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Using reviews to inform decisions about health care – a patient perspective
Using reviews to inform decisions about health care – a patient perspective <ul><li>Gill Gyte </li></ul><ul><li>Antenatal ...
A consumer perspective   <ul><li>Background </li></ul><ul><li>How consumers might use reviews, with personal examples from...
Archie Cochrane <ul><li>“ I believe that cure is rare while the need for care is widespread, and that the pursuit of cure ...
Iain Chalmers <ul><li>Unless we get the findings of Cochrane reviews to patients and consumers, we (The Cochrane Collabora...
Chris Silagy <ul><li>“ I am determined that no matter how much I  trust my treating doctors, I want to be assured that the...
Chris Silagy <ul><li>“ I also believe it is my right to determine the value that I place on different outcomes, to express...
Cochrane Systematic Reviews
Consumers using Cochrane reviews <ul><li>Consumers using Cochrane reviews in making decisions or shared decision making </...
At an individual level <ul><li>Routine iron tablets </li></ul><ul><li>Routine shaving the pubic hair in labour </li></ul><...
At an individual level <ul><li>Brazil </li></ul><ul><li>Mexico </li></ul><ul><li>Other low-income countries </li></ul>
National Childbirth Trust <ul><li>Information Sheets </li></ul><ul><li>Booklets </li></ul><ul><li>Evidence-based briefings...
National Childbirth Trust <ul><li>Support in labour </li></ul><ul><li>Antenatal perineal massage </li></ul><ul><li>Duratio...
At a national policy level <ul><li>National Institute of Clinical Excellence (NICE) guidelines:  </li></ul><ul><li>e.g.  E...
Evidence based obstetrics and women’s rights <ul><li>Brazilian Social Movements for the Humanization of Birth  </li></ul><...
Brazil <ul><li>In 2005, Brazil passed a national law (11.108/05) to guarantee a companion of woman’s choice for every wome...
Mexico <ul><li>Routine interventions in labour </li></ul><ul><li>Training of traditional birth attendants </li></ul>
Many challenges <ul><li>Reviews relevant to  consumers - PCGCP </li></ul><ul><li>Information needs to be in an accessible ...
Many challenges <ul><li>Can the Cochrane Collaboration find a way for people to reach the evidence in Cochrane reviews thr...
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Using reviews to inform decisions about health care – a patient perspective

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Gill Gyte speaking at plenary session 1 at the XV Cochrane Colloquium in Sao Paulo, Brasil

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Using reviews to inform decisions about health care – a patient perspective

  1. 1. Using reviews to inform decisions about health care – a patient perspective
  2. 2. Using reviews to inform decisions about health care – a patient perspective <ul><li>Gill Gyte </li></ul><ul><li>Antenatal Teacher, National Childbirth Trust </li></ul><ul><li>Consumer Panel Coordinator, Cochrane Pregnancy and Childbirth Group (PCG) </li></ul><ul><li>Consumer Coordinator, Cochrane Infectious Diseases Group </li></ul><ul><li>Cochrane Consumer Network </li></ul>
  3. 3. A consumer perspective <ul><li>Background </li></ul><ul><li>How consumers might use reviews, with personal examples from Pregnancy and Childbirth </li></ul><ul><li>Other experiences of consumers using reviews </li></ul><ul><li>A challenge for the Cochrane Collaboration </li></ul>
  4. 4. Archie Cochrane <ul><li>“ I believe that cure is rare while the need for care is widespread, and that the pursuit of cure at all costs may restrict the supply of care...” </li></ul><ul><li>Archie L Cochrane, 1972, p7 </li></ul><ul><li>‘ Effectiveness and Efficiency: Random Reflections on Health Services’ </li></ul>
  5. 5. Iain Chalmers <ul><li>Unless we get the findings of Cochrane reviews to patients and consumers, we (The Cochrane Collaboration) will have failed. </li></ul>
  6. 6. Chris Silagy <ul><li>“ I am determined that no matter how much I trust my treating doctors, I want to be assured that the decisions we make together are based on as much evidence as is in existence at the time. I believe that is my fundamental right, and a right of others in a similar situation.” </li></ul><ul><li>Chris Silagy, 1960-2001 </li></ul>
  7. 7. Chris Silagy <ul><li>“ I also believe it is my right to determine the value that I place on different outcomes, to express my own treatment preferences (and have these taken into account), and to feel that my treating doctors are prepared to respect my experiences as a valid and important input when we come to make decisions” </li></ul><ul><li>   Chris Silagy, 1960-2001 </li></ul>
  8. 8. Cochrane Systematic Reviews
  9. 9. Consumers using Cochrane reviews <ul><li>Consumers using Cochrane reviews in making decisions or shared decision making </li></ul><ul><li>Consumers in voluntary organisations/support groups disseminating information from Cochrane reviews to their consumers </li></ul><ul><li>Consumers on national panels/committees helping to make national guidelines and policies </li></ul>
  10. 10. At an individual level <ul><li>Routine iron tablets </li></ul><ul><li>Routine shaving the pubic hair in labour </li></ul><ul><li>Routine enema in labour </li></ul><ul><li>Routine 1 hour time limit for giving birth </li></ul><ul><li>Routine episiotomy </li></ul><ul><li>etc. </li></ul>
  11. 11. At an individual level <ul><li>Brazil </li></ul><ul><li>Mexico </li></ul><ul><li>Other low-income countries </li></ul>
  12. 12. National Childbirth Trust <ul><li>Information Sheets </li></ul><ul><li>Booklets </li></ul><ul><li>Evidence-based briefings </li></ul><ul><li>Antenatal classes </li></ul><ul><li>Breastfeeding support </li></ul><ul><li>Postnatal discussions </li></ul>
  13. 13. National Childbirth Trust <ul><li>Support in labour </li></ul><ul><li>Antenatal perineal massage </li></ul><ul><li>Duration of breastfeeding </li></ul><ul><li>etc. </li></ul>
  14. 14. At a national policy level <ul><li>National Institute of Clinical Excellence (NICE) guidelines: </li></ul><ul><li>e.g. EFM , IOL, CS , ANC , </li></ul><ul><li>PNC, IPC </li></ul><ul><li>Government policies: </li></ul><ul><li>‘ Maternity Matters’ </li></ul>
  15. 15. Evidence based obstetrics and women’s rights <ul><li>Brazilian Social Movements for the Humanization of Birth </li></ul><ul><li>Parto do Principio’s Work – A Women’s Network for Active Maternity </li></ul><ul><li>The view of obstetric nurses from Brazil </li></ul><ul><li>Doulas and their activities in Brazil </li></ul><ul><li>Pregnancy and childbirth in Mexico’ </li></ul><ul><li>Obstetric training, EBM and women’s rights </li></ul>
  16. 16. Brazil <ul><li>In 2005, Brazil passed a national law (11.108/05) to guarantee a companion of woman’s choice for every women in labor and delivery, based on the Cochrane systematic review on ‘Support in labour’. </li></ul>
  17. 17. Mexico <ul><li>Routine interventions in labour </li></ul><ul><li>Training of traditional birth attendants </li></ul>
  18. 18. Many challenges <ul><li>Reviews relevant to consumers - PCGCP </li></ul><ul><li>Information needs to be in an accessible form </li></ul><ul><li>Consumers need to trust the source </li></ul><ul><li>Cochrane reviews need to get to consumers </li></ul>
  19. 19. Many challenges <ul><li>Can the Cochrane Collaboration find a way for people to reach the evidence in Cochrane reviews through a Goggle search </li></ul>
  20. 20. obrigada

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