Plenary 1 Umbrella Reviews: what are  they, and do we need them? Lorne Becker Pembroke
Umbrella Reviews What are they, and do we need them?
The Cochrane Vision <ul><li>That healthcare decision-making around the world will be informed by high quality, timely rese...
The Clinician’s Reality
Lots of Unanswered Questions <ul><li>Random sample of 103 US family physicians </li></ul><ul><li>Researcher recorded quest...
Median  Minutes/Week  Spent Reading About My Patients: <ul><li>Self-reports at 17 Grand Rounds: </li></ul><ul><li>Medical ...
A Common Clinical Question <ul><li>What is the best treatment for a child who wets the bed? </li></ul>
Possible Treatments <ul><li>Alarm Systems </li></ul><ul><li>Medications </li></ul><ul><ul><li>Tricyclic Antidepressants </...
 
Cochrane Enuresis Reviews <ul><li>7 Reviews </li></ul><ul><li>Cover all of the potential interventions </li></ul><ul><li>R...
<ul><li>Clinical Reality </li></ul><ul><li>2 minutes per question </li></ul><ul><li>30 minutes per week </li></ul><ul><li>...
Umbrella Reviews <ul><li>Designed for busy decision makers </li></ul><ul><li>A “friendly front end”  </li></ul><ul><li>Sum...
<ul><li>4 Pages </li></ul><ul><li>2 Tables </li></ul><ul><li>7 References </li></ul>
Enuresis Umbrella Review
Enuresis Umbrella Review
Enuresis Umbrella Review
11 813 Imipramine vs.  No Treatment 13 576 Alarm vs.  No Treatment 3 208 Alarm vs. Imipramine Studies Subjects Comparison
Analyses and Figures
Umbrella Reviews Working Group <ul><li>Lorne Becker </li></ul><ul><li>Jon Deeks </li></ul><ul><li>Paul Glasziou </li></ul>...
Plenary 1 Co-chairs:   Fiona Alderdice and Monica Kjeldstr ø m Pembroke
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The Cochrane Collaboration Colloquium: Umbrella Reviews: What are they, and do we need them?

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Lorne Becker speaking at the XIV Cochrane Colloquium in Dublin, Ireland

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  • The Cochrane Collaboration Colloquium: Umbrella Reviews: What are they, and do we need them?

    1. 1. Plenary 1 Umbrella Reviews: what are they, and do we need them? Lorne Becker Pembroke
    2. 2. Umbrella Reviews What are they, and do we need them?
    3. 3. The Cochrane Vision <ul><li>That healthcare decision-making around the world will be informed by high quality, timely research evidence </li></ul>
    4. 4. The Clinician’s Reality
    5. 5. Lots of Unanswered Questions <ul><li>Random sample of 103 US family physicians </li></ul><ul><li>Researcher recorded questions after every consultation </li></ul><ul><li>3.2 questions per 10 patients seen </li></ul><ul><li>2/3 questions not pursued </li></ul><ul><li>Of questions pursued </li></ul><ul><ul><li>Mean time spent – 2 minutes </li></ul></ul><ul><ul><li>Median time spent – 1 minute </li></ul></ul>Ely et al BMJ 319, 1999, 358-361
    6. 6. Median Minutes/Week Spent Reading About My Patients: <ul><li>Self-reports at 17 Grand Rounds: </li></ul><ul><li>Medical Students: 90 minutes </li></ul><ul><li>House Officers (PGY1): 0 (up to 70%=none) </li></ul><ul><li>SHOs (PGY2-4): 20 (up to 15%=none) </li></ul><ul><li>Registrars: 45 (up to 40%=none) </li></ul><ul><li>Sr. Registrars 30 (up to 15%=none) </li></ul><ul><li>Consultants: </li></ul><ul><ul><li>Grad. Post 1975: 45 (up to 30%=none) </li></ul></ul><ul><ul><li>Grad. Pre 1975: 30 (up to 40%=none) </li></ul></ul>Data Presented by David Sackett MD
    7. 7. A Common Clinical Question <ul><li>What is the best treatment for a child who wets the bed? </li></ul>
    8. 8. Possible Treatments <ul><li>Alarm Systems </li></ul><ul><li>Medications </li></ul><ul><ul><li>Tricyclic Antidepressants </li></ul></ul><ul><ul><li>Desmopressin </li></ul></ul><ul><ul><li>Others </li></ul></ul><ul><li>Behavioral interventions </li></ul><ul><li>Complementary medicine approaches </li></ul>
    9. 10. Cochrane Enuresis Reviews <ul><li>7 Reviews </li></ul><ul><li>Cover all of the potential interventions </li></ul><ul><li>Reviews are up to date </li></ul><ul><ul><li>One from 2002 </li></ul></ul><ul><ul><li>Two each from 2003, 2004, 2005 </li></ul></ul>
    10. 11. <ul><li>Clinical Reality </li></ul><ul><li>2 minutes per question </li></ul><ul><li>30 minutes per week </li></ul><ul><li>7 Cochrane </li></ul><ul><li>Enuresis Reviews </li></ul><ul><li>410 pages </li></ul><ul><li>Excluding tables figures and references </li></ul><ul><li>- 73 pages </li></ul><ul><li>Metaviews only </li></ul><ul><li>113 Metaviews </li></ul>
    11. 12. Umbrella Reviews <ul><li>Designed for busy decision makers </li></ul><ul><li>A “friendly front end” </li></ul><ul><li>Summarizes a group of related reviews </li></ul><ul><ul><li>Minimum of text </li></ul></ul><ul><ul><li>1-3 tables </li></ul></ul><ul><ul><li>0-2 figures </li></ul></ul><ul><li>Pointers to the full Cochrane Reviews </li></ul>
    12. 13. <ul><li>4 Pages </li></ul><ul><li>2 Tables </li></ul><ul><li>7 References </li></ul>
    13. 14. Enuresis Umbrella Review
    14. 15. Enuresis Umbrella Review
    15. 16. Enuresis Umbrella Review
    16. 17. 11 813 Imipramine vs. No Treatment 13 576 Alarm vs. No Treatment 3 208 Alarm vs. Imipramine Studies Subjects Comparison
    17. 18. Analyses and Figures
    18. 19. Umbrella Reviews Working Group <ul><li>Lorne Becker </li></ul><ul><li>Jon Deeks </li></ul><ul><li>Paul Glasziou </li></ul><ul><li>Steff Lewis </li></ul><ul><li>Yoon Loke </li></ul><ul><li>Lara Maxwell </li></ul><ul><li>Andy Oxman </li></ul><ul><li>Deborah Pentesco-Gilbert </li></ul><ul><li>Rebecca Ryan </li></ul><ul><li>Peter Tugwell </li></ul><ul><li>Janet Wale </li></ul>
    19. 20. Plenary 1 Co-chairs: Fiona Alderdice and Monica Kjeldstr ø m Pembroke

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