2018 Category: Jobs

Featured Review: Nicotine replacement therapy versus control for smoking cessation

Mon, 06/04/2018 - 17:27

High-quality evidence that all forms of nicotine replacement therapy can help increase chances of successfully stopping smoking.

Nicotine replacement therapy (NRT) aims to reduce withdrawal symptoms associated with stopping smoking by replacing the nicotine from cigarettes. NRT is available as skin patches that deliver nicotine slowly, and chewing gum, nasal and oral sprays, inhalators, and lozenges/tablets, all of which deliver nicotine to the brain more quickly than skin patches, but less rapidly than from smoking cigarettes. NRT aims to temporarily replace much of the nicotine from cigarettes to reduce motivation to smoke and nicotine withdrawal symptoms, thus easing the transition from cigarette smoking to complete abstinence.

A team of Cochrane authors based in New Zealand and the United Kingdom worked with the Cochrane Tobacco Addiction Group to determine the effectiveness and safety of NRT for achieving long-term smoking cessation, compared to placebo or 'no NRT' interventions.

136 trials were examined, with 64,640 people in the main analysis. All studies were conducted with people who wanted to quit smoking, mostly adults, with smokers typically having 15 cigarettes a day at the start of the study. The overall quality of the evidence was high.

The review found that all of the commercially available forms of NRT (i.e. gum, transdermal patch, nasal spray, inhalator, oral spray, lozenge and sublingual tablet) are effective as part of a strategy to promote smoking cessation. They increase the rate of long-term quitting by approximately 50% to 60%, regardless of setting. These conclusions apply to smokers who are motivated to quit. There is little evidence about the role of NRT for individuals smoking fewer than 10 to 15 cigarettes a day.

 “This updated Cochrane Review adds 18 new studies to when it was last updated in 2012”, says Professor Paul Aveyard, the Co-ordinating Editor of the Cochrane Tobacco Addiction Group. “The overall quality of the evidence is high, meaning that further research is very unlikely to change the conclusions.”

“This review provides those looking to quit the reassurance that nicotine replacement therapy works,” says Jamie Hartmann-Boyce from the University of Oxford and the primary author of the Review. “NRT is a safe and effective way to help people quit smoking, and taken individually all forms of delivery appear similarly effective. There is some evidence that taking a short-acting  form like gum alongside patch increases quit rates further – this is covered by a separate review which will be updated later this year.”

Monday, June 4, 2018

Pages