Featured review: Control interventions in randomized trials among people with mental health disorders
- Researchers use many different control interventions in randomized trials on treatments for patients with mental health disorders, but there is little consensus on how to report and adequately design these controls. This practice has widespread consequences for the evidence base underpinning psychiatric treatments
- The choice, design and reporting of a control intervention is just as important as the experimental treatment in a randomized trial with psychiatric patients. This is not reflected in most randomized trials with mental health patients, as control interventions are often poorly reported upon and lack methodological rigor
- Some psychiatric treatments may be recommended based on just having compared the treatment with a waitlist or no-treatment control in a randomized trial, which may give a misleading picture of how effective the treatment is
Erlend Faltinsen, lead author, commented, "There is a need to develop methodological guidelines on how to design and report upon control interventions in randomized trials on psychiatric treatments, as trialists working in the field of mental health do not have a solid evidence-based framework to draw from on this issue."
Why was this review conducted?
The review investigates the beneficial and harmful effects between different control interventions in randomized trials with mental health patients. We wanted to investigate how control interventions differ from each other and to lay the empirical groundwork to develop methodological guidelines on reporting, and the design of control interventions in psychiatric randomized trials.
What did the authors do?
The authors conducted a Cochrane systematic review and meta-analysis to assess the benefits and harms between placebo, usual care (or treatment as usual) and waitlist controls versus receiving no treatment. In that way they assessed how effective and harmful different control interventions in psychiatric randomized trials are.
What did they find?
- 96 randomized trials were included and the trials involved 15 different types of mental health disorders
- When combining three different types of placebos, the beneficial effects compared with no-treatment or wait-list controls was small to moderate
- There was no significant difference between usual care controls and wait-list or no-treatment on benefits. The same was true for waitlist versus no-treatment controls
- Psychological placebos (non-active controls used mostly in psychotherapy research) showed moderate effects compared with no treatment whereas placebos used for physical treatments like surgery showed a small effect. We found no significant effects of pharmacological placebos versus no treatment
- There was little data on harms between the control interventions and the findings on harms were insignificant
- The control interventions were mostly poorly reported upon and there was little rationale for why a given control was used in most reports
What are the limitations of the evidence?
The certainty of the evidence was rated low to very low, and the risk of bias was rated high in all studies. The authors mostly included randomized trials with three intervention arms to compare two controls, which causes issues with blinding of participants and trial personnel. This limitation was due to the methodological objective of the review and may be viewed as part of the review itself rather than a flaw in the evidence-base. Many of the studies were small, however, leading to risk of small-study effects, which limits the evidence.
What gaps did the authors identify?
There is a need to develop methodological guidelines on control interventions in psychiatric randomized trials, as trialists working in the field of mental health do not have a solid evidence-based framework to work from when choosing and reporting upon controls
What important related questions were not addressed in this review?
The review did not compare usual care with placebo interventions, which would have been relevant. It did not quantify the level of reporting issues and rationale for choosing a control in a psychiatric randomized trial, which also would have been relevant.
Who will find this review most relevant?
Psychiatric researchers and especially those who conduct randomized trials will find the review relevant for their research work. It may also appeal to trialists in general and methodologists.
How up to date is this review?
The search was conducted in March 2018. The researchers were not able to screen records after this date, since the search process was very large and extracting data was exceptionally time-consuming.
Specifications: Full Time 1 year Fixed Term contract
Salary: £42,000 per annum
Location: UK based (remote)
Application Closing Date: 25 April 2022 (9am GMT)
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.
A Project Manager role has become available to support the Evidence Production and Methods Department (EPM), Publishing and Technology department (P&T), Cochrane Library Product Manager and other Central Executive Teams (CET) in delivering on high priority projects: to project manage the highest priority EPM, P&T and other Cochrane projects where appropriate.
Key essential criteria we are looking for:
- Project Management qualification
- Publishing experience
- 2-4 years’ experience in project management, change management and risk management. Proven track record in delivering projects
- Experience of Agile project management methodology
- Experience with project management software tools e.g. Microsoft Project, JIRA, Confluence, SmartSheets
For further information on the role and how to apply, please click here. The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples. Note that we will assess applications as they are received, and therefore may fill the post before the deadline.
Deadline for applications: Monday 25 April 2022 (9am GMT).
Cochrane’s Governing Board is pleased to announce the appointment of Catherine Spencer as Cochrane’s new Chief Executive Officer.
Catherine joins Cochrane from The Seafarers’ Charity where she held the position of CEO.
Prior to her role at The Seafarers’ Charity, Catherine was acting Chief Operating Officer and Director of Communications and Change Management at international public health research organisation, icddrb, in Dhaka, Bangladesh. Between 2008-2015 Catherine held various senior management roles at the Army Families Federation, including three years as Chief Executive.
Governing Board Co-Chairs, Tracey Howe and Catherine Marshall said: "We are delighted to welcome Catherine to Cochrane. Catherine is a proven Chief Executive with an exceptional record leading non-profit organisations. She brings expertise in strategic planning, change management, and communications backed by a global perspective. Catherine is well positioned to partner with the Editor-in-Chief, Karla Soares-Weiser, to lead Cochrane as we drive an exciting programme of delivering trusted evidence, promoting informed decisions, and better health.”
Catherine lives with her family in Wiltshire, England after many years moving frequently, including living and working in Canada, Germany, Cyprus and Bangladesh.
Catherine will take up the position as CEO in July 2022.
Grant to enhance evidence-informed guideline recommendations for newborn and young child health in three sub-Saharan African countries
Grant to enhance evidence-informed guideline recommendations for newborn and young child health in South Africa, Malawi and Nigeria
The Global Evidence, Local Adaptation project aims to maximise the impact of evidence for poverty-related diseases by increasing the capacity of decision makers and researchers to use global research to develop locally relevant guidelines for newborn and child health. The project will support decision makers in South Africa, Malawi and Nigeria, and will build on and add value to the large-scale programme of child-health guideline development led by the World Health Organization (WHO), with adaptation and implementation led by the WHO Afro regional office, country offices and national ministries.
“Despite progress in the health of newborns and children, most sub-Saharan African countries have not met the Sustainable Development Goals for under-five mortality,” said Tamara Kredo of Cochrane SA. “In the context of COVID-19, even though most children present with mild conditions, the consequences of the pandemic are being felt on health systems and services, hampering healthcare delivery to children and increasing poverty, food insecurity and inequity. To address these issues, policy makers and practitioners not only need evidence-based guidance on effective clinical care, they also need guidance on how to implement this care efficiently within the context of their own health systems, considering inequity (in health and access to services) caused by poverty and other factors.”
“MAGIC is thrilled to be partner in GELA,” said Per Olav Vandvik. “The need to allow WHO guidelines to make an impact in member states is critical. Now is the time to show this is possible and we believe this strong consortium of partners is excellently placed to get the work done.”
“Clinical practice guidelines offer a means to bridge the gap between research evidence and practice and are essential policy-implementation tools supporting implementation of effective, cost-effective healthcare,” added Kredo.
The European and Developing Countries Clinical Trials Partnership (EDCTP) has awarded three-year (2022 – 2025) funding of over 3 million Euro to a partnership coordinated by Cochrane South Africa (SA), South African Medical Research Council along with partners from the Norwegian Institute of Public Health, The Norwegian University of Science and Technology, Western Norway University of Applied Science, Stellenbosch University (South Africa), Cochrane Nigeria at the University of Calabar Teaching Hospital, Kamuzu University of Health Sciences (Malawi), Cochrane and the Stiftelsen MAGIC Evidence Ecosystem (Norway).
The specific objectives are to:
- ENGAGE: Identify child and newborn priority topics and the capacity needs of guideline panels.
- SYNTHESISE: Support policy makers and researchers to find, appraise and use best-available systematic reviews and guidelines.
- DECIDE: Support guideline panels’ capacity to contextualise global evidence using transparent, digitally supported standards and WHO methods for guideline development.
- SHARE: Disseminate and communicate guideline recommendations to healthcare providers and the public using innovative and user-friendly formats and digital platforms.
- LEARN: Strengthen capacity of researchers and policy makers for all aspects of guideline development, adaptation and dissemination.
- EVALUATE: Monitor and evaluate policy makers’ experiences of this approach, preferences for receiving evidence, capacity development and overall impact of the project on evidence-informed decision-making processes.
GELA will incorporate a multi-faceted, multidisciplinary research and capacity-strengthening programme using primary and secondary research, guideline-adaptation methodology and digital platforms to support delivery and dynamic local adaptation. This is enabled through a project team of African and international leaders in the field of evidence-based healthcare and guidelines methods partnering with national ministries in Malawi, Nigeria and South Africa, the WHO and its Afro regional office and the civil society group, Peoples Health Movement.
The European and Developing Countries Clinical Trials Partnership (EDCTP) is a partnership between the European Union, developing countries, donors and the pharmaceutical industry with a specific focus on funding clinical and collaborative research to detect, treat and prevent poverty-related infectious diseases in sub-Saharan Africa.
ABOUT THE PARTNERS
Cochrane South Africa
Cochrane South Africa (SA) is an intramural research unit of the South African Medical Research Council and is part of the global, independent Cochrane network of researchers, professionals, patients, carers and people interested in health. It aims to promote evidence-informed healthcare decision-making in South Africa and sub-Saharan Africa by producing high-quality, relevant, accessible systematic reviews and other synthesised research evidence.
Cochrane focuses on producing relevant and timely synthesised evidence and is a global advocate for evidence-informed health and health care. We work towards a world of improved health where decisions about health and health care are informed by high-quality, relevant and up-to-date synthesised research evidence. Our members and supporters come from more than 130 countries, worldwide.
The independent non-profit Norwegian MAGIC Evidence Ecosystem Foundation was set up in 2018 to provide sustainable and professional services to our customers (e.g. MAGICapp) while pursuing the evidence ecosystem vision through continued research and innovation.
MAGIC leads the work package on disseminating and communicating CPG recommendations to healthcare providers and the public. GELA will make use of innovative formats and the MAGIC authoring and publication platform (MAGICapp) to adapt, translate WHO guidelines for national and local use. MAGIC will also support development and adaptation of the guideline recommendations, customised to the needs of decision makers and making use of the GRADE EtD framework.
Centre for Evidence-based healthcare, Stellenbosch University
The CEBHC is a recognised leader nationally and globally for research and practice in teaching and learning for evidence-based health care (EBHC). Based at the Faculty of Medicine and Health Sciences they support undergraduate and post-graduate training in all aspects of EBHC. They lead a Masters in Clinical Epidemiology programme recognised throughout the continent. Leads at SU have spearheaded several projects linked to evidence synthesis, knowledge translation, building capacity of policymakers and researchers for evidence-informed policymaking, and supported national and international guideline projects.
The Norwegian University of Science and Technology (NTNU) focuses on knowledge creation for a better world and solutions that can change everyday life. NTNU’s Department of Health Sciences in Ålesund, part of the Faculty of Medicine and Health Sciences, has research areas focusing on health service research, clinical nursing, and education. The Department has a strong interest in collaboration and knowledge transfer between academic institutions and health services and on innovation in partnership with health services.
Western Norway University of Applied Sciences (HVL) selected evidence-based practice (EBP) as an institutional priority in 2003. Since then, HVL’s Centre for Evidence-Based Practice has conducted research and provided education in this field and has offered a master’s degree in EBP since 2008. HVL has thus taken a national position with this strategic focus on EBP, and is the only Centre for Evidence-Based Practice at universities in Norway.
The Norwegian Institute of Public Health (NIPH) acts as a national competence institution placed directly under the Ministry of Health and Care Services. Our social mission is to provide knowledge and systematic reviews to contribute to good public health efforts and healthcare services. In this way we contribute to better health, both in Norway and globally.
Cochrane Nigeria at the University of Calabar Teaching Hospital's Institute of Tropical Disease Research and Prevention is involved in the production and dissemination of relevant and priority systematic reviews of healthcare interventions, provision of technical support for development of trustworthy clinical practice guidelines and knowledge translation activities involving the media. Our long term strategic goal is to strengthen stakeholders' capacity to use evidence to inform decisions for positive individual and population health outcomes within Nigeria and the West African sub-region.
Kamuzu University of Health Sciences
Kamuzu University of Health Sciences (KUHeS) is a public-owned university established in 2019 under the act of parliament by merging the Kamuzu College of Nursing (est. 1979) and College of Medicine (est. 1991). As a key government partner, the university continues to serve the Malawi nation through provision of quality education and innovation through research as key to the health welfare of Malawi, the region and beyond. Through research the university generates evidence that informs government policies and practice in the health sector. KUHeS is an internationally recognised institution currently leading the teaching of systematic reviews, evidence-based healthcare and formulation of evidence-informed health guidelines in Malawi.
Featured review: Does giving money to people, in low‐ and middle‐income countries, without conditions attached lead to better health and other life improvements?
Specifications: Full Time (Permanent)
Salary: £60,000 per annum
Location: Flexible, UK
Application Closing Date: Friday 15 April 2022
A wonderful new opportunity has come up on the team at Cochrane, a brilliant not-for-profit publishing organisation that facilitates global medical research. They are now looking for a new Head of Editorial who will lead the editorial operations and oversee the transition of editorial processes to a centralised system. With lots of change and growth planned, this is an exciting opportunity to join an expanding team and be involved with the strategic direction and leadership of the team.
Reporting into the Editor in Chief, you will have responsibility for:
- Overseeing a small team of direct and indirect reports
- Managing editorial operations for articles submitted, contributing to the development of new processes for direct submissions
- Attending editorial board meetings as part of senior management team
- Contributing to the editorial strategy for the launch of new journals and supplementary products
- Facilitating communication and collaboration among different directorates
The ideal candidate will possess strong leadership skills and the ability to manage relationships with key stakeholders both internal and external to the business. Candidates applying do need experience with Editorial Manager as this is a new system which has been implemented. They will ideally come from an scholarly publishing background - ideally STM, and understand the importance of systematic reviews, research platforms and digital resources, and their role within research. Some experience of line management and budget management will be great, together with familiarity with a charity organisation or the healthcare sector.
Cochrane is a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesizing research findings to produce the best available evidence on what can work, what might harm and where more research is needed. Our work is recognised as the international gold standard for high quality, trusted information. An understanding of Cochrane’s work and health research more generally is an advantage, but not essential.
How to apply
If you're interested in finding out more about this great role, get in touch with Shalini Bhatt at Inspired Selection with your CV via email@example.com.
Cochrane has been a non-governmental organization in official relations with WHO since 2011, and a major aspect of this partnership is supporting WHO’s global health guidelines with relevant evidence synthesis.
The Cochrane Pregnancy and Childbirth Group has a long-standing collaboration with WHO on the development and updating of Cochrane reviews that inform WHO’s guidelines on global maternal and perinatal health.
In March 2022, WHO released the updated comprehensive guideline called ‘WHO recommendations on maternal and newborn care for a positive postnatal experience’. It focuses on the weeks shortly after the birth and makes 63 recommendations on maternal care, newborn care, health systems, and health promotion during the postnatal period.
The guideline draws on the evidence from a suite of systematic reviews and qualitative evidence syntheses, including 13 Cochrane Reviews. These Cochrane Reviews cover:
- Relief of postpartum pain (5 reviews; 3 recommendations)
- Pelvic floor muscle training for pelvic floor strengthening (1 review; 1 recommendation)
- Preventing and treating breast engorgement and mastitis (2 reviews; 4 recommendations)
- Preventing postpartum constipation (1 review; 1 recommendation)
- Vitamin D supplementation for term breastfed infants (1 review; 1 recommendation)
- Timing of discharge from health facilities to the home (1 review; 1 recommendation)
- Schedules for postnatal care contacts (1 review; 2 recommendations)
As well as the 12 Cochrane Reviews, a Cochrane qualitative evidence synthesis on the factors that influence the provision of postnatal care was used to help understand the acceptability and feasibility of different aspects of postnatal care, according to health workers.
The Cochrane evidence highlights the broadened scope of the guideline, and sheds important light on some of the most common experiences of women after having a baby.
Evidently Cochrane Author Jessica Hatcher-Moore with her first baby at home, days after giving birth. Jessica had a positive first experience of birth but felt poorly prepared for what came next. Image: © Philip Hatcher-Moore
“The WHO guideline sets out clear recommendations around the common health issues women experience after giving birth. It brings renewed and due focus to the importance of a positive postnatal experience at the heart of care - because no woman should ever feel abandoned by health services after having a baby”, says Aleena Wojcieszek, a clinical epidemiologist, science communicator, and honorary research fellow at the Australian Centre of Research Excellence in Stillbirth (Stillbirth CRE). “I was excited to highlight the need for real investment in postnatal care and urgent need for high-quality research in a recently Evidently Cochrane blog. It’s written jointly with Jessica Hatcher-Moore, a new mother, and illustrates how good postnatal care should aim to meet every individual woman’s needs, leaving the new mother, her baby and family with a positive experience of this critical period in their lives.”
"Cochrane is extremely proud of this valuable work and our continued partnership with WHO", said Dr Karla Soares-Weiser, Editor in Chief of the Cochrane Library. "This particular collaboration makes it possible to translate the latest maternal and perinatal health evidence into practice quickly, which ultimately benefits more people's health."
- Read 'WHO recommendations on maternal and newborn care for a positive postnatal experience'
- Read the Evidently Cochrane blog: 'Putting positive experiences at the centre of postnatal care'
- Visit the Cochrane Pregnancy and Childbirth website
- Visit the Cochrane Incontinence website
Wednesday, March 30, 2022
While guarding against misinformation on social media, mechanisms are not protecting trusted information
Cochrane’s Instagram posts have been removed, their Instagram account has been shadow banned, and now a Cochrane Library Twitter post about winning a prestigious award for trustworthy information has been tagged as misleading. These incidents highlight the realities of Cochrane’s call against misinformation while protecting trusted sources.
Cochrane’s health evidence syntheses are recognised as the international gold standard for high quality, trusted information. Cochrane Library reviews are used to support global and national health guidelines and policy. We advocate for evidence-informed healthcare and make our trusted evidence accessible and available to all. One way we do this is using social media to reach different audiences.
This week the prestigious Harding Prize for Useful and Trustworthy Communication was jointly awarded to by the ONS Covid Infection Survey and the Cochrane Review of Hydroxychloroquine for COVID-19. The Harding Prize, run in association with Sense About Science and the Science Media Centre, and is supported by Sir David Harding, goal is to draw attention to the unsung task of 'informing and not persuading' and celebrate those who were doing it well.
The Harding Prize judges noted that the Cochrane Infectious Disease Group’s review of the evidence for the use of hydroxychloroquine in treating COVID-19 used clear language, communicated straightforwardly, and with balance that that there was no benefit to hydroxychloroquine which outweighed the side effects and that trials of it should be stopped. This review was done with rigorous methodology and communicated with clarity and directness, which enabled policy makers, journalists, and the public to discuss and make decisions based on the best evidence.
It was particularly ironic that a celebratory tweet from the Cochrane Library about winning an award for useful and trustworthy communication was tagged by Twitter for being misleading. This tag does not allow it to be replied to, shared, or liked.
“Social media platforms are starting to act on mis/disinformation by tagging posts that are deemed misleading and penalizing repeat offenders”, says Sylvia de Haan, Cochrane’s Head of Advocacy, Communications and Partnerships. “It’s likely our ‘misleading’ tag from Twitter was due to the hydroxychloroquine hashtag. However, misleading posts are still using this hashtag without restrictions, while a post from the Cochrane Library, a leader in health evidence synthesis, is blocked. This incident, like other recent examples, illustrates how the system is imperfect. It underscores the urgent need to not only guard against misinformation on social media but have better mechanisms to protect trusted information.”
“This latest social media blunder comes after the recent launch of the Cochrane Convenes Report which highlights the parallel challenges of generating trust in evidence and countering mis/disinformation and calls for concrete action to address these issues”, says Cochrane’s Editor in Chief, Dr Karla Soares-Weiser. “There is an ongoing issue with how you hold those deliberately creating and sharing mis/disinformation to account and how you form accreditation and approval for official sources of evidence that have met certain quality control standards. We need to make it easier for people to access trustworthy information – and that includes on social media.”
Cochrane is a proud supporter of WHO’s call to action on infodemic management and is currently collaborating with science communicators at Lifeology and the Association for Healthcare Social Media. We would welcome the opportunity to discuss this recurrent issue with social media platforms directly and to work with others interested in supporting science communication. Write to us at firstname.lastname@example.org, and consider signing our call to action on trusted evidence for all in health emergencies.
Featured review: Do blood thinners prevent people who are hospitalised with COVID‐19 from developing blood clots?
The inaugural Harding Prize for Useful and Trustworthy Communication has been jointly won by the ONS Covid Infection Survey and the Cochrane Review of Hydroxychloroquine for COVID-19.
The Winton Centre at the University of Cambridge launched the Harding Prize this year to celebrate individuals or teams who had communicated information in a trustworthy and useful way - that genuinely helped people decide what to do, or help them judge a decision made by others. The award was run in association with Sense About Science and the Science Media Centre, and is supported by Sir David Harding. The organisers wanted to draw attention to the unsung task of 'informing and not persuading' and celebrate those who were doing it well.
The Harding Prize aims to encourage evidence to be presented in a balanced, non-manipulative way, open to talking about pros and cons, and about uncertainties, designed to help the audience make up their own mind on a subject – not to lead them to the conclusions that the communicator wants them to draw.
Dr Bhagteshwar Singh, and his co-authors of the Cochrane Review, published by the Cochrane Infectious Diseases Group said: “We are honoured to receive this award. Our aim was to provide clinicians, policymakers and the public with a balanced, trustworthy, and clear account of the potential benefits and harms of hydroxychloroquine when used for COVID-19. This award confirms that our review was communicated clearly and transparently, which we are thrilled to hear.”
The organisers bought together an illustrious judging panel, comprising:
- Helen Boaden (Chair): previously Director of BBC News.
- Professor Sir Jonathan Van-Tam: Deputy Chief Medical Officer for England
- Baroness Onora O’Neill: philosopher and presenter of 2002 Reith Lectures on ‘A Question of Trust’
- Fraser Nelson: Editor, Spectator
- Helen Jamison: previously Deputy Director of the Science Media Centre.
The judges made the following comments about Cochrane as a joint winner:
As with all its projects, the Cochrane review worked to internationally agreed methodology and prioritised high quality (randomised) evidence. This particular review was a summary of the evidence for the use of hydroxychloroquine in treating Covid-19. Using clear language, it communicated straightforwardly and with balance that that there was no benefit to hydroxychloroquine which outweighed the side effects and that trials of it should be stopped. That decision was then made.
This subject may seem minor in the UK where treatment by hydroxychloroquine was never a big part of medical discussion. However, many millions of people around the world, especially in the USA and Brazil, were encouraged by their leaders to take this treatment seriously.
The panel felt that just as the ONS survey was the bedrock of accurate information about Covid-19 infection rates in the UK, the Cochrane approach delivered rigorous, trustworthy and balanced reviews of scientific papers communicated with clarity and directness. Such reviews enabled policy makers, journalists and the public to discuss and make decisions based on the best evidence.
Helen Boaden, Chair of the judging panel, commented: “It's never been more important for the public and policy makers to have access to the best possible evidence before they make significant decisions for themselves or others. Both our winners set the gold standard for clearly communicating accurate, trustworthy, transparent data without frills or spin. The panel is delighted to jointly award them the inaugural Harding Prize.”
Professor Sir David Spiegelhalter, Chair of the Winton Centre, said: “The panel considered many fine examples, and we are delighted with the examples that they chose. We had intended to have a booby, ‘weasel words’ prize for untrustworthy communication dressed up as an unbiased source. There were many possible candidates, particularly in social media and in scientific pre-prints that had not gone through any peer review. But we finally decided that it would be inappropriate to highlight, and indeed publicise, such poor practice, and instead chose to focus on the positive efforts people have made. The Royal Society’s recent report makes clear that online misinformation is best tackled, not through censorship, but by encouraging a diverse media, independent fact-checking, careful monitoring, and education.”
Tracey Brown, director of Sense about Science, said: “Statistics are the currency of public life. They are how we can describe the world and debate what is getting worse or better, and never more so than during the pandemic. We are so pleased to support the Harding prize in celebrating the individuals who have sought to equip people with the means to be part of those debates."
Fiona Fox, Chief Executive of the Science Media Centre, said: “These are fantastic winners. The brilliant thing about the ONS survey is that it was communicated independently from the government communications machine so that the media and the public got to see the numbers every week free from government messaging. And in the middle of an ‘infodemic’ where 1000s of scientific papers of variable quality were circulating, Cochrane’s high quality review summarising where the best evidence lay on a much-hyped treatment undoubtedly saved lives.”
Emma Rourke, Director of health analysis and pandemic insight at ONS, said: :The Covid Infection Survey has required the skill and perseverance of a large and multi-talented team. At our core has been the need to communicate such an important and sensitive issue accurately to a diverse audience, and be trusted to do so. We are delighted with this award, and are gratified that the information we have provided has proved valuable to expert users and influential on policy, but also understood clearly by the public."
Researchers and methodologists have an important contribution to make to the response to climate change, by producing and synthesizing evidence relevant to climate-health impacts. While Cochrane has identified climate change as a key issue in its strategic plans, this editorial explores how to translate that high-level awareness into action and what work is needed.
This webinar recording from Denise Thomson, founder and convenor of the Cochrane Climate-Health Working Group, explains the group’s work and why they believe that evidence synthesis and knowledge translation are so important in tackling climate change.
Cochrane US and Lifeology hosted an International Women's Day themed #sciart challenge. The two winning designs have been selected and added to the Cochrane Store.
For International Women’s Day (IWD) on March 8th, Cochrane hosted several free events, including an art and graphic challenge with Cochrane US and Lifeology to illustrate the theme of IWD for 2022: #BreakTheBias. The art or graphic had to be related to healthcare and/or evidence synthesis.
Two amazing designs were selected and we spoke to the artists to learn more about the meaning behind the designs.
This pen and ink piece has to do with the personal geographies of women navigating their own bodies, health science, and economic access within what seems at times like an ocean wave or radio wave of fluidity. It represents the collaborative of women, building on each other's successes, and rising to higher peaks of understanding.
Shauna Lee Lange is the founder of Steam Creatives. She is an artist, analyst, and advisor with over 30 years experience in creative industries and government regulatory oversight. In 2005, she combined work in both fields to concentrate on a range of activities from self-taught professional artist, curator, and show producer to inside art influencer in the global art market. The digital component of her expert art advisory services known as Metaverse Watchdogs tracks the NFT, NFT art, crypto art, and blockchain art spaces. Steam Creatives was born out of a need to find a home for art that centered on visual communication within science and technology. Lange makes her home on Central California's coast, a place of much untouched natural beauty. You can view more of Shauna's work on the Steam Creatives website: https://steamcreatives.com/
Three women from diverse backgrounds strike the "Break the Bias pose". Each of the women are stacked on top of one another so their crossed arms form the crossings of a double helix. The rest of the DNA strands are filled with small science-themed doodles coloured in black.
Abbey Morris is a recent graduate from the Master of Science Communication program at Laurentian University in Canada. She loves science communication because it allows her to bridge her interests in art, science, and social justice. Abbey strives to make scicomm a more equitable, diverse, and inclusive space for people to share their passion for science in creative and engaging ways. You can find more of Abbey's work on her website: https://abbeymor.wixsite.com/home
Lina Cellante is a medical biotechnologist currently cutting her teeth in the medical writing world. In her previous life she was a researcher dealing with drug delivery and nanoparticles to fight brain cancer. During the years spent in the lab, she felt a growing need to better communicate her daily work and to find a way to interact more effectively with other scientists. After her Master's degree, she graduated in Journalism and Science communication and worked at the European Commission as a scientific communication officer. She has always been passionate about writing and her interests are nutrition, its positive influence on body health and mind, and how to make the most out of the technology we have to stimulate curiosity and convey positive messages. You can find more of Lina's work on her Lifeapp space: https://lifeapps.io/author/healthbites/
These designs are now available for a limited time in the Cochrane Store - on totes, t-shirts, and mugs!Friday, March 25, 2022
A statement from Cochrane's Governing Board:
"Ukraine situation: Cochrane is an independent, diverse, global organization that collaborates to produce trusted synthesized evidence, make it accessible to all, and advocate for its use. Our guiding principles include participation, collaboration and access. We endorse peace, and share World Health Organization's concern for the health of those affected.
Cochrane and Wiley provide one-click free access to the Cochrane Library for Ukraine via IP recognition. There is also full text access available through a partnership with Research4Life for Refugee Camps recognized by UNRWA or categorized by UNHCR as 'planned/managed camps.'"
Tuesday, March 8, 2022
Find exactly the evidence you need: at-a-glance PICO summaries now available with Cochrane Abstracts
With the new feature including PICO terms on review pages, you will be able to find the most relevant Cochrane evidence to answer your research or clinical question.
One way to construct a well-built question is to use the PICO model. PICO stands for Population, Intervention, Comparison, and Outcomes.
- Population (or Patient or Problem) What are the characteristics of the patient or population – for example condition?
- Intervention What is the intervention under consideration for this patient or population – for example a drug or surgical intervention?
- Comparison What is the alternative to the intervention ¬– for example a different drug or a placebo?
- Outcome What are the relevant outcomes – for example quality of life or adverse events?
Cochrane's Information Specialists and Data Curation Specialists have annotated the PICO terms of Cochrane Reviews using the Cochrane Vocabulary.
"Adding PICO summaries to Cochrane reviews will make Cochrane evidence more accessible and increase its use in health and care decisions, which is part of Cochrane’s mission.” says Cochrane’s Editor in Chief, Dr Karla Soares-Weiser.
You can already use PICO Search to find reviews in which the search term is used as a Population, Intervention, Comparison, or Outcome. For example, PICO Search enables you to find reviews which consider Diabetes specifically as a Population component or alternativity as an Outcome component, therefore enabling you to search with precision on the PICO terms which are of specific interest.
Every Cochrane Review from 2015 onwards now have the PICO terms listed under the abstract. This PICO overview helps ensure you find the most relevant Cochrane evidence to answer your research or clinical question. You will also be able to click on the individual PICO terms to see search results for all our Reviews tagged with that PICO term.
“We worked directly with users of the Cochrane Library to learn about what improvements they wanted and how we could improve their journey on the site” said Rachel Craven, Head of Cochrane Library. “Having PICO terms expertly annotated in Cochrane Reviews can help answer your research and clinical questions – we’re excited to see them now prominently placed below each Cochrane Abstract.”
76% of new guidelines issued by WHO referenced Cochrane reviews in 2021.
Cochrane’s status as a non-governmental organization (NGO) in official relations with the World Health Organization (WHO) was recently renewed at WHO’s Executive Board meeting.
The official relation status enables us to join and make statements at key WHO meetings as a non-voting participant. This includes the World Health Assembly (WHA), WHO’s decision-making body, which is attended by representatives of all Member States, and is a key forum to advocate for evidence-informed health policies.
The renewal is also underpinned by a new joint plan of work for the next three years. Activities in the plan include:
- Providing relevant evidence synthesis and methodological support for consideration in the development of new WHO guidelines, the Essential Medicines List and other guidance
- Supporting WHO with training in the interpretation of evidence synthesis
- Contributing to activities which facilitate the use of evidence in policymaking at national, regional and global levels
- Collaboration on areas of mutual interest, including on essential medicines and diagnostics; research integrity; healthy ageing; reproductive health and nutrition
WHO is a key partner for Cochrane. This relationship enables us to provide input on the way research evidence is identified, synthesized, assessed and used by WHO – and ultimately contribute to improved health for all.
Use of Cochrane evidence in WHO guidance: in figures
Cochrane has been in official relations with WHO since 2011. As of 1 February 2022, 732 reviews from 47 Cochrane Review Groups (CRGs) have been used to inform 251 WHO accredited guidelines and other evidence-based recommendations.
In 2021, 76% of new WHO guidelines were informed by evidence from Cochrane reviews. A total of 78 reviews from 16 different CRGs are referenced.
Cochrane reviews have also been used in WHO’s COVID-19 technical guidance. Last year, a total of 13 reviews were used across 20 of WHO’s COVID-19 publications.
Cochrane is proud to be a core partner of the Evidence Collaboration on COVID-19 (ECC-19), coordinated by the WHO Science Division. We were also delighted that WHO was a co-sponsor of Cochrane Convenes and we hope to collaborate further in taking forward some of the recommendations in the resulting Call to Action.
A community effort
The relationship with WHO is supported by the efforts of many members of the Cochrane community. Thank you to everyone who has contributed to this ongoing, impactful work. Particular thanks also go to Emma Carter at Cochrane UK for her work in charting how Cochrane reviews are used in WHO guidelines and other technical guidance.
For more information on the work that Cochrane does with WHO, please get in touch with Emma Thompson, Cochrane’s Advocacy and Partnerships Manager.
Read our statements made at recent major WHO events
We are pleased to share the winners of the 2021 Cochrane-REWARD prize.
The Cochrane-REWARD prize recognizes successful local or pilot initiatives that have potential to reduce research waste globally if scaled up. Cochrane has funded the prize since it began in 2017. For this iteration of the prize, submissions related to tackling research waste relevant to COVID-19 were encouraged.
The prize ceremony took place on 1 March virtually (recordings are available below). Two representatives of the prize committee – Matt Westmore, Chief Executive of the UK Health Research Authority, and Lex Bouter, Professor of Methodology and Integrity at Vrije Universiteit Amsterdam – joined to announce the winners, who gave short presentations on their initiatives. Lisa Bero, Cochrane’s Senior Research Integrity Editor, also joined the session to give an update on Cochrane’s research integrity agenda.
2021 Cochrane-REWARD prize winners
This year was particularly competitive, with many very strong contenders for the prize committee to consider. Thank you to all who submitted nominations, and congratulations to the winners below:
First prize: COVID-END
The COVID-19 Evidence Network to support Decision-making (COVID-END) was awarded first prize. Jeremy Grimshaw and John Lavis accepted the prize on behalf of the network.
COVID-END is a time-limited network of 58 global evidence synthesis, guidance and decision support partner organizations established to better coordinate the evidence synthesis response to the COVID-19 pandemic and reduce research waste.
Together with its partners, COVID-END has worked to reduce waste in all five stages of research. Selected highlights include:
- Setting up a global horizon scanning panel to proactively identify recurrent and emerging issues requiring evidence syntheses in the coming months.
- Developing interactive flow-diagrams for researchers and guideline developers planning to work on a new review or guideline pointing them to helpful resources, while encouraging them to ensure that they are not duplicating the efforts of another group.
- Creating an inventory of best evidence syntheses highlighting quality up-to-date living syntheses that make it easier for decision makers to find the best evidence.
- Establishing a COVID-END community and living hub of COVID-19 knowledge hubs to link evidence synthesis, guidance and decision-support groups around the world interested in learning from others and sharing best practices.
- Providing the foundation for the Global Commission on Evidence to Address Societal Challenges, a report which aims to seize on the once-in-a-generation focus on evidence presented by the pandemic, calling for sustained efforts to systematize the successful aspects of using evidence and to address the shortfalls.
This is drawing directly from COVID-END partners (and their lessons learned) to shape the report’s contents and identify pathways to influence for the Commission’s recommendations at global, national and local levels.
The prize committee was particularly impressed with COVID-END’s global reach, which includes participation from low- and middle-income countries (LMICs). The committee also saw that such an approach could be adapted and deployed for other crises in the future.
Second prize: MRC-NIHR Trials Methodology Research Partnership
The MRC-NIHR Trials Methodology Research Partnership (TMRP) received the second prize. Paula Williamson accepted the prize on behalf of the initiative.
TMRP is a community of practice which draws together several networks, academic institutions and partners engaged in trials and trials methodology research to strengthen links between trialists, methods researchers, clinicians, patients, the public and funders. It includes eight thematic working groups on topics such as adaptive designs, outcomes, statistical analysis and trial conduct.
As well as leading to more impactful research and less duplication of effort, better networking facilitated by TRMP enabled researchers to pivot and respond to the COVID-19 pandemic.
Selected network projects include:
- A priority-setting exercise to develop a trials methodology research agenda, feeding more specific exercises for recruitment and retention research, patient and public involvement in methods research, and priorities for methods research in LMICs.
- Designing clinical trials, including several platform trials of potential COVID-19 treatments, including the RECOVERY, AGILE, and HEAL-COVID trials.
- Developing COVID-19 core outcome sets (COS), including a ‘meta-COS’ for acute COVID-19, a COS for COVID-19 transmission prevention and a COS for Long COVID.
- Producing guidance and tools for researchers to support transparent and complete reporting of research.
The panel was very impressed with TRMP’s large body of work to date. We saw great potential to improve the overall standards of trial design, analysis and reporting if the approach were to be scaled up across further contexts.
Thank you to the Cochrane-REWARD prize committee
Special thanks to the Cochrane-REWARD prize committee for reviewing the entries during what was an especially competitive year for the prize. In 2021, the prize committee was:
- Lex Bouter, Professor of Methodology and Integrity, Vrije Universiteit Amsterdam
- Sabine Kleinert (chair), Senior Executive Editor, The Lancet
- Joan Marsh, Editor-in-Chief, The Lancet Psychiatry
- Merel Ritskes-Hoitinga, Professor in Evidence-Based Laboratory Animal Science, Radboud University Medical Center
- Kieron Rooney, Associate Professor, University of Sydney
- Matt Westmore, Chief Executive, UK Health Research Authority
Lifeology’s tagline is ‘The place where science and art converge’. They offer a platform that brings together scientists, artists, and storytellers to help people better understand and engage with science and health information and research. One of the main ways they meet their objectives is through beautifully illustrated, science-backed, bite-sized ‘flashcard’ courses about science and health-related topics aimed at the general public and students.
Knowing more about the people in science, technology, engineering, arts, and math (STEAM), how they faced adversity and overcame obstacles may inspire others to choose STEAM careers. This was the goal of Lifeology's Historic STEAM Heros card deck. Though art and storytelling they share the story of historical STEAM figures and their excellent but often under-promoted work.
In recognition of International Women's Day (IWD) happening March 8th, they have selected Anne Anderson to add to their card deck. Anne Anderson was a contributor to the stream of thinking and effort that gave birth to evidence-based health care and led to development of Cochrane. We spoke with the artist who illustrated the card, Anna Doherty, to learn more about the project.
Hi, Anna! Our Cochrane Community always finds it interesting to learn the backstory to things and learn more about people. Could you tell us a bit more about yourself?
Hi! I’m an illustrator and author from Edinburgh, Scotland. Ever since I was very small, I’ve always enjoyed drawing, so when I finished school I went to study illustration at Duncan of Jordanstone College of Art and Design. After graduating, I decided to study a masters in Children’s Book Illustration at Cambridge School of Art. Since graduating there, I’ve been working on a mixture of illustrating picture books, science illustration, and other little projects. I now have ten illustrated picture books published, some of which I wrote too! I am especially excited about working in non-fiction, which is why I think I enjoy science illustration so much, because I love learning new facts and finding fun new things to share with people. I have a mini-series called Fantastically Feminist which focuses on celebrating stories of amazing women. I wanted to make a space for kids to read in which not only showed that everyone should be equal, and that anyone can do anything regardless of their gender, but also that celebrated women who struggled to try and make things more equal for the rest of us in brilliant ways.
What an interesting mix of projects! How would you describe your art style?
I would describe my art style as digital mixed media. I usually draw on a Wacom tablet, which is connected to my computer. When I draw on the tablet, the marks I’m making come up on my screen in photoshop. I use a selection of brushes, and add in scanned textures that I’ve made with ink and paint to add some interest.
You’ve done some science communication and some lovely ‘Women in STEAM’ work. Can you tell us how you got into that?
I got into science communication through my picture book Ada Lovelace. I had always loved maths at school, so when I first heard about Ada, I was fascinated, and I started absorbing every fact about her that I could lay my hands on. After I published my book about her, it opened the door to the world of science illustration, and I was particularly excited about promoting more women in STEAM. Ada’s work wasn’t really recognised until after her death, so it’s amazing to be able to celebrate women and gender diverse scientists who are working today!
Anne Anderson is a beloved person in the Cochrane Community - we do a walk every year in her honour to raise money for an annual award in her name. Can you tell us a bit about working on that artwork?
I loved working on Anne Anderson’s illustration because she wasn’t a story I had explored before. It was fun to draw a Scottish scientist! I started by reading the research that Lifeology had collated already, and did a little more digging myself. With every ‘Historic STEAM Hero’ illustration, I start by drawing the portrait so I can get to know the person a little better first. Then I make a little list of the key things I want to include in the illustration, and think about how I can represent them. Because I work digitally, I tend to draw all the little icons first and then move them around the face to find the best composition. Each illustration is greyscale with one colour, and I chose purple for Anne because it’s the colour of International Women’s Day and represents Cochrane!