In this interview, we learn more about a series of reviews on hip fractures published on the Cochrane Library and talk to some of the authors behind this work Prof Xavier Griffin and orthopaedic surgeons Mr William Eardley and Mr Martyn Parker.

Tell us how did these reviews come about?
This work was funded by the National Institute of Health Research Systematic Reviews programme, as a joint application from Oxford University and Cochrane’s Bone, Joint and Muscle Trauma Group. The underlying concept was that there is diverse, congested and complex literature of varying quality around hip fracture and it can be hard to interpret. We wanted to improve on that and provide useful, actionable statements of the evidence for patients, clinicians and researchers.

Studies are being accumulated very quickly in this field compared to other areas of orthopaedics and the reviews that were in the Cochrane Library were out of date and had various limitations. We were aware that NICE would be reviewing and updating its guidance on the management of hip fracture in adults in 2022 so this was a timely piece of work that would link closely with work at NICE. We were in touch with them along the process sharing the questions for which patients and clinicians wanted answers, as well as sharing findings with them.

Were patients involved?
We carried out scoping work with patients and experts in this field to work out what the priority review topics would be - there could have been a hundred, but we worked together to reduce it down to what was most important. We shared this with NICE to help shape their update. This involvement of patients and their views was not happening when we all started out in this field, it is now so much more patient influenced, which is a good thing for those giving and those receiving treatment and care.

We approached these reviews as informative pieces of work giving direction to guidelines, clinical practice and research rather than being static sources of information - they feed into knowledge and then clinical practice.

Who will find these studies most useful?
Clinicians, surgeons, and trainee surgeons will find these reviews most useful as they provide the gold standard answers to questions they want answered.

The studies are also an important part of the puzzle in terms of informing what might be commissioned for research later.

We hope patients will see an improvement in their care as a result of these reviews as they give an evidence-based anchors for clinician’s recommendations.  NICE will also have these studies available to them when they update their guidance on this topic.

In the UK we have something called the National Hip Fracture Database, it audits treatment in this area, how many hip replacements take place in the UK for example. With these reviews they can report practice against best evidence which is good for patients, good for commissioners and good for people planning service delivery in their hospitals.

Who was involved?
Our success in securing this grant and the reviews done to date builds on very strong networks,
we've got a pretty research active and research savvy community partly through the work of Orthopaedic Trauma Society and the Fragility Fracture Network – we drew on this network to pull this work together. This research collaboration is what we’d like to see fostered going forwards.

These reviews were synchronised with current large trials and NICE updating their guidelines and as such they are an important piece of work to inform the wider picture and influence practice; not only in terms of influencing what treatment is given but influencing how best to study a topic – this is a shift in culture. These reviews should stand the test of time for the next ten years because they have been performed with methodological rigour and include the latest trial data.

You included very recent large landmark trials, how?
We did not want to publish Cochrane reviews that were out of date quickly. We were able to include a very large landmark new trial (WHITE5) in two of these reviews because we were aware of what each other was doing – we were in touch with each other - and we were able to access trial data prior to publication. We don’t work in a siloed way, and this has great benefit.

What value do these studies have for funders?
This body of work will help funders know where to place their funding to get maximum benefit on that spend – there are certain surgeries we can say should no longer happen and those areas no longer need to be studied.

• Visit the Cochrane Bone, Joint and Muscle Trauma Group here
• View each review here:
  • Internal fixation implants for intracapsular hip fractures in older adults
  • Arthroplasties for hip fracture in adults
  • Cephalomedullary nails versus extramedullary implants for extracapsular hip fractures in older adults
  • Surgical interventions for treating intracapsular hip fractures in older adults: a network meta-analysis
  • Surgical interventions for treating extracapsular hip fractures in older adults: a network meta-analysis
    
    

Monday, February 14, 2022

Location: Flexible location (remote working) in the UK.
Specifications: Permanent contract.
Hours: Full-time week (flexible working considered) – 37.5 hours.
Salary: £42,000 per annum.
Application Closing Date: 07 April (Midnight GMT Time)

This role is an exciting opportunity to use your financial knowledge and problem-solving skills to make a difference in the field of health care research.  

The Financial Accountant is responsible for supporting the day-to-day management and the smooth running of the financial accounting operations of Cochrane, which includes leading on financial accounting processes, balance sheet reconciliations and supporting the international payroll.  The jobholder will have an important role to create and shape the financial procedures, improve processes, outputs, and analysis for stakeholders.

You will have a minimum of 3-5 years’ experience in a similar finance role with a recognised qualification. Part-qualified candidates with particularly strong experience will be considered and supported.

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.

• For further information on the job description and how to apply, please click here 
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples. Note that we will assess applications as they are received, and therefore may fill the post before the deadline.
• Deadline for applications: 07 April 2022 (Midnight GMT).

Friday, March 25, 2022 Category: Jobs

Low‐carbohydrate versus balanced‐carbohydrate diets for reducing weight and cardiovascular risk

Key messages

• There is probably little to no difference in the weight lost by people following low-carbohydrate weight-reducing diets (also known as 'low-carb diets') compared to the weight lost by people following balanced-carbohydrate weight-reducing diets, for up to two years.
• Similarly, there is probably little to no difference between the diets for changes in heart disease risks, like diastolic blood pressure, glycosylated haemoglobin (HbA1c, a measure of blood sugar levels over 2-3 months) and LDL cholesterol (‘unhealthy’ cholesterol) up to two years.
• This was the case in people with and without type 2 diabetes.

What are low-carbohydrate and balanced-carbohydrate weight-reducing diets?
People spend lots of money on trying to lose weight using diets, products, foods and books, and continue to debate about which diets are effective and safe. So, examining the scientific evidence behind claims made is important. Low-carbohydrate diets are a broad category of weight-reducing diets that manipulate and restrict carbohydrates, protein and fat in diets. There are no consistent, widely-accepted definitions of these diets and different descriptions are used (e.g. 'low-carbohydrate, high-protein’, 'low-carbohydrate, high-fat', or ‘very low-carbohydrate’).

Low-carbohydrate diets are implemented in different ways, but they restrict grains, cereals and legumes, and other carbohydrate-containing foods; such as dairy, most fruit and certain vegetables. These foods are then typically replaced with foods higher in fat and protein; such as meats, eggs, cheese, butter, cream, oils. Some low-carbohydrate diets recommend eating as desired, while others recommend restricting the amount of energy eaten.

Balanced-carbohydrate diets contain more moderate amounts of carbohydrates, protein and fats, in line with current healthy eating advice from health authorities. When used for weight reduction, balanced diets recommend restricting the amount of energy eaten by guiding people to reduce their portion sizes and choose healthier foods (e.g. lean instead of fatty meat).

Low-carbohydrate weight-reducing diets are widely promoted, marketed and commercialised as being more effective for weight loss, and healthier, than 'balanced'-carbohydrate weight-reducing diets.

Professor Celeste Naude explains, "The weight lost by people on low-carbohydrate weight-reducing diets was similar to the weight lost by those on balanced-carbohydrate weight-reducing diets, for up to two years. Changes in heart disease risk factors were also similar in people following these diets for between one and two years. This was the case in people with and without type 2 diabetes.

"The longest of the trials lasted for two years, so we do not know if there are differences between the effects and safety of these diets beyond two years, which would be especially important for heart disease risk factors.

Most of the people in the trials did not have heart disease or related risks at the start of the studies, so we do not know if there are differences between the effects and safety of these diets in people with heart disease or risk factors, such as conditions that cause abnormal levels of fats in the blood.

Our review did not compare type or quality of carbohydrates, fats or proteins between the diets, or costs between the diets.”

What did the review authors want to find out?
They wanted to find out if low-carbohydrate weight-reducing diets were better for weight loss and heart disease risk factors than balanced-carbohydrate weight-reducing diets in adults who were overweight or living with obesity.

They wanted to find this out for people with and without type 2 diabetes.

What did they do?
They searched six electronic databases and trial registries for all trials* that compared low-carbohydrate weight-reducing diets with balanced-carbohydrate weight-reducing diets in adults who were overweight or living with obesity. The trials had to last for at least three months. The authors compared and summarised the results of the trials and rated the confidence in the combined evidence, based on factors such as study methods and sizes.

*A trial is a type of study in which participants are assigned randomly to two or more treatment groups. This is the best way to ensure similar groups of participants.

What did they find?
The authors found 61 trials involving 6925 people who were overweight or living with obesity. The biggest trial was in 419 people and the smallest was in 20 people. All except one of the trials were conducted in high-income countries worldwide, and nearly half were undertaken in the US (n=26).

Most trials were undertaken in people who did not have heart disease or risk factors (n = 36). Most people (n = 5118) did not have type 2 diabetes.

The average starting weight of people across the trials was 95 kg. Most studies lasted for six months or less (n = 37); and the longest studies (n = 6) lasted for two years.

Main results
Low-carbohydrate weight-reducing diets probably result in little to no difference in weight loss over the short term (trials lasting 3 to 8.5 months) and long term (trials lasting one to two years) compared to balanced-carbohydrate weight-reducing diets, in people with and without type 2 diabetes.

In the short term, the average difference in weight loss was about 1 kg and in the long term, the average difference was less than 1 kg.

People lost weight on both diets in some trials. The amount of weight lost on average varied greatly with both diets across the trials from less than 1 kg in some trials and up to about 12 kg in others in the short term and long term.

Similarly, low-carbohydrate weight-reducing diets probably result in little to no difference in diastolic blood pressure, glycosylated haemoglobin (HbA1c) and LDL cholesterol (‘unhealthy’ cholesterol) for up to two years.

The authors could not draw any conclusions about side effects reported by participants because very few trials reported these.

What are the limitations of the evidence?
The authors are moderately confident in the evidence. Confidence was lowered mainly because of concerns about how some the trials were conducted, which included that many trials did not report all their results. Further research may change these results.

How up to date is this evidence?
The evidence is up-to-date to June 2021.

What gaps did the authors identify?
They do not know if there are differences between the effects and safety of these diets beyond two years.

Since most of the people in the trials did not have heart disease or heart disease risks when they were recruited, the authors do not know if there are differences between the effects and safety of these diets in people with heart disease or risk factors, such as conditions that cause abnormal levels of fats in the blood.

What important related questions were not addressed in this review?
The author team did not compare type or quality of carbohydrates, fats or proteins between the diets. They also did not examine differences in costs between the diets.

• Read the full review here
• Visit the Cochrane Public Health Group website
• Visit the Cochrane Heart Group website 

Friday, January 28, 2022

Wednesday, January 26, 2022

In this free Lifeology course, learn what an infodemic is and what you can do to slow and prevent the spread of misinformation. 

Lifeology’s tagline is ‘The place where science and art converge’. They offer a platform that brings together scientists, artists, and storytellers to help people better understand and engage with science and health information and research. One of the main ways they meet their objectives is through beautifully illustrated, science-backed, bite-sized ‘flashcard’ courses about science and health-related topics aimed at the general public and students.

Image from the Lifeology's 'What is an infodemic and how can we prevent it?' course

For World Evidence-Based Healthcare (EBHC) Day, they collaborated with Cochrane to create a free course. The 41 slides walk the user through the  story of Ronald who has been misguided by misinformation and teaches what an infodemic is and how to slow the spread of misinformation.

Image from the Lifeology's 'What is an infodemic and how can we prevent it?' course

Paige Jarreau, co-founder of Lifeology, said "At Lifeology, we believe that science communication in any format, including our flashcard courses, is far better when it is the product of collaboration between scientists and professional creatives like storytellers and artists. We were pleased to be able to work closely with people from Cochrane to create this course on infodemics. We've produced a beautifully illustrated free course that is practical in its tips to combat misinformation and accessible through its plain language, empathetic storytelling and relatable imagery  - it's also available in English, French, German, Malay, Simplified Chinese, and Spanish !"

Image from the Lifeology's 'What is an infodemic and how can we prevent it?' course

Jordan Collver, the illustrator of the Lifeology course, said "This was an exciting project to work on. We had some fun with metaphors and with well known memes in this course while keeping the story empathic and relatable in a global context.'

View the Lifeology course 'what is an infodemic and how we can prevent it?' in:

•  English
• French
• German
• Malay
• Simplified Chinese
• Spanish

Learn more about Lifeology: 

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

Thursday, June 2, 2022

Tuesday, January 18, 2022

Cochrane Crowd is a citizen science platform  where a global community of volunteers help to classify the research needed to support informed decision-making about healthcare. Cochrane Crowd volunteers review descriptions of research studies to identify and classify clinical trials.

 A new task has just gone live on Cochrane Crowd. It is a citation screening task that we are doing in partnership with The Healthcare Improvement Studies Institute (THIS Institute).

It forms a part of a methodological study that aims to assess the accuracy of crowdsourcing the screening of search results. Unlike some of the previous studies we’ve done, this one is a little bit different. Instead of asking you to assess a record for possible relevance, we want you to assess it for irrelevance! Our hypothesis is that a crowd can still make a big difference in weeding out the obviously irrelevant records, and that by framing the task in this way, we will reduce the chances of possibly relevant records being rejected.

Are you up for joining this task? If so, head to crowd.cochrane.org and log in. On your tasks page you should see a task called: Training for healthcare professionals in electronic fetal monitoring using cardiotocograph.

We are going to run this study as a randomised study. When you click on the training module, you will be randomised to one of three tasks. Each of the three tasks will look exactly the same. The difference between the three tasks is the agreement algorithm in the background. This algorithm provides a ‘final’ classification on a record based on a certain number and order of individual classifications made by contributors. We are testing three different agreement algorithms as part of this methodological study.

There is of course a training module. It should only take around 10-15 minutes to complete. Once done you will be able to screen some ‘real’ records. Do as many as you like. If you manage to do 250 or more, you will get named acknowledgement in any write-ups of this methods study and be able to download a certificate.

As always, this kind of work would not be possible without the help of this fantastic community. If you are able to take part, then thank you very much indeed from the teams at THIS Institute and Cochrane Crowd.

If you have any questions, please don’t hesitate to get in touch with me: anna.noel-storr@rdm.ox.ac.uk

With best wishes to all and happy citation screening!

Anna and Sarah

• Visit Cochrane Crowd here
• Read The THIS-Crowd Exclusion Study FAQ's
• Follow Cochrane Crowd on Twitter

Friday, January 14, 2022

Location: UK based role with occasional global travel
Salary: £110-120,000 per annum
Contract type: Permanent
Date closing: 06/02/2022

Cochrane is a global independent community of more than 100,000 people who search for and summarize the best evidence from health and care research to help our beneficiaries make informed choices about health and care.  

Our members and supporters come from more than 220 countries worldwide including researchers, health professionals, patients, carers, and people passionate about improving health and care outcomes for everyone, everywhere.

Chief Executive
£110, 120,000 per annum
UK based role with occasional global travel

Cochrane’s work providing accessible, credible information to improve global health - has never been more important or relevant than it is today.

This Chief Executive role is an extraordinary opportunity for an inspirational, experienced and authentic leader, passionate about evidence and health care, to join Cochrane and work with a highly committed and engaged Board and talented staff team to lead the development of a new long-term strategy.

We are seeking someone with experience working in a multi-stakeholder environment, ideally in a global context, with exceptional interpersonal and communication skills with proven capacity to develop influential internal and external relationships.  Thoughtful, curious, and with a supportive leadership style; you will bring a strong track record of leading teams; fostering a high-performing culture; driving organisational change and growing income.  Critically, you will share our vision of a world of better health for all people where decisions about health and care are informed by high-quality evidence.

Cochrane is a global community and we value the diverse range of experience that this brings.  We strive to be an equal opportunities employer and welcome application from people from all races, religions, genders, sexual orientation, lived experience or ability.

• For further information, the role and how to apply please download the full appointment brief here  
• Closing Date: Sunday 6th February 2022
• If you require this document in an alternative format, please contact executiveadmin@prospect-us.co.uk or call 020 7691 1920

Thursday, January 13, 2022 Category: Jobs

Senior Research Integrity Editor, Lisa Bero, discusses this subject in a recent Nature article.

Never has it been more important to foster trust in scientific evidence than in the ongoing coronavirus pandemic. Cochrane is committed to independence, transparency, and integrity in healthcare research. The Research Integrity Team works to support and strengthen this commitment through research, policy development and implementation, advocacy and community outreach.

Recently, Senior Research Integrity Editor, Lisa Bero, has written a World View in Nature on the topic of working together to tackle the issue of problematic studies – studies where there are serious concerns about the trustworthiness of the data or findings. In the article she explains the tools and resources Cochrane uses as described in its policy for ‘Managing potentially problematic studies’, to empower reviewers to act when they suspect an issue. 

Research Integrity Editor, Stephanie Boughton, says “It was great to highlight Cochrane’s leading work in this area. We are building upon Cochrane’s strong history of conducting meta-research to detect research integrity problems. I hope all systematic review authors take up Lisa’s call to action and use tools described in Cochrane’s policy for ‘Managing potential problematic studies’ when they suspect an issue.”

• Read the full article by Lisa Bero in Nature
• Find out more about Cochrane’s Research Integrity Team  

Wednesday, January 19, 2022

Specifications:  Part Time, 1 day per week
Location: UK based (remote)
Application Closing Date: 25 January 2022

Cochrane UK is seeking a dynamic, self-motivated Transition Support Project Manager to lead and manage a support service for UK-based Cochrane Review Groups (CRGs) and those who work with them during a period of transition to a new review production model. 

You will join a small and friendly team at Cochrane UK and will work closely with the UK-based CRGs, Cochrane’s Editorial and Methods Department (EMD) and Cochrane Support Service to develop and operate processes to minimize disruption during the transition period.   

You will have in-depth knowledge and understanding of the existing Cochrane publication model and editorial processes.  You will have experience of the processes involved in conducting and editing systematic reviews and submitting funding bids.  You will have excellent communication and project management skills with the ability to build effective stakeholder relationships.

The role will be for 1 day per week with the potential to increase if, and when,  the requirements of the project change over the next 12 months.   

This role can be arranged either as a secondment (with your employer’s permission) or with you working as a self-employed contractor. 

If you would like more information please contact Therese Docherty, Business & Programme Manager (therese.docherty@cochrane.nhs.uk) for the full job description and person specification.

Deadline for applications: 25 January 2022.

Monday, January 10, 2022 Category: Jobs

Specifications: Full Time
Salary:  £42,000 per annum
Location: UK based (remote)
Application Closing Date: 31 January 2022

Cochrane is a global independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making the vast amounts of evidence generated through research useful for informing decisions about health. We do this by identifying, appraising and synthesizing individual research findings to produce the best available evidence on what can work, what might harm and where more research is needed.

A Project Manager role has become available to support the Evidence Production and Methods Department (EPM), Publishing and Technology department (P&T), Cochrane Library Product Manager and other Central Executive Teams (CET) in delivering on high priority projects: to project manage the highest priority EPM, P&T and other Cochrane projects where appropriate.

• For further information on the role and how to apply, please click here. 
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples.
• Note that we will assess applications as they are received, and therefore may fill the post before the deadline.
• Deadline for applications: Monday 31 January 2022 (12 midnight GMT).

Monday, January 10, 2022 Category: Jobs

Location: Flexible location (remote working) – contract type dependent on location.
Specifications: 1 Mar to 1 September 2022. Fixed-term employment contract if successful applicant based in UK, Germany or Denmark. Consultancy contract in other locations.
Hours: Full time 37.5 hours per week.
Salary: £30,000 per annum.
Application Closing Date: Sunday 23 January 2022 (Midnight GMT).

This role is an exciting opportunity to use your communication and problem-solving skills to make a difference in the field of healthcare research and publishing.  

Cochrane recently implemented Editorial Manager as the editorial and production system for Cochrane Reviews. This role has a significant focus on supporting authors, editors and peer reviewers in using Editorial Manager for submission and peer review; and our linked system Convey for managing Declarations of Interest. Applications are particularly welcomed from candidates with experience of using these or similar systems.

The Cochrane Support team provides technical and user support to Cochrane editorial teams and review authors; and handle enquiries from members of the public about Cochrane’s work. We pride ourselves on our timely and coordinated support service, covering a broad range of areas, with a focus on Cochrane review-writing software and editorial processing and publication.
The team works closely with Cochrane’s Central Editorial Service and other related departments, to ensure accurate, consistent responses to queries on Cochrane technology, policies and methods.

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.

• For further information on the role and how to apply, please click here  
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples. Note that we will assess applications as they are received, and therefore may fill the post before the deadline
• Deadline for applications: Sunday 23 January 2022 (12 midnight GMT)
• Interviews to be held on: week beginning 31 January (times to be confirmed)

Thursday, January 6, 2022 Category: Jobs

New review from Cochrane Tobacco and Addiction Group

Key messages
Heated tobacco probably exposes people to fewer toxins than cigarettes, but possibly more than not using any tobacco. Falls in cigarette sales appeared to speed up following the launch of heated tobacco in Japan, but the authors are uncertain whether this is caused by people switching from cigarettes to heated tobacco.

The authors need more independently funded research into whether heated tobacco helps people stop smoking, whether it results in unwanted effects, and the impact of rising heated tobacco use on smoking rates. 

What are heated tobacco products?
Heated tobacco products are designed to heat tobacco to a high enough temperature to release vapour, without burning it or producing smoke. They differ from e‐cigarettes because they heat tobacco leaf/sheet rather than a liquid. Many of the harmful chemicals in cigarette smoke are created by burning tobacco. So heating not burning tobacco could reduce the amount of chemicals a user ingests. Some people report stopping smoking cigarettes entirely by switching to using heated tobacco.   Why the team did this Cochrane Review?
Because cigarette smoking is addictive, many people find it difficult to stop despite the harm it causes. The author team aimed to find out whether trying to switch to heated tobacco helps people stop smoking cigarettes, and whether it results in unwanted effects. They also wanted to find out whether rising heated tobacco use has affected smoking rates or cigarette sales.   What did the authors do
They looked for studies that reported on the use of heated tobacco for stopping smoking, and on unwanted effects and toxin exposure in people asked to use heated tobacco. Here they only included randomised controlled trials, where treatments were given to people at random. This type of study is considered the most reliable way of determining if a treatment works. Finally, they searched for studies looking at changes in smoking rates and cigarette sales following the launch of heated tobacco to market. They included studies published up to January 2021.   What they found
Their search found 13 relevant studies. No studies reported whether heated tobacco helps people stop smoking cigarettes. Eleven trials, all funded by tobacco companies and with 2666 adult smokers, compared unwanted effects and toxin levels in people randomly assigned to use heated tobacco or to continue smoking cigarettes or abstain from tobacco use.

Two studies looked at how trends in cigarette sales changed following the launch of heated tobacco in Japan.

What are the results of our review?
The authors do not know whether using heated tobacco helps people to stop smoking cigarettes (no studies measured this).

They are uncertain whether the chances of getting unwanted symptoms from being asked to use heated tobacco are different compared with cigarettes (6 studies, 1713 participants) or no tobacco (2 studies, 237 participants). Serious unwanted symptoms in the short time period studied (average 13 weeks) were rare in all groups, which means we are uncertain about any differences. Toxin levels were probably lower in people using heated tobacco than those smoking cigarettes (10 studies, 1959 participants), but may be higher than in people not using any tobacco products (5 studies, 382 participants).

The launch of heated tobacco products in Japan may have caused the decline in cigarette sales to speed up over time (two studies), but it is unclear whether the fall in the percentage of people who smoke also sped up because no studies looked at this. 

How reliable are these results?
Results are based on data from a small number of studies, most of which were funded by tobacco companies.

Results on unwanted effects are likely to change as more evidence becomes available. However, we are moderately confident that levels of measured toxins are lower in people using heated tobacco than smoking cigarettes, but less confident that levels were higher than in people not using any tobacco. We are also less confident that the launch of heated tobacco caused the fall in cigarette sales to speed up, as results came from a single country.

• Read the full review
• Learn more about the Tobacco and Addiction group

Thursday, January 6, 2022

Tuesday, January 4, 2022

The World Health Organization defines an infodemic as “overabundance of information – some accurate and some not – that occurs during an epidemic. It can lead to confusion and ultimately mistrust in governments and public health response”. This has been a particular challenge during the COVID-19 pandemic.

Cochrane US Senior Officer, Tiffany Duque joined The Eco Well on a webinar to talk about the importance of credible information and the infodemic. She also covered what Cochrane does and how people can get involved. 

• Join Cochrane
• What is Cochrane?
• What are systematic reviews?
• Understanding health evidence in COVID-19 times

Tuesday, December 21, 2021

Dear Community members and friends,

Context
So much happens in a year. Last year, Cochrane responded quickly to the pandemic with rapid, living reviews – sharing the best evidence on key interventions and diagnostic tests to support the world in tackling this unprecedented challenge.  We made all of our Coronavirus (COVID-19) resources freely available, open access – which they remain today, including our COVID-19 Study Register which now has references to well over 100,000 studies. Our work has never been more important or relevant.

We find ourselves still living with the pandemic in 2021. The rollout of vaccines has been a great global achievement, but exacerbated health inequalities as the global north rolled out vaccinations, and the global south has been left behind.

2021 was the year we committed to full Open Access publishing by 2025, as part of making our evidence accessible, usable, and available to all. This is a vital step towards achieving our vision of “better health for all people”, and also reflects the fantastic drive towards open access across the publishing sector and particularly for peer reviewed research – core to our work and impact. This will have implications for our income and business model, and so we plan to diversify our income streams and our products.  

We were fortunate this year to receive over £17m funding from global funders to Cochrane groups globally. We look forward to continuing those relationships and working with them to do even more to improve health for all people. 

Transformation
In this context, we have launched a programme of transformation to ensure we maintain our relevance and pre-eminence into the future. Our ‘Strategy for Change’ describes our priorities for working in a changing environment through to 2023, building on the insight and feedback of the extraordinary Cochrane community, and the experience of the pandemic.   Cochrane Reviews are recognized internationally as a gold standard for high-quality, trusted health information. We do not accept commercial or conflicted funding, which is vital for us to generate authoritative and reliable information, working freely, unconstrained by commercial and financial interests. This makes it even more important that we adapt and change, and get fit for the future so we can not only survive but thrive into the future.

As part of that transformation programme, over the last three months the Cochrane community has discussed:

• How we can remain true to our values while adapting to challenges;
• How we remain the standard-setter for evidence synthesis; and
• How to change to ensure we produce timely, high-quality evidence that serves the different users of evidence.

Achievements
2021 has been another year of exceptional achievement for Cochrane.  Highlights include:

• The Impact Factor for the Cochrane Database of Systematic Reviews grew to 9.266.
• In 2021, 3100 authors prepared new and updated reviews by summarising evidence from over 10,000 included studies
• We made statements at two World Health Assemblies - advocating for the need of evidence synthesis in the response to COVID-19
• We hosted a major event - Cochrane Convenes: Preparing for and responding to global health emergencies: what have we learnt from COVID-19
• The Cochrane Library now has a total of 17 national and regional licenses, representing immediate full access for more than 500 million people.

See more of our achievements

Plans for 2022
Your contributions shaped the strategy for change and have offered valuable insights as we consider the future. They ensure we can together build a sustainable future and remain at the forefront of evidence synthesis. We will now be determining the direction of travel for how we produce evidence synthesis in future, and progressing implementation of this multi-year change programme. We continue to improve our process, structures and systems for evidence production to be able to respond quickly and reliably to user-needs, whilst demonstrating good research and publishing practice.

In 2022, we will be seeking new ways to generate income and be sustainable in the context of our commitment to Open Access, funding challenges and competition.  We will be recruiting a new Chief Executive, and a Director of Development to lead on fundraising.

We are hugely proud of our Cochrane Community whose collective energy, drive and enthusiasm make such a difference. Collaboration is our watchword and we work together to achieve our goals bringing together diverse interests, expertise, and geographies.  While there are challenges, we know it is more important than ever to share our evidence and contribute to a world of better health for all people.

Thank you for all you do. We are hugely optimistic about the future, and look forward to seeing you and working with you in 2022 and beyond.  All the best for the holidays and new year.

Tracey Howe, Co-chair

Catherine Marshall, Co-chair

Karla Soares-Weiser, Editor-in-Chief

Judith Brodie, Interim Chief Executive

Tuesday, December 21, 2021 Category: The difference we make

Dru Riddle is an Associate Professor of Professional Practice at Texas Christian University, Co-chair of the  Cochrane US Network Executive, was a moderator and panel member of the recent Cochrane Convenes.  Drawing on experiences of the COVID-19 pandemic, the inaugural Cochrane Convenes brought together leaders across the world to explore and then recommend the changes needed in evidence synthesis to prepare for and respond to future global health emergencies. He recently spoke to Becker’s Healthcare Podcast which features interviews and conversations with the latest in thought leadership in the healthcare industry. The episode discusses his advice to listen more than you talk, influencing without controlling, Cochrane Convenes and more.

• Visit the Cochrane US website
• Learn more about Cochrane Convenes

 

Tuesday, December 21, 2021

Real-time reviews of research findings could help policymakers address global crises such as COVID-19, says this article published  in Nature. Living evidence was first developed by Cochrane and is an important recommendation that came out of the recent Cochrane Convenes meetings which looked at how we can better prepare for future health emergencies.

According to scientists writing in the peer-reviewed journal Nature, policy missteps will continue to overshadow the global response to COVID-19 because policymakers are overwhelmed with rapidly shifting research evidence. Faced with new challenges such as the Omicron variant, decision-makers can’t keep up with the flood of new research studies when drawing up policy. This results in muddled strategies, erodes trust in science and fuels controversy, according to the authors.

They are now urging countries to adopt a new scientific approach that summarizes scientific research in near real time.

This system called ‘living evidence’ produces rigorous and ready-to-go summaries of all relevant scientific research, and keeps them up to date by rapidly incorporating new research findings.

Policy makers and clinicians can draw on a form of scientific knowledge that is both rigorous and trustworthy, and includes all the latest science – something that has not been available previously.

Living evidence was first developed by researchers from Cochrane, a leading producer of scientific evidence on health topics, and tested by the Australian Stroke Foundation in their national clinical guidelines as a way to cut the time lag between research being published and implementation of new treatments. Cochrane defines living systematic reviews (LSRs) as ones which are  continually updated, incorporating relevant new evidence as it becomes available. There are now 7 LSRs in the Cochrane Library and 3 LSR protocols. Learn more about Cochrane's Living systematic reviews. 

Recently Cochrane hosted  Cochrane Convenes; an online event, co-sponsored by WHO, and co-organised with COVID-END (COVID-19 Evidence Network to support Decision-making).  It brought together leaders across the world to explore and then recommend the changes needed in evidence synthesis to prepare for and respond to future global health emergencies. Prioritizing and supporting the creation and use of living evidence was a recommendation that came out as part of these meetings. Learn more about Cochrane Convenes. 

“Decisions relevant to global challenges must be informed by the best available evidence,” says lead author Julian Elliott from the Australian Living Evidence Consortium at Cochrane Australia, Monash University, Melbourne.

“Otherwise, policy missteps with every new challenge of the pandemic, such as the rise of the Omicron variant, will lead to unnecessary and untold health, social and economic impacts. It should no longer be acceptable for evidence to be out of date, biased or selective. Without trustworthy and up-to-date research reviews, the world risks making ill-informed decisions and wasting resources. We call on policymakers as well as researchers in every scientific field, and their funders, to adopt the living-evidence model. Science doesn’t stand still, neither should its translation into action.”

Typically, national policies and guidelines draw on formal summaries of research. Known as systematic reviews, scientists combine evidence from individual studies then analyse the data to calculate an overall result. Used since the 1980s, this approach is aimed at creating a clear understanding of the scientific knowledge available. Systematic review has been the basis for high-impact decision-making not only in health but also in other fields such as education and poverty eradication.    

However, the authors say these reviews are often of poor quality, duplicative and out of date, especially when there is ‘a flood of new research’ such as in the current pandemic.

The authors highlight the drug remdesivir which ‘weak but promising’ data suggested could treat COVID-19. In 2020, 30 systematic reviews were produced to assess remdesivir’s efficacy. Yet many were outdated before they were published because they omitted ‘recently published primary studies’, according to the authors. Read Cochrane's living systematic review on Remdesivir.

Living evidence overcomes these issues. Researchers continuously identify new studies by monitoring databases of the latest journal publications and other digital collections, often enabled by artificial intelligence and other technologies.

Dr Jeremy Grimshaw, co-author and co-lead of COVID-END (a global umbrella organization of evidence synthesis groups, including Cochrane ), argues that living evidence has been essential to addressing COVID-19 and similar models should be adopted to address other global challenges.
 
“Citizens, practitioners, managers and policy makers need trustworthy living evidence to address day-by-day decisions and ongoing challenges such as antimicrobial resistance. The Global Commission on Evidence to Address Societal Challenges will be reporting early next year with further recommendations about how we can do this.”

Living evidence can help tackle some of the world’s greatest challenges such as climate change. Prof Jan Minx, co-author and a co-chair of the Campbell Climate Solutions Coordinating Group, says that “current knowledge on what solutions work to solve the climate crisis is still patchy. We need to respond quickly and cannot afford many mistakes. There is no alternative to an agile approach to evidence-based policy that can deal with the flood of research and rigorously inform the thousands of decisions required to decarbonize the world economy.  Using living evidence in the field of climate science is critical to meet this challenge”.

You can read the full Nature Comment here: https://www.nature.com/articles/d41586-021-03690-1

The authors

• Julian Elliott directs the Australian Living Evidence Consortium, based at Cochrane Australia, Monash University, Melbourne, Australia and is chief executive of Covidence.org.
• Rebecca Lawrence is managing director, F1000 Research, London, UK, is a Board Member of Open Research Central and was a member of the Open Science Policy Platform of the European Commission.
• Jan C. Minx heads the Working Group on Applied Sustainability Science at the Mercator Research Institute on Global Commons and Climate Change; is professor for climate change and public policy at the Priestley International Centre for Climate at the University of Leeds, UK; and co-chairs the Campbell Coordinating Group on Climate Solutions.
• Olufemi T. Oladapo is unit head, Maternal and Perinatal Health, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
• Philippe Ravaud is director of the Centre for Epidemiological and Statistical Research Sorbonne Paris Cité (CRESS-UMR1153), Inserm/Université de Paris, and director of the Centre for Clinical Epidemiology, Hôpital Hôtel-Dieu, Paris, France.
• Britta Tendal is director of the Department of Evidence-Based Medicine, Danish Health Authority, Copenhagen, Denmark.
• James Thomas is professor of social research and policy, and deputy director, Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), UCL Social Research Institute, Institute of Education, University College London, UK.
• Tari Turner is Associate Professor, Cochrane Australia, School of Public Health and Preventive Medicine, Monash University; Director, National COVID-19 Clinical Evidence Taskforce.
• Per Olav Vandvik is professor at the Department of Health Management and Health Economics, University of Oslo, Norway; a researcher at the Norwegian Knowledge Centre; and chief executive of the MAGIC Foundation.
• Jeremy M. Grimshaw is senior scientist, Clinical Epidemiology Program, Ottawa Hospital Research Institute; and full professor, Department of Medicine, University of Ottawa.

Thursday, December 16, 2021

Job Title: Evaluator– Clinical Innovation Adoption Programme

Organisation:  Oxford Academic Health Science Network

Salary: £47,126 to £53k

Workload: 0.8 to 1 WTE

Deadline: Apply before 17 January

The Clinical Innovation Adoption Programme  works with all the Network’s stakeholders and partners to deliver improved health and increased economic growth across the region. Success in this role will be defined by successful delivery of evaluations of projects from the Clinical Innovation Adoption Programme, working with the NHS, the life sciences industries, academics and other stakeholders. Evaluations include projects that are being delivered from our NHSEI and Office of Life Science commissions, and additionally won bids.

This post requires the individual to have an excellent understanding of methodologies that could be applied in real world situations. The evaluation outputs must provide sufficient rigour so that the evidence can be used for further quality improvement opportunities and scale up/roll out across the NHS. 

The successful candidate should have the required skills for evaluation delivery which includes design, ability to lead on workshops, judgement on appropriate methods, knowledge and experience of conducting literature searches, qualitative interviews, surveys focus groups and quantitative analysis (awareness).

The post-holder will work alongside CIA Project Managers and with selected innovators to evaluate impact. Innovations include technologies (AI, digital or medical devices), drugs and new models of working. Innovations within this programme are either nearly ready, ready, or in the process of being deployed.

• Expressions of interest can be emailed to  Tracey Marriott, Director of Clinical Innovation Adoption at tracey.marriott@oxfordahsn.org

Tuesday, January 4, 2022 Category: Jobs

Location: Flexible location (remote working) in the UK.
Specifications: Permanent contract.
Hours: Full-time week (flexible working considered) – 37.5 hours.
Salary: £40,000 per annum.
Application Closing Date: Monday 31 January (Midnight GMT).

This role is an exciting opportunity to use your problem-solving skills to make a difference in the field of health care research.  

As the Cochrane Library Business Analyst, you will gather, investigate, validate, and document business requirements using workshops, user research, user cases, and task and workflow analysis. You will ensure requirements are sufficiently detailed, reviewed, signed off, and kept up-to-date and are fully traceable. You will create and manage functional specifications, and contribute to identifying and validating appropriate solutions to support business objectives.

You will act as a key liaison between the relevant Cochrane stakeholders and departments, our publisher and their outsourced development vendor, to gather requirements, ensure that technical needs are well defined, that feature implementation goals are met, and that go-to-market activities are successfully performed.

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.

• For further information on the role and how to apply, please click here. 
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples. Note that we will assess applications as they are received, and therefore may fill the post before the deadline.
• Deadline for applications: Monday 31 January (Midnight GMT).

Tuesday, January 11, 2022 Category: Jobs