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Strategies to reduce antibiotic prescribing for acute respiratory infections in primary care

Fri, 09/08/2017 - 07:15

This Cochrane Overview is the first publication produced with the support of Cochrane’s Fast Track service. This service, which is offered by the Cochrane Editorial Unit, supports expedited production of high-quality, high-impact Cochrane Reviews. For more information, please visit the Fast Track information page.

Key findings:

  • A new Cochrane Overview has identified effective and safe clinician-focussed interventions to reduce antibiotic prescribing for acute respiratory infections (ARIs) in primary care.
  • The authors found that point-of-care CRP testing, procalcitonin-guided management and shared decision making probably safely reduce antibiotic prescribing in the management of ARIs compared to usual care.
  • There were no trials in the included reviews which compared interventions against one another, so we do not know which is most effective at reducing antibiotic prescribing for ARIs in primary care.

 Context:

  •  Antibiotic resistance has become a major public health problem, with some infections no longer treatable using currently available drugs. The inappropriate use of antibiotics is associated with the increase of resistance.
  •  Most antibiotics are prescribed in primary care, and most commonly for ARIs. In most cases ARIs seen in primary care are spontaneously resolved without antibiotics.
  • The management of ARIs in primary care is therefore a key target for influencing the antibiotic prescribing behaviour of clinicians.

What does the review say?:

  • The authors identified eight systematic reviews assessing clinician-focussed interventions to influence antibiotic prescribing for ARIs in primary care, containing a total of 44 trials.
  • Moderate-quality evidence suggests that the following interventions probably have an important effect on reducing antibiotic prescribing in primary care:
    • C-reactive protein point-of-care testing in general practice probably reduces antibiotic prescribing with little or no effect on symptom duration, patient satisfaction, or reconsultation;
    • shared decision making in the management of ARI in general practice probably reduces antibiotic prescribing without increasing likelihood of reconsultation, and may maintain patient satisfaction;
    • procalcitonin-guided management of ARI in probably reduces antibiotic prescribing in general practice and emergency departments without affecting health-related quality of life and whilst avoiding treatment failure.
  • There were no trials in the included reviews which compared these interventions against one another, so we do not know which is the most effective.
  • For the other interventions, including multifaceted interventions, those centred on clinician education, patient information leaflets, and the use of rapid viral diagnostics, the evidence was of low or very low quality across outcomes, and we could not confidently draw any conclusions about the effects of these interventions compared to usual care. Further primary research is necessary to improve the evidence base in order to be able to make informed decisions about the value of these interventions.
  • None of the trials in the included reviews reported on management costs for the treatment of an ARI or any associated complications, so it was difficult to weigh the benefits and costs of implementing these interventions in practice.
  • Most of this research was undertaken in high-income countries, and it may not generalize to other settings.

Get access to this Cochrane Overview online: Clinician-targeted interventions to influence antibiotic prescribing behaviour for acute respiratory infections in primary care: an overview of systematic reviews

Friday, September 8, 2017

Welcome to the 2017 Global Evidence Summit

Thu, 09/07/2017 - 15:11

A very warm welcome to Cape Town! We look forward to welcoming more than 1400 people from at least 67 countries to the first ever Global Evidence Summit.

The Global Evidence Summit will be the first time that CochraneThe Campbell CollaborationGuidelines International NetworkInternational Society for Evidence-based Health Care, and Joanna Briggs Institute have joined forces to create this premiere event in evidence-based policy.

The theme of the Summit is ‘Using evidence. Improving lives’ and aims to advance the use of reliable research evidence in addressing some of the world’s most serious health and social challenges. We’ve created an illuminating line-up of content and world-class speakers and facilitators that promises to excite, intrigue and engage wide audiences.

We hope the Summit will provide the fruitful ground for all delegates to meet, share and collaborate to progress our aims. For a full programme schedule visit globalevidencesummit.org/signup.

Enjoy the Summit, and do take some time to explore a little of our beautiful country during your stay with us.

Best wishes,

Jimmy Volmink and Tamara Kredo
Chairs of the Organising Committees for the 2017 Global Evidence Summit

Monday, September 11, 2017

Cochrane Tobacco Addiction Group releases priority setting report

Tue, 09/05/2017 - 16:38

The Cochrane Tobacco Addiction Group, based at the University of Oxford in the UK, is one of the oldest groups working on Cochrane Reviews. It has produced dozens of these during the last two decades and in 2016, it embarked on a project to identify the top priorities for future research into tobacco control. 

The Cochrane Tobacco Addiction Group's research prioritization exercise involved more than 300 people and identified a total of 183 unanswered questions in tobacco control through two online surveys and an Oxford-based workshop. It identified 24 priority questions, grouped into eight priority themes. This new set of research priorities to support tobacco control will help ensure future research provides the greatest benefit to public health and value for money.

"The range, appearance, and accessibility of tobacco products has changed significantly in recent years," said Dr Jamie Hartmann-Boyce, Senior Researcher and Managing Editor in the Cochrane Tobacco Addiction Group, which is based in Oxford University's Nuffield Department of Primary Care Health Sciences. "Technology has given rise to new ways of delivering nicotine that can help reduce the harms associated with traditional cigarettes.

"To ensure our research continues to address the contemporary issues in tobacco control, we aimed to develop a set of research priorities that represent the views of the widest group possible."

Thursday, September 7, 2017

Cochrane announces a three-year agreement to establish a Cochrane Russian Associate Centre at the Kazan Federal University

Thu, 08/31/2017 - 19:35

Cochrane Russia was established at the Kazan Federal University in 2014 and was soon assigned as the national coordinating center for Cochrane. Partnering together they have launched two master programs (in evidence-based medicine and pharmacology), held several international conferences, a national round-table of evidence based medicine, courses for new systematic reviewers, and published many systematic reviews. An agreement has been recently signed that will have Kazan Federal Univerity hosting Cochrane Russia for the next three years.

Cochrane CEO, Mark Wilson said: “I’m delighted to sign this three-year agreement with Rector Gafurov to establish a Cochrane Russia Associate Centre at the Kazan Federal University. Followed up with the appropriate resourcing it provides a great opportunity for the KFU and Cochrane to develop evidence-informed medicine in the Russian Federation and establish KFU’s leadership in this area. There is so much potential for Cochrane evidence to make a huge contribution to improving Russia’s health outcomes;  and we are looking forward to working further with  Lilia Ziganshina, the Cochrane Russia team, and her colleagues at KFU to accomplish this.”

Friday, September 1, 2017

Cochrane in numbers: April-June 2017

Thu, 08/24/2017 - 15:54

We are pleased to announce the publication of our organizational Dashboard for the second quarter of 2017. This Dashboard, which we publish quarterly, presents our achievements in a series of key metrics, such as publishing output, Cochrane Library usage, and progress on meeting Strategy to 2020 targets. Work on Strategy targets is covered in more detail in the Target Report below.

This initiative is part of Cochrane’s commitment to organizational transparency. For everyone interested in Cochrane and our work, these critical indicators provide an opportunity to monitor our production and dissemination of evidence, and our organizational health.

Highlights from the second quarter include:

  • Global usage of Cochrane.org continues its quarter-by-quarter growth; now exceeding 3.5m sessions in the quarter.
  • 62% of Cochrane.org usage is viewing non-English content. Usage is soaring in South America. Mexico has become the top user of Cochrane.org, replacing USA for the first time and exceeding half a million sessions in a quarter for the first time.
  • Sales and royalties year to date are excellent. Royalties year to date are up 24.5% compared with the same period last year.

For more information:

Friday, August 25, 2017

Cochrane recommends Covidence for new reviews

Wed, 08/23/2017 - 14:58

Covidence is one of Cochrane’s recommended tools to support you in some of the most labour-intensive stages of your systematic review, saving up to 35% of researcher time. Covidence allows your team to upload search results, screen abstracts and full text, complete data collection, conduct risk of bias assessment, resolve disagreements and export data into RevMan or Excel. Covidence is free to use for all Cochrane reviews, and is designed to be intuitive and user-friendly.

Want to know more about Covidence?

Give it a try and let us know what you think!

Visit Covidence

The Covidence platform continues to evolve, with recent product updates advancing the tool towards the vision of a world where answers to questions about health and other fields of human wellbeing are accurate, up to date and accessible. The Covidence team is committed to engaging with the Cochrane community and continuing to make improvements that are user-focused. Significant improvements have been made recently to data extraction and to importing.

Covidence at Global Evidence Summit

The Covidence team will be at stand 13A at the Global Evidence Summit in Cape Town. Please say hello and let us know how your research is going! In addition, two workshops will be held: Introduction to Covidence, and Covidence Forum. Introduction to Covidence is a complete walk-through of the tool designed for novice users. Covidence Forum is intended for individuals already familiar with Covidence, and will share more in-depth tips and have additional time for discussion and feedback.

Recent updates

Additional customisation during data extraction

Covidence has a streamlined data extraction form with many of the standard elements pre-programmed, minimising time research teams have to spend on constructing their forms. You can see a walkthrough of creating a data extraction form in Covidence here.

You’ll see that there have been several recent additions to make the form even more flexible. You can now create custom effect measures, in which the data type collected in the table can be an integer, a decimal, a percentage, or even free text for qualitative outcomes. Furthermore, these data types are now validated, so the system will flag for users when a data point differs from the indicated type. Custom text fields can also be added to several sections of the form, so if there’s information you’d like to capture that isn’t covered in the standard form, you can create a place for it.

Improved Imports

You can now view your import history directly from your review dashboard. In addition, in response to feedback that the de-duplication process was unclear, it is now displayed more explicitly in this improved review history on the dashboard. Finally, the structure of the importer has been significantly improved leading to faster and more stable imports!

What’s coming next

Upcoming work will focus on building relationships directly with each Cochrane Review Group to lay foundations for further integration between Archie / Cochrane and Covidence. Our intention is that in the future, reviews will be automatically created under the Cochrane Review Group in Covidenceas soon as they are registered, making it seamless for teams to begin work as soon as they’d like. Each review will be associated with a specific group account in Covidence, which will also enable editorial team members to easily see an overview of how everyone is going.  Your Covidence homepage will look similar to the accompanying image, with reviews collated by review group for easy organisation.

Have some ideas on how to continue improving Covidence?

Thank you for voicing your feedback and user needs, these are an invaluable input into our product roadmap and prioritisationprocess. The Covidenceteam would love to hear more from you! Please contact CovidenceSupport at support@covidence.org if you’d like to share some ideas, have a chat, or just say hello!

Thursday, August 24, 2017

Cochrane Africa: A network of healthcare decision making launches across sub-Saharan Africa

Tue, 08/22/2017 - 19:42

Cochrane is delighted to announce the official launch of Cochrane Africa; a network with a vision to increase the use of best evidence to inform healthcare decision making across the sub-Saharan African continent.

The Africa Network consists of regional centres including its co-ordinating centre at Cochrane South Africa, South African Medical Research Council, and the establishment of hubs at University of Calabar, Teaching Hospital, Nigeria, Stellenbosch University, South Africa and Yaoundé University, Cameroon.

Cochrane Africa is part of the global, independent Cochrane network of researchers, professionals, patients, carers, and people interested in health. The Network will promote evidence-based decision making in health care across the sub-Saharan African region by supporting and training new authors of Cochrane Reviews, as well as working with clinicians, professional associations, policy makers, patients, and the media to encourage the dissemination and use of Cochrane evidence.

Since the late 1990s, African collaborators have worked to improve the production of high-quality, Africa-relevant reviews and to support their use in policy and practice through stakeholder engagement and capacity building. In 2007, the informal Cochrane Network was created to build on this track record and to enhance and expand these activities.

Reviews from Africa have informed several national and international guidelines, particularly in the areas of malaria, tuberculosis, and HIV/AIDS.

Cochrane Africa Founding Director Jimmy Volmink warmly welcomed today’s news: “Cochrane SA has been investing in building capacity and relationships on the African continent over many years, and it is now wonderful to see the vision of a formally registered Cochrane African Network coming to fruition.”

Cochrane Africa will be co-ordinated by Cochrane SA, which will offer methodological support, mentoring, and supervision to the regions.

The Director of Cochrane South Africa, Charles Wiysonge, says this is a hugely exciting opportunity: “The launch of the first-ever Cochrane Africa Network is very important, both to sub-Saharan Africa and globally. Producing and increasing the dissemination of the best-available information on health care is critical for clinicians and patients everywhere in the world, including Africa. We wish to build partnerships to promote evidence-informed health care in collaboration with African leadership, and create further opportunities to grow the network.”

Solange Durão from the Cochrane Africa Coordinating Unit is proud to be a part of this Network: “Health care will benefit from the increased presence of Cochrane’s work in sub-Saharan Africa. Conducting relevant reviews based on priority setting, identification of research gaps, and regional stakeholder needs is going to stimulate and focus our actions relating to the care of patients based on strong scientific evidence. Many African countries will benefit from this collaboration as we welcome new contributors to build capacity by providing learning and mentoring opportunities for conducting and using relevant Cochrane systematic reviews.”

Cochrane’s CEO Mark Wilson says: “I believe this is an important announcement for improved health outcomes in Africa. The continent’s health and healthcare challenges are huge, and with limited resources and fragile health systems in many countries it is more important than anywhere else in the world that the decisions of Africa’s doctors, nurses and policy-makers are made on the basis of the best evidence. Cochrane Africa will deepen and expand the scope, reach, and impact of Cochrane evidence on health and healthcare decision making; as well as developing Africa’s own production of high-quality evidence amongst its clinicians, researchers and academics. I’m delighted we are launching Cochrane Africa, our newest geographic network, at the Global Evidence Summit in Cape Town as an indication of Cochrane’s growing commitment to overcoming the global inequalities in healthcare provision and life chances that continue to exist.”

For all media enquiries, please contact Michelle Galloway, Michelle.Galloway@mrc.ac.za or the  Cochrane Press Office

Southern and Eastern Africa Hub        
Taryn Young     
Centre for Evidence-Based Health Care
Stellenbosch University
W: www.sun.ac.za/cebhc

West Africa Hub            
Martin Meremikwu and Emmanuel Effa               
Cochrane Nigeria
Calabar Institute of Tropical Diseases Research & Prevention
University of Calabar Teaching Hospital
Nigeria
W: www.nigeria.cochrane.org    

 Francophone Africa Hub          
Pierre Ongolo-Zogo and Lawrence Mbuagbaw  
Centre for the Development of Best Practices in Health
Yaoundé Central Hospital
Yaoundé
Cameroon
W: www.cdbph.org   

Cochrane Africa Coordinating Unit     
Tamara Kredo, Solange Durão, Charles Wiysonge and Taryn Young        
Cochrane South Africa
South African Medical Research Council
W: www.mrc.ac.za/cochrane or southafrica.cochrane.org

Cochrane Africa
W: africa.cochrane.org
T: +27 21 938 0256
E: cochrane.africa@mrc.ac.za

 

 

 

Tuesday, August 22, 2017

Health benefits for lone parents unlikely from welfare-to-work initiatives

Mon, 08/21/2017 - 14:51

A new Cochrane Review has examined large welfare-to-work studies conducted in North America.

Led by Dr Marcia Gibson from the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, the review looks at a series of welfare-to-work studies, comparing what happened to lone parents who were in welfare-to-work interventions with lone parents who were not.

The review indicates that welfare-to-work interventions probably have little to no effect on the health of lone parents. The study also found that effects on lone parent employment rates were small, as those who were not in the interventions often found work on their own.

The studies included in the Cochrane Review were large welfare-to-work studies, conducted in North America, where welfare reform was implemented in the 1990s.

Key findings included:

  • Although in some countries lawmakers and policy advisors have argued that such policies will have positive health benefits, the Cochrane Review findings indicate that there is probably very little to no effect on health.
  • Poverty and depression remained high among all participants in the studies analyzed, whether they took part in a welfare to work intervention or not. 
  • Lone parents appear to find work by themselves when jobs are available.
  • Economic conditions may have a stronger influence on lone parent employment than interventions in the welfare system that mandate employment. 
  • Employment increased both for parents who were in welfare-to-work programmes and those who were not, but income did not increase.

Lead author of the review Dr Gibson said: “The evidence from our Cochrane Review indicates that welfare to work probably does not change lone parents’ health, and may have negative effects in some cases. In conjunction with evidence from other studies, our findings also suggest that economic conditions are likely to have a stronger influence on lone parent employment.”

Work on the Cochrane Review “Welfare-to-work interventions and their effects on the mental and physical health of lone parents and their children” was funded by the UK Medical Research Council and the Scottish Government Chief Scientist Office.


For more information contact Elizabeth McMeekin or Ali Howard in the University of Glasgow Communications and Public Affairs Office on 0141 330 4831 or 0141 330 6557; or email Elizabeth.mcmeekin@glasgow.ac.uk or ali.howard@glasgow.ac.uk

Follow us on Twitter @UofGNews

About Cochrane
Cochrane is a global independent network of researchers, professionals, patients, carers, and people interested in health.

Cochrane produces reviews which study all of the best available evidence generated through research and make it easier to inform decisions about health. These are called systematic reviews.

Cochrane is a not-for-profit organization with collaborators from more than 130 countries working together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. Our work is recognized as representing an international gold standard for high quality, trusted information.

Find out more at cochrane.org

Follow us on twitter @cochranecollab

Monday, August 21, 2017

Promoting evidence-based health care in Africa

Thu, 08/17/2017 - 20:27

Charles Shey Wiysonge, Director of Cochane South Africa, gave an interview to the World Health Organization Bulletin. Here is a re-post , with premission, from their recent publication.

Charles Shey Wiysonge is devoted to encouraging better use of scientific evidence for health policies and programmes in African countries. He is the director of the South African Cochrane Centre, a unit of the South African Medical Research Council, and a professor of epidemiology and biostatistics at the department of Global Health in the Faculty of Medicine and Health Sciences at Stellenbosch University in South Africa. He was Chief Research Officer at the Joint United Nations Programme on HIV/AIDS 2006–2007 and a Medical Research Council Africa Fellow at the University of Cape Town (UCT) 2004–2006. In Cameroon, he worked for the National Ministry of Public Health 1998–2004. From 1995 to 1998, he was a physician at the University Teaching Hospital in Yaoundé, Cameroon. He is a member of several editorial boards and joined the World Health Organization’s (WHO) Strategic Advisory Group of Experts on immunization in 2016. He graduated in medicine from the University of Yaoundé I in 1995, earned his Master’s degree in epidemiology from Cambridge University in the United Kingdom of Great Britain and Northern Ireland and a Doctor of Philosophy in vaccinology from UCT. 

Q: How did you become interested in medicine and public health?

A: Growing up in Cameroon I wanted to study mathematics and was drawn to complex equations and aeronautics, but people said I should study medicine, so I did. At medical school most students wanted to become clinical specialists, public health was not popular at all. After graduating, several things drew me to public health. I worked as a hospital physician and saw several outbreaks of measles. People used to say “don’t count your children until measles have come and gone.” Children were dying of measles every day. This experience eventually led me to work on immunization. Also, while working in internal medicine, there were several treatment options for hypertension and heart disease. I was not always sure which was the best. That’s when I discovered evidence-based medicine. At that time – around the year 2000 – the Cochrane Collaboration started a new fellowship to train leaders in evidence based medicine from low- and middle income countries. I applied, became the first holder of the award and trained at the Cochrane Centre in Oxford.

Q: What is evidence-based medicine?

A: Research and other evidence are constantly changing and health-care professionals need to keep up with the latest developments so they can offer the interventions that are known to work and not those that are harmful or ineffective. There are many examples of unspeakable and unnecessary suffering resulting from the failure to take an evidence-based approach to clinical care. For example, in 1999 Cochrane researchers did a systematic review to find out whether drugs that inhibited massive calcium influx into cells reduce the risk of death or dependency after stroke. At the time, stroke patients were widely treated with calcium channel blockers. They found no evidence of a beneficial effect. Evidence-based medicine has been defined as the “conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients”, although today, health-care professionals prefer the term “evidence-based health care” for a more holistic approach.

Q: You did not learn about evidence based health care at medical school, is it included in medical curricula today?

A: Some medical and dental schools in South Africa offer separate courses on evidence-based health care, others have embedded the approach in all courses, and some do both. Our Cochrane collaborators at the universities of Calabar in Nigeria and Yaoundé I in Cameroon also offer programmes in the evidence-based approach for physicians. Evidence-based health care is included in the curricula for health-care professionals in these and some other African  countries, but more needs to be done at the undergraduate and the postgraduate levels across the continent.

Q: The Cochrane Collaboration prepares and disseminates information on what works and what doesn’t in health care globally. How is the South African Cochrane Centre doing this in Africa?

A: Our centre was set up in 1997 as a unit of the South African Medical Research Council. It is the only Cochrane centre in Africa and has a branch in Nigeria. There is increasing recognition in sub-Saharan African countries, that policy-making should be based on the best available scientific evidence. To this end, we have been training researchers in these countries to do systematic reviews and recently expanded these activities via the recently established Cochrane African Network. The Cochrane Collaboration charges a fee to access its global library of systematic reviews and other evidence. Low-income countries can access this evidence via a special online platform, thanks to the Evidence Aid initiative. In South Africa, free access to the Cochrane Library is now provided by the South African Medical Research Council and we hope other middle-income countries in Africa will follow this model.

Q: Are the Cochrane reviews useful in Africa too, or do countries in Africa need evidence that is tailored to their specific situation?

A: Not all Cochrane reviews are applicable to Africa. Since 2007, the South African Cochrane Centre has collaborated with the Centre for Informed Health Choices in Norway and others to improve the use of reliable research evidence in policy and management decisions in Africa. We found, overall, that most primary studies on health system issues are from high-income countries and that only some of these reviews are applicable in low-income settings, including parts of sub-Saharan Africa. For this reason, reviews that synthesize such studies have limited relevance to Africa, especially those written by researchers with no experience in Africa.

Q: So more research is needed that is specific to sub-Saharan Africa?

A: Our analyses suggest that external partners, rather than national priorities, have driven health research in most African countries over the last two decades. However, we don’t need to re-invent the wheel, as much of the global research evidence is applicable to Africa. A major priority for new research in African countries should  therefore be implementation research. This type of research helps us understand which health-care interventions work in specific contexts and which do not, and to test different ways to make health-care more effective. African countries often fail to make optimal use of evidence in decision-making, resulting in unnecessary loss of life, reduced quality of life and lost productivity. An example, is acquired immune deficiency syndrome (AIDS) denialism in South Africa from 1998 to 2003, characterized by the refusal to use antiretrovirals for human immunodeficiency virus (HIV) prevention and treatment. This resulted in a reversal of gains in child survival and life expectancy and the loss of a generation of economically active adults in their prime.

Q: How are you working to make policymakers in Africa more aware of the need to base their health-care decisions on the best available scientific evidence?

A: The use of health research in decision-making in African countries is generally weak. That’s why we advocate for the dissemination and use of evidence, and building partnerships to promote evidence-informed health care in collaboration with decision makers. African countries sometimes develop new guidelines, but often adopt or adapt existing WHO guidelines to suit national contexts. Our analyses of the development or contextualization of guidelines used in African countries reveals deficiencies in the rigour of development and adherence to international reporting standards. We advise countries on how to develop guidelines for their specific national contexts. We try to work with the health ministries through expert groups to encourage governments to base their policies on the best available evidence and we are involved in initiatives, such as the Effective Health Care Research Consortium, an international group with partners in Cameroon, Kenya, Nigeria and South Africa. However, we are limited by financial constraints, as our work does not attract much funding.

Q: What are the barriers stopping African countries from basing their public health policies and practice on the best scientific evidence?

A: There are several barriers. The health research field in Africa is characterized by numerous players, diverse interests, dispersed efforts and uncertain outcomes in relation to its impact on the major health challenges of the continent. For a better understanding and uptake of scientific evidence in health policymaking, we need a stronger research community – research is not well funded or supported in many African countries – and this community needs to forge closer links with policy-makers, programme managers and implementers. Sometimes the evidence is difficult for policy-makers to understand. That’s why we provide easy-to-read summaries for them. Sometimes, policy-makers ignore the evidence because it’s not what they want to hear. For example, the South African Department of Health once asked the South African Cochrane Centre to prepare a review of the evidence on how best to prevent mother-to-child transmission of HIV infection. But when we gave them the review, they ignored it.

Q: Have you noticed any improvement in the uptake of evidence in health policy-making?

A: We have seen a positive change in attitudes towards the use of evidence in health-care planning. For example, the Paediatric Association of Kenya has been using explicit, transparent guideline development procedures when developing recommendations for the prevention and treatment of childhood conditions for the last decade. Another example is the increasing number of African countries with functioning national immunization technical advisory groups, which provide evidence-based advice to national health authorities on how to implement WHO vaccine policies and recommendations.

Q: How will the conference you are hosting in Cape Town from 13 to 16 September contribute to improving the uptake of scientific evidence in policy-making in Africa?

A: The Cochrane Collaboration holds a colloquium every year. This year will be the first time that Cochrane will be joined by the four other biggest players in evidence-based policy: the Campbell Collaboration, the Johanna Briggs Institute, the Guidelines International Network and the International Society for Evidence based Health Care, to organise the first ever Global Evidence Summit. We are expecting thousands of participants, including those from every health-care discipline and from virtually every country on the continent of Africa. There is strong evidence that such interactive, educational meetings, can help health-care workers improve their performance. Participants will have the chance to learn more about guideline development, using evidence for emerging global health and social crises and how the evidence community can overcome denial of clear scientific findings. We are really excited about this opportunity to highlight the evidencebased approach to policy and practice in health for countries in Africa.

Wednesday, September 20, 2017

Cytology versus HPV testing for cervical cancer screening in the general population: a DTA Review from the Cochrane Gynaecological, Neuro-oncology and Orphan Cancers Group, (CGNOC)

Mon, 08/14/2017 - 15:27

Cochrane Reviews are systematic reviews of research in health care and policy. They are internationally recognized as a high-quality source of evidence for decision-making. They collate and summarize all the best available research evidence on the effects of healthcare interventions or the accuracy of diagnostic tests into a systematic review.

Diagnostic Test Accuracy Reviews (DTA) provide essential information regarding the accuracy of the available diagnostic tools for key decision makers, including patients, clinicians, guideline developers and researchers. 

The purpose of a Cochrane DTA review is very like the purpose of a conventional Cochrane systematic review. Using explicit, transparent, and systematic methods to pool together all the available evidence relevant to a DTA research question, we can obtain more precise estimates of the accuracy of diagnostic tests than single DTA studies alone can provide. Estimates of sensitivity and specificity may also be more generalizable than estimates from single studies.

Cochrane GNOC has recently published its DTA review: Cytology versus HPV testing for cervical cancer screening in the general population.

Among its many international collaborators, Cochrane GNOC Group works with key contributors who are interested in disseminating evidence about the accuracy tests for diagnosing cancer. We spoke with three contributors, Jo Morrison, Co-ordinating Editor of Cochrane GNOC, Kate Sanger, Head of Communications & Public Affairs, Jo's Cervical Cancer Trust and Nuala Livingstone, Editor of the Cochrane Editorial Unit, to discuss the importance of this Review:

How important was this Cochrane Review to produce?

 Jo Morrison: The review compares the accuracy of two different methods of testing cervical smears in picking up pre-cancerous changes (known as high grade cervical intra-epithelial neoplasia – HG CIN).  Both tests start with a smear test, taken by directly visualising the cervix and using a ‘broom’ or spatula to sweep cells off the cervix.  The difference is in what is done with the test once it is in the pot.  One test puts cells onto a slide so they can be examined under a microscope and is called cytology, often called a Pap test.  The other test takes a sample of cells and checks for the presence of viruses that can lead to pre-cancerous changes in the cervix (HG CIN). These viruses are called high risk Human Papilloma Virus or HR HPV.  The test for the virus looks for genetic material (either DNA or RNA depending on the test) using a process called the polymerase chain reaction (PCR) and does not rely on someone looking at cells down a microscope.

Kate Sanger: This review is timely, as in the UK it has been announced that testing for HPV as the primary cervical screening test is to be rolled out over the coming years. We are in a position where the implications of this change on the workforce, systems and indeed patients are at the top of the agenda. The aim of the screening programme is to reduce incidence and mortality from cervical cancer through identifying women who are more at risk of the disease and providing treatment where appropriate. The confirmation through this review that screening for HPV is more sensitive and therefore more effective at identifying cases of CIN 2 or greater is extremely welcome and positive.

What did they find? 

Jo Morrison: This DTA review found 40 studies comparing the two tests in over 140,000 women who had a smear test.  Testing a smear test for HR HPV is less likely to miss HG CIN, as it is a more sensitive test than cytology. However, if the test is positive there is a lower chance that there really is HG CIN, as it is a less specific test.  For every 1000 women who had a smear test, 20 actually had HG CIN.  Cytology (Pap test) would have correctly identified 12 of these women (but missed 8 women with HG CIN); HPV testing would have correctly identified 16 women (and missed 4).  The test is therefore more sensitive and has fewer false negative tests than cytology.  However, this increased sensitivity comes at a cost.  The HPV test would have suggested that 101 women had HG CIN when in fact they did not, whereas only 29 women would have had an over-call (false positive) with cytology (Pap) testing. This would result in an increase in women needing to be referred to a clinic for colposcopy, were the HPV test used as a stand-alone test, causing increased anxiety for these women.  This is because the test is less specific and has more false positive test results than cytology.

What does this mean for clinical practice?

Jo Morrison: For the UK, this will mean that we can change the cervical screening programme.  Currently all smears are screened for cytology first and those with features of low grade dyskaryosis are ‘triaged’ using HPV testing – those with HR HPV detected are referred to colposcopy. And those with no HR HPV are returned to routine re-call.  However, mathematically, it makes more sense to use the most sensitive test (HPV test) up-front and then use cytology on those found to have HR HPV.  By introducing a second level test after HPV testing, fewer false positives will be generated and fewer women will require colposcopy than with HPV testing alone.  However, this change will have major implications for the screening programme since: 1) more women may be referred to colposcopy; 2) overall many fewer smears will require cytological evaluation. This has repercussions for the current laboratory services, since many fewer cytopathology screeners will be required and the service could be streamlined to only a few laboratories providing this service across the UK (since there are minimum numbers of smears screened per screener to maintain expertise).

World-wide this has major benefits since HPV testing is much more easily deliverable in the developing world that cytological screening, which is where the heaviest burden of disease from cervical cancer lies.

Kate Sanger: For patients, there is a clear need for increased information provision regarding why the changes to the screening programme are beneficial and the different pathways women invited for screening may take depending on the outcome of their initial HPV test. For women testing negative for HPV it is essential that they fully understand the need to continue to attend screening when next invited; greater symptom awareness for all women must also be increased. It is especially important that women who test positive for high risk HPV, but do not have cell changes that require treatment, fully understand what it means, for example with women starting new relationships or who may have multiple sexual partners. This is essential to reduce uncertainty, distress and to ensure being ‘HPV positive’ does not get a negative stigma attached to it. Information and support need to be available to women at every stage with clinicians able to signpost women to external sources.

How robust is this evidence? 

Nuala Livingstone: Overall, I would consider this evidence to be robust. The review authors have provided detailed, and carefully considered information in this review to assist the user in assessing the ‘robustness’ of the evidence.

Firstly, they assessed the methodological quality of the included studies using the QUADAS tool, as recommended by the Cochrane Diagnostic Test Accuracy Working Group. This assessment revealed that most the included studies in this this review were ‘low risk of bias’. Review authors also assessed the quality of the body of evidence for each outcome in the Cochrane review using the GRADE considerations. This assessment considers the methodological quality of the included studies (as assessed by QUADAS) along with the precision, consistency, completeness and applicability of the evidence available. Based on these factors, review authors judged the overall quality of the evidence in this review to range from moderate to high. Evidence was downgraded from ‘high’ to ‘moderate’ quality because the sensitivity values among included studies were slightly inconsistent, with values ranging from 52%-94% for Cytology, and 61% to 100% for HPV testing.

Kate Sanger: It would be interesting to see a breakdown of the research by age group, as women under 25 and over 65 were part of the study and in the UK these women are not invited for screening. Data on women over 65 could contribute to evidence as to whether there should be a consideration of increasing the screening age in the UK. With women under 25 further research into the impact of the HPV vaccination on incidence will be particularly important, especially following the potential introduction of Gardasil 9.

How clinically relevant is it, and how can the evidence be used?

Jo Morrison: This review is highly clinically relevant and affects all women in a screened population – ideally it should be relevant to all women world-wide, since universal cervical screening would be a major contributor to global health and the burden of disease is largely in less developed countries.

What would your message be to clinicians and policy-makers in this area or cervical screening?

 Jo Morrison: HPV-testing has increased sensitivity, but less specific than cytology.  Used as the up-front test in a two-stage screening test, it has the potential to reduce the number of false-negative tests, thereby reducing the number of ‘interval’ cancers, which are missed by cytologyical screening.  There are also potentials for cost savings, although this review did not perform an economic evaluation.

What would your message be to patients?  

Nuala Livingstone: The high sensitivity of this test should provide reassurance that a negative result on this test is highly likely to be accurate. This finding is supported by moderate to high quality evidence, which suggests we can be fairly certain in the result. However, a positive result will not necessarily prove to be true.

Jo Morrison: HPV testing is much less likely to miss changes than conventional cytology, although this may come at the price of more women needing referral to colposcopy for someone to look at their cervix and possibly perform biopsies. It is hugely reassuring to have a negative HPV test, since this shows that the risk of having CIN is very low.  There is the possibility that the interval between smear tests could be extended, reducing the frequency that women need smears, which nobody enjoys!  However, this would need to be tested in a different sort of study than a DTA study.

What further research would you like to see, and what would this tell us?

Jo Morrison: The results of studies comparing screening programmes using conventional cytological screening up-front versus HPV screening up-front are in progress and initial results demonstrate that this is likely to reduce the number of cancers missed by the screening test due to false negative smear results.

Kate Sanger: This review provides evidence which will hopefully increase activity to ensure the roll out of HPV primary in the UK is not delayed. It also provides a range of considerations that policy makers and clinicians need to address to ensure the physical and emotional health of the women in their population is protected. We must however not lose sight that across the UK attendance of screening is in worrying decline and addressing this, regardless of the screening test, must remain a priority.

Nuala Livingstone: The results of this review have provided detailed an important information regarding the statistical evidence available for this research question. However, I would like to see further research that provides information regarding the clinical importance of the evidence, and the long-term implications for women.

Jo Morrison, Nuala Livingstone, Kate Sanger.
Jo, Nuala and Kate’s words stated and expressed in this blog are entirely personal, and do not represent any official views or opinions of Cochrane.

CGNOC
CGNOC are committed to providing reliable evidence required to make important decisions on issues concerning Gynaecological cancers, Neuro-oncology and related topics.

CGNOC's main task is to facilitate the identification of reports of controlled clinical trials and to carry out systematic reviews which are then published on the Cochrane Library. The reviews are updated as new evidence is identified. This ensures that Cochrane reviews are relevant, useful, usable and used.

Evidence relating to the care of people with cancer comes from a number of sources and so a multi-faceted approach is taken, including searching electronic databases of clinical trial reports, handsearching printed journals, and scanning of the 'grey' literature i.e. conference proceedings and abstracts. Every effort is made to find unpublished trials to avoid bias.

f you would like more information about proposing a review title or getting involved with the Cochrane Gynaecological, Neuro-oncology and Orphan Cancer Group, please contact us:

For more information, please contact:

E-mail: ruh-tr.gnoc-cochrane@nhs.net 

Twitter:   @Cochrane_GNOCG

Jo’s Cervical Cancer Trust is the only UK charity dedicated to women affected by cervical cancer and cervical abnormalities. Our vision is a future where cervical cancer is a thing of the past. We want to see cervical cancer prevented and the impact for everyone affected by cervical abnormalities and cervical cancer reduced. We do this through providing the highest quality information and support, and campaigning for excellence in cervical cancer treatment and prevention. www.jostrust.org.uk

August 2017: The Cochrane Official Blog is curated and maintained by the Communications & External Affairs Department. To submit items for publication to the blog or to add comments to a blog, please email news@cochrane.org.

Monday, August 14, 2017

Cochrane seeks Statistician – Oslo, Norway

Wed, 08/09/2017 - 13:39

Cochrane Norway and the Norwegian Satellite of the Cochrane Effective Practice and Organisation of Care (EPOC) review group, which has the responsibility for developing systematic reviews of interventions to improve health systems are seeking a full-time statistician. Closing date for applications is 1 September. 

For complete information on the job and how to apply, read more at the Norwegian Insitute of Public Health websbite

Wednesday, August 9, 2017 Category: Jobs

Cancer Council NSW seeks Systematic Reviewer – Woolloomooloo, NSW

Wed, 08/09/2017 - 03:03

Cancer Council NSW is seeking a Systematic Reviewer to join their Cancer Research Division on a two-year, full-time contract. Closing date for applications is 15 August.

For complete information on the job and how to apply, read more at the Cancer Council site.

Wednesday, August 9, 2017 Category: Jobs

Cochrane seeks Events and Office Coordinator - Oxford, UK

Fri, 08/04/2017 - 14:26

14-month maternity cover

Cochrane UK is seeking an organized and enthusiastic individual to join our small, friendly team at the UK Cochrane Centre in the role of Events and Office Coordinator. This is an exciting time to join us, as we are organizing a global healthcare evidence conference for 1200 delegates in September 2018. This role is vital to the organization of the event and offers an opportunity, as a 14-month post, to organize and deliver an inspiring and successful conference.

Main responsibilities include day-to-day running of the office, coordination of our training programmes, diary management and events organization.

Essential requirements:

  • Excellent planning and organizational skills 
  • Excellent customer service and interpersonal skills
  • Ability to work autonomously to find solutions
  • Keen interest in learning new skills 

This is a full-time maternity cover band 5, NHS employed position, based in Summertown, Oxford. It would suit a highly motivated individual, with previous experience in organising events, who works well as part of a team, is adaptable, enjoys communicating with a wide range of people and is keen to contribute to a global effort to produce reliable, accessible healthcare evidence.

Cochrane is a global independent network of researchers, professionals, patients, carers and people interested in health. We are a not-for-profit organization with contributors from more than 120 countries working together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. We do this by producing reviews that summarize the best available evidence generated through research to inform decisions about health. Cochrane Systematic Reviews are published online, in full text, in the Cochrane Database of Systematic Reviews in the Cochrane Library

Cochrane UK is one of 14 Cochrane Centres around the world supporting the global work of Cochrane. Cochrane UK is funded by the National Institute for Health Research (NIHR) and hosted by the Oxford University Hospitals NHS Trust. The centre supports the production of Cochrane systematic reviews through a learning and development programme. We also aim to maximize the impact of Cochrane reviews by disseminating the findings widely to health professionals, researchers, commissioners, the public, charities and the media, through social media, events, presentations and partnerships.

Closing Date: 16th August 2017
Interview Date: 21st August 2017
For additional details and to apply, see posting on the Oxford Univerity Hospital.

Friday, August 4, 2017 Category: Jobs

New national license agreement provides India with unlimited access to the Cochrane Library

Tue, 08/01/2017 - 18:58

John Wiley and Sons Inc. (NYSE:JWa) (NYSE:JWb) is pleased to announce that students, practitioners, researchers, and patients in India will now have access to more than 7,000 published systematic reviews in healthcare interventions through one-click access to the Cochrane Library. Cochrane is a leading resource in evidence-based research across areas including pregnancy, mental health, surgical procedures, and public health. Cochrane Reviews provide independent high-quality evidence to aid healthcare decision making.

The collaboration between Wiley, Cochrane, and the National Medical Library in India offers free access, through IP recognition, to the Cochrane Library across India. This opportunity has been made possible thanks to the National Medical Library and will provide more than 1.3 billion residents of India availability to the gold standard in evidence-based healthcare research. The license will run from 2017 to 2020.

Dr K P Singh, Director of the National Medical Library, welcomed the move: “This national license will have a great impact on the quality of evidence and research used in healthcare interventions across India. We are very committed to future-proofing our healthcare system and by enabling one-click free access to the Cochrane Library we are looking after our population.”

More than 1,300 Indian researchers have contributed to Cochrane research. This demonstrates the importance of the new national license. Access to the best research in the world is key to developing young practitioners’ careers but also offers patients and other interested parties access to the latest interventions in health care. According to the Medical Council of India, as of 2017 there are 460 recognized medical colleges with a combined capacity to provide medical education for 63,985 students. The Medical Council of India's motto is “to provide quality medical care to all Indians through promotion and maintenance of excellence in medical education.” Its website maintains an up-to-date list.

Deputy Editor in Chief of the Cochrane Library, Karla Soares-Weiser, welcomed today’s announcement: “All countries need to ensure that scarce and limited health resources are used as effectively as possible. A national license provides India with unlimited access to the Cochrane Library. This is an important springboard for the further development of evidence-informed health care across India.”

Cochrane is a global independent network of researchers, professionals, patients, careers, and people interested in health. The organization gathers and summarizes the best evidence from research to help make informed choices about treatment. More than 37,000 Cochrane contributors from over 130 countries work together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. There are 53 Review Groups covering a variety of health topics, from Infectious Disease to Oral Health to Pregnancy and Childbirth. 

Deborah Pentesco-Gilbert, Editorial Director, Cochrane at John Wiley & Sons said, “A national license is a fantastic opportunity to ensure evidence-based healthcare interventions are reaching all parts of India. Whether it’s a university researcher reviewing the latest findings, a general practitioner seeking current best practices, or a patient looking for the new treatment options, we are thrilled to provide gold-standard healthcare interventions through the Cochrane Library.”

Additional Information

Media contacts:

Dawn Peters (US) +1 781-388-8408
Tom Griffin (UK) +44 (0) 1865 476213
Canon Carson (US) +1 201-748-5838 x25838
sciencenewsroom@wiley.com
Follow us on Twitter @WileyNews

About Cochrane
Cochrane is a global independent network of researchers, professionals, patients, carers, and people interested in health. Cochrane produces reviews which study all of the best available evidence generated through research and make it easier to inform decisions about health. Find out more at www.cochrane.org or follow on twitter @cochranecollab. The Cochrane Library is published by Wiley.

About Wiley
Wiley, a global company, helps people and organizations develop the skills and knowledge they need to succeed. Our online scientific, technical, medical, and scholarly journals, combined with our digital learning, assessment and certification solutions help universities, learned societies, businesses, governments and individuals increase the academic and professional impact of their work. For more than 200 years, we have delivered consistent performance to our stakeholders. The company's website can be accessed at www.wiley.com.

Tuesday, August 1, 2017

Cochrane seeks Managing Editor for Cochrane Infectious Diseases Group - Liverpool, UK

Tue, 08/01/2017 - 13:56

The Department of Clinical Sciences has an exciting opportunity for a Managing Editor to work in the Cochrane Infectious Diseases Group

The Liverpool School of Tropical Medicine (LSTM) is an internationally recognised centre of excellence for research in tropical diseases.  This includes the Centre for Evidence Synthesis in Global Health, which houses the Cochrane Infectious Diseases Group (CIDG), one of the first Cochrane Groups and highly successful, and well known for its exacting standards.

As the Managing Editor of CIDG you will help organize review production across over 600 authors from some 52 countries. These reviews are around the effects of healthcare interventions for infectious diseases, particularly malaria, tuberculosis, diarrhoea, tropical diseases and HIV/AIDS. You will be interacting with Editors from CIDG of international repute, working closely with the dynamic team of in-house researchers, administrators and communication specialists as well as authors and partners who are part of the Effective Health Care Research Programme Consortium. You will also be the link between the existing and potential authors who need support for the Cochrane Reviews. As a representative of CIDG, you will participate in events and working groups and ensure that developments on both sides are communicated and updated. You will be responsible for the day to day management of the CIDG Editorial team in addition to implementing the CIDG strategic plan.

It is essential for this role that you possess a postgraduate degree in biomedical science or a health-related subject, with proven experience in writing up medical or biomedical scientific research clearly and concisely. If you have been involved in working with Cochrane Reviews, or systematic reviews, and have experience of technical editing; including copy editing/proof reading in medicine or biomedical science, it will also be an added advantage. Given the wide scope in people management and interactions, the job holder must have worked with and managed teams from diverse backgrounds and qualifications. The successful candidate must be able to demonstrate scientific writing skills, have advanced IT and excellent project management skills, as well as the ability to adapt to new software. Given the nature of the role, you must be able to travel nationally and internationally.

Closing Date: Tuesday 15th August 2017

See full job posting on the Liverpool School of Tropical Medicine website

Tuesday, August 1, 2017 Category: Jobs

Taking vitamin supplements may slow down the progression of a common eye disease

Mon, 07/31/2017 - 21:02

Latest evidence published in the Cochrane Library suggests that taking a multivitamin supplement that includes vitamin E, carotenoids (beta-carotene or lutein or zeaxanthin), vitamin C, and zinc may slow down the progression of the common eye disease age-related macular degeneration (AMD).

See additional resources at the bottom of the page

Age-related macular degeneration (AMD) is a progressive and sight-threatening disease affecting the central area of the retina and affects large numbers of people across the world. Population-based studies suggest that in older people (80 years and older), approximately one in three people have early signs of the disease.

There are numerous unanswered questions in the treatment of AMD. There has been a growing perception amongst eyecare professionals that taking vitamin supplements and antioxidants, such as lutein and zeaxanthin, may protect patients against the progression of the eye disease.

A team of Cochrane researchers conducted a study to assess whether taking antioxidant vitamin and mineral supplements slows down the progression of AMD in people with a diagnosis of AMD. They collected and analyzed data from 19 studies involving men and women from Australia, China, Europe, and the USA.

Lead author Jenny Evans from the London School of Hygiene & Tropical Medicine explains more:

How important was it to update this Cochrane Review?
This is a topic that is currently of much interest to people with AMD. The review was last updated in 2012 and we knew that there were new studies available.

What did you find?
We found 19 studies that compared various types of vitamins against placebo in people with AMD. The evidence was mixed, but there was one large study in the USA that suggested that a particular combination of these vitamins may slow down the progression of the disease. 

We did not find evidence that these supplements on their own were so useful.

What does this mean?
If you have a diagnosis of AMD, then vitamin supplements may be helpful.

How robust is this evidence?
The evidence is not so robust. Most of the evidence comes from one large study from the USA which followed people up over six years. The other studies in the review were small and shorter duration and less conclusive.

What would your message be to eyecare practitioners?
People with AMD may be interested in taking vitamin supplements. The benefits and harms should be explained clearly.

What would your message be to patients already taking vitamin supplements for AMD?
The decision as to whether or not to take vitamin supplements is up to you. You may wish to discuss these again at your next visit to your eyecare practitioner.

What does this mean for patients who think they are at higher risk of progression of the disease?
Vitamin supplements are generally regarded as safe. They may be helpful but your vision may deteriorate further, even if you take these supplements. Regular visits to your eyecare practitioner are advised. 

What further research would you like to see, and what would this tell us?
It would be good to have a large trial comparing a supplement containing vitamin C, E, lutein, zeaxanthin, and zinc with taking no supplement for people with AMD to see if this slows down progression to visual loss.

Monday, July 31, 2017

Taking vitamin supplements will not prevent a common eye disease

Mon, 07/31/2017 - 20:43

Latest evidence published in the Cochrane Library suggests that taking vitamin supplements, such as vitamin E or beta-carotene, may not prevent the common eye disease age-related macular degeneration (AMD).  

See additional resources at the bottom of this page

Age-related macular degeneration (AMD) is a progressive and sight-threatening disease affecting the central area of the retina and affects large numbers of people across the world. Population-based studies suggest that in older people (80 years and older), approximately one in three people have early signs of the disease.

There are numerous unanswered questions in the prevention of AMD. There has been a growing perception amongst eyecare professionals that taking vitamin supplements - in particular, antioxidant supplements such as lutein and zeaxanthin - may protect patients against the onset of the eye disease.

A team of Cochrane researchers conducted a study to assess whether taking antioxidant vitamin and mineral supplements prevents the development of AMD.

They collected and analysed data from five studies involving men and women from Australia, USA, and Finland.

Lead author Jenny Evans from the London School of Hygiene & Tropical Medicine explains more:

How important was it to update this Cochrane Review?
This is a topic that is currently of much interest to people in the general population. The review was last updated in 2012 and we knew that there were new studies available.

What did you find?
We found five large studies that compared taking vitamin E, beta-carotene, vitamin C, and multivitamin with taking a placebo in people in the general population.

People taking these supplements had a similar chance of developing AMD compared with people not taking the supplements. We did not find any relevant studies of lutein and zeaxanthin in the general population.

What does this mean?
If you are healthy, with a healthy diet, and you do not have problems with your eyes, then taking vitamin supplements is not necessary.

How robust is this evidence?
The evidence is robust. The studies were large (more than 75,000 people) and were well conducted. There is an evidence gap for whether or not to take lutein or zeaxanthin to prevent AMD.

What would your message be to eyecare practitioners?
Be aware that there is no evidence that antioxidant supplements prevent AMD.

What would your message be to patients already taking vitamin supplements to prevent AMD? 
The decision as to whether or not to take vitamin supplements is up to you. Vitamin supplements are generally regarded as safe. You may wish to discuss these again at your next visit to your eyecare practitioner. 

What does this mean for patients who think they are at higher risk of contracting the disease?
The decision as to whether or not to take these supplements is up to you. If you choose not to take them, you are unlikely to be putting yourself at greater risk of developing AMD.

What further research would you like to see, and what would this tell us?
It would be good to have a large trial comparing lutein and zeaxanthin with taking no supplement in people who have not yet developed AMD. The aim would be to see whether taking supplements reduces the chance of developing this condition. 

Monday, July 31, 2017

Cochrane election results and appointments to the Governing Board

Thu, 07/27/2017 - 13:48

We are delighted to announce the results of the recent elections and appointments to the Governing Board:

Co-Chair:

  • Martin Burton has been appointed by the Board as its Co-Chair for a term of two years. Martin served as a member of the Board until this month, and already has substantial leadership experience in Cochrane as Director of Cochrane UK and Co-ordinating Editor of the Cochrane Ear Nose & Throat Review Group. Martin is based in Oxford, UK, and will share chairing duties with Cindy Farquhar, who is Co-ordinating Editor of the Gynaecology and Fertility Review Group, and is based in Auckland, New Zealand.

Two internal members:

The election of internal members of the Governing Board has now concluded, and you have elected the following two candidates for a term of three years:

  • Tracey Howe - director of the Cochrane Global Ageing Field and based in Glasgow, UK.
  • Joerg Meerpohl - serving Board member who has now been re-elected. Co-Director of Cochrane Germany and based in Freiburg, Germany.

Three external members:

The Board has appointed three external members of the Board for a term of three years:

  • Maria Gladys Faba Beaumont - sociologist by training and works with the National Institute of Public Health in Mexico and the Pan American Heath Organization; based in Mexico City
  • David Hammerstein Mintz - civil society advocate for the Commons Network, an organization that he co-founded, former Member of the European Parliament and based in Valencia, Spain.
  • Rae Lamb - Aged Care Complaints Commissioner for Australia and has a background in health journalism and health services research; based in Melbourne.

Cochrane congratulates and welcomes the new members and extends its grateful thanks to Lisa Bero, outgoing Co-Chair; and Mona Nasser and Denise Thomson, outgoing Board members, for their outstanding contributions to Cochrane as members of the Board.

More information on these election results and appointments and Cochrane’s electoral procedures

Thursday, July 27, 2017

The Cochrane/G-I-N Partnership in 2017

Thu, 07/27/2017 - 02:55

Cochrane and the Guidelines International Network (G-I-N) have been formal partners since 2014. We work together collaboratively to ensure that evidence is both useful and used by people making decisions about health, from individuals to clinicians to international health policy-makers from all over the world.

The latest collaboration between Cochrane and G-I-N is a new release of Cochrane's TaskExchange platform, which extends TaskExchange's remit to include tasks related to developing guidelines.

For more information, please see the full update, including a video presenting the partnership, on the Cochrane Community site.

Thursday, July 27, 2017

Cochrane seeks Administrator - London, UK

Tue, 07/25/2017 - 16:53

Specifications: Full Time
Annual Salary: £23,333
Location: London
Application Closing Date: 13th August 2017

This role is an exciting opportunity to use your administration experience to make a difference in the field of health care research. 

Working as part of a team, the Administrator will handle a variety of office support tasks such as servicing meetings, making travel arrangements, diary management and maintaining electronic records.  The role also includes dedicated support for our External Affairs team, administering funding applications, maintaining donor reports and managing contact databases.

We are looking for an efficient 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:

  • Previous experience of providing administrative support.
  • Intermediate level IT skills, including Word, Excel and PowerPoint.
  • Excellent written and verbal communication skills.
  • Excellent interpersonal skills.
  • Professional telephone manner.
  • Ability to work methodically and accurately.
  • A flexible approach with the ability to respond quickly to issues as they arise.
  • A pro-active approach to problem-solving.
  • Awareness of handling confidential and sensitive information.

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 the healthcare charity sector more generally is an advantage, but not essential.

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

For further information, please download the full job description.

Deadline for applications: 13th August (12 midnight GMT)

Tuesday, July 25, 2017

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