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

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

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

    + Cochrane.CollaborationCochrane.Collaboration, 3 years ago

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