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Cochrane Review author training workshop, January 22-23, 2009 at the University of Calgary Health Sciences Centre

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  • Introduction

    1. 1. Canadian Cochrane Network & Centre Standard Author Training
    2. 2. Trainers or Participants <ul><li>Roger Thomas, MD, Ph.D., CCFP. MRCGP, Professor, Department of Family Medicine </li></ul><ul><li>Diane Lorenzetti M.L.S., Research Librarian, Institute of Health Economics, Centre for Health and Policy Studies, Department of Community Health Sciences, Faculty of Medicine </li></ul><ul><li>Marcus Vaska, BA, MLIS </li></ul><ul><li>Bachelor of Health Sciences Librarian </li></ul>
    3. 3. Workshop Plan <ul><li>Outline of what going to cover on both days, breaks, lunch (see “OUTLINE”) </li></ul><ul><li>Overview of the Cochrane Collaboration and the Canadian Cochrane Network and Centre </li></ul>
    4. 4. “ 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
    5. 5. Collaboration’s Mission Statement The Cochrane Collaboration is a unique worldwide 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 health care interventions.
    6. 6. Centres 12 Networks Methods Groups 13 Fields 16 Steering Group Structure of The Cochrane Collaboration Review Groups 52
    7. 7. Cochrane Centres
    8. 8. Cochrane Centres <ul><li>Promote awareness of The Cochrane Collaboration </li></ul><ul><li>Support The Cochrane Collaboration on a </li></ul><ul><li>geographical basis </li></ul><ul><li>Help coordinate and support members </li></ul><ul><li>e.g. education & training </li></ul><ul><li>Establish partnerships </li></ul>
    9. 9. Canadian Cochrane Centre <ul><li>Director – Jeremy Grimshaw </li></ul><ul><li>Executive Director – Mary Ellen Schaafsma </li></ul><ul><li>Knowledge Broker – Cheryl Arratoon </li></ul><ul><li>Education Coordinator – Adrienne Stevens </li></ul><ul><li>Communications Specialist – Jeanette Doucet </li></ul><ul><li>Administrative Assistant – Lisa McGovern </li></ul><ul><li>Policy Liaison Initiative – John Lavis, </li></ul><ul><li>Lori Greco (McMaster site) </li></ul><ul><li>Email: [email_address] </li></ul>
    10. 10. Cochrane Training in Canada <ul><li>Conduct Systematic Reviews </li></ul><ul><ul><li>Introductory </li></ul></ul><ul><ul><li>Standard </li></ul></ul><ul><ul><li>Advanced </li></ul></ul><ul><li>Use of Systematic Reviews </li></ul><ul><ul><li>Introductory </li></ul></ul><ul><ul><li>KT </li></ul></ul><ul><li>Researchers, Practitioners, </li></ul><ul><li>Policy makers, Consumers </li></ul>
    11. 11. <ul><li>Cochrane Review Groups </li></ul><ul><li>International group of experts with an interest in a health problem area </li></ul><ul><li>Prepare and maintain systematic reviews </li></ul><ul><li>Willing and able to review all relevant research on specified health care problems </li></ul>
    12. 12. <ul><li>Back Review Group </li></ul><ul><li>Effective Practice and Organization of Care RG </li></ul><ul><li>Hypertension Review Group </li></ul><ul><li>Inflammatory Bowel Disease and Functional Bowel Disorders Review Group </li></ul><ul><li>Musculoskeletal Review Group </li></ul>Cochrane Review Groups Worldwide there are 52 registered review groups, 5 of which have their editorial base in Canada
    13. 13. Cochrane Fields <ul><li>Represent a population, group, or type of care that overlaps multiple review group areas </li></ul><ul><ul><li>E.g., primary care, health care of older people </li></ul></ul><ul><li>Ensures their priorities are reflected in the work of Review Groups </li></ul><ul><li> Child Health Field </li></ul><ul><li> Health Equity Field </li></ul>
    14. 14. <ul><li>Cochrane Methods Groups </li></ul><ul><li>Develop methodology and advise the Collaboration on how the validity and precision of systematic reviews can be improved </li></ul><ul><li>eg. Statistical methods, non-randomized studies, information retrieval </li></ul><ul><ul><li>Bias Methods Group </li></ul></ul>
    15. 15. <ul><li>The Cochrane Consumer Network </li></ul><ul><li>Supports the role of consumers within Cochrane </li></ul><ul><li>Facilitates the dissemination of information to patients & families </li></ul>
    16. 16. Le R é seau-centre canadian Cochrane
    17. 17. Canadian Cochrane Centre Affiliates <ul><li>22 healthcare professional, research, and patient organizations </li></ul><ul><li>Advise CCNC on future directions and activities </li></ul><ul><li>Promote the awareness, appreciation, distribution, and use of Cochrane reviews among their members </li></ul>
    18. 18. Affiliate Organizations - sample <ul><li>Canadian Medical Association </li></ul><ul><li>Canadian Nurses Association </li></ul><ul><li>Canadian Pharmacists Association </li></ul><ul><li>Canadian Physiotherapy Association </li></ul><ul><li>Arthritis Society </li></ul><ul><li>Canadian Association of Occupational Therapists </li></ul><ul><li>Canadian Association of Speech-Language Pathologists and Audiologists </li></ul><ul><li>Canadian Cancer Society </li></ul><ul><li>Canadian Chiropractic Association </li></ul><ul><li>Canadian Agency for Drugs and Technologies in Health </li></ul><ul><li>Canadian Dental Association </li></ul><ul><li>Canadian Health Libraries Association </li></ul><ul><li>WorksafeBC, Evidence Based Practice Group, Clinical Services </li></ul><ul><li>etc. </li></ul>
    19. 19. New Editor-in-Chief: Dr. David Tovey
    20. 20. What is The Cochrane Library? <ul><li>Main output of Cochrane Collaboration </li></ul><ul><li>Contains Cochrane reviews & other databases </li></ul>
    21. 21. Ways to Get Involved <ul><li>Author, peer reviewer </li></ul><ul><li>Handsearcher </li></ul><ul><li>Methods Group </li></ul><ul><li>Disseminate findings </li></ul><ul><li>Consumer Network </li></ul><ul><li>CCInfo, Cochrane News, Relay Cochrane! </li></ul>Contact information sheet in training kit
    22. 22. Introduction to Cochrane Reviews
    23. 23. What are the different review types? Type: Feature: Scoping Literature Review Narrative Question What is known about a topic What is known about a topic Broad Search strategy Unknown Unknown Not known Selection of studies Known, but post hoc Unknown Not known Inferences Thematic, makes comparisons Descriptive May be based on evidence Advantages Rapid appraisal, identifies research gaps Maps what is known Breadth, historical, phenomena
    24. 24. What are the different review types? Type: Feature: Realist Systematic Review Cochrane Review Question Broad: complex theory-based Focused Effect of healthcare interventions Search strategy Known, and Iterative Described Detailed description Selection of studies Known, and iterative Uniformly applied criteria Criteria (RCTs) Inferences Explanatory rather than ‘judgmental’ Clearly based on scientific evidence Advantages Contextualized (what works, for who, when?) Replicable, resolve discordance Recommendation re. efficacy of interventions
    25. 25. What is a systematic review? <ul><li>A review of a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant research, and to collect and analyse data from the studies that are included in the review. </li></ul><ul><li>Cochrane Collaboration (2005) Glossary of Terms in The Cochrane Collaboration </li></ul>
    26. 26. Cochrane Reviews <ul><li>Effects of healthcare interventions </li></ul><ul><li>Summarize evidence and help people to understand </li></ul><ul><li>Careful not to impose own values, preferences, local context </li></ul><ul><li>Keep audience in mind while writing </li></ul><ul><li>All have the same structured format </li></ul><ul><li>Protocol -> Review </li></ul>
    27. 27. The strength of a Cochrane review <ul><ul><li>Rigour of methodology </li></ul></ul><ul><ul><li>Broad scope of literature included </li></ul></ul><ul><ul><li>Updated and maintained </li></ul></ul><ul><ul><li>Inclusiveness of perspectives </li></ul></ul><ul><ul><li>Plain language summary </li></ul></ul><ul><ul><li>Independence from commercial interests </li></ul></ul>
    28. 28. Funding of Cochrane Reviews <ul><li>Many organizations provide funding for systematic reviews </li></ul><ul><li>Include research funding agencies, those providing or funding health care services </li></ul><ul><li>Cannot be funded through a commercial source or agency with a vested interest in reviews </li></ul><ul><li>Handbook Chapter 2.6 </li></ul>
    29. 29. Careful Formulation of Research Question <ul><li>Population </li></ul><ul><li>Intervention </li></ul><ul><li>Comparison </li></ul><ul><li>Outcomes </li></ul><ul><li>Study Designs </li></ul>
    30. 30. Thorough Assessment of Risk of Bias <ul><li>Selection bias – sequence generation </li></ul><ul><li>-- allocation concealment </li></ul><ul><li>Performance bias </li></ul><ul><li>– blinding </li></ul><ul><li>-- imperfect delivery of intervention </li></ul><ul><li>Attrition </li></ul><ul><li>– loss of participants </li></ul><ul><li>-- differential loss of participants from intervention </li></ul><ul><li>and control groups </li></ul><ul><li>-- incomplete outcome data for those remaining in </li></ul><ul><li>study </li></ul><ul><li>Detection Bias </li></ul><ul><li>Reporting Bias </li></ul><ul><li>-- Selective reporting of outcomes from literature </li></ul><ul><li>-- Selective reporting of outcomes planned in study Protocol </li></ul>
    31. 31. Guidelines for Protocol and Review Process Review Submission If no review, registered title becomes available to others 6 Months Title Registration Approval of title by Editorial Board Protocol Submission If no protocol, registered title becomes available to other interested reviewers 1.5 Years
    32. 32. Overview of Cochrane Process <ul><li>Review team </li></ul><ul><li>Decide on and register a title </li></ul><ul><li>Publish protocol: draft -> editorial process (RGC) -> RGC publish protocol to Cochrane Library </li></ul><ul><li>Publish review: draft -> editorial process (RGC) -> RGC publish review to Cochrane Library </li></ul><ul><li>Access the Review Group’s module published on The Cochrane Library for processes and methods </li></ul><ul><li>Keep in touch with Review Group for next steps! </li></ul>
    33. 33. Review Team <ul><li>Two or more people </li></ul><ul><ul><li>For methods </li></ul></ul><ul><ul><li>Range of Expertise – check with Review Group </li></ul></ul><ul><ul><li> ◊ Content </li></ul></ul><ul><ul><li> ◊ Methodology (including statistical) </li></ul></ul><ul><ul><li> ◊ Searching (Trials Search Coordinator) </li></ul></ul><ul><ul><li> ◊ Translation </li></ul></ul><ul><ul><li> ◊ International (encouraged) </li></ul></ul><ul><ul><li> ◊ Others – varied regions, settings, consumers </li></ul></ul>Commitment to the life of the Review!
    34. 34. Software <ul><li>Archie </li></ul><ul><li>● Start a review file (only RGC) </li></ul><ul><li>● Storing drafts and published versions </li></ul><ul><li>● Publish to The Cochrane Library (only RGC) </li></ul><ul><li>Review Manager 5 (RevMan 5) </li></ul><ul><li>● Writing and editing reviews </li></ul><ul><li>● Includes analysis software for meta-analyses </li></ul><ul><li>GRADEpro – SoF tables and quality of evidence </li></ul>
    35. 35. Review Title <ul><li>Standard format – succinct </li></ul><ul><li><Intervention> for <health problem> </li></ul><ul><li>E.g. acetaminophen for osteoarthritis </li></ul><ul><li>Variations on the format where needed – refer to Handbook Chapter 4.2.1 for guidance </li></ul><ul><li>E.g. scalpel vs. electrosurgery for abdominal incisions </li></ul><ul><li>E.g. haloperidol for the treatment of nausea and vomiting in palliative care patients </li></ul><ul><li>Registered titles available on </li></ul>