cochrane reviews: summarising the best evidence to inform healthcare decisions
TRANSCRIPT
Cochrane reviews: Summarising the best evidence to inform healthcare decisions
Nicola Lindson-Hawley & Jamie Hartmann-BoyceManaging Editors for Cochrane TAG
[email protected] @CochraneTAG
UKCTAS ECR Conference 2015 16th September 2015
• Nuffield Department of Primary Care Health Sciences
• Two overlapping teams
• Topic areas include: harm reduction, e-cigarettes, nicotine preloading, smoking reduction, attentional bias
• Methods: randomised controlled trials; systematic reviews; ecological momentary assessment
Tobacco at Oxford University
Cochrane Tobacco
Addiction Group (TAG)
Behavioural Medicine
Team (BMT)
Tim LancasterLindsay SteadRafael Perera
Paul AveyardNicola Lindson-HawleyJamie Hartmann-Boyce
Rachna BeghSarah Tearne
• Introduction to Cochrane
• How to use the Cochrane Library
• The Tobacco Addiction Group (TAG)
• The Drugs and Alcohol Group (CDAG)
• Experiences of Cochrane
• How to get involved
• Questions
What we’ll cover
WHAT?• Gathers and summarises the best evidence from research
HOW?• Systematically reviewing the available evidence
WHY?• To help doctors, nurses, patients, carers, researchers,
funders, policy makers & guidance developers to enhance their healthcare knowledge and decision making
Cochrane
• Decentralised structure – 53 Cochrane Review Groups
• Review groups are topic specific
• Based in over 100 countries
• Largely funded by government grants
Cochrane
• Efficient way to access the body of research
- saves time required for searching
- critical appraisal
- interpretation of results
• Explores differences between studies
• Reliable basis for decision making
- unbiased selection of relevant information
- useful for health care, policy, future research
Why systematic reviews?
What is so special about a Cochrane review?
Unbiased
• Systematic search
• All languages• Risk of bias
assessment
Reliable
• Cochrane Handbook
• Published protocol
• 2 reviewers assess & extract
Up to date
• Update approx. every 2 years
• Prioritise active areas
Accessible
• Open access in UK
• Plain language summaries
• Summary of findings tables
PROTOCOL• Clearly stated objectives• Pre-defined eligibility criteria• Explicit, reproducible methodology• Search strategy
www.cochranelibrary.comFinding Cochrane Reviews
• Bullet point style to look like this
• Bullet point style to look like this and can go across multiple lines
• Bullet point style to look like this
• Bullet point style to look like this and can go across multiple lines
• Bullet point style to look like this and can go across multiple lines
Browse by review group
But Cochrane reviews are so long?!
• Abstract
• Plain language summary
• Overviews of reviews
• Summary of findings tables: summary of key information from review, presents most important outcomes for someone making a decision
Behavioural interventions as adjuncts to pharmacotherapy for smoking cessation
Patient or population: People using smoking cessation pharmacotherapySettings: Health care and community settingsIntervention: Behavioural interventions as adjuncts to pharmacotherapyOutcomes Illustrative comparative risks* (95% CI) Relative effect
(95% CI)No of Participants(studies)
Quality of the evidence(GRADE)
Comments
Assumed risk Corresponding risk
Control Behavioural interventions as adjuncts to pharmacotherapy
Smoking cessation at longest follow-upFollow-up: 6 - 24 months
Study population RR 1.16 (1.09 to 1.24)
15506(38 studies)
⊕⊕⊕⊕high1,2
183 per 1000 213 per 1000(200 to 227)
Median quit rate210 per 1000 244 per 1000
(229 to 260)
*The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
GRADE Working Group grades of evidenceHigh quality: Further research is very unlikely to change our confidence in the estimate of effect.Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.Very low quality: We are very uncertain about the estimate.Footnotes1 All studies rated at low or unclear risk of bias2 No overall evidence of statistical heterogeneity (I² = 3%), or of differences between the subgroups defined by pharmacotherapy
Stead LF, Lancaster T. Behavioural interventions as adjuncts to pharmacotherapy for smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 12. Art. No.: CD009670. DOI: 10.1002/14651858.CD009670.pub2.
• Founded in 1996
• Coordinating editor – Tim Lancaster• Editorial advisory board – Paul Aveyard, John Hughes
(University of Vermont) & Robert West (UCL)• Managing Editors – Nicola Lindson-Hawley, Jamie
Hartmann-Boyce, Lindsay Stead • Statistics advisor – Rafael Perera• Trials Search Coordinator – Lindsay Stead• Authors – 349 registered
• Review interventions for tobacco use & prevention, such as behavioural, pharmacotherapies, mass media, policies, e-cigarettes
Tobacco Addiction Group (TAG)
• Also manage some ‘orphan’ reviews e.g. of treatments for allergies
• We currently have:
- 12 reviews in the pipeline
- 12 published protocols
- 73 published reviews
• Based in the Radcliffe Observatory Quarter, Oxford
• Funded by the NIHR
• http://tobacco.cochrane.org/
• Follow us on Twitter @cochraneTAG
Tobacco Addiction Group (TAG)
• Founded in 1998
• Editorial base: Plus:- Marina Davoli - 485 authors- Laura Amato - 9 editors- Zuzana Mitrova - 125 referees- Silvia Minozzi
• Based in Rome at ASL Roma E (Health care provider/Local Authority)
Drug & Alcohol Group (CDAG)
• The group conduct reviews within the following topic areas: opiates; alcohol; psychostimulants; poly drug use; prevention
• Reviews on alcohol: 17 in the pipeline; 10 published protocols & 23 published full reviews.
• http://cda.cochrane.org
• Funded by the Department of Epidemiology, Lazio regional Health Service of Lazio Region, Italy
Drug & Alcohol Group (CDAG)
• Research associate UKCTAS funded PhD (smoking cessation & primary care) at University of Birmingham
• New Cochrane TAG protocol & review
• Co-app & trial manager for the Preloading Trial
• Transferred to Primary Care; University of Oxford- the base of Cochrane TAG
Our experiences: Nicola
• Volunteered to assist Cochrane TAG
• Managing Editor job became available. So now I:
- author reviews
- support our external authors
- manage the editorial & publication process
- manage social media & other promotion
- manage PPI input
Our experiences: Nicola
Led update of review of motivational interviewing for
cessation
fdfds
Co-author of review of interventions to
increase medication adherence- data
extraction
Our experiences: NicolaResulting opportunities
Peer reviewed publication and dissemination at conferences
Plenary sessions at UKNSCC & ASH
Wales
Review and social media training courses with Cochrane UK
Requested publications summarising
reviews e.g. JAMA
Promoting Cochrane at conferences
PhD research used to inform NICE guidance
Cochrane podcasts. Available at
cochrane.org & iTunes
Blog posts for Cochrane
Communications & UKCTAS
Our experiences: Jamie• Medical publishing maternity cover for CTAG
managing editor research associate for CTAG DPhil student and research associate
• First review:
• Since then I’ve been an author on 11 reviews
Our experiences: JamieResulting opportunities
Peer reviewed publication and dissemination at
conferences
Advanced methods training, including risk of bias tools
Input on Cochrane editorial policies
Liaising with NICE and WHO on
guideline development
Involvement in divisional REF
committee Media appearances, including press briefing,
Today Show on Radio 4 and Channel 4 NewsInvited articles,
including BMJ & Addiction
• There are many ways that you can get involved Cochrane Review Groups:
- Author a Cochrane Review (new or update)- Become a peer referee and comment on draft protocols and reviews- Translate articles for inclusion in Cochrane Reviews- Suggest topics for reviews
• CDAG have a number of reviews that need updating
• Contact:
Getting involved
Nicola [email protected]
Zuzana Mitrova [email protected]
Questions?