Featured Review: Interventions for patients and caregivers to improve knowledge of sickle cell disease and recognition of its related complications
Positive effects of educational interventions on improving patient knowledge of sickle cell disease and reducing depression
Sickle cell disease is a lifelong, inherited disorder which can cause a number of complications throughout an individual's life. It may cause a huge burden on both the patient and their family, including frequent visits to healthcare facilities. The illness causes not just physical complications such as painful crises and strokes, but may have many other effects such as depression, poor quality of life, coping issues, and poor family relationships. When people with a chronic illness have better understanding about their illness, they manage their illness better and can improve their quality of life.
A team of Cochrane authors based in Barbados and Jamaica, supported by Cochrane Caribbean, worked with Cochrane Cystic Fibrosis and Genetic Disorders to determine if any educational interventions have helped people with sickle cell disease and their caregivers to improve their understanding of the disease, recognize its complications, improve their adherence to treatment, affect how they utilize health care, and improve other social and psychological problems that they might face. Their review includes 12 trials involving a total of 563 people with the disease, aged 6-35 years of age.
Educational programs and other interventions resulted in improvements in both patients’ and their caregivers’ knowledge or understanding of sickle cell disease, and a decrease in the patients’ levels of depression. Effects on patients' knowledge were maintained for longer than for caregivers. The interventions studied showed no effect on patients' utilization of health services, relationships between families, caregiver or patient skills, coping, or health-related quality of life of the patient. No comparative data were reported for patients or caregivers (or both) recognizing signs and symptoms leading to self-management. No trials assessed adherence to treatment.
“This review identifies important positive effects of educational interventions on improving patients’ knowledge of their sickle cell disease and reducing their depression. Improvements in patients' knowledge were maintained for longer than for caregivers. The effect on knowledge was significant but small, and whether it offers any clinical benefit is uncertain,” says Dr. Monika R Asnani (an author with Cochrane Caribbean) of the Sickle Cell Unit at the Caribbean Institute for Health Research, University of the West Indies and co-lead author of the Cochrane Review. “Significant factors limiting these effects could be trials recruiting low numbers of participants and there was much variation between studies. To better study effects on outcomes, further controlled trials are needed with rigorous attention given to improving recruitment and retention and to decrease bias.”
Read the full Cochrane Review
Visit the Cochrane Cystic Fibrosis and Genetic Disorders Group website
Visit the Cochrane Caribbean website
The International Infection Prevention week is the 3rd full week in October every year - a good time to share some of our relevant Cochrane evidence.
Central venous catheters: latest evidence for nursing practice on Evidently Cochrane
Replacing peripheral venous catheters: have you ditched the routine? on Evidently Cochrane
Getting evidence into nursing practice: replacing the routine on Evidently Cochrane
Vaccines for Preventing Rotavirus Diarrhoea: Vaccines in Use on Cochrane Child Health blog
There is a @WeNurses chat on Thursday 20th October at 8pm BST on the use of gloves & aprons for infection prevention & the (lack of) evidence. It’s guest hosted by two infection specialist nurses and will use the hashtag #wenurses. Details here.
Click on the title or image to go to the full Cochrane Review.
The 2009 Lancet series on adding value and reducing waste in research has documented that much research is wasted because its outcomes cannot be used . The waste occurs during 5 stages of research production: question selection, study design, research conduct, publication, and reporting [2,3]. For each of design, publication, and reporting there is a "loss" of around 50%, which implies a total waste of at least 85%. This translates into an estimated global loss of around $170 billion per year. Much of this waste appears to be avoidable or remediable, but there is little recognition of the need to develop and implement the needed remedies.
The Cochrane-REWARD prize will highlight both underused "remedies" and the need to invest in research to identify problems and solutions to them. Cochrane is now calling for nominations for the 2017 prize.
More information on the prize and how to submit a nomination
- Chalmers I, Glasziou P. Avoidable waste in the production and reporting of research evidence. Lancet. 2009 Jul 4;374(9683):86-9.
- Macleod MR, Michie S, Roberts I, et al. Biomedical research: increasing value, reducing waste. Lancet. 2014 Jan 11;383(9912):101-4.
- Glasziou P, Altman DG, Bossuyt P, et al. Reducing waste from incomplete or unusable reports of biomedical research. Lancet. 2014 Jan 18;383(9913):267-76.
Following the loss of funding in support of their work, Frans and Anja Helmerhorst have decided to retire from their roles as the Co-ordinating and Managing Editors of the Fertility Regulation Group. We thank them for their contribution to Cochrane over many years and wish them both well in their retirement.
We are therefore looking for a new home for the Fertility Regulation Group: covering systematic reviews of contraception and abortion. The current portfolio of the
Group includes 77 completed reviews, 13 published protocols and 4 titles. Information on the work of the group can be found on its website: http://fertility-regulation.cochrane.org. Carol Manion, who is currently the group’s Trials Search Co-ordinator is willing to stay on in support of the group.
We will accept application from within existing Cochrane groups and beyond, but applicant groups should be aware of the following requirements:
- The group should be led by someone who has experience of authoring and editing Cochrane Reviews and also has relevant content expertise,
- The group will need to demonstrate that it has secure funding for its activities for at least 3 years, or a high prospect of being able to secure this.
- Core members of the team will include one or more lead editor (“Co-ordinating Editor”), Managing Editor (ME) and Trials Search Coordinator (TSC). Both the ME and TSC should either have relevant skills and expertise, or experience of working in these roles within a CRG, or preferably both (see here).
- The Co-ordinating Editor and her/his institution will be required to sign a Memorandum of Understanding with Cochrane, and will need to be able to demonstrate capacity to deliver at least 0.1 FTE availability / week, and preferably more.
- The ME and TSC will need to be able to contribute at least 0.5 FTE availability per week each, and must both be funded for their Cochrane activities.
- The group will need to develop an editorial board, but current members of the board may be willing to continue in the role, on request (see here).
Guidance on setting up a CRG can be found in the Cochrane Organisational Policy Manual but please note that this content is currently being updated.
Potential applicants should familiarise themselves with Cochrane’s commercial sponsorship and conflict of interest policies and the current core activities of a Cochrane Review Group.
Individuals or groups who are interested to explore this are welcome to speak with Frans Helmerhorst, outgoing Co-ordinating Editor (email@example.com) or David Tovey, Editor in Chief (firstname.lastname@example.org).
To apply please send a cover letter detailing the responses to the numbered bullet points above, and a short Curriculum Vitae of prospective Co-ordinating Editors, Managing Editors and Trials Search Coordinators to David Tovey. The closing date for applications is 30th November 2016.
After nine years’ service as Co-ordinating Editor and Deputy Co-ordinating Editor for the Cochrane Colorectal Cancer Group (CCCG), Rick Nelson has decided to step down. We are grateful to Rick for his contribution to Cochrane over this period as an editor and author.
We are now looking to appoint one or more new Co-ordinating Editor(s) to provide leadership of the Group. This is an important opportunity to lead and shape the future development of a strategically important area of Cochrane’s healthcare evidence coverage. The appointment is timely in the context of discussions about the structure and function of Cochrane’s Review Groups. Currently the Group’s scope also covers other abdominal surgery-related topics, including hernia and appendicitis, in addition to the detection, treatment and monitoring of colorectal cancer. The scope and therefore the name of the Review Group are open for discussion with the incoming Co-ordinating Editor.
The CCCG portfolio of reviews includes 168 active reviews and 37 protocols. On average, reviews published by the Group in 2014 and 2015 were cited 7.5 times.
Applications are welcomed from individuals based in any country. We invite applications from within existing Cochrane Groups and beyond, and also individuals interested in a job share. Applicants should be aware of the following requirements:
1. The Co-ordinating Editor(s) must have
- Experience of authoring Cochrane or alternative high quality systematic reviews
- Clinical expertise, either as a surgeon or oncologist
- Methodology expertise in the field of evidence synthesis, including risk of bias and GRADEassessments
2. The following attributes are desirable
- Experience of editing Cochrane reviews or equivalent
- Advanced methodological skills and knowledge
3. There is no funding available from Cochrane to support this post. Henning Keinke Andersen, the Group’s Managing Editor, and Sys Johnsen, the Information Specialist, are both based in Copenhagen, and have indicated that they are willing to continue in their roles. If the incoming Co-ordinating Editor wishes to introduce new staff members, she/he will need to demonstrate that secure funding to support these positions is available for at least 3 years, or there is a high prospect of being able to secure this.
4. The Co-ordinating Editor(s) will be required to sign a Memorandum of Understanding (MOU) with Cochrane, and will need to be able to demonstrate capacity to deliver at least 1 full day or equivalent availability per week, and to attend regional and international Cochrane editorial meetings. It is desirable that the Co-ordinating Editor’s host institution is also a signatory of the MOU.
5. The current members of the Editorial Board have indicated their willingness to continue in the role. However, the incoming Co-ordinating Editor may seek to strengthen the Board through recruiting additional members (see here).
Potential applicants should familiarise themselves with Cochrane’s commercial sponsorship and conflict of interest policies and the current expectations of a Cochrane Review Group.
Individuals who are interested to explore this opportunity are welcome to speak with David Tovey, Editor-in-Chief (email@example.com).
To apply, please send a cover letter detailing the responses to the numbered bullet points above, and a short Curriculum Vitae to David Tovey. The closing date for applications is 30th November.Friday, October 14, 2016 Category: Jobs
You can make a difference as a citizen scientist
Cochrane Crowd, Cochrane’s new citizen science platform, is a global community made up of volunteers who are helping to identify the research needed to support informed decision-making about healthcare treatments. Cochrane Crowd has reached 900,000 individual classifications of reports of randomized controlled trials (RCTs) eligible for Cochrane’s Central Register of Controlled Trials (CENTRAL), helping Cochrane Review authors around the world to find the evidence they need for their reviews. Every contribution counts – and we’d like your help reaching one million citations before the year is done.
Just 60 seconds a day can make a difference
In the last 20 years research output has grown exponentially, making it really difficult to keep up with the evidence. As a Cochrane citizen scientist, you would be helping us to identify and describe the research that may be very important in helping us to determine whether a treatment works, or whether a diagnostic test is accurate.
No previous experience required, you can start now or read some frequently asked questions.
Together we can reach 1 million citations screened!
Cochrane’s Steering Group and Senior Management Team invite you to attend the Annual General Meeting (“AGM”) on Tuesday 25th October 2016 . The meeting will be held at the Grand Hilton Seoul, at the 24th Cochrane Colloquium in Seoul, Republic of Korea.
Cochrane is a registered charity in the United Kingdom and must adhere to the legal requirements governing UK charities; one of these requirements is to hold an annual meeting of members. Currently, Cochrane’s members are its registered Groups (entities): Centres, Fields, Methods Groups and Review Groups; and one person from each Group is expected to attend the AGM.
The full list of business to be conducted at this AGM-special session is set out in the Agenda together with the attachments to the Agenda.
Item 14 on the Agenda is an open discussion, during which any attendee at the AGM will have the opportunity to ask members of the Steering Group and Central Executive’s senior management any question about the organisation, its strategic direction, management and funding. To facilitate discussion, attendees are encouraged to submit their questions in advance using the designated Colloquium website form. Any member of the Cochrane community who is not attending the AGM or Colloquium is also invited to submit questions here and they will either be answered at the meeting or in writing following the meeting, time permitting.
This is not your only opportunity to ask questions of Cochrane’s leadership. There will be an informal lunch meeting hosted by the Steering Group Co-Chairs Lisa Bero and Cindy Farquhar, and CEO Mark Wilson, earlier in the day of the AGM-special session (25th October), from 13:00 -13:50 local time in Seoul, to which Colloquium attendees are cordially invited. This will provide another, more informal opportunity for engagement with them.Wednesday, October 12, 2016
Successful two-day workshop increases awareness of evidence-based medicine and Cochrane
The Kazan Federal University, the home of Cochrane Russia, hosted a two-day workshop on the first step of conducting a systematic review; from registering the title to drafting the protocol. The workshop was intended for health professionals, researchers, academics, and teachers, willing to commit to development of Cochrane systematic reviews as authors or peer reviewers, and to Cochrane activities in Russia.
The event was a great success, with 15 graduating the two-day course and significant media coverage of the event and Cochrane’s work. Several news and TV stations covered the event, helping to increase the profile of Cochrane in Russia and inform the general public about the importance of evidence-based medicine.
Selected news coverage:
• В КФУ прошла уникальная для России школа доказательной медицины Кокрейн
• В "Прессуха Медиа Служба"
• В новостном блоке сайта КФУ
• Новости КФУ от 08.09.2016
A round-up of selected recent coverage citing, discussing, and presenting health evidence - updated throughout the month.
Cochrane contributor Hilda Bastian blogs on PLoS in memory of longtime Cochrane contributor Andrew Herxheimer and shares the untold story of his father, Herbert Herxheimer.
En route, Air Canada’s in-flight magazine, spotlight frequent flyer Peter Tugwell, Coordinating Editor of Cochrane Musculoskeletal.
Professor Edzard Ernst draws on Cochrane Evidence in his post on homeopathy in his post in Spector Health.
Tuesday, October 4, 2016
The World Health Organization (WHO), at the United Nations International Day of Older Persons (September 30), organised an event to support this year’s theme ‘Take a stand against ageism’. Cochrane Global Ageing, represented by Sue Marcus and Tracey Howe, participated in the event and made the following statement:
‘We’re delighted to be here on this significant day to celebrate the international day of older persons and the launch of Cochrane Global Ageing.
For those of you who may not be aware, Cochrane has been producing systematic reviews about health and health care for over 20 years and has had an official relationship with WHO for the past 5 years.
Cochrane Global Ageing will build on this relationship and continue to work with WHO to address the need for age appropriate systematic reviews and evidence synthesis methods that reflect both the multidisciplinary nature and diversity of ageing worldwide.
In setting up Cochrane Global Ageing, our first question was: to what extent do ageist attitudes impact on research in general and Cochrane Reviews in particular?
Our preliminary search of the Cochrane Library found only 45 reviews and 14 protocols from about 10000 records - that’s less than 1% of all reviews – and the term “ageing” showed no hits at all.
So we have to ask ourselves…. Is this evidence that ageism is present in our organization and policy practices? Or, does it indicate a problem of indexing and evolving terminology, making evidence difficult to find? We know for example that older people are under-represented in clinical trials. Clearly we need to look at this more closely.
In addition to this we’ll also be working with WHO on priority setting, to better reflect the needs and rights of older people. Ensuring wider dissemination, knowledge exchange and including older people in the process will be key.
We’re looking forward to creating a new era of evidence that doesn’t discriminate against older people and accords them the respect and dignity they truly deserve.’
Tracey Howe (Cochrane Global Ageing), Sylvia de Haan (Cochrane), Sue Marcus (Cochrane Global Ageing) and Ritu Sadana (WHO) meeting in front of WHO Executive Board room
In response to the statement, John Beard, WHO Director of Ageing and Life Course, said:
‘Many trials preferentially recruit younger adults excluding older people with multiple comorbidities and polypharmacy even though their physiology is quite different. Something like 80% of clinical trials exclude older people as subjects. It is absolutely crucial we move forward on this and it is great to see Cochrane leading the way.’
We all need to be able to make sense of evidence, whether we’re making decisions about treatments, or weighing up the latest health story to hit the headlines. Cochrane UK, in partnership with Students 4 Best Evidence, are putting the spotlight on common errors and misunderstandings with our new campaign, Understanding Evidence.
This series brings together the ideas that underpin the way we think about evidence. It shares resources and initiatives that can help with making sense of evidence, and highlights opportunities to get involved with others with an interest in evidence.
Please join us on social media (#UnderstandingEvidence), share your ideas, and help us make sure that we challenge claims and think critically.
So far this year, 90% of the 2016 WHO guidelines contain Cochrane Evidence
Cochrane exists so that healthcare decisions get better. During the past 20 years, Cochrane has helped to transform the way health decisions are made. Cochrane contributors - 37,000 from more than 130 countries - work together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. Many of our contributors are world leaders in their fields - medicine, health policy, research methodology, or consumer advocacy - and our groups are situated in some of the world's most respected academic and medical institutions. Our work is recognized as representing an international gold standard for high quality, trusted information.
Cochrane has been a non-governmental organization in official relations with the World Health Organization (WHO) since 2011. WHO develops global health guidelines, which are of a high methodological quality and are developed through a transparent, evidence-based decision-making process. Ensuring there is an appropriate use of evidence within these guidelines, represents one of the core functions of WHO.
The percentage of Cochrane Reviews used in WHO guidelines have been steadily raising. So far for 2016, Cochrane Reviews have been included in 90% of the WHO guidelines, which surpasses last year’s 75% inclusion rate. As of 26 September 2016, 474 reviews from Cochrane Review Groups have been used to inform 160 World Health Organization accredited guidelines and other evidence-based recommendations published between 2008 and 2016. Of the 160 WHO guidelines and other evidence-based recommendations that have used Cochrane reviews to inform their guidance, 14 have used over 10 reviews in any one guideline.
Cochrane’s partnership with WHO is helping to put our high quality evidence into guidelines that will have an impact upon health policies and clinical practise worldwide. It’s also a testament to the important and hard work that many in the Cochrane community are putting forward.
Specifications: Full Time
Salary: £24,000 - £28,000
Location: London, UK
Application Closing Date: 20/10/2016
Cochrane is a global independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making the vast amounts of evidence generated through research useful for informing decisions about health. We do this by identifying, appraising and synthesizing individual research findings to produce the best available evidence on what can work, what might harm and where more research is needed.
Our work is recognised as the international gold standard for high quality, trusted information. We want to be the leading advocate for evidence-informed health care across the world.
This is a new and exciting role for an individual passionate about finance and who would relish the challenge of creating new standard operating procedures to join our finance and core services team. The role will predominantly be the point of contact for colleagues in relation to payments and payment enquiries. This role will be 37.5 hours per week.
The successful candidate will need to be extremely well organized to manage a high workload. We are looking for an experienced Purchase Ledger with previous experience in a similar role with a proven collaborative approach to assist our internal and external customer needs with financial information.
For more information, please see the full job description.
If you would like to apply for this position, please send a CV along with a supporting statement to firstname.lastname@example.org with “Purchase Ledger Assistant” 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.
Sue Marcus joined Cochrane in 2010 as Managing Editor of Cochrane’s Dementia and Cognitive Improvement Group, after being a Researcher at the Oxford Institute of Population Ageing in the UK. She has a passion for demography and health.
Now, in conjunction with being a Cochrane Managing Editor, she is embracing an exciting new opportunity as Co-Director of the new Cochrane Field, Global Ageing, which launches on October 1st 2016.
How did Cochrane Ageing come about?
A group of us began discussions back in 2013 as part of a natural evolution of the Cochrane Healthcare of Older People Field (HCOP). My background is in demography and health and I had felt for a while that there was a need - or maybe ‘opportunity’ is a better word - to expand on what had been achieved by the HCOP. The result is the launch of Cochrane Global Ageing. Broadly, its aims are to promote the quality, dissemination, accessibility, applicability and impact of Cochrane systematic reviews and hopefully this will contribute towards better health and wellbeing of older people, everywhere. We want to connect people globally, within and outside Cochrane, and facilitate the sharing of knowledge and experiences related to global ageing and health so Cochrane can produce age appropriate reviews. Ageing is multidisciplinary by nature and we need reviews that reflect this so they are relevant and accessible to a wide audience - consumers, review editors, authors, specialists, policymakers, educators, commissioners and funders.
What do you plan to do?
We want to support and work with the Cochrane Review Groups who will produce these reviews. We also want to find ways to better disseminate them. We want to make this evidence more accessible by drawing on and extending our international network of users of Cochrane Reviews, and by extension support the collection and dissemination of global evidence about ageing and health. Knowledge exchange and translation will be key here.
Has the work of Global Ageing already started?
Yes, it has. We’re working closely with the World Health Organization. When we looked at the WHO’s action plan on ageing and health, we found it resonated well with the aims and objectives of Cochrane’s strategy to 2020. WHO have invited us to be part of their steering group for a priority setting exercise, which is to be developed this year. We have been invited to speak from the floor at the WHO meeting in Geneva on September 30th to celebrate the UN International Day of Older Persons. This coincides with the launch of CGA. We’re also holding a special session at the Seoul Colloquium, and we’re currently defining our scope by conducting a broad stakeholder engagement and prioritisation process with the advice and advocacy of our international Advisory Board. This will help us achieve our mission and objectives.
What impact would you like Global Ageing to have?
Ageing and health is not just about disease-focussed evidence, although this is very important.
We want to make sure that Global Ageing builds and develops effective relationships and ensure communication flows between researchers and decision-makers and reaches knowledge users, funders, older people, families and caregivers, and professional organisations. Ideally, these endeavours will contribute to reliable, high-quality primary research that is prioritized to answer pertinent, ‘real world’ health questions that are age appropriate and that improve the evidence-base on which our work is built.
In addition to building international capacity to synthesize research, we’d like to see more involvement from older people themselves. We know for example they are under-represented in clinical trials so this could be a way to give them a ‘voice’. This could mean greater participation in research and helping identify research questions and the need for innovation - including the development of study designs, services, technologies etc. Older people are a very valuable and under used resource!
How do you feel about the launch of Global Ageing?
I think it’s a very exciting development - and it carries a good deal of responsibility too! I’m very fortunate to be working with two highly-respected colleagues, Tracey Howe and Vivian Welch who are Co-Directors. They bring a range of expertise and experience that’s crucial to our success. There’s a wealth of talent, expertise and passion throughout Cochrane, and we’d like to see this harnessed and expressed through a variety of contributions to Cochrane Global Ageing. The new and innovative ways to get involved, such as Task Exchange and Cochrane Crowd will be the perfect vehicles for such contributions. We hope to work in partnership with complementary initiatives both within and external to Cochrane. We dare to think that the activities of Cochrane Global Ageing will provide a new gateway to optimising the health and wellbeing of ageing populations everywhere.
We’d love to hear from anyone who wishes to be involved with us! Visit the Cochrane Global Ageing website or send us an email.
European Stroke Organisation in association with Cochrane Stroke seeks a Guidelines Development Support Person - flexible location
Specifications: Half time (0.5 FTE)
Salary: £20,000 to £25,000
Application closing date: Friday 14 October 2016
The European Stroke Organisation (ESO) is a non-for-profit organisation that aims to improve stroke care in Europe and worldwide. As part of this effort, the development of Guidelines by ESO is a major cornerstone. The Guideline Committee (GC) of ESO has a central role in this process and has recently published a standard operating procedure (SOP; available here), which ensures that each ESO Guideline Document is developed according to the highest standards.
ESO, in association with the Cochrane Stroke Group, is looking for a person who will provide multi-level support to the ESO working groups during the development of ESO Guideline Documents.
The successful candidate is expected to have expertise in:
• developing and performing complex and comprehensive systematic literature searches;
• importing data and performing meta-analyses using Cochrane’s Review Manager software;
• assisting with identifying and summarising all relevant evidence in evidence profiles using the GRADE Profiler software (as described in the SOP);
• assisting in the grading of available evidence (as described in the SOP);
• interdisciplinary communications with technical staff from different countries and backgrounds: all communication and work-related activities will be in English.
Ideally, the successful candidate will have expertise in all aforementioned points. However, ESO will also consider applications from interested candidates who do not have expertise in all these points.
For more information, please see the full job description.
To apply, please send applications, by Friday 14 October 2016, to email@example.com along with a detailed curriculum vitae. Your application should indicate to what extent you meet the requirements for the post outlined in the job description and provide specific examples. List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post. Selected candidates may be required to attend for interview.
For many women with breast cancer, the use of post-operative radiotherapy will allow them to undergo less extensive surgery. In mid-July, Brisbane-based Radiation Oncologist Brigid Hickey and colleagues from Australia and New Zealand published two review updates that consider critical questions about the size of the doses in which radiation is given. Here, Brigid shares her thoughts on the important findings of both reviews.
‘So who gets breast cancer? Women with families, women with jobs, women with busy lives,’ says Brigid. ‘So from a patient perspective, our latest review updates consider really important questions about access to the most effective and convenient treatments that are the least disruptive to daily life. And from a more clinical perspective, they provide evidence to inform both the best patient outcomes and the most efficient use of our healthcare resources.’
The third update of Fraction size in radiation therapy for breast conservation in early breast cancer looked at nine studies involving 8,228 women. It asked if giving fewer radiation treatments using a higher radiation dose at each visit was as effective as the conventional 25 to 30 radiation treatments. ‘It’s very satisfying to be able to say that we now have high quality evidence for all sorts of outcomes, including local recurrence-free survival, breast appearance, toxicity, overall survival and breast cancer-specific survival. So in practical terms for example this means a patient may come for treatment 21 times instead of 30, and that’s meaningful for them because treatment can be incredibly disruptive. This is particularly the case for women in regional and rural areas, who we know may opt for mastectomy over the difficulties of travelling long distances to receive frequent treatments. We can now reassure patients with this precise data and robust evidence that fewer treatments are just as effective and the cosmetic outcome is just as good.’
‘And on the clinical side, if we can accommodate more people with fewer treatments we see an immediate benefit in terms of reducing waiting times for machines. These findings will also be incorporated into clinical guidelines, as with our earlier reviews that informed both NHS and Australian guidelines. These can be tightened up further now that we have this new evidence. It’s not always the case that we can be so absolute, but in this instance you could say that doing the Summary of Findings table was particularly satisfying as we really do have the evidence we needed.’
The second priority review update wasn’t as conclusive, as Brigid explains. ‘To some degree the jury is still out on Partial breast irradiation for early breast cancer and it’s more of a work in progress. In this case we looked at whether giving radiotherapy (RT) to part of the breast is as good as giving RT to the whole breast. Women with early breast cancer who choose to keep their breast need to have RT as well as surgery to remove the cancer to make sure it does not regrow in the breast. This usually means 25 to 30 visits to the RT department, five times a week. It’s not surprising that the idea of treating someone in five as opposed to 30 or 25 treatments is very appealing to patients and specialists alike. So this approach is already being used quite widely in some parts of the world, but we don’t really feel that the evidence is there yet. Our latest review update found that at the moment partial breast irradiation doesn’t give the same cancer control as treating the whole breast, and it may cause worse side effects. However, there are still four big ongoing studies that we are waiting to see results from. Ideally they will help us come to a more definitive conclusion in the next update of this review.’
For more details about both reviews and the implications of their findings, listen to Brigid discuss them on these Cochrane podcasts:
Specifications: Part-time, 17.5 hours per week
Salary: £30,738 to £32,600 per annum (pro rata)
Location: Oxford Road, Manchester, UK
Application Closing Date: 12 Oct 2016
Cochrane Wounds is looking for a dynamic and enthusiastic individual with excellent communication skills to support the production of systematic reviews in the field of wound care.
You will be a graduate with a strong health information background. A qualification in librarianship, information science or equivalent experience is essential.
Experience of designing and conducting online literature searches of databases such as MEDLINE, good computer literacy and a sound knowledge of medical terminology and systematic reviews are also essential.
You will have excellent interpersonal, time management and organisational skills and be able to work with considerable autonomy to regular deadlines.
As an equal opportunities employer we welcome applicants from all sections of the community regardless of gender, ethnicity, disability, sexual orientation and transgender status. All appointments are made on merit.
The Cochrane Library iPad edition presents the latest Cochrane evidence in a convenient mobile format. Monthly issues feature Cochrane Reviews selected by the Editor in Chief and abridged to optimize the iPad reading experience.
Use the Cochrane Library iPad app to easily access abstracts, read selected reviews, and view full-page Summary of Findings tables. With access to a range of topics each month, create reading lists tailored to your own interests. All content in the app is free, and new issues will download regularly to your Newsstand.
Monash University Mental Health and General Practice is seeking a Research Fellow (Evidence Review)
Job No: 552703
Faculty of Medicine, Nursing and Health Sciences
School of Primary Health Care
Department of General Practice
Location: Notting Hill
Employment Type: Part-time (0.8)
Duration: 12 month fixed-term appointment
Pro-rata of $62,271 - $84,513 pa Level A PhD
(plus 9.5% employer superannuation)
For complete information on the position and how to apply, please see the full posting on the Monash website.Friday, September 23, 2016 Category: Jobs
Cochrane is delighted to announce that we have received a grant of USD $1.15 million from the Bill & Melinda Gates Foundation. The grant will support the development of Cochrane's next generation evidence system, with a specific focus on maternal and child health. This system is a major component of Cochrane's wider technology development program designed to address the challenge of ever-increasing health data, often with conflicting research findings, and builds on Cochrane’s initial investment in projects including Linked Data and Project Transform. The next generation evidence system will develop new technology, ontology, structures, machine learning, and crowd engagement to change the ways health data are utilized and discover new solutions for global health.
Project work funded by this grant will run from September 2016 to late February 2017, and project funds will be dispersed among many Cochrane Groups including the Child Health Field and the Pregnancy and Childbirth and Neonatal Review Groups.
“We are delighted and honoured to receive this grant,” said Mark Wilson, Cochrane’s CEO. “We are proud that this award represents an endorsement of strategic investments we have been making in Linked Data and new ways of working.”Thursday, September 22, 2016