Use of indirect comparison methods in systematic reviews: a survey of Cochrane review authors

2011 ◽  
Vol 3 (2) ◽  
pp. 71-79 ◽  
Author(s):  
Asmaa S. Abdelhamid ◽  
Yoon K. Loke ◽  
Sheetal Parekh-Bhurke ◽  
Yen-Fu Chen ◽  
Alex Sutton ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Cochrane Review ◽  
Indirect Comparison ◽  
Comparison Methods

scholarly journals Cochrane Schizophrenia Group’s Study-Based Register of Randomized Controlled Trials: Development and Content Analysis

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Farhad Shokraneh ◽  
Clive E Adams
Keyword(s):  
Content Analysis ◽  
Randomized Controlled Trials ◽  
Systematic Reviews ◽  
Research Policy ◽  
Cochrane Review ◽  
Gis Mapping ◽  
Controlled Trials ◽  
Policy And Practice ◽  
Randomized Controlled ◽  
Review Team

Abstract Background Study-based registers facilitate systematic reviews through shortening the process for review team and reducing considerable waste during the review process. Such a register also provides new insights about trends of trials in a sub-specialty. This paper reports development and content analysis of Cochrane Schizophrenia Group’s Study-Based Register. Methods The randomized controlled trials were collected through systematic searches of major information sources. Data points were extracted, curated and classified in the register. We report trends using regression analyses in Microsoft Excel and we used GIS mapping (GunnMap 2) to visualize the geographical distribution of the origin of schizophrenia trials. Results Although only 17% of trials were registered, the number of reports form registered trials is steadily increasing and registered trials produce more reports. Clinical trial registers are main source of trial reports followed by sub-specialty journals. Schizophrenia trials have been published in 23 languages from 90 countries while 105 nations do not have any reported schizophrenia trials. Only 9.7% of trials were included in at least one Cochrane review. Pharmacotherapy is the main target of trials while trials targeting psychotherapy are increasing in a continuous rate. The number of people randomized in trials is on average 114 with 60 being the most frequent sample size. Conclusions Curated datasets within the register uncover new patterns in data that have implications for research, policy, and practice for testing new interventions in trials or systematic reviews.

scholarly journals A systematic review of pharmacist-led audit and feedback interventions to influence prescribing behaviour in general practice settings

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i34-i35
Author(s):  
M Carter ◽  
N Abutheraa ◽  
N Ivers ◽  
J Grimshaw ◽  
S Chapman ◽  
...  
Keyword(s):  
General Practice ◽  
Systematic Reviews ◽  
Health Professionals ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Audit And Feedback ◽  
Cochrane Library ◽  
Randomised Trials ◽  
Prescribing Behaviour ◽  
Meta Analyses

Abstract Introduction Audit and Feedback (A&F) involves measuring data about practice, comparing it with clinical guidelines, professional standards or peer performance, and then feeding back the data to individuals/groups of health professionals to encourage change in practice (if required). A 2012 Cochrane review (1) found A&F was effective in changing health professionals’ behaviour and suggested that the person who delivers the A&F intervention influences its effect. Increasingly, pharmacists work in general practice and often have responsibility for medication review and repeat prescriptions. The effectiveness of pharmacist-led A&F in influencing prescribing behaviour is uncertain. Aim This secondary analysis from an ongoing update of the original Cochrane review aims to identify and describe pharmacist-led A&F interventions and evaluate their impact on prescribing behaviour in general practice compared with no intervention. Methods This sub-review is registered with PROSPERO: CRD42020194355 and complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (2). For the updated Cochrane review, the Cochrane Effective Practice and Organization of Care Group searched MEDLINE (1946 to present), EMBASE, CINAHL and Cochrane Library (March 2019) to identify randomised trials featuring A&F interventions. For this sub-review, authors screened titles and abstracts (May 2020) to identify trials involving pharmacist-led A&F interventions in primary care, extracted data, and assessed risk of bias (RoB) in eligible studies. Review results are summarised descriptively. Heterogeneity will be assessed and a random-effects meta-analysis is planned. Publication bias for selected outcomes and the certainty of the body of evidence will be evaluated and presented. Sub-group analyses will be conducted. Results Titles and abstracts of 295 studies identified for inclusion in the Cochrane A&F review update were screened. Eleven studies (all cluster-randomised trials) conducted in 9 countries (Denmark, Italy, Netherlands, Norway, Republic of Ireland, UK, Australia, Malaysia, USA) were identified for inclusion (Figure 1). Six studies had low RoB, two had high risk due to dissimilarities between trial arms at baseline and/or insufficient detail about randomisation, and three studies had unclear RoB. Studies examined the effect of A&F on prescribing for specific conditions (e.g. hypertension), medications (e.g. antibiotics), populations (e.g. patients >70), and prescribing errors (e.g. inappropriate dose). The pharmacist delivering A&F was a colleague of intervention participants in five studies. Pharmacists’ levels of skill and experience varied; seven studies reported details of pharmacist training undertaken for trial purposes. A&F interventions in nine studies demonstrated changes in prescribing, including reductions in errors or inappropriate prescribing according to the study aims and smaller increases in unwanted prescribing compared with the control group. Data analyses are ongoing (results will be available for the conference). Conclusion The preliminary results demonstrate the effectiveness of pharmacist-led A&F interventions in different countries and health systems with influencing prescribing practice to align more closely with guidance. Studies measured different prescribing behaviours; meta-analysis is unlikely to include all 11 studies. Further detailed analysis including feedback format/content/frequency and pharmacist skill level/experience, work-base (external/internal to recipients), will examine the impact of specific features on intervention effectiveness. References 1. Ivers N, Jamtvedt G, Flottorp S, Young JM, Odgaard-Jensen J, French SD, et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012(6):CD000259. 2. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.

scholarly journals The impact of Cochrane Reviews: a mixed-methods evaluation of outputs from Cochrane Review Groups supported by the National Institute for Health Research

2015 ◽  
Vol 19 (28) ◽  
pp. 1-100 ◽  
Author(s):  
Frances Bunn ◽  
Daksha Trivedi ◽  
Phil Alderson ◽  
Laura Hamilton ◽  
Alice Martin ◽  
...  
Keyword(s):  
Health Care ◽  
Systematic Reviews ◽  
Health Research ◽  
Cochrane Review ◽  
Economic Benefits ◽  
Value For Money ◽  
Health Technologies ◽  
Cochrane Reviews ◽  
The Uk ◽  
The Impact

BackgroundThe last few decades have seen a growing emphasis on evidence-informed decision-making in health care. Systematic reviews, such as those produced by Cochrane, have been a key component of this movement. The National Institute for Health Research (NIHR) Systematic Review Programme currently supports 20 Cochrane Review Groups (CRGs) in the UK and it is important that this funding represents value for money.Aims and objectivesThe overall aim was to identify the impacts and likely impacts on health care, patient outcomes and value for money of Cochrane Reviews published by 20 NIHR-funded CRGs during the years 2007–11.DesignWe sent questionnaires to CRGs and review authors, undertook interviews with guideline developers (GDs) and used bibliometrics and documentary review to get an overview of CRG impact and to evaluate the impact of a sample of 60 Cochrane Reviews. The evaluation was guided by a framework with four categories (knowledge production, research targeting, informing policy development and impact on practice/services).ResultsA total of 3187 new and updated reviews were published on the Cochrane Database of Systematic Reviews between 2007 and 2011, 1502 (47%) of which were produced by the 20 CRGs funded by the NIHR. We found 40 examples where reviews appeared to have influenced primary research and reviews had contributed to the creation of new knowledge and stimulated debate. Twenty-seven of the 60 reviews had 100 or more citations in Google Scholar™ (Google, CA, USA). Overall, 483 systematic reviews had been cited in 247 sets of guidance. This included 62 sets of international guidance, 175 sets of national guidance (87 from the UK) and 10 examples of local guidance. Evidence from the interviews suggested that Cochrane Reviews often play an instrumental role in informing guidance, although reviews being a poor fit with guideline scope or methods, reviews being out of date and a lack of communication between CRGs and GDs were barriers to their use. Cochrane Reviews appeared to have led to a number of benefits to the health service including safer or more appropriate use of medication or other health technologies or the identification of new effective drugs or treatments. However, whether or not these changes were directly as a result of the Cochrane Review and not the result of subsequent clinical guidance was difficult to judge. Potential benefits of Cochrane Reviews included economic benefits through budget savings or the release of funds, improvements in clinical quality, the reduction in the use of unproven or unnecessary procedures and improvements in patient and carer experiences.ConclusionsThis study identified a number of impacts and likely impacts of Cochrane Reviews. The clearest impacts of Cochrane Reviews are on research targeting and health-care policy, with less evidence of a direct impact on clinical practice and the organisation and delivery of NHS services. Although it is important for researchers to consider how they might increase the influence of their work, such impacts are difficult to measure. More work is required to develop suitable methods for defining and quantifying the impact of research.FundingThe NIHR Health Technology Assessment programme.

scholarly journals Diverse mechanisms and treatment strategies to confront fatigue in multiple sclerosis: A systematic review

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 563
Author(s):  
Sumanth Khadke ◽  
tehmina siddique
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Reviews ◽  
Observational Studies ◽  
Behavioral Therapy ◽  
Combined Treatment ◽  
Cochrane Review ◽  
Treatment Strategies ◽  
Individual Treatment ◽  
Positive Effects ◽  
Positive Effect

Background: Firm conclusions about the applicability of treatment methods other than pharmacotherapy in treating fatigue in multiple sclerosis (MS) remain elusive. Our objective is to synthesize and review the epidemiological literature systematically and find an effective therapeutic plan for fatigue. The effect of individual treatment and combined treatment strategies are studied. Methods: An electronic database search included EBSCO, PubMed, SCIENCE DIRECT and Scopus from January 1, 2013, to September 30, 2018. Search terms used are “Fatigue AND Multiple sclerosis AND therapy”. The articles included in the study are open access, published in last five years, not restricted to region and language. The search included randomized controlled trials (RCTs), observational studies, and systematic reviews. Results: We included 13 systematic reviews, 10 RCTs and 7 observational studies. A Cochrane review on 3206 patients showed exercise therapy to have a positive effect on fatigue in RRMS patients. The EPOC trial showed switching interferon therapy or glatiramer to fingolimod showed improved fatigue levels. The FACETS trial showed incorporating behavioral therapy to ongoing recommended therapy is beneficial. Few observational studies demonstrated that fatigue is influenced by pain, mood problems, and depression. Conclusions: The diverse pathology of fatigue related to MS is important in understanding and quantifying the role of each causal factor. Evidence reveals a positive effect on fatigue levels of RRMS patients with regular CBT and exercise-based combination therapy. Progressive forms of the disease have the worst prognosis. Individually aerobic exercises, behavioral therapy and pharmacotherapy have positive effects. A modified amalgamation of the same is a better hope for MS patients.

scholarly journals Quality assessment of studies included in Cochrane oral health systematic reviews

2020 ◽  
Author(s):  
Ahmad Sofi-Mahmudi ◽  
Pouria Iranparvar ◽  
Maryam Shakiba ◽  
Erfan Shamsoddin ◽  
Hossein Mohammad-Rahimi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Oral Health ◽  
High Risk ◽  
Systematic Reviews ◽  
Randomized Clinical Trials ◽  
Cochrane Review ◽  
Risk Of Bias ◽  
Double Blind ◽  
Cochrane Reviews ◽  
Performance Bias

AbstractObjectivesThe Risk of Bias (RoB) and other characteristics of randomized clinical trials included in Cochrane oral health systematic reviews were assessed.Study Design and SettingsAll the trials included in Cochrane oral health systematic reviews were examined. The RoB was evaluated for all the included clinical trials according to the Cochrane review standards. The Overall Risk of Bias (ORoB) was defined in this study based on the criteria for determining the overall bias in Cochrane’s RoB tool-v2. Descriptive analyses were carried out to determine the frequency of each intended variable.ResultsA total of 2565 studies were included in our analysis. The majority of the studies (n=1600) had sample sizes of 50 or higher. As for blinding, 907 studies were labelled as double-blind. Performance bias showed the highest rate of high risk (31.4%). Almost half of the studies had a high ORoB compared to 11.1% with low ORoB. The studies that used placebos had higher low ORoB (14.8% vs. 10.7%). The double-blind studies had the highest low ORoB (23.6%). The studies with a cross-over design had the highest low ORoB (28.8%).ConclusionOverall, the RoB for the studies on dentistry and oral health in Cochrane reviews was deemed high.

scholarly journals Claims of ‘no difference’ or ‘no effect’ in Cochrane and other systematic reviews

2020 ◽  
pp. bmjebm-2019-111257 ◽  
Author(s):  
Phoebe Rose Marson Smith ◽  
Lynda Ware ◽  
Clive Adams ◽  
Iain Chalmers
Keyword(s):  
Adverse Effects ◽  
Systematic Reviews ◽  
Statistical Significance ◽  
Cochrane Review ◽  
Relevant Information ◽  
Significance Testing ◽  
Statistical Significance Testing ◽  
Cochrane Reviews ◽  
Treatment Claims

Estimates of treatment effects/differences derived from controlled comparisons are subject to uncertainty, both because of the quality of the data and the play of chance. Despite this, authors sometimes use statistical significance testing to make definitive statements that ‘no difference exists between’ treatments. A survey to assess abstracts of Cochrane reviews published in 2001/2002 identified unqualified claims of ‘no difference’ or ‘no effect’ in 259 (21.3%) out of 1212 review abstracts surveyed. We have repeated the survey to assess the frequency of such claims among the abstracts of Cochrane and other systematic reviews published in 2017. We surveyed the 643 Cochrane review abstracts published in 2017 and a random sample of 643 abstracts of other systematic reviews published in the same year. We excluded review abstracts that referred only to a protocol, lacked a conclusion or did not contain any relevant information. We took steps to reduce biases during our survey. 'No difference/no effect' was claimed in the abstracts of 36 (7.8%) of 460 Cochrane reviews and in the abstracts of 13 (6.0%) of 218 other systematic reviews. Incorrect claims of no difference/no effect of treatments were substantially less common in Cochrane reviews published in in 2017 than they were in abstracts of reviews published in 2001/2002. We hope that this reflects greater efforts to reduce biases and inconsistent judgements in the later survey as well as more careful wording of review abstracts. There are numerous other ways of wording treatment claims incorrectly. These must be addressed because they can have adverse effects on healthcare and health research.

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