Thursday, September 26, 2024

预防艾滋病毒阳性孕妇感染疟疾的药物 关键信息 ·对于艾滋病毒抗体阳性的孕妇，在艾滋病毒感染者的常规感染预防治疗(每日复方新诺明)中添加抗疟药物(如甲氟喹或双氢青蒿素/哌喹)： -可能减少母亲分娩时感染疟疾的风险; -可能减少胎盘中的疟疾感染; -可能不会影响产前或产后失去婴儿的风险，也不会影响婴儿出生体重过低的风险。 ·虽然甲氟喹与每日复方新诺明合用可能会降低艾滋病毒阳性妇女感染疟疾的风险，但它可能会增加艾滋病毒母婴传播的风险，并可能有较高的药物不良反应风险。 ·双氢青蒿素/哌喹添加到每天服用复方新诺明中，可能会降低艾滋病毒阳性孕妇胎盘感染疟疾的风险。它可能对低出生体重或出生前后失去婴儿的风险，或轻微副作用（如呕吐）的风险可能没有影响。 为什么艾滋病毒阳性孕妇的疟疾预防很重要？ 艾滋病毒抗体阳性的孕妇容易感染疟疾。同时感染疟疾和艾滋病毒会怀孕期间的疟疾恶化，从而增加妇女及其婴儿患健康并发症的风险。在疟疾常见的许多国家，建议每天服用一种名为复方新诺明的药物，以预防艾滋病毒感染者（包括孕妇）的感染。服用复方新诺明的妇女不能服用建议用于预防妊娠期疟疾的药物磺胺多辛-乙胺嘧啶，因为这两种药物之间可能存在负相互作用。 我们想了解什么？ 我们想知道目前可用的抗疟药物在用于预防艾滋病毒阳性孕妇的疟疾是否有效和安全。这是对2011年发表的Cochrane系统综述的更新。 我们做了什么? 我们检索...

体感游戏对痴呆或轻度认知障碍患者的益处与风险？ 关键信息 • 参与纳入身体活动的视频游戏（“体感游戏”）可能有助于痴呆和轻度认知障碍患者改善学习和记忆等思维技能，但我们并不确定。 • 目前几乎没有证据表明体感游戏能改善痴呆和轻度认知障碍患者的行走能力、平衡能力或处理日常任务（如结账或购物）的能力。 什么是痴呆和轻度认知障碍？ 痴呆是一种脑部变化影响个人记忆、思维和执行日常事务能力的病症。它可能导致人们在记住事情、制定计划、集中注意力或沟通方面遇到困难。这些变化通常会随着时间的推移而加重，最终可能干扰日常生活。 轻度认知障碍是在记忆和思维方面存在一些困难，但尚未达到痴呆的程度。然而，轻度认知障碍可能会增加进展为痴呆的风险。尽管轻度认知障碍患者可能在清晰地记忆或思考方面存在困难，但他们仍然能够处理日常任务，如结账、购物和保持家中整洁。简而言之，轻度认知障碍存在一些记忆和思维上的困难，但没有痴呆那么严重，但是可能随着时间的推移而恶化。 什么是体感游戏？ 目前，减缓痴呆等疾病的治疗方法并不多。但我们知道，终生保持身体和心理活跃可以降低患痴呆的风险。一些专家认为，鼓励保持身体和心理活跃可能有助于减轻痴呆症状和轻度认知障碍的影响。随着新技术的发展，我们现在可以利用虚拟现实和互动游戏（称为体感游戏）提供身体和心理训练。体感游戏被视为一种良好的选择，因为它们相对容易让老年人在家中使用，并且能够提...

At the United Nations Summit of the Future, two major funding bodies announced £54.2 million of new funding for evidence synthesis: £45 million from Wellcome and £9.2 million from UK Research and Innovation (UKRI).

The announcements represent significant investment in evidence synthesis to help tackle global inequity and address the UN’s Sustainable Development Goals. Cochrane was represented at the summit by our Editor in Chief, Dr Karla Soares-Weiser.

“It is invigorating to see major global funders recognizing the importance of evidence synthesis in addressing the challenges facing the world today and in the future,” says Karla. “This significant investment has the potential to catalyze a step change in evidence synthesis, making it more timely, relevant and equitable. Cochrane has a proud history of advancing evidence synthesis, and we stand ready to support this vital global effort. I am especially excited at the potential to reduce global inequities in both producing and accessing high-quality evidence.”

Both funding calls are aimed at building infrastructure to support rapid evidence synthesis projects so that policymakers have access to the latest evidence on a given topic. The Wellcome announcement focuses on ‘living evidence synthesis’, where systematic reviews are continually updated so they always reflect the latest evidence. Wellcome’s announcement notes that ‘the Cochrane Collaboration, which produces gold-standard evidence syntheses in medicine, increasingly backs living evidence models’.

Living evidence

Cochrane is a pioneer of living systematic reviews, having published the world’s first living systematic reviews in 2017. Lessons from the pilot project were published in 2019, in a project co-led by Professor Tari Turner at Cochrane Australia, who serves on Cochrane’s Editorial Board and is Academic Director of the Australian Living Evidence Collaboration.

“It’s fantastic to see this global commitment to living evidence and recognition of Cochrane's leadership in this area,” says Tari. “The new funding is fantastic news for both evidence synthesis professionals and decision-makers who need up-to-date evidence. Living reviews come with many opportunities and challenges which we identified in our pilot programmes, and it’s great to see them getting the attention they deserve.”

 

Tuesday, September 24, 2024

Monday, September 23, 2024

As the pace of new research accelerates, keeping systematic reviews up-to-date with the latest evidence has become increasingly vital. Cochrane is at the forefront of this evolution with our leadership in living systematic reviews (LSRs)—a dynamic approach that ensures evidence remains current and relevant.

What's a systematic review?
A systematic review attempts to identify, appraise, and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a specific research question. Researchers conducting systematic reviews use explicit, systematic methods that are selected with a view aimed at minimizing bias, to produce more reliable findings to inform decision making. 

For those new to the concept, here's a short video from Cochrane Consumers and Communication that explains what a systematic review is, how researchers prepare them, and why they’re a crucial part of making informed health decisions  - both for professionals and the public.

What is living evidence?
Living evidence refers to a systematic review that is continually updated to incorporate new and relevant information as it becomes available. Unlike traditional systematic reviews, which may be updated infrequently or not at all, living systematic reviews (LSRs) are underpinned by ongoing, active monitoring of the evidence base.

Key Features of LSRs:

• Continual Monitoring: LSRs involve regular, often monthly, searches for new evidence.
• Immediate Updates: New important evidence, including data, studies, or information, is promptly included.
• Up-to-Date Communication: The status of the review and any new evidence are communicated clearly and regularly.

While LSRs employ the same core review methods as other Cochrane Reviews, they also incorporate predefined and transparent decisions on how frequently new evidence is sought, how it is integrated, and the rationale behind these decisions. Cochrane continues to innovate by providing updated information on the status of our reviews and each updated review is assigned a new citation and DOI, linking it to previous versions and ensuring the most current evidence is available.

Watch all the videos from this series

Why living systematic reviews?

LSRs represent a significant advancement in evidence synthesis, connecting evidence and practice more seamlessly than traditional methods. They are hugely valuable to healthcare professionals, decision-makers, guideline developers,  policy-makers, funders, consumers (patients and carers), and publishers who require up-to-date evidence for informed decision-making.

Technological advancements, such as online platforms, linked data, and machine learning, have made large-scale living evidence approaches feasible. The growth of collaborative research, open data initiatives, and citizen science also supports the maintenance of high-value datasets and LSRs - areas that Cochrane is also leading.

Cochrane’s role and innovations

Since launching the world's first pilot living reviews in 2017, Cochrane has been a trailblazer in this field. Professor Tari Turner, member of the Cochrane Library Editorial Board and Director of the Australian Living Evidence Collaboration based at  Cochrane Australia, has been instrumental in developing and applying living evidence approaches. According to Tari:

"Living evidence synthesis is transforming how we navigate uncertainty and make evidence accessible. By continually updating our living reviews, Cochrane is ensuring that decision-makers have the most current information at their fingertips."

Living systematic reviews are a testament to Cochrane's commitment to producing evidence that is not only trustworthy but also continuously relevant. As we move forward, we remain dedicated to leading in this space and advancing the field of evidence synthesis.

• Learn more about Cochrane's living systematic reviews
• What is the difference between a Cochrane systematic review of interventions and a Cochrane diagnostic test accuracy review?
• Learn more about Cochrane and our work

Monday, October 28, 2024

辅助技术能否帮助改善成人中风后因肌肉和肌腱缩短而导致的关节僵硬？ 关键信息 •由于我们只发现了7项低质量的研究，因此我们无法确定使用辅助技术治疗是否优于传统治疗。 •需要进一步来衡量研究辅助技术治疗成年中风患者挛缩的利弊。 什么是挛缩？ 中风后，许多人会因肌肉和肌腱变短和变硬而导致肢体畸形。挛缩的主要原因是肢体被固定在缩短的位置。 什么是辅助技术？ 辅助技术是使用电流或机械手段（如夹板）拉伸肌肉和软组织的设备。 我们想了解什么？ 我们想知道是否有任何辅助技术比常规治疗、不治疗或其他辅助技术更好的改善成人中风后的被动活动范围（一个人在外界帮助下关节活动的程度）和卫生状况。我们还想了解辅助技术是否会产生任何不良影响。 我们做了什么？ 我们检索了评估辅助技术与无治疗、常规治疗或其他辅助技术相比效果的研究。我们对研究结果进行了比较和总结，并根据研究方法和规模等因素对证据的可信度进行了评级。 我们发现了什么？ 我们发现有7项对辅助技术和常规疗法进行了比较的小型研究。辅助技术的类型包括电刺激、夹板、使用铰链板定位手腕以及带有电刺激的非机器人装置。治疗时间持续了4至12周。一些研究将中风以外的患者和中风患者都包括在内。在可能的情况下，我们只分析了中风患者的结果。 主要研究结果 我们仅分析了五项涉及252人研究的数据。治疗的即时效果是在研究期间最后一次拉伸干预后测量的。 在改善腕部、肩部或肘部被...

对于尚未扩散至身体其他部位的低风险妊娠滋养细胞肿瘤，“保留生育能力”手术有哪些益处和危害？ 关键信息 我们对不影响生育功能的手术（即“保留生育功能”的手术干预）在伴随或不伴随化疗情况下治疗低风险、未扩散到身体其他部位的妊娠滋养细胞肿瘤（即“非转移性”）的益处和风险非常不确定。 需要更大规模、设计良好的研究来确定保留生育功能手术对患有低风险、非转移性妊娠滋养细胞肿瘤女性的益处和伤害。 什么是妊娠滋养细胞肿瘤？ 妊娠滋养细胞肿瘤 (Gestational trophoblastic neoplasia ，GTN) 是一种罕见的癌症，可能在怀孕后于子宫内发生，尤其是在葡萄胎妊娠（即受精卵出现异常，导致胎儿和胎盘无法正常发育）后更容易患上。它可能引起异常出血或激素过高。治疗通常根据癌症的严重程度，采用化疗、手术或两者结合的方式进行。化疗是低风险、非转移性妊娠滋养细胞肿瘤患者的标准治疗方法，但这可能会影响女性的生育能力。对于希望保留生育能力的患者，“保留生育能力”手术干预可以作为一种替代方案。接受保留生育能力的手术可以避免化疗带来的副作用。 我们想发现什么？ 我们希望了解保留生育能力的手术对治疗成功率、缓解时间、复发、因病死亡、因治疗死亡、怀孕率、生活质量、化疗周期数、任何不良事件以及紧急子宫切除的影响。 我们做了什么？ 我们检索了调查保留生育能力手术与化疗的效果比较（比较1）、保留生育能...

治疗贫血的药物是否有助于预防急性肾损伤？ 关键信息 • 当肾脏突然失去过滤血液中废物的能力时，就会发生急性肾损伤。红细胞生成刺激剂主要用于治疗红细胞生成问题，可能对急性肾损伤高风险人群或早期发现的患者有益。 • 对于有发生急性肾损伤风险的人，促红细胞生成刺激剂可能对急性肾损伤的发生风险或死亡风险几乎没有影响，并且可能对启动透析的需求也没有显著影响。同样，肾功能指标和不良事件（如血栓、心脏病发作、中风或高血压）可能也没有差异。 问题是什么？ • 当肾脏突然失去过滤血液中废物的能力时，就会发生急性肾损伤。这种情况在需要重症监护的住院患者中最为常见。如果急性肾损伤严重，可能会致命，但对于既往健康的人群，急性肾损伤是可以逆转的。 促红细胞生成刺激剂主要用于治疗红细胞生成问题，通常用于长期肾衰竭（肾脏功能不足以维持生命的状态）的患者。然而，在动物研究中，促红细胞生成刺激剂被证明可帮助保护肾脏免受疾病侵害，因此可能对急性肾损伤高风险人群（如接受心脏手术者）或早期急性肾损伤患者有益。 我们做了什么? 我们检索了所有评估促红细胞生成刺激剂对急性肾损伤高风险人群或急性肾损伤患者的益处和危害的试验。 我们发现了什么? 我们发现了20项研究，共纳入5348名有急性肾损伤风险的人。受试者人数从10到1302不等，所有研究均在医院进行。所有研究均将促红细胞生成刺激剂与安慰剂（假药）或常规护理进行比较。 对...

Wednesday, September 18, 2024

Wednesday, September 18, 2024

Title: Managing Editor
Specifications: 12 months Fixed Term – Contract
Salary: £42,000 per annum
Location: UK, Germany or Denmark – Remote/Flexible
Closing date: 30 September 2024

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 around the world. 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.

Reporting to the Senior Managing Editor and working with members of the Editorial Production and Methods Directorate, the role holder will need to have good awareness of Cochrane guidance for different types of standard and complex systematic reviews (intervention, qualitative, diagnostic test accuracy, prognosis, rapid and overview), plan how they will need to be handled in their team, and work to ensure that deadlines are met. The role holder will also be required to ensure that pilots aimed at innovating the editorial process can be supported as needed.

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 30 September 2024.
• 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

Wednesday, September 18, 2024 Category: Jobs

Cochrane is excited to announce that its flagship event, the Cochrane Colloquium, will be hosted in India in October 2026. Building on the momentum of previous successful gatherings, including the Cochrane London Colloquium and the Global Evidence Summit in Prague, this eagerly awaited event will unite the global healthcare evidence synthesis community to foster collaboration, share insights, and drive lasting impact.

The Cochrane Colloquium is an annual international conference that brings together a diverse range of participants, including researchers, healthcare professionals, policymakers, patients, and carers. It provides a unique platform for those passionate about evidence synthesis and evidence-based healthcare to share knowledge, engage in practical workshops, and explore innovative approaches. The event is also a vibrant space for networking, making it a crucial part of the global effort to improve health outcomes through reliable, high-quality evidence.

The 2026 Colloquium will focus on themes that resonate across healthcare and policy sectors: Bridging Gaps, Global Evidence, Local Impact, and Equitable Action. These themes will drive discussions on the importance of evidence in addressing health disparities and achieving equitable healthcare solutions around the world.

Catherine Spencer, CEO of Cochrane, shared her enthusiasm: “The 2026 Cochrane Colloquium will be pivotal for anyone involved in evidence-based healthcare. These themes are crucial for advancing evidence production, implementation, and policy, and we are excited to develop a programme that addresses these vital areas.”

The Cochrane India Network were at the recent Global Evidence Summit. At their stand they engaged with attendees and provided information about the 2026 Cochrane Colloquium, receiving an enthusiastic response. During the closing plenary, they showcased a video and extended a heartfelt invitation to join them in India for the upcoming Colloquium.

Dr Neeta Mohanty from Cochrane India expressed excitement about hosting the Colloquium."It is an honour to invite you all to India for the 2026 Colloquium. Attending previous Colloquia has been a highlight for our team and we are looking forward to welcoming you and being your warm hosts."

We are excited to put together an engaging programme and to bring the community together. Stay tuned for more updates and sign up for the 2026 Colloquium newsletter to keep in touch and be among the first to receive news and announcements.

• Visit the Cochrane India Network website
• Sign up for the 2026 Colloquium newsletter

Wednesday, September 25, 2024

Tuesday, September 17, 2024

对于肾衰竭患者来说，自动化腹膜透析是否优于持续性可移动腹膜透析？ 关键信息 • 肾衰竭患者（即肾脏功能不足以维持生命的情况）需要某种形式的肾脏替代治疗来维持生命。透析的目的是通过清除溶质、毒素和多余液体来模拟正常肾脏的功能。腹膜透析是一种透析方式，它利用腹腔的膜作为过滤器，通过向腹腔内注入溶液来吸收血液中的废物和多余的液体，从而清除体内的代谢废物。我们比较了全自动腹膜透析（通过机器自动输送透析液）与持续性可携带式腹膜透析（手动输送透析液）。 • 我们对全自动腹膜透析相比持续性可携带式腹膜透析在肾衰竭患者中的益处或危害尚不确定。我们仅发现了两项研究，共纳入131名患者。 • 需要更大规模且设计良好的研究来确定全自动腹膜透析相较于持续性可携带式腹膜透析的潜在益处。未来的研究应关注重要的患者结局，例如生活质量以及患者参与正常日常生活的能力，包括工作、学习、娱乐和社交活动。 什么是腹膜透析？ 肾衰竭是指一个人的肾脏功能不足以维持生命的情况。需要以透析或移植的肾脏替代治疗来维持生命。透析旨在从肾衰竭患者体内清除溶质、毒素和液体，以模拟天然肾脏的功能。腹膜透析是一种利用腹腔内的膜 - 称为腹膜 - 来清除血液中的废物的透析方式。此透析通常在家中进行，甚至可以在睡眠时完成。在腹膜透析过程中，一种称为透析液的液体会通过手术植入的管路进入腹腔。当透析液流入腹腔后，会停留1到6个小时，通过吸收废物和...

Tuesday, September 10, 2024

能够延缓或减缓进行性多发性硬化症不同治疗方法的益处和风险是什么？ 关键信息 • 总的来说，我们非常不确定治疗对复发和减缓残疾恶化的影响。我们确实发现证据表明，两年后使用利妥昔单抗和三年后使用干扰素β-1b治疗可能会略微减少复发人数。 • 因不良事件而停止用药的人数在接受干扰素β-1a治疗时略高，并且在接受干扰素β-1b、利妥昔单抗、免疫球蛋白、醋酸格拉替雷、那他珠单抗、芬戈莫德、西尼莫德和奥克莱珠单抗抗治疗时可能略高。 • 对于进行性多发性硬化症患者，需要进行更长时间的比较研究，以评价药物对免疫系统的作用随着时间的推移带来的益处和危害。未来的研究还应考虑对进行性多发性硬化症患者重要的其他影响，如生活质量和思考、学习、记忆、判断和决策能力。 背景 多发性硬化症是由免疫系统受损导致的大脑和脊髓炎症引起的，这种损伤逐渐限制了日常活动。多发性硬化症患者通常会感到疲劳、疼痛、肌肉痉挛以及身体某些部位的感觉和力量降低或丧失。症状的出现称为“复发”，通常会随后逐渐恢复（“缓解”），这被称为“复发-缓解型”多发性硬化症。当复发期间没有恢复或不完全恢复时，这称为“进行性”多发性硬化症。 多年来，大多数复发-缓解型多发性硬化症患者的残疾状况会持续恶化，无法康复。这被称为“继发性进行性”多发性硬化症。在每100个病例中，大约有15个多发性硬化症从发病开始就呈现进行性病程，没有复发和恢复。这被称为“原发...

能够延缓或减缓进行性多发性硬化症不同治疗方法的益处和风险是什么？ 关键信息 • 总的来说，我们非常不确定治疗对复发和减缓残疾恶化的影响。我们确实发现证据表明，两年后使用利妥昔单抗和三年后使用干扰素β-1b治疗可能会略微减少复发人数。 • 因不良事件而停止用药的人数在接受干扰素β-1a治疗时略高，并且在接受干扰素β-1b、利妥昔单抗、免疫球蛋白、醋酸格拉替雷、那他珠单抗、芬戈莫德、西尼莫德和奥克莱珠单抗抗治疗时可能略高。 • 对于进行性多发性硬化症患者，需要进行更长时间的比较研究，以评价药物对免疫系统的作用随着时间的推移带来的益处和危害。未来的研究还应考虑对进行性多发性硬化症患者重要的其他影响，如生活质量和思考、学习、记忆、判断和决策能力。 背景 多发性硬化症是由免疫系统受损导致的大脑和脊髓炎症引起的，这种损伤逐渐限制了日常活动。多发性硬化症患者通常会感到疲劳、疼痛、肌肉痉挛以及身体某些部位的感觉和力量降低或丧失。症状的出现称为“复发”，通常会随后逐渐恢复（“缓解”），这被称为“复发-缓解型”多发性硬化症。当复发期间没有恢复或不完全恢复时，这称为“进行性”多发性硬化症。 多年来，大多数复发-缓解型多发性硬化症患者的残疾状况会持续恶化，无法康复。这被称为“继发性进行性”多发性硬化症。在每100个病例中，大约有15个多发性硬化症从发病开始就呈现进行性病程，没有复发和恢复。这被称为“原发...

捐赠母乳是否能预防极早产或极低出生体重儿的严重肠道疾病？ 关键信息 • 给极早产或极低出生体重儿提供捐赠母乳而不是配方奶，可将坏死性小肠结肠炎的风险降低约一半。 • 对婴儿住院期间的感染率或死亡率可能影响很小或没有影响。 什么是坏死性小肠结肠炎？ 极早产（早产超过8周）和极低出生体重儿（小于1.5公斤）有罹患坏死性小肠结肠炎的风险，这种严重的情况会使婴儿的肠道内壁发炎和坏死。这种情况会导致严重的感染、死亡、残疾或发育问题。 什么是捐赠母乳？ 预防极早产或极低出生体重婴儿坏死性小肠结肠炎的一种方法，可能是在婴儿母乳不足时，喂食其他母乳（由其他女性捐赠的母乳），而非人工配方奶（通常由牛奶改良而成）。 我们想发现什么？ 我们想知道，当母亲无法提供母乳时，给极早产儿或极低出生体重儿喂食捐赠母乳而不是配方奶，是否会降低坏死性小肠结肠炎、严重感染和死亡的风险。 我们做了什么？ 我们检索研究，比较和总结我们发现的研究结果。我们根据研究方法和样本量等因素对证据的可信度进行评级。 我们发现了什么? 我们识别了12项试验，共涉及2296名婴儿。给极早产或极低出生体重儿提供捐赠母乳而不是配方奶，可将坏死性小肠结肠炎的风险降低约一半。对婴儿住院期间的感染率或死亡率可能影响很小或没有影响。 证据的局限性是什么？ 我们对捐赠母乳对坏死性小肠结肠炎影响的证据充满信心。我们对严重感染和死亡的证据只有中等信心，因...

Thursday, September 5, 2024