预防血凝块溶解的药物（抗纤维蛋白溶解疗法）用于改善动脉瘤破裂引起的蛛网膜下腔出血后的恢复 研究问题 抗纤维蛋白溶解疗法对动脉瘤性蛛网膜下腔出血患者有什么效果？ 研究背景 蛛网膜下腔出血是指出血到大脑和颅骨之间的小空间，该空间包含为大脑供血的血管（蛛网膜下腔）。这种出血的原因通常是其中一条脑血管中的薄弱点（动脉瘤）破裂。蛛网膜下腔出血是一种相对少见的中风类型，但通常发生在年轻时（一半的人年龄小于50岁），因此具有重大的社会经济影响。蛛网膜下腔出血后的预后通常很差；三分之一的人在出血后死亡；而在幸存者中，五分之一的人在日常活动中需要协助。蛛网膜下腔出血后恢复不良的一个重要原因是动脉瘤反复（复发）出血（再出血）。这被认为是由天然血凝块溶解（纤维蛋白溶解）活动引起的。降低血凝块溶解速度的药物，称为抗纤维蛋白溶解药物，被作为一种治疗方法，以降低复发性出血的风险并改善蛛网膜下腔出血后的恢复。 研究特征 目前的证据更新至 2022年5月。本综述纳入了11项试验，共有2717名受试者，研究了抗纤维蛋白溶解药物对动脉瘤破裂引起的蛛网膜下腔出血患者的效果。 主要研究结果 抗纤维蛋白溶解治疗可降低再出血的风险，但不会提高总体生存率或独立进行日常活动的机会。我们的结论是，没有证据支持对动脉瘤破裂引起的蛛网膜下腔出血患者进行常规抗纤维蛋白溶解治疗。 证据质量 我们将结局的证据评估为中等质量到高质量，这意味...

卒中后知觉障碍的干预 关键信息 卒中会影响一个人处理和理解来自感官信息的能力，包括听觉、嗅觉、躯体感觉（体温、位置和运动的感觉）、味觉、触觉和视觉。处理和理解来自这些感官的信息被称为知觉。 很少有研究确定任何治疗对卒中相关知觉问题是否有帮助。 患有卒中相关听觉、嗅觉、躯体感觉、味觉、触觉和视觉问题的人群应继续按照临床指南的建议参与康复治疗。医疗保健专业人员应根据当前的临床指南和建议，继续为卒中相关的知觉问题提供康复服务。 什么是知觉障碍？ 在卒中之前，成年人通过他们的感官收集关于世界的信息，包括听觉、嗅觉、躯体感觉、味觉、触觉和视觉。躯体感觉是指从皮肤、肌肉或关节产生的感觉，包括对压力、振动、温度和位置的知觉。收集的信息可能包括他们看到的物体的颜色、形状和大小。连同记忆和文化体验，一个人可以从另一个人的面部表情中了解他们的感受。其他例子像是如何通过嗅觉识别不同的气味，以及如何通过触觉感受不同的质地。卒中会影响这些能力。 如何治疗知觉障碍？ 医疗保健专业人员，包括职业治疗师、物理治疗师和心理学家，可能会提供不同的疗法。治疗可能包括药物、大脑刺激或通过活动、游戏、策略或高强度重复任务进行知觉康复。 我们想知道什么？ 我们想知道接受任何知觉障碍治疗是否比不接受治疗好。我们通过观察人们进行日常活动的能力来衡量改善情况。我们测量了治疗是否也有助于其他方面，例如生活质量、心理健康和感知。我们...

预防遗传性血管性水肿发作的药物治疗 什么是遗传性血管性水肿以及如何治疗？ 遗传性血管性水肿（Hereditary angioedema, HAE）是一种严重且可能危及生命的疾病，会导致急性肿胀（突然发作）、疼痛和生活质量下降。现已有几种新药被用来治疗HAE急性发作和防止其复发。有些药物是口服的，而另一些则是皮下注射，或通过静脉直接注入血液。 目前用于预防HAE发作的药物是人C1酯酶抑制剂（通常缩写为C1-INH）、贝罗司他、拉那芦人单抗、氨甲环酸和达那唑。此外，我们还发现了另一种药物（阿伏司他），其预防HAE发作的能力正在研究当中。 我们想知道什么？ 我们调查了这些药物是否会减少HAE发作的次数，以及如果发作，那么发作的严重程度是否比不用药物时低。我们还研究了服用这些药物的人是否有更好的生活质量，以及这些药物是否会引起不必要的副作用。 我们做了什么？ 我们在医学数据库中检索了针对患有HAE的儿童或成人的临床研究，这些研究将预防HAE发作的药物与安慰剂（一种假治疗）或其他药物进行了比较。 我们发现了什么？ 我们找到了15项研究，共有912名受试者。除阿伏司他外的所有药物都减少了HAE发作的次数，即使确实发作了，使用了C1-INH和拉那芦人单抗的患者严重程度也较低（没有关于其他药物的结果）。我们发现大多数药物改善了HAE患者的生活质量，并且通常是安全的，因为它们不会增加严重和不太严重...

Cochrane has joined other health and social care bodies in a pledge to improve public involvement in research.

Cochrane has signed up to the Shared Commitment to Public Involvement in Health and Social Care Research. The Shared Commitment aims to bring about changes which will drive up standards in health and social care research. The statement was developed in partnership with members of the public and was launched in March 2022 during Science Week. 

Public involvement refers to all the ways in which the research community works together with people including patients, carers, advocates, service users, and members of the community.

Dr Matt Westmore, Health Research Authority Chief Executive, said: “It’s great to have Cochrane joining our Shared Commitment to Public Involvement.

This shared statement, developed with patients, research participants and leaders in health and social care research, will ensure public involvement is embedded across the health and social care research system.

The entire research system is sending the same strong message. That public involvement is always important, always expected and always possible. The evidence is that better research results from involvement, and better research delivers benefits for patients.”

Cochrane is an international, not-for-profit network of clinicians, patients and careers, researchers, and policy-makers creating high-quality healthcare evidence synthesises.

Catherine Spencer, Cochrane CEO, said: “Cochrane provides high-quality, synthesized evidence for health decisions. Involving the public ensures that our focus is meaningful and our evidence is accessible. Signing this public involvement pledge makes a clear statement; the input and involvement of patients, carers, and the public is valued by Cochrane.”

Richard Morley, Cochrane’s Consumer Engagement Officer, explains: “Cochrane has a long and rich history of collaborating with healthcare consumers. The Cochrane Consumer Network has played a formal role since 1995 with over 2,000 members and 2 Consumer Executives serving on the Cochrane Council. We have recently launched a framework that will help guide Cochrane’s work to 2027. Signing this public involvement pledge solidifies Cochrane’s commitment to ensuring that healthcare consumers are embedded and central to our work.”

Maureen Smith, Chair of the consumers Executive, said: “Cochrane consumers have a long tradition of involvement to ensure that evidence is accessible, relevant, and responds to the needs of their communities all over the world. Signing this pledge signals Cochrane’s firm commitment to advancing and supporting the incredible potential of consumers in their roles as users of evidence and producers of evidence.”

Organisations who have signed the shared commitment include:

• The Academy of Medical Sciences
• The Association of Medical Research Charities
• The Association of the British Pharmaceutical Industry
• Cancer Research UK
• Cochrane
• Health and Care Research Wales
• Health and Social Care Northern Ireland
• Health Research Authority (HRA)
• Medicines and Healthcare products Regulatory Agency
• National Coordinating Centre for Public Engagement
• National Institute for Health Research
• NIHR Applied Research Collaboration (ARC) North East and North Cumbria
• NHS Research Scotland
• Universities UK
• UK Research and Innovation

The statement, signed by leaders at each organisation, reads:

Public involvement is important, expected and possible in all types of health and social care research.

Together our organisations and members fund, support and regulate health and social care research. This statement is our joint commitment to improve the extent and quality of public involvement across the sector so that it is consistently excellent.

People have the right to be involved in all health and social care research. Excellent public involvement is an essential part of health and social care research and has been shown to improve its quality and impact. People’s lived experiences should be a key driver for health and social care research.

When we talk about public involvement, we mean all the ways in which the research community works together with people including patients, carers, advocates, service users, and members of the community.

Excellent public involvement is inclusive, values all contributions, ensures people have a meaningful say in what happens and influences outcomes, as set out in the UK Standards for Public Involvement.

Working together we will support the research community to carry out excellent public involvement. We will provide or share guidance, policies, systems, and incentives.

We will:

• listen to and learn from the people and communities we involve and apply and share that learning 
• build and share the evidence of how to involve the public and the impact this has 
• support improvements in equality, diversity, and inclusion in public involvement 
• promote the UK Standards for Public Involvement.

We will embed this commitment into the decision-making processes of our organisations.

• Learn more about Cochrane’s commitment to healthcare consumers
• Join Cochrane’s work as a patient, carer, or member of the public

Monday, December 12, 2022

Specifications: Part time 30 hours per week (0.8 FTE) - 1 year Fixed term contract
Salary:  £41,000 per annum full time equivalent
Location: Ideally based in the UK, Germany or Denmark. Candidates from the rest of the world will be considered; however, Cochrane’s Central Executive Team is only able to offer consultancy contracts outside these countries (1-year fixed-term contracts)
Application Closing Date: 20 November 2022

Cochrane has established a centrally-resourced Editorial Service to support the efficient and timely publication of high-quality systematic reviews in the Cochrane Library. The reviews that are published through the Central Editorial Service address some of the research questions considered to be the most important to decision makers.

Reporting to the Head of Editorial, the CES Information Specialist will provide post-submission search peer review as a member of the Central Editorial Service and to coordinate the Cochrane Information Specialists' Search Peer Review Team

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.

The majority of Cochrane Central Executive staff are located in London, UK, however flexible locations are possible for the right candidate. Please note, however, that we are only able to offer consultancy contracts outside of the UK, Germany or Denmark.

We will consider extended notice periods if required for applicants who wish to honour existing contracts. We fully support remote and flexible working arrangements.  

How to apply

• For further information on the role and how to apply, please click here.  
• The deadline to receive your application is by 20 November 2022.  
• 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.
• Read our Recruitment Privacy Statement

Tuesday, November 1, 2022 Category: Jobs

Specifications: Permanent Part time (0.5 FTE)
Salary: £43,000 per annum full time equivalent (pro rata to part time hours)
Location: Ideally based in the UK, Germany or Denmark. Candidates from the rest of the world will be considered; however, Cochrane’s Central Executive Team is only able to offer consultancy contracts outside these countries (1-year fixed-term contracts)
Application Closing Date:  14 November 2022

Cochrane is a charity and 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. They do this by synthesising research findings to produce the best available evidence on what works. Their work has been recognised as the international gold standard for high quality, trusted information.

The core purpose of this role is to advise and contribute to the development of Cochrane information products and deliver on key projects for the Publishing & Technology Directorate (P&T).

The majority of Cochrane Central Executive staff are located in London, UK, however flexible locations are possible for the right candidate. Please note, however, that we are only able to offer consultancy contracts outside of the UK, Germany or Denmark.

Cochrane welcomes applications from a wide range of perspectives, experiences, locations and backgrounds; diversity, equity and inclusion are key to their values.

We will consider extended notice periods if required for applicants who wish to honour existing contracts. We fully support remote and flexible working arrangements.  

How to apply

• For further information on the role and how to apply, please click here. 
• The deadline to receive your application is by 14 November 2022.  
• 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.
• Read our Recruitment Privacy Statement

Tuesday, November 1, 2022 Category: Jobs

Healthcare decision making can be complex – learn from Sarah’s personal story and make use of Cochrane resources.

Evidence-based healthcare is the integration of the best research evidence with clinical expertise and patient values. It is often represented with these three elements in a Venn diagram with these three equally important elements. However, decision making in healthcare isn’t always so neat and uncomplicated.  Cochrane systematic reviews contribute to the best available, current, valid, and relevant evidence in this process. Cochrane is also committed to helping others understand evidence-based healthcare and the role of evidence.

Sarah Chapman, a former nurse with a long career in health research, had progressive hearing loss since early adulthood. Recently she was faced with a life changing decision if she would like to go ahead with an optional cochlear implant. In this video with illustrations by Karen Morley, Sarah talks us through her personal story of healthcare decision making and how evidence and other factors fit into her thinking.

 

Sarah explains, “We are messy creature full of messy emotions, living complex lives, and it's in that space that we make our healthcare decisions. Understanding evidence and learning to spot which health information is trustworthy is important to all patients and caregivers – and Cochrane has the resources that can help with this.” You can learn more about Sarah’s in her personal blog, ‘From Ear to Eternity.’

Cochrane has a long and rich history of collaborating with healthcare consumers (patients, carers, and the public). Presenting our evidence in a way that is useful for people making decisions about healthcare and advocating for evidence in health and care is an important part of our work.

Cochrane’s Evidence Essentials is a free introduction to Evidence Based Medicine, clinical trials, systematic reviews, and how to use evidence when making decisions about your health. It was co-produced with patients and caregivers and it is presented a interactive and accessible manner.

Catherine Spencer, Cochrane CEO, says “For Cochrane to achieve its vision, producing high quality reviews of health evidence isn’t enough. Cochrane aspires to a world where all health decisions are informed by high-quality evidence – which means people need to first understand evidence and how to use it. As Sarah’s story shows, making health decisions can be complex. Cochrane’s Evidence Essentials helps people understand health evidence and how to use it. We hope that anyone new to the world of evidence-based healthcare will find this resource indispensable.”

• View the free online resource ‘Cochrane Evidence Essentials’
• Get involved in Cochrane’s work as a patient or carer

Friday, January 19, 2024 Category: The difference we make

在分娩后几天内插入植入物或宫内节育器（线圈）进行避孕或等待4至6周更好？ 当我们在本摘要中使用术语“人”时，我们指的是目前具有怀孕能力的人。 关键信息 - 在分娩后几天内放置避孕植入物或宫内节育器（ intrauterine devices, IUDs）（立即植入，在医院期间），而不是等待4至6周进行插入（延迟植入），会增加植入它们的人数。 -植入时间对分娩后6个月或12个月使用这些避孕方法的人数几乎没有影响。 -宫内节育器的排出似乎更常见于立即插入的人群。 - 需要进一步研究立即植入和延迟放置植入物和宫内节育器的意外怀孕率。 什么是避孕植入物或宫内节育器？ 避孕植入物和宫内节育器（intrauterine devices, IUDs）是高效的节育方法，可逆且可在分娩后不久安全使用。植入物插入上臂，宫内节育器由医生或护士插入子宫（子宫）。使用这些避孕方法的人使用植入物或宫内节育器。 适当的怀孕间隔对孕妇和新生儿的健康都有好处。通常，在分娩后的第一次全面健康检查时（通常在分娩后六周左右）提供避孕措施。然而，有些人在这次访问之前发生性行为，或者不参加植入，这增加了意外怀孕的风险。在分娩后几天内，在出院前插入避孕植入物或宫内节育器，对患者和医务人员来说很方便。已知有植入物或宫内节育器的人没有怀孕，这种做法可能会增加能够使用这些避孕方法的人数。 我们想知道什么？ 我们想了解在分娩后几天内...

Wednesday, October 26, 2022

Sometimes people avoid talking about uncertainty in scientific findings…but they shouldn't! Gain insights and practical advice on how to communicate uncertainty in this free resource.

Science is complicated and inherently uncertain – it’s hard for scientists and researchers to know how to talk with diverse audiences about this. We are excited for the launch of ‘How to communicate scientific uncertainty’ – a free resource directed at communication professionals and scientists and researchers sharing their work.

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, health information, and research. One of the main ways they meet their objectives is through beautifully illustrated, evidence-informed, bite-sized ‘flashcard’ courses about science and health-related topics aimed at the general public and students. 

“Drawing on experiences of the COVID-19 pandemic, Cochrane Convenes brought together leaders from across the world to explore and then recommend the changes needed in evidence synthesis to better prepare for and respond to future global health emergencies,” explains Cochrane's Editor in Chief, Dr Karla Soares-Weiser. “The Cochrane Convenes Report has a strong call for action for the research community to communicate scientific uncertainty better – this Lifeology course is a fantastic resource to address this.”

Author Nicole Kelp from Colorado State University says, “Uncertainty is complicated for all humans to handle, myself included! It was helpful to consider science communication from this empathic perspective while writing this course.” The Harding Centre for Risk Literacy reviewed a pre-final version. The course was reviewed multiple times by Muriah Umoquit, Senior Communications Officer at Cochrane.

This course has 43 cards illustrated beautifully by Jordan Hunter who uses the analogy of a Park Ranger helping people navigate the terrain with signage. “This project was a fun one to work on, “says Jordon. “The imagery in this course highlights the diversity of audiences and instead of text, I used symbols in speech bubbles so that the course can be easily translated.”

"Science communication thrives through collaboration among scientists, topic thought leaders, communication professionals, and creative visionaries like storytellers and artists," emphasized Muriah Umoquit, Senior Communications Officer at Cochrane and reviewer for this course. "It was great to join forces once again with Lifeology. This is the third collaboration with Lifeology, following the creation of the impactful resources ‘What is an infodemic and how can we prevent it?’ and ‘How to talk about vaccines when you’re not an expert’. We are thrilled to present our latest endeavor: a free resource on communicating scientific uncertainty. This invaluable resource is packed with practical advice and utilizes accessible language, empathetic storytelling, and relatable imagery. Join us and explore its enlightening content today!"

View the Lifeology course 'how to communicate scientific uncertainty' in:

• English
• Malay 

Learn more about Lifeology:

• Interview with Lifeology
• Lifeology website
• Lifeology on Twitter
• Lifeology on Instagram
• Lifeology on Slack

Wednesday, May 31, 2023

无创正压通气治疗中枢性睡眠呼吸暂停患者 本综述的研究内容是什么？ 本综述研究了无创正压通气（non-invasive ventilation, NIV）与其他治疗方法或不同类型的NIV相比对中枢性睡眠呼吸暂停（central sleep apnoea, CSA）患者的疗效，CSA是一种由于大脑无法向肌肉发出呼吸信号，导致患者在睡眠过程中经常停止呼吸的疾病。CSA更常见于男性和患有慢性心脏病的患者。CSA患者可能会在夜间经常醒来，在白天感到非常困倦，且不能像平时那样锻炼。睡眠呼吸暂停还可能增加患其他疾病的风险，如心脏病发作、卒中和死亡。 在NIV中，常用机器来帮助患者呼吸。在NIV治疗期间，患者通过使用面罩或鼻罩将空气强制吸入肺部，从而减少费力呼吸的需要。有几种类型的NIV疗法可用，他们通过不同的方式提供呼吸支持；下面是一些例子。 •持续气道正压通气（Continuous positive airway pressure, CPAP）：空气持续地被压入肺部（吸气和呼气期间）。 •双水平正压通气（Bilevel positive airway pressure, BiPAP）：吸气时空气压入肺部比呼气时更多。 •自适应伺服通气（Adaptive servo ventilation, ASV）：当患者停止呼吸时，空气强制压入肺部。 无创通气可以帮助空气进入肺部。然而，我们不知道NIV能...

外用皮质类固醇治疗干眼症的利弊 什么是干眼症 干眼症是一种常见疾病，通常发生在眼泪不能充分润滑眼睛的个体。多种原因可导致眼泪不足且不稳定。例如，当泪液产生过少或质量较差时可能会发生干眼症。泪液不稳定可导致眼睛表面发生炎症和损伤。干眼症时患者很不舒服，经常感到刺痛或灼痛，甚至视力模糊。 干眼症应如何治疗？ 干眼症有多种治疗方案。对于因泪液中水层相对缺乏引起的干眼症，治疗方法可能包括人工泪液、催泪剂、血清滴眼液和泪点塞。对于泪液中脂质层分泌受阻引起的干眼症，治疗方案可能包括局部应用抗生素、热敷和使用抗炎药，如皮质类固醇和环孢菌素A（CsA）。皮质类固醇滴眼液能够减轻炎症反应，并在短期内缓解症状。眼压升高和发生白内障是长期使用皮质类固醇的常见问题。 我们想从中发现什么？ 我们评估了皮质类固醇滴眼液单用或联用其他药物能否改善干眼症状，或用于诊断和监测干眼症的检查结果。我们还评估了皮质类固醇滴眼液是否会对眼睛造成任何不良影响。 我们做了什么 我们开展了一项系统综述。检索了对比皮质类固醇滴眼液和润滑液、其他阳性治疗或不治疗的研究。我们总结了相关研究的结果，并根据受试者的数量和各研究使用的方法对证据进行了分级。 我们发现了什么？ 最终纳入了22项临床试验，共涉及4169名干眼症患者。除1项试验纳入3至14岁的儿童外，大多数试验的受试者是平均年龄介于50至67岁的成年人。治疗时间在7天到3月不等...

系统性皮质类固醇治疗神经根性和非神经根性下腰痛 关键信息 对于神经根性下腰痛： -系统性皮质类固醇在治疗后不久可能对改善疼痛和功能有较小益处（短期随访），并可能在治疗后一段时间内改善功能（长期随访）； -虽然益处似乎不大，但系统性皮质类固醇可能是有用的，因为它们容易获取、成本较低，短时间内使用几乎没有副作用；但系统性皮质类固醇可能无益于避免手术； -目前尚不清楚系统性皮质类固醇的有效性是否会随着症状持续时间的变化而变化，因为对神经根性下腰痛的最佳剂量和治疗时间尚不清楚；避免高剂量可能降低伤害风险。 对于非神经根性背痛和椎管狭窄： -系统性皮质类固醇的益处尚不清楚。 什么是下腰痛以及如何治疗？ 系统性皮质类固醇是一种作用于全身的抗炎药物。对于患有神经根性下腰痛（坐骨神经痛，或与背部神经受压有关的腰痛，通常是由椎间盘突出或鼓胀引起的）的患者，皮质类固醇可以通过减轻椎间盘突出或鼓胀引起的肿胀和相关压迫来缓解疼痛，从而减少影响神经的压力。其他类型的腰痛（如“非神经根性”【或无神经累及】或由于椎管狭窄【脊柱变窄】引起的腰痛和腿痛）也可能有炎症成分，可对系统性皮质类固醇产生反应。 我们做了什么？ 我们检索了临床试验的医学数据库，以比较皮质类固醇与安慰剂（虚拟治疗）或无皮质类固醇治疗对成年人下腰痛的影响。我们比较并总结了他们的结果，根据研究方法和研究规模等因素对证据的可信度进行了评级。 我们发...

抗抑郁药治疗骨关节炎 研究背景 骨关节炎是一种以软骨减少和关节间隙狭窄为特征的关节疾病。它可能导致疼痛、畸形和残疾。 抗抑郁药物被认为是通过调节中枢神经系统的神经通路来影响疼痛的。 我们旨在评估抗抑郁药治疗膝关节和髋关节骨性关节炎疼痛的临床效益和伤害。 研究特征 本综述更新至2021年1月。我们纳入了9项含有2122名受试者的临床试验，将抗抑郁药与安慰剂（一种虚拟治疗）和非甾体抗炎药（广泛用于缓解疼痛和减轻炎症）进行比较。更多受试者为女性（70%），平均年龄为54.4至65.9岁。7项试验只检查了膝关节骨关节炎。其中2项还纳入髋关节骨关节炎的患者。所有试验都比较了抗抑郁药与安慰剂，使用或不使用非甾体抗炎药物。 关键结果 与安慰剂相比，抗抑郁药收效甚微。 疼痛 与安慰剂相比，服用抗抑郁药的疼痛在0-10量表中多减轻0.59分。 ——安慰剂组的疼痛减轻了1.73分。 ——服用抗抑郁药组的疼痛减轻了2.32分。 临床反应 临床反应被认为是疼痛减轻50%或以上。与安慰剂相比，服用抗抑郁药的人大约减少了16%（即六分之一）。 ——服用安慰剂的受试者中28.65%有临床反应。 ——服用抗抑郁药的受试者中45.2%有临床反应。 身体功能 身体功能是通过步行、爬楼梯和做家务来衡量的。与安慰剂相比，使用抗抑郁药的治疗效果提高了6%。与安慰剂相比，使用抗抑郁药后，在0-100分的范围内，功能得分减少...

Cochrane's framework to 2027 builds on existing work leading to consumer involvement throughout the entire process of research and dissemination of Cochrane evidence. 

Healthcare consumers (patients, carers, and the public) play a vital role in making sure that Cochrane evidence addresses important questions and is produced, presented, and made available in a way that’s useful for people making difficult decisions about healthcare. 

Our consumer volunteers are a vital part of our evidence community, and we thank them for contributing their time, skills and lived experience to the organisation. 

Cochrane supports consumer involvement and engagement in health research because it promotes transparency, accountability, and trust in the way that research is produced; results in evidence that addresses consumers’ needs; reduces waste in research; improves the translation of research into policy and practice;  leads to improved benefits for health systems and better outcomes for patients; is consistent with current health research approaches; and is expected or mandated by our funders, partners, and consumers themselves.

Cochrane's framework for consumer engagement and involvement to 2027 is a result of significant involvement of stakeholders: a task group, consultations, surveys, prioritisation exercises, and drawing on central strategies and previous work with consumers.

We would like to thank all those people who contributed to creating this ambitious vision and we look forward to the work ahead to make this a reality. 

Richard Morley, Cochrane’s Consumer Engagement Officer, explains; “Cochrane has a long and rich history of collaborating with healthcare consumers. The Cochrane Consumer Network has played a formal role since 1995 with over 2,000 members and 2 Consumer Executives serving on the Cochrane Council. This framework will help guide Cochrane’s work to 2027; upscaling our existing efforts and ensure consumers are embedded and central to our work.”

The framework has five elements:

1. Engagement - a programme of communication about health research, evidence dissemination, recruitment and learning that helps more people use evidence in health decision making.
2. Co-production - increase the number of reviews prioritised and that involve consumers in the evidence production process to ensure that reviews are aligned with users’ needs and support consumer involvement in the governance of Cochrane.
3. Accessibility - a programme to improve health literacy amongst healthcare consumers that covers understanding evidence, health research, critical appraisal, and shared decision making, whilst working to make Cochrane evidence more accessible.
4. Partnership - establish a range of international strategic partnerships, including patient groups, to develop engagement, co-production, advocacy and health literacy activities leading to the dissemination of Cochrane evidence and improved engagement and involvement.
5. Evaluation and reporting - establish an observatory in order to ensure Cochrane’s work in engagement and involvement is evidence based, and to monitor and evaluate the impact of its work.

“Cochrane’s importance in the world of evidence-based medicine, its increasingly global reach, and growing membership, create an opportunity to significantly develop its work to engage with an international patient and public audience,” says Catherine Spencer, Cochrane CEO. “This framework ensures that patients, carers and the public are at the heart of what Cochrane does.” 

Chris Champion, Cochrane's Engagement, Learning and Support, explains how the framework fits in to Cochrane's engagement strategy and how you can get involved. 

Maureen Smith, Chair of the Cochrane Consumer Network Executive, explains how the framework fits into Cochrane's engagement strategy and is relevant to patients, carers, and the public.

• Read and download ‘Cochrane consumer engagement and involvement framework to 2027’
• Visit the Cochrane Consumer Network Website
• Get involved with Cochrane as a patient or carer

Friday, March 10, 2023

Monday, October 17, 2022

炎症检测能否帮助医生决定是否使用抗生素治疗呼吸道感染? 关键信息 1.当患者在医生办公室出现呼吸道感染症状时，医生在就诊期间使用 C反应蛋白即时检测 可能会减少开具抗生素处方的患者数量，而不会影响患者康复。 2.我们不知道 降钙素原即时检测 是否对抗生素使用或患者康复有影响。 3.未来的研究应重点关注儿童、免疫系统疾病患者以及患有合并症（其他疾病）的80岁及以上人群。建议开展评估降钙素原和新型生物标志物以指导抗生素处方的研究。 什么是即时检测？ 即时检测在诊疗期间进行，只需要几滴血，可在3到20分钟内提供结果。这意味着 不需要 将血液样本运送到实验室，并且可以在就医期间立即使用结果来做出治疗选择。即时检测可以检测您的身体为应对炎症而在血液中产生的的不同物质，这些物质称为生物标志物。 什么是炎症和生物标志物？ 炎症是对细菌或病毒感染等损伤的反应。您的身体在炎症反应中会自然产生一些物质，这些物质可以在血液中检测到，这些物质被称为生物标志物。生物标志物的即时检测常用于有呼吸道感染症状的患者。检测结果可以告知医生什么时候 不 需要抗生素治疗以预防严重疾病和可能死亡的严重细菌感染。目前有三种类型的生物标志物可用作即时检测：C反应蛋白、降钙素原和白细胞。 什么是抗生素？ 抗生素是用于治疗细菌感染的药物，通常用于治疗呼吸道感染。然而，大多数呼吸道感染是由病毒引起的，例如普通感冒，抗生素对其无效...

抗组胺药预防和治疗晕动病 本综述的目的是什么？ 晕动病，也称为晕船或晕车，主要表现为恶心和呕吐。这些症状是由被动的身体运动引起的，即你的身体为响应其他实际运动（例如开车或坐在船上）而不自觉移动，或是因暴露于虚拟运动（例如虚拟现实模拟）和移动的视觉环境（例如从行驶的火车窗户向外看）而产生的运动错觉。抗组胺药是预防或治疗晕动病的一种常用药物。在本综述中，我们想知道这些药物是否真的起作用了。 关键信息 我们发现，易晕车的成年人服用抗组胺药在自然条件下（如坐船或飞机）出现晕动病的风险较安慰剂（模拟治疗）更低。同时，抗组胺药较安慰剂更容易产生镇静，即让人昏昏欲睡。沒有研究对抗组胺药能否有效治疗已出现的晕动病症状进行评估，其在18岁以下儿童中的信息也很少。与其他药物和非药物相比，抗组胺药的真实效果、其他不良反应以及对身体功能的影响（例如心率或肠胃运动）仍不确定。 本综述研究了什么？ 我们查找已患有晕动病的受试者接受抗组胺药或安慰剂（模拟治疗）的研究。我们也查找对比抗组胺药与其他药物或非药物治疗的研究。 本综述的主要结果是什么？ 抗组胺药对比安慰剂 结果显示，抗组胺药在自然条件下预防晕动病症狀的效果可能比安慰剂更好。 在试验条件下（即实验室中），与安慰剂相比，抗组胺药能否有效预防晕动病，或是否影响胃性快速心律失常（肠胃内运动）仍不确定。 与安慰剂相比，抗组胺药可能更容易引发镇静（即嗜睡）。但它...

髋关节或膝关节骨性关节炎运动疗法的辅助治疗 本综述的目的是什么？ 骨关节炎是一种慢性退行性疾病，常影响髋关节和膝关节，可导致疼痛和日常活动困难，例如行走等。陆上运动疗法指在陆地上进行的运动（与水中运动相对），是一种一线治疗方法。本综述旨在评估陆上运动疗法联合其他辅助疗法是否可以改善髋关节或膝关节骨性关节炎患者的疼痛、功能、生活质量、受试者报告的自我整体评估或 X 光变化。辅助疗法包括手法治疗、心理或饮食疗法、电物理疗法（如热、冷、神经刺激、超声波或激光疗法）或针灸。纳入比较辅助疗法联合陆上运动疗法与 1) 假（或模拟）辅助疗法联合陆上运动疗法或 2）仅陆上运动疗法的研究。 检索日期 本系统评价更新至2021年6月10日。 我们发现了什么？ 本研究纳入了来自24个国家共6508名受试者的62项 RCT，其中大部分是女性。平均年龄在52-83岁之间，出现症状的时间为9个月至12 年。60项研究纳入了膝关节骨性关节炎患者，1项纳入了髋关节骨性关节炎患者，1项纳入了膝和髋关节骨性关节炎患者。22项试验将辅助疗法联合运动疗法与假辅助疗法联合运动疗法进行比较，41项试验将辅助疗法联合运动疗法与仅运动疗法进行比较。38项试验评估了电物理治疗，7项评估了手法治疗，4项评估了针灸/干针或贴敷，3项评估了心理或饮食干预、全身振动（这涉及站在振动平台上）或水疗/矿泥疗法，1项评估了足部矫形器（鞋垫）。...

【治疗幼年特发性关节炎（JIA）相关性葡萄膜炎：肿瘤坏死因子（TNF）抑制剂的效果如何？】 关键信息 阿达木单抗似乎对治疗JIA相关性葡萄膜炎有益，而依那西普的证据非常有限。我们没有找到足够的证据来说明这些药物是否能预防视力下降；然而，研究的时间可能还不够长，不足以检测到视力的变化。TNF抑制剂的副作用通常是轻微的，尽管罕见严重副作用发生。 什么是幼年特发性关节炎相关性葡萄膜炎？ 幼年特发性关节炎（Juvenile idiopathic arthritis, JIA）是儿童时期最常见的慢性风湿性疾病，可引起关节炎症（关节炎）。一些患有JIA的患者也会出现眼部炎症，称为葡萄膜炎。如果未及时发现和治疗，葡萄膜炎可导致永久性眼损伤、视力障碍或失明。 怎样治疗JIA-相关性葡萄膜炎？ 有几种类型的药物用来治疗JIA-相关性葡萄膜炎。一组称为肿瘤坏死因子（tumor necrosis factor, TNF）抑制剂的药物是用于JIA和JIA-相关性葡萄膜炎的治疗方法之一。这些治疗针对的是一种叫做“肿瘤坏死因子”的蛋白质。这些药物可以抑制免疫系统，以减少炎症并防止眼睛损伤。 我们想知道什么？ 本综述的主要目的是确定TNF抑制剂是否可以改善JIA-相关性葡萄膜炎的症状，并总结这些治疗方法可能的伤害。 我们做了什么？ 我们检索了医学文献中比较TNF抑制剂与安慰剂治疗JIA-相关性葡萄膜炎的研究。...