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Cochrane seeks Senior Editor (Methods) - Full time, permanent

Fri, 10/11/2019 - 09:37

Specifications: Full Time, Permanent
Salary: Competitive
Location: London/Flexible
Application Closing Date: 1st November 2019 at midnight (GMT)

This role is an exciting opportunity to use your experience as a Senior Editor to make a difference in the field of health care research. 

The purpose of this role is to support the Editor in Chief of the Cochrane Library and help to deliver the methods-related objectives and targets of the Cochrane Editorial and Methods Department (EMD).

The role’s duties can be divided into the two areas:

Editorial and Methods Leadership

  • To play a major role in the development of methods used in Cochrane by assisting in the development, implementation or evaluation of new or existing methods in Cochrane Reviews
  • To ensure that the methods support from a dedicated unit in the EMD meets the needs of the CRG Networks
  • To support the Editor in Chief in the development and implementation of Cochrane’s Content Strategy to ensure the Cochrane Library remains a premier international source of healthcare evidence
  • To ensure that appropriate methodological review has been carried out for high profile reviews and reviews using complex methods prior to publication
  • To liaise with the Deputy Editor in Chief to support the efficient production of high-quality and timely Cochrane Reviews

Operational Leadership

  • Developing, managing and supporting the delivering of projects that are relevant to the EMD’s mission; to involve managing schedules, supervising less experienced staff, and co-ordination with contributors and publisher
  • Contributing to the development of methods-related editorial policies and supporting the Deputy Editor in Chief with their implementation
  • Working closely with the Cochrane Library Product Owner, Deputy Editor in Chief, and SMT to support delivery of publishing strategy for Cochrane
  • Working with members of the Learning team to help develop training that meets methods learning needs of Cochrane contributors 
  • Contributing to Cochrane’s budget planning processes, and managing the resources associated with the Methods portfolio
  • Identifying continuous improvement opportunities and work with colleagues to ensure that new processes, workflows systems and lessons learned are implemented effectively

We are looking for a self-motivated and highly organised individual who is able to work effectively and collaboratively with a diverse range of contacts across the world.  The successful candidate will also have:

  • Degree in relevant field or equivalent; relevant postgraduate qualification is desirable
  • Knowledge and skills relevant to the systematic review methods, including familiarity with Cochrane guidance and standards on the design, conduct, and reporting of systematic reviews
  • Experience of developing, implementing, and using different methods in systematic reviews
  • Proven ability to solve problems and make decisions, think strategically, with awareness of when to use her/his discretion and when to escalate
  • Excellent written and verbal communication skills; and verifiable competence working with people from a variety of cultures and leading geographically dispersed teams
  • Proficient IT skills, including Word, Excel and PowerPoint
  • Strong organization and prioritization skills; and an ability to work methodically, accurately, and with attention to detail
  • Experience of initiating, creating, and commissioning reports
  • Experience of team and individual line management and supervision, including working remotely
  • Develop and maintain working relationships with key stakeholders
  • Available for occasional travel locally and internationally

Cochrane is a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesizing research findings to produce the best available evidence on what can work, what might harm and where more research is needed. Our work is recognised as the international gold standard for high quality, trusted information.

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with “Senior Methods Editor” in the subject line.  The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples.  List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

  • For further information, please download the full job description from here.
  • Deadline for applications: 1st November 2019
  • Interviews will be held on: Mid november, dates to be confirmed
  • For more information, contact recruitment@cochrane.org

 

Friday, October 11, 2019

Featured Review: Does delaying cord clamping or using cord milking at birth improve the health of babies born too early?

Thu, 10/10/2019 - 08:48

Delayed cord clamping improves health of babies born too early: updated Cochrane Review

This updated Cochrane systematic review  finds that delayed, rather than early, cord clamping may reduce the risk of death before discharge for babies born preterm.

The authors set out to determine if delayed cord clamping or umbilical cord milking improves the health outcomes for babies born before 37 weeks' gestation. These interventions were compared with early cord clamping.

Babies born before 37 weeks, or preterm, have poorer health outcomes than babies born at term, particularly if they are born before 32 weeks. They can experience problems with the functioning of many of their major organs including their lungs, gut and hearts, and have a greater risk of dying or having long-term problems such as cerebral palsy. After birth, the babies may need blood transfusions and drugs to strengthen their heart contractions (inotropes) and to raise their blood pressure. It is important to try to find ways of improving the health of these tiny babies.

Lead author Heike Rabe, Professor of Perinatal Medicine and Honorary Consultant Neonatologist at Brighton and Sussex Medical School said: “Early clamping of the umbilical cord has been standard practice over many years. It allows the baby to be transferred quickly to care from a specialist team of doctors either at the side of the room or in another room. Yet, delayed clamping for half to three or more minutes allows continuing blood flow between the mother and her baby, and this may help the baby to adjust to breathing air. Squeezing blood along the umbilical cord towards the baby (milking the cord) can boost the baby's blood volume, and this may improve the baby's health.”

“Our study found that delayed, rather than early, cord clamping may reduce the risk of death before discharge for babies born preterm. As there have only been a few studies that follow babies for health outcomes in early childhood to date and there is insufficient evidence for reliable conclusions on providing immediate care for the baby beside the mother with the cord intact, immediate neonatal care with the cord intact requires further study.” 

Researchers collected and analysed 40 published studies, which provided data on 4,884 babies and their mothers. These studies had been undertaken across the world, but mostly in high-income countries and the births were in hospitals which practiced early clamping.

Friday, October 11, 2019

Cochrane seeks Assistant Editor - London, UK

Mon, 10/07/2019 - 18:06

Specifications: Full Time, Permanent
Salary: £30,000 - £35,000
Location: London
Application Closing Date: 20th October 2019

This role is an exciting opportunity to use your experience as an Assistant Editor to make a difference in the field of health care research. 

The Assistant Editor will support the editorial publishing team in daily publishing operations, editorial and publishing policy development, and setting the publishing strategy for Cochrane content.

Some of their responsibilities will include:

  • Manage editorial workflows for Editorials from submission through to publication on the Cochrane Library, working with authors, editors, peer reviewers, and Cochrane’s publisher, to ensure that content is published on time and to a high standard.
  • Monitor comments received on Cochrane content (including Cochrane Reviews), support comment publication processes, and track progress against targets.
  • Use content management systems to edit and publish changes to public-facing websites (including the Cochrane Library and the Cochrane Editorial and Publishing Policy Resource).
  • Assist with preparing, editing, and updating editorial and publishing policies and related guidance.
  • Assist with research into areas of editorial and publishing policy and practice; this will include collating data (e.g. using surveys, querying databases, analysing metrics) and preparing reports related to editorial policies or published content for different audiences.
  • Assist with the management and development of the Cochrane Style Manual.

We are looking for a self-motivated and highly organised individual who is able to work effectively and collaboratively with a diverse range of contacts across the world.  The successful candidate will also have:

  • Degree in relevant field or equivalent experience.
  • An understanding of the importance of systematic reviews to healthcare decision-making.
  • Previous experience in a similar editorial or publishing role.
  • An ability to develop and maintain working relationships with key stakeholders.
  • Strong organization and prioritization skills.
  • Excellent written and verbal communication skills.
  • Proficient level IT skills, including but not limited to Word, Excel, and PowerPoint; and able to quickly adopt to different IT packages being used by the organization such as website content management systems (e.g. Drupal, Confluence).
  • Ability to work methodically and accurately with attention to detail.
  • A pro-active approach to problem-solving.

Cochrane is a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesizing research findings to produce the best available evidence on what can work, what might harm and where more research is needed. Our work is recognised as the international gold standard for high quality, trusted information.

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with “Assistant Editor” in the subject line.  The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples.  List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

For further information, please download the full job description.

Deadline for applications: 20th October (12 midnight GMT)

Interviews to be held on: 4th November 2019 (TBC)

Monday, October 7, 2019 Category: Jobs

Featured Review: Can people stop smoking by cutting down the amount they smoke first?

Thu, 10/03/2019 - 10:40

This Cochrane Review looks at whether cutting down before quitting helps people to stop smoking, and the best ways that people can cut down to help them stop completely, the study included 51 studies of over 22,000 people who smoked tobacco.

Nicola Lindson, lead author of this Cochrane review explains, “The standard way people are told to quit smoking is to smoke as normal until a quit day, when they stop using all cigarettes. However, many have tried this before and been unsuccessful, and might like to try something new.”

“Some people prefer to cut down the number of cigarettes they smoke before quitting completely. However, before healthcare services give people a choice of cutting down first or stopping all at once we wanted to find out whether cutting down helps as many people to stop smoking.”

The review authors described the following implications for practice:

  • Evidence suggests that neither reducing smoking to quit nor quitting abruptly results in superior quit rates; people could therefore be given a choice of how to quit, and support provided to people who would specifically like to reduce their smoking before quitting.
  • There is some evidence that using fast‐acting NRT or varenicline whilst reducing smoking before a quit day may help more people to quit smoking than reducing to quit without these pharmacological aids.
  • There is some evidence that providing behavioural support to reduce to quit helps more people to stop smoking than providing people with self‐help resources only.
  • There is currently no clear evidence in support of certain reduction methods over others; however, further evidence could change this conclusion.

Read the review here
Learn more about the Cochrane Tobacco and Addiction Group

Thursday, October 3, 2019

Cochrane seeks Community Support Officer - permanent, part time, flexible location

Tue, 10/01/2019 - 15:01

Specifications: Permanent, part time (0.4 FTE), flexible work pattern
Salary: £30,000 (pro-rata)
Location: Flexible (anywhere in the world) office-based/remote working
Application Closing Date: 31st October 2019 (12 Midnight GMT)

This role is an exciting opportunity to use your communication and problem-solving skills to make a difference in the field of health care research. 

The Community Support Officer will be joining Cochrane’s Community Support team. The Community Support team is the first point of contact for the international Cochrane community, providing a timely and coordinated support service. We resolve queries covering a broad range of areas including Cochrane Account login, Cochrane review software (e.g. Archie, RevMan), membership, training, websites, sales and research. The Community Support Officers are the day-to-day face of the team, answering the majority of queries and escalating complex enquiries appropriately.

This team sits within the People Services department in Cochrane’s Central Executive. The department provides all people-focused services within Cochrane, including inclusive learning programmes, platforms to enable participation in diverse Cochrane activities, human resources, consumer engagement and a wide range of internal and public-facing support services.

We are looking for a self-motivated and highly organised individual who is able to work effectively and collaboratively with a diverse range of contacts across the world.  The successful candidate will also have:

  • Experience in providing excellent customer service, including excellent interpersonal communication skills; a courteous, professional manner; and the ability to manage complaints with diplomacy and resilience.
  • Proactive and flexible approach to learning new systems and products in order to provide the best possible customer support.
  • Experience with software and systems related to customer service, such as HappyFox, Jira, SugarCRM and MailChimp.
  • Excellent English-language communication skills (both verbal and written), including experience in communicating technical content, tailoring standard communications to individual requirements, and working with people from a variety of cultural and linguistic backgrounds.
  • Good attention to detail to ensure that community members always receive accurate information.
  • Experience in working collaboratively within complex organisations, including diverse and geographically-dispersed staff, collaborator and stakeholder groups across different time zones.
  • Self-motivated and results-oriented, with excellent organisation and time management skills, including the ability to work to deadlines as part of an interdependent team working remotely.
  • Familiarity with and commitment to Cochrane’s mission and values.
  • Openness to continuous professional development and training.

Cochrane is a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesizing research findings to produce the best available evidence on what can work, what might harm and where more research is needed. Our work is recognised as the international gold standard for high quality, trusted information.

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with “Community Support Officer” in the subject line.  The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples.  List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

  • For further information, please download the full job description from here
  • Deadline for applications: 31st October 2019 (12 midnight GMT)
  • Interviews to be held on: 14th November - times to be confirmed.

Tuesday, October 1, 2019 Category: Jobs

New Cochrane Handbook for Systematic Reviews of Interventions

Tue, 10/01/2019 - 07:22

Cochrane is delighted to announce the publication of the new edition of the Cochrane Handbook for Systematic Reviews of Interventions following  extensive revision. Designed for authors and editors of Cochrane Reviews, but equally useful for anyone conducting systematic reviews, it describes the methods and best practices in planning, conducting and interpretation of systematic reviews to inform decision-making around the use of health and healthcare interventions. Revised from cover to cover since the last major update in 2008, the Handbook reflects current best practice based on the latest methods research, and provides the only such comprehensive guide to conducting systematic reviews of interventions for both new and experienced authors. 

The new edition of the Handbook is divided into four parts. The first section (available only online) addresses issues specific to working with Cochrane. The second describes the core methods applicable to systematic reviews of interventions, from framing the question through to interpreting the results. The third and fourth parts address specific perspectives and methodological issues that are relevant to some, though not all, reviews, such as non-randomized studies, qualitative evidence and economics evidence.

The new edition includes: 

  • A new chapter addressing issues around intervention complexity, covering interventions with multiple components, interventions in which there are interactions between the intervention and its context, and interventions that are introduced into complex systems, as well as a new chapter addressing how equity can be considered in systematic reviews.
  • A major new chapter on network meta-analysis, because decision makers often need to decide among multiple intervention options.
  • Substantial developments in the area of risk of bias assessment, including extensively revised guidance on risk of bias assessment in randomized trials and assessing reporting biases, and a new chapter on risk of bias assessment in non-randomized trials.
  • New chapters addressing how authors can plan the review’s questions, comparisons and outcomes to ensure effective and meaningful synthesis, as well as how to plan for and execute synthesis using methods other than meta-analysis.

Cochrane’s Editor in Chief, Karla Soares-Weiser warmly welcomed today’s launch: “This Handbook is well respected within the evidence-based community and represents a hugely collaborative effort from numerous methodologists, authors, and editors across Cochrane. Their  collective accomplishment will, undoubtedly, improve the skills and knowledge of systematic reviewers working around the world.”

Professor Julian Higgins, Senior Editor of the Handbook, said, “We encourage those conducting systematic reviews to update their knowledge and skills with the help of this Handbook. It has been completely revised to reflect current good practice, with several new chapters as well as comprehensive updates across the existing content.

“In the eleven years since the previous publication there have been important advances in methods used to conduct systematic reviews, and we have tried to make these accessible to review authors. Substantial amounts of new material reflect developments in our understanding of bias in research, and in how to address complexity.

“We are keen to ensure that Cochrane Reviews are useful to end users, including health professionals, policy decision makers and consumers. As a result, network meta-analysis is now portrayed as a key method. We also recognize that many reviews can’t access data suitable for meta-analysis, so we describe appropriate alternative methods for synthesis that still allow robust conclusions to be drawn.”

The Handbook has been written by a team of over one hundred authors and editors, led by Senior Editors Professor Julian Higgins and Professor James Thomas, alongside Associate Editors Jacqueline Chandler, Miranda Cumpston, Associate Professor Tianjing Li, Dr Matthew Page, and Associate Professor Vivian Welch.  

 

Monday, September 30, 2019

Publication of Cochrane Review: ‘Exercise therapy for chronic fatigue syndrome’

Mon, 09/30/2019 - 12:49

Today, Cochrane publishes an amended version of the Review, 'Exercise therapy for chronic fatigue syndrome.’ In the last nine months, this Cochrane Review has been modified by the review’s authors and evaluated by independent peer reviewers and editors. It now places more emphasis on the limited applicability of the evidence to definitions of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) used in the included studies, the long-term effects of exercise on symptoms of fatigue, and acknowledges the limitations of the evidence about harms that may occur.

Cochrane’s Editor-in-Chief, Dr Karla Soares-Weiser, commented on the publication of the review, “Cochrane recognizes the importance of providing the best available evidence on interventions for ME/CFS to enable patients and clinicians across the world to make well-informed decisions about treatment. This amended review is still based on a research question and a set of methods from 2002, and reflects evidence from studies that applied definitions of ME/CFS from the 1990s. Having heard different views expressed about the evidence base for this condition, we acknowledge that the publication of this amended review will not resolve all the ongoing questions about this globally important health topic.

“We have decided, therefore, that a new approach to the publication of evidence in this area is needed; and, today we are committing to the production of a full update of this Cochrane Review, beginning with a comprehensive review of the protocol, which will be developed in consultation with an independent advisory group that we intend to convene. This group will involve partners from patient-advocacy groups from different parts of the world who will help us to embed a patient-focused, contemporary perspective on the review question, methods and findings.” 

She added, “By forging better relationships with patients, as well as the groups that represent them and the clinicians who seek to treat them, we can improve the way in which future Cochrane Reviews in this area address important questions and meet patients’and clinicians’ needs. I can confirm that work will begin on this new review at the beginning of 2020 and that we will keep patient groups regularly informed of progress during the subsequent months.”

Wednesday, October 2, 2019

Featured Review: Interventions for unexplained infertility

Fri, 09/27/2019 - 15:50

Couples are classified as having unexplained infertility when they have tried to conceive for at least one year and no abnormality in semen analysis, ovulation, or tubal patency has been identified. Treatment options for unexplained infertility include expectant management, ovarian stimulation (OS), intrauterine insemination (IUI), OS-IUI, and in vitro fertilisation (IVF) with or without intracytoplasmic sperm injection (ICSI). Cochrane authors conducted network meta-analysis on interventions for unexplained infertility.

Cochrane Gynecology and Fertility sat down with Dr Rui Wang, the lead author of the study, who answered their questions and shared some details about the network meta-analysis they conducted and what was found.

 

Rui Wang is a research fellow at Department of Obstetrics and Gynaecology, Monash University. He has recently completed his PhD on the application of evidence synthesis methods in reproductive medicine at The University of Adelaide. He is a trainee scientific editor for BJOG. His research interests include evidence-based women’s health, RCTs, and evidence synthesis methods.

What was the research question?
There are five commonly used treatment strategies for couples with unexplained infertility, including expectant management, ovarian stimulation (OS), intrauterine insemination (IUI), OS‐IUI, and in vitro fertilisation (IVF) with or without intracytoplasmic sperm injection (ICSI). Among these five treatment options, which one is the most effective and safe option?

What is network meta‐analysis?
Network meta‐analysis (NMA) synthesises evidence of comparisons that have been compared directly or indirectly for the same clinical condition and therefore allows simultaneous comparison of multiple treatment options.

How is NMA different from regular meta-analysis? What are the advantages of this method?
Pairwise meta-analysis allows the comparison of two interventions at a time while network meta-analysis allows multiple comparisons. If two interventions have not been compared directly, pairwise meta-analysis cannot estimate the difference between these two interventions. However, In a network meta-analyses, if two interventions have both been compared with the same third intervention, the difference between these two interventions can be estimated.

How did you and your team decide on this approach?
There are five interventions of interest: expectant management, ovarian stimulation (OS), intrauterine insemination (IUI), OS‐IUI, and IVF with or without ICSI. Thus doing multiple pairwise meta-analysis between any two interventions does not seem to directly guide clinical decisions. Moreover, in some comparisons, there are either no studios or the number of studies is limited. Therefore, NMA is the best approach in this scenario to account for both direct and indirect comparisons, and to allow the comparisons of multiple interventions simultaneously.

What were your findings?
Evidence of differences in live birth between expectant management and the other four treatments (OS, IUI, OS‐IUI, and IVF/ICSI) was insufficient. Compared to expectant management/IUI, OS may increase the chances of multiple pregnancy, and OS‐IUI probably increases the chances of multiple pregnancy. Evidence showing differences between IVF/ICSI and expectant management for multiple pregnancy was insufficient.

Is there anything else you would like to add?
As unexplained infertility is a broad definition, the treatment effects of these interventions may vary in different couples. We found in our sensitivity analysis that in couples with poor prognosis of natural conception,  OS-IUI and IVF/ICSI increased live birth rate compared to expectant management. However, this should be interpreted with caution and needs to be confirmed in future trials.

Friday, September 27, 2019

Request for Proposal: Help Cochrane monitor and evaluate its Knowledge Translation work?

Fri, 09/27/2019 - 14:55

Cochrane is delighted to share this Request for Proposal for a new project to develop and support the monitoring and evaluation work of Cochrane’s Knowledge Translation (KT) activities.

Knowledge Translation in Cochrane is defined as “the process of supporting the use of health evidence from our high quality, trusted Cochrane Reviews by those who need it to make health decisions.” 

Across Cochrane, KT activities are designed and implemented in a way which we hope is most likely to impact on the usefulness, and the use of, our reviews. We know that understanding how to monitor and evaluate knowledge translation work is a topic that has consistently been identified as a priority. As more Cochrane groups develop their KT work, providing support (which may include training, guidance and examples) to develop mechanisms for monitoring and evaluation is imperative so that we can work towards understanding the impact of Cochrane evidence on affecting change in policy and practice.

This new and exciting opportunity is a commissioned piece of work open to anyone within Cochrane’s Community as well as external organizations working in this area. The successful proposal will help develop formal frameworks and mechanisms for monitoring and evaluating Cochrane’s KT activities and to develop training materials and resources to support Cochrane contributors and members build plans for monitoring and evaluating their KT work programmes.

We are looking for a successful project team with the following skills:

  • An in-depth understanding of programme theory (logic models and/or theory of change) and monitoring and evaluation framework; and, with the expertise and experience to apply this understanding into practical implementation;
  • Experience of working with at least one of the Cochrane’s KT audiences, (consumers and the public; practitioners; policy-makers and healthcare managers; researchers and research funders) to develop both programme theories (logic models and/or theory of change) and developing monitoring and evaluation frameworks based on these with a focus on implementation;

Further details of objectives and deliverables are available in the Request for Proposal.

All applications should be sent via email to Jo Anthony, Head of Knowledge Translation, janthony@cochrane.org by Thursday 31st October 2019, 17:00 GMT.

If you are interested in finding out more, please contact Jo or Karen Head, Cochrane’s Knowledge Translation Project Manager (khead@cochrane.org)

  • Review the Request for Proposal
  • Find out more about Knowledge Translation in Cochrane.
Friday, September 27, 2019

Podcast: Effects of nutritional interventions to increase nutritional status in children living in urban slums in low- and middle-income countries

Fri, 09/27/2019 - 14:31

Cochrane Reviews cover a wide range of issues relating to good nutrition for children and adults and the collection were added to in June 2019 by a reviews dedicated to issues faced by young children living in urban slums in low- and middle-income countries. We asked the lead author, Sophie Goudet from the Centre for Global Health and Human Development at Loughborough University in the UK, to tell us about the need for the review and what it found.

UN-Habitat estimates that at least one billion people live in urban slums, which are places in cities without adequate access to health care, clean water, and sanitation. More than 90% of these slums are in low- and middle-income nations, with the residents usually living in poverty, with little food security. One consequence of an inadequate diet is that people will have very short stature for their age, called growth stunting. It’s associated with greater susceptibility to infection, cognitive and behavioural problems, and lower adult work performance and earnings.

Nutritional interventions might be one way to prevent this, and our review is the first comprehensive and systematic assessment of the impact of these interventions on the growth of young children who live in urban slums.

We included 15 studies, involving more than 9000 children under five and approaching 4000 pregnant women. A range of interventions were tested, including maternal nutrition education, nutrient supplementation of mothers, infants, and children, such as adding zinc or iron, nutrition systems strengthening, and a combination of these. None of the studies modified the diet by providing additional food to families from locally available sources and allowing them to use it as they best saw fit.

We judged the scientific quality of the studies to be very low to moderate, which was mainly because they had not been designed to cope with problems linked to doing research in urban slum communities. These challenges include the amount of moving around that people do, making it difficult to keep supplying them with supplements or monitoring the height of the children.

On the basis of everything we found, we can conclude that there is no evidence of an effect of giving pregnant mothers zinc supplementation on the size of their newborns, it’s not clear if nutrient supplementation increases the height of children, and the impact of interventions supporting nutrition activities within health services is uncertain. On a more positive note, educating mothers on good nutrition when they were pregnant did help to increase their baby’s birth weight.

In summary, our review highlights the need for a better understanding of urban slum environments and the people who live there, not least because interventions we included have been shown to be successful in other settings. Good quality research is needed into the effects of multi-sectorial interventions, combining nutrition-specific and sensitive methods and programmes, as well as the effects of 'up-stream' practices and policies of governmental, non-governmental organisations, and the business sector to improve low birth weight and stunting in poor urban environments.

Thursday, October 10, 2019

Cochrane Iberoamerica and the Spanish Ministry of Health join together for the launch of Biblioteca Cochrane

Thu, 09/26/2019 - 11:09

Cochrane is delighted to support the official launch of the Spanish Cochrane Library known as ‘Biblioteca Cochrane’ in Madrid today

‘Biblioteca Cochrane’ is the Spanish portal of the Cochrane Libary, an online platform providing high-quality, independently produced evidence to inform healthcare decision-making and to end-users whose preferred language is not English.

The platform, designed in collaboration with Cochrane’s publisher Wiley and built by the technology platform provider HighWire, includes several features that will improve the experience for Spanish-speaking users and the ability to search health topics in different languages.

Today’s event, organized by Cochrane Iberoamerica takes place at the Ministry of Health in Madrid, followed by a workshop for those interested in improving their understanding and use of ‘Biblioteca Cochrane’.

Only around 6% of the world’s population are native English speakers, while 75% of people don’t speak English at all. This means many people do not have access to high quality health information, because it is not readily available in a language that they understand. ‘Biblioteca Cochrane’ first launched in the summer of 2018 making the Cochrane Library more accessible for Spanish speakers around the world. ‘Biblioteca Cochrane’ currently has almost 5,000 Spanish translations of Cochrane Reviews.

Xavier Bonfill, Director of Cochrane Iberoamerica said: "This event brings together the Spanish Ministry of Health with Cochrane to celebrate the history of the use of the Cochrane Library in Spain since 2003. For sixteen years, millions of Spanish citizens have had access to the Cochrane Library; the difference is that now we are able to offer a multi-language platform for Spanish speakers that integrates the Cochrane Library with a Spanish portal and search facility including Spanish translations of most Cochrane Reviews.”

 

Attending today’s launch in Madrid, Cochrane’s Editor-in-Chief, Dr Karla Soares-Weiser, said: “Breaking down linguistic barriers is at the heart of Cochrane’s diversity ambition, so, today is a wonderful milestone for Cochrane to celebrate the Spanish Cochrane Library with the Spanish Ministry of Health in this way. This is the first time the Cochrane Library has been translated and published in a language other than English, proving the feasibility and potential of it as a multi-lingual resource. This has become a beacon for other countries to follow suit in their own languages.”

Today also sees the launch of two new Cochrane centres in Madrid responsible for promoting Cochrane’s mission within the Faculty of Medicine at Universidad Francisco de Vitoria and the Faculty of Odontology, Complutense, University of Madrid.

More information about today’s launch event is available in Spanish.

Resources in Spanish:

 

 

Tuesday, October 1, 2019

Featured Review: How safe is it to add regular formoterol to inhaled corticosteroid for adults or children with asthma?

Thu, 09/26/2019 - 08:00

Asthma is a disease of the lungs, symptoms include wheezing, breathlessness, and chest tightness.

Two main features of asthma are underlying inflammation and bronchoconstriction (tightening of the muscles around small tubes in the lungs). The inflammation can be treated with daily steroid inhalers. The bronchoconstriction can be treated with a beta2-agonist to relax the muscles. This opens up the airways and makes it easier to breathe. Beta2-agonists can be used two ways: to provide relief from symptoms of chest tightness ('short-acting beta2-agonists') and to help prevent symptoms from occurring ('long-acting beta2-agonists', or LABAs).

When asthma is not controlled by daily low-dose ICS, many asthma guidelines recommend additional daily LABA, such as formoterol. The author team are confident that LABA improves lung function, quality of life, and worsening symptoms such as shortness of breath, wheezing, coughing and chest tightness. However, there is long-standing controversy about how safe these drugs are for people with asthma. The review authors wanted to explore this by focusing on rare and serious harms. These are defined as events that are life-threatening, require admission to hospital or by making stays in hospital longer, or result in persistent or significant disability/incapacity or a birth defect.

The review author team analysed data from 29 studies in 35,751 adults and 10 studies in 4,035 children aged up to 17 years.

Importantly, almost all trials were sponsored by drug manufacturers.

Thirty deaths were reported in 35,751 adults. Seventeen of these deaths were reported in participants taking formoterol and ICS, and 13 deaths in participants who were taking ICS alone. Three deaths reported in adults taking formoterol and ICS were due to asthma, but there were no asthma-related deaths with ICS alone. No deaths were reported in children up to 17 years age.

The number of people experiencing serious harms of any cause was similar in adults with and without formoterol. Although there was no difference in the risk of serious harms in adults with asthma who were taking regular formoterol in combination with ICS, we could not confirm whether taking formoterol in addition to ICS reduced or increased the risk of events compared to taking ICS alone.

The review authors were moderately certain regarding the data in adults, but less certain about the effects of adding formoterol to ICS in children. Given the low number of deaths that occurred in the studies, they do not yet have enough information to be able to measure accurately the risk of adding formoterol to ICS on number of deaths.

The review authors were not able to state confidently that taking formoterol in addition to ICS carried no risk of increasing the number of deaths in comparison with ICS alone. On the other hand, they found no conclusive evidence of an increase in serious harm. Three asthma-related deaths occurred in a total of 12,777 adults treated with formoterol in combination with ICS. There was no conclusive evidence of risk of non-fatal serious harms attributed to asthma when formoterol was combined with ICS in adults.

  

Thursday, September 26, 2019

Stoptober

Wed, 09/25/2019 - 14:02

Stoptober began in 2012 as an event  to encouraging people to quit smoking for good. Since then it has become an annual 28-day mass quitting attempt, offering resources and support for anyone trying to become smoke-free. It's an excellent to put the spotlight on the latest Cochrane evidence on quitting smoking.

In May 2019, the Cochrane Library released a Special Collection which highlights a selection of new or recently updated clinically relevant Cochrane Reviews that address tobacco addiction in the general population. The Cochrane Reviews in this collection are maintained by the Cochrane Tobacco Addiction Group who work to ensure that interventions to treat or prevent tobacco addiction are supported by good-quality evidence that can inform healthcare  decisions and policies.

Featured Evidence:Additional resources Tuesday, October 1, 2019

Cochrane seeks Head of Finance - Full time, Flexible location, preference for London-based

Wed, 09/25/2019 - 11:55

Specifications: Full Time, permanent
Salary: £72,000
Location: Flexible, though with a preference for London-based
Application Closing Date: 10th October 2019 (12 Midnight GMT)

Cochrane is the world’s most respected producer of high-quality health evidence to inform decision-making by healthcare practitioners, patients and carers, researchers and policymakers. Our global independent network of over 11,000 members and 68,000 supporters analyze and summarize the best evidence from research and publish it in the Cochrane Library (www.cochranelibrary.com). Cochrane is passionate about improving health outcomes for everyone, everywhere by helping them to make informed choices about healthcare issues and we have been doing this for 25 years.

We are looking for someone with exceptional leadership skills and experience to join our Senior Management Team as Head of Finance. This is a newly-created role that reports to the Chief Executive Officer, and we will look to you to:

  • Manage and develop the infrastructure, systems and processes for finance, audit and contracts management to support Cochrane’s work;
  • Advise the Governing Board as part of its Finance & Investment committee, Remuneration committee and Risk Management & Audit committee;
  • Support the work of the trustees of The Cochrane Collaboration (a UK charity and registered company); the Board of Directors of Cochrane Trading Co. Ltd; Cochrane Innovations Ltd. and IKMD Denmark by providing timely and appropriate advice and reports; and ensure statutory filings are made.
  • Act as Company Secretary for Cochrane Trading Co. Ltd, Cochrane Innovations Ltd. and IKMD Denmark.
  • Lead and support the annual budgeting process (including forecasting future scenarios) for all Cochrane entities.
  • Lead and support the Finance team in providing high-quality financial management, including relevant analysis of financial risks and opportunities, for Board consideration
  • Lead and manage the contracts management, legal and audit functions; and relationships with its banks, insurers, auditors, solicitors and HM Revenue.
  • Ensure that Cochrane’s financial procedures, systems, tools and internal controls protect the organization against fraud and other misuse of funds.
  • Manage leasing arrangements and associated management issues connected with Cochrane Offices in London, Denmark and Germany.

If you can offer:

  • A Master’s degree in finance, business administration (or equivalent experience).
  • An internationally recognized chartered accountancy qualification and strong technical accountancy skills.
  • Extensive experience in strategic planning and budgeting for organizations with an income of at least £5 million; and the management of financial and supporting infrastructure systems.
  • Demonstrable experience of managing finance departments and major financial projects or initiatives, including experience of negotiating agreements and managing vendor relationships.
    then we would like to hear from you.  In return, we can offer you a stimulating, highly collegiate, work environment with plenty of scope to make your own mark.

To apply, please send a detailed CV and a short covering letter to recruitment@cochrane.org setting out your reasons for applying and giving details of your availability.

Wednesday, September 25, 2019 Category: Jobs

World Alzheimer's Day

Thu, 09/19/2019 - 15:09

In clinical practice “Doctor, do I have dementia?” is an increasingly common question, but one that is often difficult to answer.  Accurate diagnosis is the first step in managing someone with cognitive concerns. Early diagnosis of a cognitive syndrome, if present, can allow people to make sense of their symptoms, and can help people plan their future, while allowing access to treatments and support.

To mark World Alzheimer's Day on September 21, the Cochrane Dementia and Cognitive Improvement Group have brought together all the completed test accuracy reviews focusing on cognitive screening tests and questionnaires. This Special Collection also includes the supporting materials that they have developed for researchers and reviewers.

Thursday, September 19, 2019

Standard registration deadline: September 26th 2019

Thu, 09/19/2019 - 12:39

The deadline for standard registration for the 2019 Cochrane Colloquium is quickly approaching: it is this Thursday September 26th!

Cochrane’s annual flagship event brings together hundreds of clinicians, health professionals, policy makers, researchers, patients, consumers and others to discuss and learn about the wide usage of Cochrane evidence in health decision-making at all levels.

This year’s Colloquium will take place 22-25 October, with the theme “Embracing diversity”. The full Scientific Program is now posted online!

There is still time to register; September 26 is the deadline for delegates to take advantage of group and regional discounts and the standard registration rate.

Join us in Santiago in October for #CochraneSantiago!

Register here: https://colloquium2019.cochrane.org/registration-fees

See you then!

Monday, September 23, 2019

Cochrane seeks Software Developer - Full time, permanent

Thu, 09/19/2019 - 10:02

Specifications: Full Time, permanent
Location: Copenhagen, Denmark (work permit required)
Application Closing Date: 13th October 2019 (12 Midnight GMT)

Are you passionate about software, do you have a quality-focused mind-set and drive to make a difference for health care world-wide? We are a global organization that strives to inform health-care decisions every day. Our development team is located in Copenhagen and supports the process of creating systematic reviews through a web-based application.

“Cochrane summarizes the findings so people making important decisions – you, your doctor, the people who write medical guidelines – can use unbiased information to make difficult choices without having to read every study out there…” Sifting the evidence, The Guardian, 14 September 2016

There are a lot of great things about working here, but by far the greatest benefit is the team. We are a group of motivated, mission-driven people who love learning from each other. Our aim is to work closely with our users, which is interesting and sometimes challenging in a global organization like ours. We take pride in doing great work and collaborate well with each other.

As our new software developer, you'll contribute to the design and development of the web-based software used by thousands of Cochrane authors to produce systematic reviews, including writing, statistical analysis, data management, and integrations with partner tools for study curation, data extraction, and more. Due to the fast-paced nature of our release cycle, the team interact frequently with users and other stakeholders.

Who are we looking for?

  • Strong hands-on experience designing and building web applications in an Agile setting;
  • Experience with web technologies (e.g. REST), Java EE, AngularJS, etc.;
  • Analytical and efficient problem solver that challenges the product and the process around it;
  • Result oriented with a high degree of accountability, commitment and responsibility;
  • Passionate about working in a cross-functional team and providing constructive feedback for continuous improvement;
  • At least 3 years industry experience working as a full-time software developer for web applications;
  • Bachelor or Masters Degree in Computer Science (or a related field) OR equivalent work experience;
  • Fluent in English.

We consider it beneficial if you have knowledge of Cochrane, evidence-based health care, systematic reviews, and/or the global health sector.

What you'll be doing

  • Work with a talented and collaborative agile team that is passionate about delivering a quality product to our users;
  • Design, develop, test, and maintain Cochrane systematic review production systems;
  • Achieve and maintain a high level of automated test coverage;
  • Help drive continuous improvement of product, code, and processes.

How to apply

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with “Software Developer” in the subject line.  The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples.  List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

Thursday, September 19, 2019 Category: Jobs

Cochrane seeks Test Automation Engineer - Full time, permanent

Thu, 09/19/2019 - 09:25

Specifications: Full Time, permanent
Location: Copenhagen, Denmark (work permit required)
Application Closing Date: 13th October 2019 (12 Midnight GMT)

Are you passionate about software, do you have a quality-focused mind-set and drive to make a difference for health care world-wide? We are a global organization that strives to inform health-care decisions every day. Our development team is located in Copenhagen and supports the process of creating systematic reviews through a web-based application.

“Cochrane summarizes the findings so people making important decisions – you, your doctor, the people who write medical guidelines – can use unbiased information to make difficult choices without having to read every study out there…” Sifting the evidence, The Guardian, 14 September 2016

There are a lot of great things about working here, but by far the greatest benefit is the team. We are a group of motivated, mission-driven people who love learning from each other. Our aim is to work closely with our users, which is interesting and sometimes challenging in a global organization like ours. We take pride in doing great work and collaborate well with each other.

As our new test automation engineer, you'll be upgrading and building automated tests for our product. Due to the fast-paced nature of our release cycle, our goal is to maintain product development velocity while having confidence in the quality of our code. You will build out test suites to increase regression test coverage and work cross-functionally to implement quality-minded practices in the product lifecycle process. Our hope is that you can challenge our current way of working and have the experience to pinpoint which tools would fit us best. 

Who are we looking for?

  • Strong hands-on test automation experience with BDD and/or TDD methods in an Agile setting;
  • Experience of translating acceptance criteria into a robust and integrated test solution;
  • Analytical and efficient problem solver that challenges the product and the process around it;
  • Result oriented with a high degree of accountability, commitment and responsibility;
  • Passionate about working in a cross-functional team and providing constructive feedback for continuous improvement;
  • At least 3 years industry experience working as a full-time test automation engineer for web applications;
  • Bachelor or Masters Degree in Computer Science (or a related field) OR equivalent work experience;
  • Fluent in English

We consider it beneficial if you have knowledge of Cochrane, evidence-based health care, systematic reviews, and/or the global health sector.

What you'll be doing

  • Work with a talented and collaborative agile team that is passionate about delivering a quality product to our users;
  • Advocate and work cross-team to implement quality-minded practices in the product lifecycle process;
  • Identify, implement, and maintain automatic tests to help increase regression coverage for our fast-paced development lifecycle;
  • Embrace emerging technologies and solutions to ensure we deliver the quality that our users need;
  • Provide 2nd level technical support.

How to apply

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with “Test Automation Engineer” in the subject line.  The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples.  List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

 

Thursday, September 19, 2019 Category: Jobs

Pre-Colloquium Events

Wed, 09/18/2019 - 15:09

The two days prior to the official 2019 Cochrane Colloquium Scientific Program will see some exciting pre-Colloquium events!

Starting off Colloquium festivities on Sunday, October 20, is the Student Satellite Event. Hosted and sponsored by the University of Valparaíso, this Satellite event will feature a wide range of international speakers, including Dr. Gordon Guyatt as keynote speaker. The event will be held at the Health Campus of the University of Valparaíso in Viña del Mar, approx. 100 km from Santiago and next to the UNESCO World Heritage city of Valparaíso.

Several Pre-Colloquium events will be held on Monday, October 21. The all-day #CochraneTech Santiago Symposium will explore the integration of new technology and tools into the systematic review process. A full-day “train the trainers” workshop is geared toward members of the Cochrane Trainers’ Network. Spanish and English versions of a full-day workshop on the GRADE approach and creating Summary of Findings Tables will be held, as well as the full-day GRADE Working Group Meeting. The Methods Group Co-Convener Meeting will be held in the morning, while the 2019 Methods Symposium, titled “Developing robust review protocols with increasingly diverse evidence” will take place in the afternoon. An invitation-only KT Training Workshop on supporting policymakers in the use of synthesized evidence will take place all-day on Monday, as will a Seminar titled “The Kidnapping of Evidence-Based Medicine”, hosted by Chilean organization Médicos Sin Marca. Plans are also underway for Cochrane Consumer satellite event, which will be confirmed soon.

To learn more about these events, including registration, visit the Pre-Colloquium Satellites page here:
https://colloquium2019.cochrane.org/pre-colloquium-satellites-and-meetings

The full Scientific Program of this year’s Colloquium can be found here:
https://colloquium2019.cochrane.org/signup/d/2019-10-22

Don’t forget, there is still time to register for this year’s Colloquium! Standard registration and discounts end on September 26:
https://colloquium2019.cochrane.org/registration-fees

 

 

Wednesday, September 18, 2019

Featured Review: Imaging with PET during chemotherapy to predict outcome in adults with Hodgkin lymphoma

Tue, 09/17/2019 - 08:10

Hodgkin lymphoma (HL) is one of the most common haematological malignancies in young adults and, with cure rates of 90%, has become curable for the majority of individuals. Positron emission tomography (PET) is an imaging tool used to monitor a tumour’s metabolic activity, stage and progression. Interim PET during chemotherapy has been posited as a prognostic factor in individuals with HL to distinguish between those with a poor prognosis and those with a better prognosis. This distinction is important to inform decision-making on the clinical pathway of individuals with HL.

In this interview with the lead author of this Review we asked Research Associate, Angela Aldin from Cochrane Haematological Malignancies to tell us more about it.

What is (interim) PET and what does the PET scan result indicate?
A positron emission tomography (PET) is an imaging tool that is used for the diagnosis and/or monitoring of a disease. In individuals with Hodgkin lymphoma (HL), a PET scan at diagnosis helps to identify the stage of the disease and aids the treating physician in deciding upon the treatment pathway of the individual. An interim PET scan, however, is conducted during therapy, for instance after the second cycle of chemotherapy, to see whether the individual is responding to the allocated treatment. The Deauville five-point scale is the most commonly used scale for the interpretation of the scans and for assessing the extent of the disease. For example, individuals with a score of four or five are said to have a positive PET scan result, as the PET scan shows a higher uptake and metabolic activity of the cancer cells, and noticeable evidence of disease. Individuals with a score between one and three have a negative PET scan with a lower uptake of the cancer cells.

What was the objective of this review?
The objective of this review was to determine whether in previously untreated adults with HL (all stages) receiving first-line therapy, interim PET scan results (i.e. a positive or a negative result) can distinguish between those with a poor prognosis and those with a better prognosis, and thereby predict survival in each group.

How many studies were included? What was included and what was excluded?
We included twenty-three studies in total, in this review. In all studies, interim PET was conducted during first-line therapy and after two, three, and/or four cycles of chemotherapy in adults with HL (all stages). We included both retrospective and prospective studies that provided evidence on our prognostic factor of interest (interim PET-scan results) and outcomes of interest (overall survival, progression-free survival and PET-associated adverse events). It was important to include studies in which the treatment regimen of the participants was not adapted according to the interim PET scan results. In other words, irrespective of the interim PET scan result (interim PET-positive or interim PET-negative), participants should continue with the same treatment regimen as specified at the beginning of the study. The reason being that the occurrence of the predicted outcome in each group shall be attributable to the prognostic factor of interest (the interim PET scan result) rather than the modified treatments. Hence, we excluded studies that in their design allowed adaptation of the initially allocated treatment regimen of participants based on their interim PET scan result. In other words, modification of treatment based on the PET results would mask the true impact of the interim-PET as a prognostic factor. Once the significance of the interim-PET results is proven (as this was the aim of the review), then a different type of clinical study would be necessary before recommendations for treatment alterations based on PET results is offered to clinicians.

How certain is the evidence?
We pooled unadjusted effect estimates for overall survival (only nine studies offered relevant data) and progression-free survival (fourteen studies). Our concerns regarding the certainty of the evidence mainly lie with the methodology of the primary studies, particularly the reporting and presentation of the study results. Hence, we could not include all studies in meta-analysis and have very low to moderate certainty in the evidence.

For overall survival, we have moderate-certainty evidence that individuals with HL who have a negative interim PET scan result have better survival compared to those with a positive interim PET scan result.

For progression-free survival, we have very low certainty-evidence that individuals who have a negative interim PET scan result may have longer cancer free periods compared to those with a positive interim PET scan result. For this outcome, we also found some inconsistency as to how the outcome was defined as it is a composite outcome containing different endpoints.

We are not able to comment on PET-associated adverse events as no study measured nor reported these.

Are there different types of prognosis reviews?
This review is a systematic review of prognostic factor studies (type 2 below). However, there are four different types of studies on prognosis:

  1. Studies on overall prognosis (i.e. the likely outcome or course of a certain health condition)
  2. Prognostic factor studies (i.e. factors that are associated with a certain health outcome)
  3. Prognostic model studies (i.e. a combination/set of prognostic factors that together predict a certain health outcome)
  4. Stratified medicine research (i.e. using prognostic factors and models to guide the individual treatment path).

Reviews of studies on prognosis fit with the move towards new innovative review types, as the methodology behind the assessment of these studies as well as the pooling and summary of individual study results from studies on prognosis is still new and under development. An accurate and correct prognosis of health-related outcomes lies at the heart of each individual. Therefore, it is important to define and continuously refine the methodology of such reviews in order to be able to provide a good and thorough overview of the evidence on a specific research question related to prognosis.

Why was this topic considered to be high priority and therefore eligible for Cochrane’s Fast- Track initiative, and what was your experience of working with Cochrane Fast-Track?
This project was funded by the German Federal Ministry of Education and Research (01KG1709) as it answers a clinically relevant question that interim PET successfully distinguishes between individuals with a poor prognosis (interim PET-positive) and individuals with a good prognosis (interim PET-negative). This evidence can aid clinical decision-making on the treatment pathway of affected individuals with HL. The treatment pathway of an individual may be adapted based on their interim PET scan result in order to receive the treatment with the greatest efficacy and least toxicity possible. Furthermore, HL is a disease that is most common in young adults.

The evidence that this review provides may also be used in national and international clinical guidelines regarding the treatment pathways of individuals with HL. Further reasons as to why it was considered to be a high priority review and was therefore eligible for the Fast Track is because it is the first Cochrane prognostic factor review with meta-analysis in the Cochrane Library. It was developed through close collaboration with the Cochrane Prognosis Methods Group, as well as the GRADE Prognosis Working Group. The conduct of systematic reviews of prognosis studies is increasingly growing and with our review we try to contribute to the methodological developments and provide a guide for future authors of such reviews. Therefore, the author team applied to the Fast Track team due to the above mentioned reasons and the review met the eligibility criteria and was considered to be an important review for Cochrane. We had a very positive experience with the Cochrane Fast-Track team. We were guided and supported through each step of the editorial and publishing phase, and were continuously updated by the team regarding the status of our review. We received very thorough and detailed feedback from internal and external peer- reviewers who greatly helped in improving this review.

Photo credit: Uniklinik Köln

Wednesday, September 11, 2019

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