Cochrane China recently hosted a virtual event for the evidence-based medicine community that brought together many of its partners, local expertise, and international speakers. Here the team provides an overview of who was involved and what was covered at the event. 

The 3rd Beijing forum of evidence-based medicine and Cochrane China Network Symposium was successfully held virtually on January 15th, 2023. The host of this conference were Cochrane China Network and Beijing GRADE Center. The organizers are Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, affiliate of the Cochrane China Network; Beijing GRADE Center; and Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine. The co-organizers are affiliates of the Cochrane China Network, including Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong; Evidence-based Medicine Centre, Fudan University; Centre for Evidence-based and Translational Medicine, Wuhan University; Cochrane China Centre, West China Hospital, Sichuan University; Centre for Evidence-based Medicine and Clinical Research, Peking University; School of Public Health, Chongqing Medical University; Institute of Health Data Science, Lanzhou University; Evidence-based Medicine Centre, University of Nottingham Ningbo.

Professor Liu Jianping, director of the Centre for Evidence-Based Medicine of Beijing University of Chinese Medicine, and senior research fellow Fei Yutong at Beijing University of Chinese Medicine served as the chairmen of the conference. Meanwhile, the conference invited Professor Gordon Guyatt, McMaster University, Canada, senior management of the Cochrane China Network headquarters, a total of 5 internationally renowned scholars from the United Kingdom, the United States, Hong Kong and other countries and regions, as well as speakers from 9 member units of the Cochrane China Network. In total, 25 scholars gave academic reports.

The conference conducted in-depth exchange and discussions of cutting-edge evidence-based medicine topics, which was divided into four modules: interpretation of the Cochrane review publishing policy, translational evidence, research frontiers in systematic reviews and evidence synthesis, and research methods in clinical practice.

 To start,  Liu Jianping, the chairman of the conference, Centre for Evidence-Based Medicine of Beijing University of Chinese Medicine, and Chen Yingyao, Qian Huitang and Jin Yinghui, the rotating chairmen of the Cochrane China Network executive committee, delivered opening speeches, respectively.

Liu Jianping briefly introduced the origin and development of the Cochrane China Network, and hoped that everyone could communicate and exchange with each other on the progress and achievement in methodologies, as well as the opportunities and challenges faced through this conference.

Chen Yingyao, on behalf of the Cochrane China Network executive committee, warmly welcomed the presence of all experts and listeners attending the conference, and expressed heartfelt thanks to the hosts and organizers of the conference, as nine member units from eight regions could carry out academic exchanges through this cloud platform.

Qian Huitang stated that the conference invited experts and scholars from home and abroad to make academic reports, which provided a platform for communication and exchange among member units, and wished the conference a complete success. Jin Yinghui said that Cochrane China Network has been trying to participate in the production, dissemination and translation of evidence since the establishment of it two years ago, and hoped to attract more researchers and clinical workers to improve patients' health concepts based on the best evidence through the academic conference held biennially.

 On the morning of January 15th, the module of the conference was interpretation of the Cochrane review publishing policy. Catherine Spencer, the Cochrane’s chief executive officer, Gordon Guyatt, the founder of evidence-based medicine, McMaster University, Tiffany Duque, the central executive team of Cochrane, Liu Jianping, Beijing University of Chinese Medicine, and Liu Qin, Chongqing Medical University, were invited to explain the content Changes and New Strategies of Cochrane, GRADE for Network Meta-analysis, Communicating Science & Evidence during Health Emergencies, Cochrane Review of Traditional Chinese Medicine: Current Status and Challenges, and Interpretation of the Cochrane Review Publishing Policy in simple terms. The conference was hosted by Fei Yutong.

 On the morning of January 15th, with the module of “translational evidence–1”, Susan Wieland, director of Cochrane Complementary Medicine Department, Jin Yinghui, Wuhan University, Chen Yaolong, Lanzhou University, and Xia Jun with GRADE Center of university of Nottingham Ningbo were invited to separately report on Cochrane Complementary Medicine: The Global Benefit of Chinese Collaboration, Implementation Evaluation of Clinical Practice Guidelines, Scientificity, Transparency, Applicability and Rankings (STAR) Tool for Clinical Practice Guidelines, and Use of Cochrane's Reviews to Inform WHO Guidelines, which were focused on as a hot issue and frontier of research related to guidelines. The conference was hosted by Li Xun.

 On the afternoon of January 15th, the conference’s module was “translational evidence–2”. It invited Richard Hubbard, University of Nottingham Ningbo, Hao Yufang, Beijing University of Chinese Medicine, Tian Jinhui, Centre for Evidence-based Medicine of Lanzhou University, Li Xun, Beijing University of Chinese Medicine, and Wang Yongbo, Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, to reported on Using Routinely Collected Data for Clinical Research, Development and Adaptation of Nursing Guidelines for Integrative Chinese and Western Medicine, Progress and Challenges of the Research Methods on the Synthesis and Translational Evidence in Evidence Ecosystem, Enhancing Medical Students' Awareness of Evidence-based Medicine and Their Ability to Transform Knowledge Through Cochrane Evidence, Development of Clinical Practice Guideline Knowledge Graph, surrounding the key issues of interest in the process of developing and evaluating evidence-based medicine evidence. The conference was hosted by Wang Ping.

 In the module of “research frontiers in systematic reviews and evidence synthesis”, Zhan Siyan, Peking University, Nie Xiaolu, Beijing Children's Hospital, Capital Medical University, Wu Shanshan, Beijing Friendship Hospital, Capital Medical University, Yang Zhirong, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Mou Huanyu and Li Caixia, Chinese University of Hong Kong, and Huang Qiao, Wuhan University, were invited to introduce Progress in Evidence Synthesis, Umbrella Reviews: Strengths and Limitations, Evidence Synthesis of Predictive Models: A Case Study of Liver Cancer Risk Prediction, A New Method for Evidence Synthesis to Determine the Effectiveness of COVID-19 Vaccines, Effectiveness of Dyadic Psychoeducational Intervention for Stroke Survivors and Family Caregivers on Functional and Psychosocial Health: A Systematic Review and Meta-analysis, Effects of Nurse-led Interventions on Early Detection of Cancer: A Systematic Review and Meta-analysis, and Development and Promotion of An Online Helper for Systematic Reviews of Evidence-based Medicine. The conference was co-hosted by Han Mei, Beijing University of Chinese Medicine, and Sun Feng, Peking University.

 In the “research methods in clinical practice” module, Chen Shiyao, Fudan University, Shi Qiuling, Chongqing Medical University, Peng Xiaoxia, Beijing Children's Hospital, Capital Medical University, Tan Jing and Yu Jiajie, West China Hospital, Sichuan University, were invited to introduce Taking Clinical Practice to the Forefront of Research, Statistical Significance VS Clinical Significance: An Introduction to Minimum Clinically Meaningful Changes in Patient-reported Outcomes, Establishment of Reference Intervals and Clinical Decision Limits, The Development and Application of A RWD-based Method for Assessing the Effectiveness of Traditional Chinese Medicine in Pregnant Women, and Application of IDEAL in Surgical Clinical Researches. The conference was hosted by Xing Jingli.

This forum is another grand conference of the Cochrane China network two years after the founding conference of the Cochrane China Network. It is a high-level international conference in the field of Chinese evidence-based medicine. It is expected that Cochrane China Network will have better development in the work and research of Cochrane with the deeper and further academic collision and exchange.

A warm thank you and congratulations to everyone involved!

• Learn more about Cochrane China
• Get involved with Cochrane
• Learn more about events happening at Cochrane

Writen by Wang Ping and Li Xun. Reviewed by Fei Yutong, Liu Jianping, Li Feng, and Li Chenhui.

Friday, February 17, 2023

Overall lack of evidence raises questions about the benefits

People with chronic back pain may turn to spinal cord stimulation to ease their pain, but a University of Sydney led Cochrane Review found no sustained benefits to the surgery that outweigh the costs and risks.  

Spinal cord stimulation, a medical technology suggested to treat people with chronic back pain, does not provide long-term relief and may cause harm, according to a Cochrane Review released today.

Spinal cord stimulation is thought to work by planting a device that sends electrical pulses to the spinal cord to interrupt nerve signals before they reach the brain.

The study reviewed published clinical data on spinal cord stimulation. This included randomised controlled trials, considered to be the most robust method to measure the effectiveness of a treatment in medical research.

The researchers analysed the results of 13 clinical trials, looking at data from 699 participants, comparing spinal cord stimulation treatment with placebo or no treatment for low back pain.

Cochrane reviews are trusted by researchers, medical professionals and policymakers because they use robust methodologies to combine evidence from multiple sources, reducing the impact of bias and random error that can make individual studies less reliable.

The review concluded that spinal cord stimulation is no better than a placebo for treating low back pain, with probably little to no benefits for people with low back pain or improving their quality of life.

There was little to no clinical data regarding the long-term effectiveness of spinal cord stimulation, including the risk of side effects and complications.

The researchers also found that adverse side effects to the surgery were poorly documented overall, preventing them from concluding the level of risk involved. Harms from spinal cord stimulation could include nerve damage, infection, and the electrical leads moving, all of which may need repeated surgeries.

The review findings have been submitted to the Federal Department of Health and Aged Care prosthesis list review taskforce. The taskforce is reviewing the eligibility of current prostheses subsidised by Medicare.

In Australia, the devices' long-term safety and performance are also being re-accessed by The Therapeutic Goods Administration (TGA), the country’s regulatory authority for therapeutic goods.

“Spinal cord stimulation is invasive and has a great financial cost to people who choose surgery as a last resort to alleviate their pain. Our review found that the long-term benefits and harms are essentially unknown,” said lead researcher Dr Adrian Traeger from Sydney Musculoskeletal Health, an initiative of the University of Sydney, Sydney Local Health District and Northern Sydney Local Health District.

“Our review of the clinical data suggests no sustained benefits to the surgery outweigh the costs and risks.

“Low back pain is one of the leading causes of disability worldwide. Our findings further emphasise the urgent need to review funding arrangements for chronic pain care to help patients in their search for relief. There are evidence-based physical and psychological therapies for back pain; ensuring access to these is essential.”

The review team found multiple gaps in clinical data.

There were no studies that investigated the long-term (more than 12 months) impact of spinal cord stimulation on low back pain. The longest was a single six-month trial.

The majority of clinical trials only looked at the immediate impact of the device, which is a time frame of less than a month.

The review team provided a list of recommendations, which include future spinal cord stimulation clinical trials to be at least 12 months, clearly document the number of people who experience adverse events and comparison with other pain treatment options.

Professor Chris Maher, Co-Director of Sydney Musculoskeletal Health, said,

“Our review found that the clinical benefit of adding spinal cord stimulation to treat low back pain remains unknown. When coupled with the reality that these devices are very expensive and often breakdown there is clearly a problem here that should be of concern to regulators.”

A separate Cochrane review, in which the researchers were not involved, examined the effect of spinal cord stimulation versus placebo in people with chronic pain. Similar to this review, it concluded there was a lack of evidence to suggest long-term benefits in treating chronic pain.

• Read the full review in the Cochrane Library 
• Read the University of Sydney Press Release 

Tuesday, March 7, 2023

减缓儿童近视进展的干预措施 关键信息 • 滴眼液中的阿托品等药物可以减缓儿童短视或近视的发展，还可以减少近视引起的眼球伸长。高剂量的阿托品最有效。我们不确定低剂量阿托品的效果。 • 一些治疗方法，包括特殊类型的眼镜镜片和隐形眼镜，可能会减缓近视的发展，但它们的效果仍然不确定，并且没有足够的信息说明是否有产生不良反应的风险。 • 也不清楚所报告的药物或镜片对减缓近视加深的益处是否能持续多年。 什么是近视？ 近视（或短视）是指人们难以看清远处的物体，而近处的物体仍保持清晰。它在世界范围内非常普遍，影响了中国和东南亚一半以上的儿童。近视可能会损害生活的许多方面，包括上学和职业活动。而且，近视的人眼睛更长，这意味着视网膜被拉长了。这使眼睛在以后的生活中更容易患上青光眼、黄斑病和视网膜脱离等眼病。 如何治疗近视？ 尽管传统的眼镜或隐形眼镜能够矫正近视，但它们并不能减缓近视的发展。许多光学疗法（如传统眼镜与隐形眼镜）与药物可减缓近视的进展。近视治疗需要在儿童时期进行，因为此时近视发展最快。阿托品滴眼液等药物可能有效，但会导致对眩光的敏感性增加，并导致阅读时出现问题，尤其是在高剂量时。也可以使用在镜片内包含多个聚焦点的特殊眼镜（多焦点或周边离焦镜片）。这些也可以作为软性隐形眼镜提供。其它称为角膜塑形术的隐形眼镜，旨在暂时改变眼睛表面的形状，在睡眠期间佩戴并在白天摘下。软性隐形眼镜和角膜塑形术都...

孕期服用膳食补充剂肌醇用于预防妊娠糖尿病的发生 关键信息 患有妊娠糖尿病的女性在孕期和分娩期间有较高的风险会出现并发症，并且之后患糖尿病的风险也更高。妊娠糖尿病患者的婴儿在体型上可能比较大，导致出生时容易受伤。这些孩子在婴儿期，甚至往后的儿童或青年时期都有罹患糖尿病的风险。全世界罹患妊娠糖尿病的女性人数正在增加，因此，找到简单且具有成本效益的方法来预防妊娠糖尿病是非常重要的。 肌醇是一种天然存在的糖分，存在于谷物、玉米、绿色蔬菜和肉类中，可影响人体对胰岛素的敏感性。 我们想知道什么？ 我们想了解肌醇是否可作为预防妊娠糖尿病的有效产前膳食补充剂。 我们做了什么？ 我们检索了比较肌醇（单独使用或合并其他疗法）与不治疗或其他治疗的研究。我们对研究结果进行比较及总结后，根据研究方法和规模等因素评估了证据的可信度。 我们发现了什么？ 我们发现了7项研究，涉及1319名怀孕10周至24周的女性。 主要研究结果 我们尚不清楚补充肌醇与妊娠糖尿病发生率的降低是否有关。然而，肌醇可能与妊娠期高血压疾病的减少有关。我们尚不清楚补充肌醇是否会减少出生时大于胎龄儿的数量。 这些研究没有提供任何关于新生儿死亡（出生前或出生后不久）、忧郁症或分娩后继发2型糖尿病的信息。在报告这一结局的5项研究中，没有治疗对母体不良反应的呈现；另外2项研究未提及这一点。 我们不清楚补充肌醇对孕期体重增加或对低血糖婴儿的影响。...

Specifications: Permanent – Full Time
Salary: 28,000 per annum  
Location: UK – Remote/Flexible
Directorate: Finance and Corporate Services Directorate  
Closing date: 26 Feb 2023
 
Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters from more than 220 countries. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into five directorates: Evidence Production and Methods, Publishing and Technology, Development, and Finance and Corporate Services.

Your role will play an important part in ensuring that day-to-day finance is run smoothly. You will be someone who can learn new systems and processes quickly, is numerate and accurate in their work and has good attention to detail. This role sits within the Finance and Corporate Services Directorate. You will be one of four employees that make up the finance team. You will report to the Financial Accountant.

This is a work from home position, but you will have to attend meetings in London occasionally

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values: Collaboration: Underpins everting we do, locally and globally. Relevant: The right evidence at the right time in the right format. Integrity: Independent and transparent. Quality: Reviewing and improving what we do, maintaining rigour and trust.  

You can expect: 

• An opportunity to truly impact health globally  
• A flexible work environment  
• A comprehensive onboarding experiences
• An environment where people feel welcome, heard, and included, regardless of their differences

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

How to apply

• For further information on the role and how to apply, please click here.
• The deadline to receive your application is 26th  Feb 2023.
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples. 
• Read our Recruitment Privacy Statement

Monday, February 13, 2023 Category: Jobs

Monday, February 13, 2023

Monday, February 13, 2023

In recognition of 2023 International Women's Day (IWD), Cochrane hosted a virtual event. The event featured a panel of accomplished women from diverse backgrounds discussing the IWD 2023 theme of #EmbraceEquity.

The panelists will shared their experiences and insights on topics such as gender equity in clinical trials, the impact of gender on health outcomes, and strategies for promoting equity in healthcare and in evidence synthesis. 

Tiffany Duque, Cochrane US Senior Officer and Panelist says, "The 2023 IWD event was run by our talented Cochrane US Mentees. This is the second cohort through the Cochrane Mentoree program. They come from 12 different countries and range from students to early career professionals; all with a shining future in Cochrane."

"We were excited to bring together this group of dynamic women to discuss issues of equity in healthcare," says Paola Andrencci, Cochrane US Mentor Program coordinator and lead on this event. "Their diverse perspectives and experiences will help us identify the barriers to equity and work towards solutions that benefit all patients. We thank everyone from the Cochrane community and beyond that joined us for this event!"

We welcome everyone to watch a recording of the event: 

Several other videos were recorded for IWD and shared on social media:

Rehab Emad Ashmawy (Cochrane US mentee, Egypt) interviews Senator Professor Randa Mostafa. Many thanks to Mohmed Gamal for his efforts and time in capturing and editing this video.

Dr. Manar Ahmed Kamal introduces herself and answers a few questions.
Many thanks to Yasmine Ayman, Rahma Sameh, and Rawan Osama for their time and effort in filming this video.

Dr Sara Nasser (Chief Executive Officer, Pan Arabian Society of Gynecologic Oncology Research) shares her work and speaks about the importance of courage.

Related resources:

• VIDEO: 2022 International Women's Day Panel on gender bias in health science and evidence synthesis
• VIDEO: 2021 International Women's Day Panel on diversity in health evidence synthesis
• Celebrating Anne Anderson and Cochrane diversity with new designs: an interview with artist Heather Tubwon
• Cochrane Indonesia’s Director reflects on her continued contributions to maternal and perinatal health and the work of Cochrane

Friday, March 10, 2023

为需要康复的患者提供居家康复服务的影响因素：一项定性证据综合 本Cochrane定性证据综合的目的是探讨居家康复服务的影响因素。本综合研究了面对面康复服务以及远程康复服务。为了回答这个问题，我们分析了53项定性研究。 关键信息 面对面或远程居家康复比基于设施的服务更容易获得，也更方便。患者、提供者和家属还描述了居家服务如何改变他们之间关系的性质，并可能产生积极和消极的实际和资源影响。 本综合的研究内容是什么？ 新冠肺炎疫情使居家医疗保健受到更多关注。包括面对面或使用远程康复提供居家康复服务。居家康复服务可能成为患者康复过程中的常见选择，或取代基于设施的服务，或作为这些服务的补充。随着人们越来越多地使用数字技术，远程康复也变得越来越普遍。 该综合的主要发现是什么？ 我们分析了53项患者居家接受康复服务的定性研究。在一些研究中，医疗保健提供者亲自提供服务。在其他研究中，提供者使用数字技术通过远程康复提供服务。这些研究探讨了患者、家属和医疗保健提供者的观点和经验。大多数研究来自高收入国家。 我们的研究结果强调了几个可能影响居家康复的组织和实施的因素。我们认为以下结果具有中度至高度的可信度。 面对面或远程提供居家康复服务 患者体验到居家服务很方便，并且对其日常活动的干扰较小。患者和提供者还表示，这些服务可以鼓励患者的自我管理，并让他们在康复过程中有掌控感。但是患者、家属和提供者描述了在家...

对患有神经性残疾和长期肺部感染的儿童使用抗生素 “神经障碍”是指一组主要由神经系统问题（如脑瘫）、神经肌肉问题（如肌肉萎缩症）或发育问题（如发育障碍、唐氏综合症）导致的疾病。患有这些疾病的儿童和青少年可能有类似的行动、喂食和咳嗽问题。胸部和呼吸问题（包括肺部感染）是患有神经障碍的儿童和青少年经常遇到的问题，也是他们需要住院治疗的一个原因。 对于那些不能完全清除胸部分泌物或经常感染的人来说，肺部感染可能无法完全根除，因此变成了“慢性感染”。目前还不清楚什么治疗方法对处于这种情况的儿童和青少年是最好的。 我们试图系统地评价所有关于儿童和青少年慢性肺部感染的抗生素治疗的临床试验。我们评价了截至2022年2月的1968项已发表的研究，这些研究来自不同的在线数据库，但没有一项与本系统综述相关。有两项研究正在进行中，因此不能被纳入当前版本。 令我们感到失望的是，我们没有找到任何临床试验来回答这一重要问题。这是未来工作的一个重点，以便处于这种情况的儿童和年轻人能够得到尽可能好的治疗。 如果您发现此证据有帮助，请考虑向 Cochrane 捐款。我们是一家慈善机构，提供可获取的证据来帮助人们做出健康和护理决定。捐赠 作者结论:  本系统综述的结果强调，在对18岁以下患有神经障碍的儿童和青少年进行慢性肺部感染的抗生素治疗方面缺乏证据。因此，需要对这一主题进行进一步的研究。 阅读摘要全文……...

The recently updated GOLD report includes evidence from 7 Cochrane Airways systematic reviews, helping to align it with the latest and best available evidence.  

Chronic obstructive lung disease (COPD) is usually caused by smoking or other airway irritants. COPD damages the lungs and causes airways to narrow which makes it difficult to breathe.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) works with healthcare professionals and public health officials worldwide to raise awareness of COPD and improve the prevention and treatment of this lung disease. The GOLD strategy document for diagnosing, managing, and preventing COPD and the corresponding pocket guide is developed for healthcare professionals based on the best scientific information available. This global evidence-based document is used as a tool to implement effective management programs based on local healthcare systems around the world.

"The GOLD Report is the most widely accepted and followed COPD guideline," explains Emma Jackson, Managing Editor of Cochrane Airways. "We were pleased to see that 7 Cochrane Airways systematic reviews were added to the GOLD Report 2023 recommendations for the first time; over 35 Cochrane Reviews are already referenced in the GOLD Report."

"Cochrane is a not-for-profit organization with collaborators from more than 190 countries working together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest,” says Rebecca Fortescue, Co-ordinating Editor for Cochrane Airways Editor. “Cochrane Reviews are known as the ‘gold standard’ when it comes to health evidence synthesis. We are delighted to see that 7 Cochrane Airway reviews were added in the 2023 GOLD Report to help align clinical practice with the latest and best available evidence.”

The seven reviews included in the 2023 Report for the first time are:

• Dual combination therapy versus long‐acting bronchodilators alone for chronic obstructive pulmonary disease (COPD)
• Inhaled corticosteroids for the treatment of COVID-19
• Interventions to improve adherence to pharmacological therapy for chronic obstructive pulmonary disease (COPD)
• Integrated disease management interventions for patients with chronic obstructive pulmonary disease
• Chronic non-invasive ventilation for chronic obstructive pulmonary disease
• Self-management interventions for people with chronic obstructive pulmonary disease
• Mucolytics for bronchiectasis

Lead author of the review on dual combination inhaler therapy, Yuji Oba says, “COPD is the third leading cause of death worldwide. Inhaler therapy is the mainstay treatment of COPD and the choice of inhalers is of paramount importance for patients and healthcare providers. The 2018 Cochrane review addressed which inhaler was the most efficacious and safe in the advanced form of COPD. We are proud to see the GOLD Report was updated and modified the first choice of inhaler treatment based on our Cochrane review. We are currently updating this Cochrane review and are looking forward to having our work contribute to future GOLD Reports." 

• See a list of all Cochrane reviews on COPD

Wednesday, February 8, 2023 Category: The difference we make

与纯机械、单纯口服抗生素或无肠道准备相比，联合机械和口服抗生素肠道准备能否降低择期结肠或直肠切除术后并发症的风险? 关键信息 -与单独的机械肠道准备相比，联合机械（使用泻药）和口服抗生素肠道准备可能会减少手术部位感染（伤口感染和腹腔感染）的发生，以及吻合口渗漏（肠道缝合连接处泄漏）的可能性。 -单独口服抗生素可能与联合机械和口服抗生素肠道准备一样有效，但根据现有数据无法明确确定。 -与联合机械和口服抗生素肠道准备相比，不进行肠道准备是否对术后并发症的发生有影响，尚不能根据现有数据确定。 术前肠准备的目的是什么？ 由于大肠内有自然细菌的植株，在切开大肠的手术中，更容易发生手术部位的感染。为了预防这些感染，手术前肠道准备旨在减少肠道的粪便污染并最大限度地减少细菌定植。 肠道准备是如何进行的? 可以机械地进行术前肠道准备，使用泻药冲洗肠道，或服用口服抗生素进行局部去污。这两种方法可以单独或组合执行。 我们想了解什么? 我们想了解联合口服抗生素肠道准备与单独机械或口服抗生素的肠道准备、不进行肠道准备相比，是否对以下方面有影响： -手术部位感染的发生 -吻合口漏的发生 此外，我们还想了解联合肠道准备是否对死亡率、轻度或重度术后并发症的发生率、术后肠梗阻（肠动力障碍）的可能性或住院时间有影响。此外，我们想研究肠道准备干预的副作用在联合治疗与单纯机械、单纯口服抗生素或不进行肠道准备之间是否存在...

Title: Internal Communications Manager
Specifications: Permanent – Full Time
Salary: £52,508
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)
Directorate: Development
Closing date: 20 Feb 2023
Interview date: 9 March 2023

Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters from more than 220 countries. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into five directorates: Evidence Production and Methods, Publishing and Technology, Development, and Finance and Corporate Services.

This is an exciting opportunity to build a new function from the ground up, as Cochrane’s first dedicated internal communications role. The first priority for this role will be to establish effective internal communications structures and processes for Cochrane’s~100 core staff, who are distributed across multiple countries and time zones. This includes developing an intranet and regular staff communications.

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values: Collaboration: Underpins everything we do, locally and globally. Relevant: The right evidence at the right time in the right format. Integrity: Independent and transparent. Quality: Reviewing and improving what we do, maintaining rigour and trust.

You can expect:

• An opportunity to truly impact health globally
• A flexible work environment
• A comprehensive onboarding experiences
• An environment where people feel welcome, heard, and included, regardless of their differences

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

How to apply

• For further information on the role and how to apply, please click here.
• The deadline to receive your application is 20 Feb 2023.
• If you are invited for interview, this will take place on 9 March 2023 via Teams.
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples.
• Read our Recruitment Privacy Statement

Monday, February 6, 2023 Category: Jobs

Title: Future of Evidence Synthesis Administrative Support Officer
Specifications: Fixed Term – 2 Years
Location: UK – Remote/Flexible
Salary: £27,071
Directorate: Evidence Production & Methods
Closing date: 20 Feb 2023

Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters from more than 220 countries. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into five directorates: Evidence Production and Methods, Publishing and Technology, Development, and Finance and Corporate Services.

The Future of Evidence Synthesis (FES) is a critical programme of work for Cochrane over the next 3-5 years. Successful delivery is essential is Cochrane to achieve the Strategy for Change objectives and become a sustainable organisation. This role provides effective and efficient administrative support for the FES programme generally and supports the pilot phase of the Thematic Group pilot specifically.

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values: Collaboration: Underpins everything we do, locally and globally. Relevant: The right evidence at the right time in the right format. Integrity: Independent and transparent. Quality: Reviewing and improving what we do, maintaining rigour and trust.

You can expect:

• An opportunity to truly impact health globally
• A flexible work environment
• A comprehensive onboarding experiences
• An environment where people feel welcome, heard, and included, regardless of their differences

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

How to apply

• For further information on the role and how to apply, please click here
• The deadline to receive your application is 20 Feb 2023.
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples.
• Read our Recruitment Privacy Statement

Monday, February 6, 2023 Category: Jobs

数字技术真的能帮助囊性纤维化患者坚持雾化疗法吗？ 重要信息 短期内数字技术可以帮助囊性纤维化（cystic fibrosis, CF）患者依从（或“遵从”）其吸入治疗，但对肺功能或肺部恶化（疾病突然发作）几乎没有影响。 从中期来看，通过在线平台将数字化监测与量身定制的支持相结合可能会鼓励人们坚持吸入治疗并减轻治疗负担（囊性纤维化患者的医疗保健需求及对他们福利的影响），但不会改善生活质量。 未来的研究应该着眼于使用数字技术来帮助囊性纤维化儿童和成人患者遵从其吸入治疗，并考虑依从性的提高将如何影响治疗计划的其他方面。 什么是囊性纤维化？ 囊性纤维化是一种危及生命的遗传性疾病，粘稠的粘液会积聚在肺部和消化系统，随着时间的推移，肺部会受损，并最终可能会停止工作。 如何治疗囊性纤维化？ 目前没有能治愈囊性纤维化的方法，但治疗有助于控制症状及减少并发症。治疗方法包括使用抗生素预防和治疗胸腔感染，以及使用药物稀释肺部粘液，使其更容易咳出。囊性纤维化患者使用吸入器和雾化器将药物快速输送到肺部，雾化器是一种可将药液变成雾状，然后通过接嘴或面罩吸入的小型机器。 囊性纤维化的治疗复杂又费时；患者通常每天需要花费2至2.5小时进行治疗。 目前数字技术逐渐用来帮助人们通过活动跟踪器和手机应用程序监控他们的健康和健身情况。对于囊性纤维化患者，数字技术被用来追踪和改进其治疗的管理方式。一些技术能将信息上传到互...

Registration is now open for the 2023 Cochrane Colloquium. Register before the 01 June 2023 to get the reduced early bird rate

You can now register for the Cochrane Colloquium, which will take place at the Queen Elizabeth II (QEII) Centre in London from 4th to 6th September 2023, with Satellite events on 3rd September.

The Colloquium is an annual event for everyone with an interest in the use of evidence in healthcare decision making including those engaged in evidence production, co-production, dissemination, implementation and policy making, as well as those making individual healthcare decisions.

This year’s theme is ‘Forward together for trusted evidence’. It will explore the challenges for the future around the trustworthiness of healthcare data and information whilst also celebrating 30 years of producing trusted evidence. 

Students, healthcare consumers, and people from low-income, lower-middle-income, and upper-middle-income economies (LMIC) are eligible for a reduced rate.

As well as now being able to register, you can submit an abstract or submit a workshop for the event.

We look forward to welcoming you to London!

Register today:

• Register here
• Registration fees – reduced early bird rate ends on 01 June 2023
• Registration guidelines and policies

Further information

• Colloquium website 
• #CochraneLondon
• Press contact: Katie Abbotts, Cochrane UK
• Sign up for newsletter updates

Monday, February 6, 2023

Thursday, February 2, 2023

主动呼吸循环技术（ACBT）与其他气道疏通疗法治疗囊性纤维化患者的对比 系统综述问题 与囊性纤维化患者的其他气道疏通方法相比，主动循环呼吸技术（active cycle of breathing technique, ACBT）的效果如何？ 背景 慢性感染在囊性纤维化中很常见，反复感染会导致肺部损伤和疾病。囊性纤维化患者使用气道疏通疗法来清除粘液并改善肺功能。ACBT联合使用三种呼吸方法来松解和清除粘液。本综述是对此前发表的综述的更新。 检索日期 证据检索日期截至：2021年3月29日。 研究特征 虽然本综述纳入了22项比较ACBT与其他气道疏通疗法的研究，但只有八项研究（259名受试者）报告了可供纳入分析的数据。八项研究中的每一项都比较了不同的技术：ACBT与自体引流、气道振荡装置、高频胸部按压装置、呼气正压、常规胸部理疗以及ACBT联合运动。大多数研究随访了一天，但有两项研究随访了一到三年。受试者的年龄范围为6至63岁，大多数（59%）为男性。 主要研究结果 本综述发现，ACBT在受试者偏好、生活质量、运动耐力、肺功能、痰液重量、氧饱和度和肺部恶化次数等结局方面与其他疗法相当。我们无法证明何种技术更优。需要更长期的研究来进一步充分评估ACBT对囊性纤维化患者重要结局（如生活质量和偏好）的影响。 证据的可信度 证据的可信度非常低甚至没有可信度，我们认为进一步研究所分析的干预措施...

局部类固醇注射治疗腕管综合征 关键信息 腕部注射皮质类固醇可能会改善腕管综合征（腕部神经受压）的症状和手部功能长达六个月。在注射后三个月内的生活质量评价和评价的神经传导检查也可能有所改善。一年的随访评价显示皮质类固醇注射有可能会减少对手术的需求。局部类固醇注射治疗的副作用似乎比较少见。然而，多达三分之一的人在没有治疗的情况下症状也会自行改善。 什么是腕管综合征？ 腕管综合征在世界范围内非常普遍，影响人们的生活质量，并给卫生系统带来巨大的经济损失。当手腕中的正中神经“受刺激”时会导致疼痛、刺痛、麻木，有时还会导致无力和功能丧失，主要发生在手和手指上。 腕管综合征如何治疗？ 皮质类固醇是减轻炎症和肿胀的药物。皮质类固醇注射到腕管（手掌侧被骨骼和韧带包围的狭窄通道）往往用于轻度或中度症状，并且比手术便宜得多，但其有效性和持久性存在争议。 我们想要做什么？ 我们想了解将局部皮质类固醇（“类固醇”）注射到手腕腕管中是否有益于腕管综合征患者。本系统综述的作者们收集并分析了所有相关的研究来回答这个问题，共发现了 14 项研究。 我们做了什么？ 我们在医学数据库中检索了评价注射后长达六个月内局部皮质类固醇注射对手部症状和功能以及对神经损伤电检查（称为神经传导研究）改善的影响的研究。我们还研究了长达 12 个月患者的手术需求、生活质量和注射副作用。 我们发现了什么？ 我们发现了9项来自北美、欧洲和...

Taking vitamin D supplements does not reduce the risk of asthma attacks in children or adults, according to an updated Cochrane review.

These findings are in contrast to a previous Cochrane review that indicated a reduction in asthma attacks in people taking vitamin D. However, the review found no harm in taking vitamin D and it did not examine other possible health benefits.

The review was carried out by researchers from Queen Mary University of London and the University of Edinburgh. Researcher Adrian Martineau, Clinical Professor of Respiratory Infection and Immunity at Queen Mary University of London, said: “Vitamin D deficiency has been linked to an increased risk of severe asthma attacks and our previous Cochrane review, published in 2016, found that vitamin D reduced the risk of asthma attacks. However, more studies have been published since then and when we included the extra data in our updated review, the overall results changed. We found that vitamin D supplements had no effect on risk of asthma attacks or on control of asthma symptoms compared with a placebo.”

Professor Martineau and his colleagues analysed the results of 20 randomised controlled trials – the gold-standard for medical research – including data on 1,155 children and 1,070 adults with asthma. This compares to nine trials involving a total of 1,093 people whose data contributed to the previous review. The majority of patients in the trials had mild to moderate asthma.

When they compared patients who were assigned to take a vitamin D supplement with patients who were assigned to take a placebo (dummy medication), the researchers found no statistically significant difference in the number of people who experienced an asthma attack requiring treatment with a course of steroid tablets.

The review did not find any effect of taking vitamin D on asthma control even when people were vitamin D-deficient when they joined the studies, or with different doses of the supplement, or in people of different ages.

Professor Martineau said: “In contrast to our previous Cochrane review on this topic, this updated review does not find that vitamin D offers protection against asthma attacks or improves control of asthma symptoms. However, the trials we looked at did not include many people with severe asthma or people with very low levels of vitamin D in their blood, so these are areas where more research is still needed."

Anne Williamson, the first author on the study who is also from Queen Mary University of London, commented: “We can’t be certain why this updated review has given a different result to our original study from 2016. It could be that people with asthma may be getting better treatment than previously. Or it could be that, in general, rates of vitamin D deficiency have decreased over time, due to increasing intake of supplements or fortified foods. Either of these factors could obscure potential benefits from taking vitamin D supplements. Regardless of the reason, these most recent findings are likely to be correct for people living with asthma today.

This also highlights why it’s vital to update reviews when more research is published.”

Today’s review includes data from 20 clinical trials, compared with nine in the 2016 review, and children with asthma are better represented than previously. The review team say they have also applied stricter criteria on which studies would be included, compared to some other reviews. For example, they excluded studies that did not compare vitamin D with a placebo and those that did not monitor patients for at least 12 weeks.

Most of the trials included in the review involved patients taking cholecalciferol, which is the typical form of vitamin D supplement. One trial that used calcidiol, which is a compound that the body can make from vitamin D, reported an improvement in asthma control in patients taking this supplement. The reviewers say further research is needed to confirm whether this form of vitamin D has benefits for people with asthma.

• Read the full review on the Cochrane Library 
• Read the Evidently Cochrane blog 'Vitamin D for asthma: new evidence, new message'

Williamson A, Martineau AR, Sheikh A, Jolliffe D, Griffiths CJ. Vitamin D for the management of asthma. Cochrane Database of Systematic Reviews 2023, Issue 2. Art. No.: CD011511. DOI: 10.1002/14651858.CD011511.pub3.

Monday, February 6, 2023