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Laser therapy for venous leg ulcers. Oral zinc for arterial

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Laser therapy for venous leg ulcers. Oral zinc for arterial and venous leg ulcers ... leg ulcers. Topical agents or dressings for pain in venous leg ulcers ... – PowerPoint PPT presentation

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Title: Laser therapy for venous leg ulcers. Oral zinc for arterial


1
  • www.cochrane.org

2
  • Janet Wale (Cochrane Consumer Network)
  • mission
  • Cochrane reviews and The Cochrane Library
  • structure of the Collaboration
  • Jordi Pardo Pardo (Iberoamerican Cochrane Centre)
  • diversity
  • Maryann Napoli (Consumer)
  • efficacy and adverse events in systematic
    reviews
  • Jane Cracknell (Review Group Coordinator)
  • editorial base perspective
  • Andy Oxman (Review Author)
  • types of studies, bias, grading of evidence
  • Arne Ohlsson (Centre Director)
  • where to from here

3
It is surely a great criticism of our profession
that we have not organised a critical summary, by
specialty or subspecialty, adapted periodically,
of all relevant randomized controlled trials.
Archie Cochrane, 1979
4
The Cochrane Collaboration is an international
organization that aims to help people make
well-informed decisions about health care by
preparing, maintaining, and promoting the
accessibility of systematic reviews of the
effects of healthcare interventions. ie
synthesising healthcare evidence (since 1993)
5
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6
  • Cochrane Database of Systematic Reviews
  • Full text systematic reviews - ongoing and
    completed
  • (currently 3,559 reviews and protocols)
  • Database of Abstracts of Reviews of Effects
  • Assessments of reviews
  • (currently 4,795 abstracts of non-Cochrane
    reviews)
  • Cochrane Central Register of Controlled Trials
  • Bibliographic references of reports of trials
  • (currently 415,918 citations of trials)
  • Cochrane Database of Methodology Reviews
  • Systematic reviews of methodology issues
  • (currently 18 reviews and protocols)
  • The Cochrane Methodology Register
  • References to methodology studies
  • (currently 5,668 theory and methods related
    citations)

7
  • EFFECT OF LONGER-TERM MODEST SALT REDUCTION ON
    BLOOD PRESSURE
  • He FJ, MacGregor GA
  • Date of most recent amendment 04 February
    2004Date of most recent substantive amendment
    06 October 2003
  • This review should be cited as He FJ, MacGregor
    GA. Effect of longer-term modest salt reduction
    on blood pressure (Cochrane Review). In The
    Cochrane Library, Issue 3, 2004. Chichester, UK
    John Wiley Sons, Ltd.

8
Vitamin D and vitamin D analogues for preventing
fractures associated with involutional and
post-menopausal osteoporosis Gillespie WJ,
Avenell A, Henry DA, OConnell DL, Robertson
J This Review should be cited as Gillespie WJ,
Avenell A, Henry DA, OConnell DL, Robertson J.
Vitamin D and vitamin D analogues for preventing
fractures associated with involutional and
post-menopausal osteoporosis. The Cochrane
Database of Systematic Reviews 2001, Issue 1.
This version first published online 22 January
2001 in Issue 1, 2001. A B S T R A C
T Background Due to their known effects on bone
metabolism, vitamin D and related compounds have
been proposed for the prevention of osteoporosis
and fractures. Objectives To determine the
effects of supplementation with Vitamin D or a
Vitamin D analogue in the prevention of fractures
of the axial and appendicular skeleton in elderly
men or women with involutional or post-menopausal
osteoporosis.
9
  • Some review titles
  • Water for wound cleansing
  • Therapeutic touch for healing acute wounds
  • Removal of nail polish and finger rings to
    prevent surgical infection
  • Preoperative fasting for adults to prevent
    perioperative complications
  • Gauze and tape and transparent polyurethane
    dressings for central venous catheters
  • Topical negative pressure for treating chronic
    wounds
  • Beds, mattresses and cushions for pressure sore
    prevention and treatment
  • Nutritional interventions for preventing and
    treating pressure ulcers
  • Therapeutic ultrasound for pressure sores
  • Compression for venous leg ulcers
  • Electromagnetic therapy for treating venous leg
    ulcers
  • Intermittent pneumatic compression for treating
    venous leg ulcers
  • Laser therapy for venous leg ulcers
  • Oral zinc for arterial and venous leg ulcers
  • Pentoxifylline for treating venous leg ulcers
  • Topical agents or dressings for pain in venous
    leg ulcers
  • Patient education for preventing diabetic foot
    ulceration

10
Review Groups
Centres
Steering Group
Methods Groups
Fields
Consumer Network
11
The Steering Group is supported by the
Secretariat
Claire Allen Deputy Administrator
Jini Hetherington Administrator and Company
Secretary
Nick Royle Chief Executive Officer
Louise Kitchener Administrative Assistant
12
  • Review Groups are composed of persons from
    around the world who share an interest in
    developing and maintaining systematic reviews
    relevant to a particular health area.
  • coordinated by an editorial team who edit and
    assemble completed reviews into modules for
    inclusion in The Cochrane Library.

13
  • Acute Respiratory Infections Group Airways
  • Anaesthesia
  • Back
  • Breast Cancer
  • Colorectal Cancer
  • Consumers and Communication
  • Dementia and Cognitive Improvement Depression,
    Anxiety and Neurosis Developmental, Psychosocial
    and Learning Problems
  • Drugs and Alcohol
  • Ear, Nose and Throat Disorders Effective
    Practice and Organisation of Care
  • Epilepsy
  • Eyes and Vision
  • Fertility Regulation
  • Gynaecological Cancer
  • Haematological MalignanciesHeart
  • Hepato-Biliary HIV/AIDSHypertensionIncontinenc
    e
  • Infectious Diseases
  • Inflammatory Bowel Disease
  • Injuries
  • Lung Cancer
  • Menstrual Disorders and Subfertility Metabolic
    and Endocrine Disorders Methodology
  • Movement Disorders
  • Multiple Sclerosis
  • Musculoskeletal
  • Musculoskeletal Injuries
  • Neonatal
  • Neuromuscular Disease
  • Oral Health
  • Pain, Palliative and Supportive Care Peripheral
    Vascular Diseases Pregnancy and Childbirth
  • Prostatic and Urologic CancersRenal
  • Schizophrenia
  • Sexually Transmitted DiseasesSkin
  • Stroke
  • Tobacco Addiction
  • Upper Gastrointestinal Pancreatic Diseases
  • Wounds

14
  • There should be a clear barrier between the
    production of Cochrane reviews and any funding
    from commercial sources with financial interests
    in the conclusions of Cochrane reviews.
  • Thus, sponsorship of a Cochrane review by any
    commercial source or sources (as defined above)
    is prohibited. Policy on Commercial Sponsorship

15
  • areas of interest which extend across a number
    of health problems/specific population
  • ensure that their priorities are reflected in the
    work of existing CRGs
  • compile specialized databases to serve their
    specific needs
  • Cancer NetworkChild Health Complementary
    Medicine Consumer NetworkHealth Care of Older
    People Health Promotion and Public
    HealthNeurological NetworkOccupational Health
    Pre-hospital and Emergency Health Primary
    Health Care Rehabilitation and Related Therapies
    Vaccines from http//www.cochrane.org

16
  • ?composed of individuals with an interest and
    expertise in the science of systematic reviews
  • ?provide advice and support in the development of
    the methods of systematic reviews
  • Applicability and Recommendations
    Campbell-Cochrane Health Economics
    Health-Related Quality of Life Individual
    Patient Data Meta-analysis Non-Randomised
    Studies Prospective Meta-Analysis Qualitative
    Reporting Bias Screening and Diagnostic Tests
    Statistical Methods Group from
    http//www.cochrane.org

17
Clinical expertise
Best research evidence
EBM
Patient values
Sackett DL, Strauss SE, Richardson WS, Rosenberg
W, Haynes RB. Evidence-Based Medicine. Second
Edition 2000 - Churchill Livingstone
Slide provided by Bernd Richter
18
The Consumer Network works to ensure that the
consumer perspective is incorporated into
Cochrane systematic reviews www.cochrane.org/
consumers
19
  • a good systematic review of
  • whatever evidence is available,
  • even in highly uncertain situations,
  • helps make the policymaking process more
    transparent
  • and
  • the political or commercial considerations more
    visible.
  • Moynihan R. Evaluating Health Services A
    Reporter Covers the Science of Research
    Synthesis, Milbank Memorial Trust 2004p31.
  • and identifies context, research needs

20
The Guiding Principles
  • Collaboration
  • Building on enthusiasm of individuals
  • Avoiding duplication
  • Minimizing bias
  • Keeping up to date
  • Ensuring relevance
  • Ensuring access
  • Continuous quality improvement
  • Continuity
  • Enabling wide participation

21
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