Talk given at the UKCTAS early career researcher conference Sept 2015 by Jamie Hartmann-Boyce & Nicola Lindson-Hawley of Cochrane Tobacco Addiciton Group

1. Cochrane reviews:
Summarising the best
evidence to inform
healthcare decisions
Nicola Lindson-Hawley & Jamie Hartmann-Boyce
Managing Editors for Cochrane TAG
nicola.lindson-hawley@phc.ox.ac.uk
@CochraneTAG
UKCTAS ECR Conference 2015 16th September 2015

2. • Nuffield Department of Primary Care Health Sciences
• Two overlapping teams
• Topic areas include: harm reduction, e-cigarettes, nicotine
preloading, smoking reduction, attentional bias
• Methods: randomised controlled trials; systematic reviews;
ecological momentary assessment
Tobacco at Oxford University
Cochrane
Tobacco
Addiction
Group
(TAG)
Behavioural
Medicine
Team (BMT)
Tim Lancaster
Lindsay Stead
Rafael Perera
Paul Aveyard
Nicola Lindson-Hawley
Jamie Hartmann-Boyce
Rachna Begh
Sarah Tearne

3. • Introduction to Cochrane
• How to use the Cochrane Library
• The Tobacco Addiction Group (TAG)
• The Drugs and Alcohol Group (CDAG)
• Experiences of Cochrane
• How to get involved
• Questions
What we’ll cover

4. WHAT?
• Gathers and summarises the best evidence from research
HOW?
• Systematically reviewing the available evidence
WHY?
• To help doctors, nurses, patients, carers, researchers,
funders, policy makers & guidance developers to enhance
their healthcare knowledge and decision making
Cochrane

5. • Decentralised structure – 53 Cochrane Review Groups
• Review groups are topic specific
• Based in over 100 countries
• Largely funded by government grants
Cochrane

6. • Efficient way to access the body of research
- saves time required for searching
- critical appraisal
- interpretation of results
• Explores differences between studies
• Reliable basis for decision making
- unbiased selection of relevant information
- useful for health care, policy, future research
Why systematic reviews?

7. What is so special about a
Cochrane review?
Unbiased
•Systematic
search
•All languages
•Risk of bias
assessment
Reliable
•Cochrane
Handbook
•Published
protocol
•2 reviewers
assess &
extract
Up to date
•Update approx.
every 2 years
•Prioritise
active areas
Accessible
•Open access in
UK
•Plain language
summaries
•Summary of
findings tables
PROTOCOL
• Clearly stated objectives
• Pre-defined eligibility criteria
• Explicit, reproducible methodology
• Search strategy

8. www.cochranelibrary.com
Finding Cochrane Reviews

9. • Bullet point style to look like this
• Bullet point style to look like this and
can go across multiple lines
• Bullet point style to look like this
• Bullet point style to look like this and
can go across multiple lines
• Bullet point style to look like this and
can go across multiple lines
Browse by review group

10. But Cochrane reviews are
so long?!
• Abstract
• Plain language summary
• Overviews of reviews
• Summary of findings tables: summary of
key information from review, presents
most important outcomes for someone
making a decision

11. Behavioural interventions as adjuncts to pharmacotherapy for smoking cessation
Patient or population: People using smoking cessation pharmacotherapy
Settings: Health care and community settings
Intervention: Behavioural interventions as adjuncts to pharmacotherapy
Outcomes Illustrative comparative risks* (95% CI) Relative effect
(95% CI)
No of Participants
(studies)
Quality of the
evidence
(GRADE)
Comments
Assumed risk Corresponding risk
Control Behavioural
interventions as
adjuncts to
pharmacotherapy
Smoking cessation
at longest follow-up
Follow-up: 6 - 24
months
Study population RR 1.16
(1.09 to 1.24)
15506
(38 studies)
⊕⊕⊕⊕
high1,2
183 per 1000 213 per 1000
(200 to 227)
Median quit rate
210 per 1000 244 per 1000
(229 to 260)
*The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the
intervention (and its 95% CI).
GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the
estimate.
Very low quality: We are very uncertain about the estimate.
Footnotes
1 All studies rated at low or unclear risk of bias
2 No overall evidence of statistical heterogeneity (I² = 3%), or of differences between the subgroups defined by pharmacotherapy
Stead LF, Lancaster T. Behavioural interventions as adjuncts to pharmacotherapy for smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 12. Art.
No.: CD009670. DOI: 10.1002/14651858.CD009670.pub2.

12. • Founded in 1996
• Coordinating editor – Tim Lancaster
• Editorial advisory board – Paul Aveyard, John Hughes
(University of Vermont) & Robert West (UCL)
• Managing Editors – Nicola Lindson-Hawley, Jamie
Hartmann-Boyce, Lindsay Stead
• Statistics advisor – Rafael Perera
• Trials Search Coordinator – Lindsay Stead
• Authors – 349 registered
• Review interventions for tobacco use & prevention, such
as behavioural, pharmacotherapies, mass media,
policies, e-cigarettes
Tobacco Addiction Group (TAG)

13. • Also manage some ‘orphan’ reviews e.g. of treatments for
allergies
• We currently have:
- 12 reviews in the pipeline
- 12 published protocols
- 73 published reviews
• Based in the Radcliffe
Observatory Quarter, Oxford
• Funded by the NIHR
• http://tobacco.cochrane.org/
• Follow us on Twitter @cochraneTAG
Tobacco Addiction Group (TAG)

14. • Founded in 1998
• Editorial base: Plus:
- Marina Davoli - 485 authors
- Laura Amato - 9 editors
- Zuzana Mitrova - 125 referees
- Silvia Minozzi
• Based in Rome at ASL
Roma E (Health care
provider/Local Authority)
Drug & Alcohol Group (CDAG)

15. • The group conduct reviews within the following topic
areas: opiates; alcohol; psychostimulants; poly drug
use; prevention
• Reviews on alcohol: 17 in the pipeline; 10 published
protocols & 23 published full reviews.
• http://cda.cochrane.org
• Funded by the Department of Epidemiology, Lazio
regional Health Service
of Lazio Region, Italy
Drug & Alcohol Group (CDAG)

16. • Research associate UKCTAS funded PhD (smoking
cessation & primary care) at University of Birmingham
• New Cochrane TAG protocol & review
• Co-app & trial manager for the Preloading Trial
• Transferred to Primary Care; University of Oxford- the base
of Cochrane TAG
Our experiences: Nicola

17. • Volunteered to assist Cochrane TAG
• Managing Editor job became available. So now I:
- author reviews
- support our external authors
- manage the editorial & publication process
- manage social media & other promotion
- manage PPI input
Our experiences: Nicola
Led update of review
of motivational
interviewing for
cessation
fdfds
Co-author of review of
interventions to
increase medication
adherence- data
extraction

18. Our experiences: Nicola
Resulting opportunities
Peer reviewed
publication and
dissemination at
conferences
Plenary sessions
at UKNSCC & ASH
Wales
Review and social
media training
courses with
Cochrane UK
Requested
publications
summarising
reviews e.g. JAMA
Promoting Cochrane at
conferences
PhD research
used to inform
NICE guidance
Cochrane podcasts.
Available at
cochrane.org &
iTunes
Blog posts for
Cochrane
Communications
& UKCTAS

19. Our experiences: Jamie
• Medical publishing maternity cover for CTAG
managing editor research associate for CTAG
DPhil student and research associate
• First review:
• Since then I’ve been an author on 11 reviews

20. Our experiences: Jamie
Resulting opportunities
Peer reviewed
publication and
dissemination at
conferences
Advanced methods
training, including
risk of bias tools
Input on
Cochrane
editorial
policies
Liaising with NICE
and WHO on
guideline
development
Involvement in
divisional REF
committee Media appearances,
including press briefing,
Today Show on Radio 4 and
Channel 4 NewsInvited articles,
including BMJ &
Addiction

21. • There are many ways that you can get involved
Cochrane Review Groups:
- Author a Cochrane Review (new or update)
- Become a peer referee and comment on draft protocols
and reviews
- Translate articles for inclusion in Cochrane Reviews
- Suggest topics for reviews
• CDAG have a number of reviews that need updating
• Contact:
Getting involved
Nicola Lindson-Hawley
nicola.lindson-hawley@phc.ox.ac.uk
Zuzana Mitrova
s.mitrova@deplazio.it

22. Questions?