scholarly journals Identifying the gaps, reducing the waste, and setting priorities in Cochrane gynaecology research

Author(s):  
Marian Showell ◽  
Devanshi Jani ◽  
Cindy Farquhar ◽  
Vanessa Jordan

Objective The aim of this project was to identify gaps and research waste in the dissemination of Cochrane gynaecology evidence in the Cochrane database of systematic reviews (CDSR). Design A research article Setting The Cochrane Gynaecology and Fertility (CGF) Group’s specialised register of random controlled trials (RCTs). Sample Trials looking at benign gynaecological conditions, contained in the CGF specialised register, published between the years 2010-2011. Methods Gynaecology trials from the CGF specialised register were matched, by the specific gynaecological issue and treatment, to existing Cochrane reviews. Unmatched trials were categorised to develop and prioritise new review topics. Main outcome measures Proportions Results 740 trials, published from 2010 to 2011, were exported from the specialised register, after removing duplicates and out of scope trials, 185 of these trials were found to be already included in Cochrane reviews. 422 trials were found to be unused, however 192 (26%) of these could be included in an existing CGF SR if it were updated. 230 trials (32%) were not matched to any review title and from these 21 new review titles were developed. The topic with the largest number of associated ‘unused’ trials, was ‘Plant and herbal extracts for symptoms of menopause’. Conclusions This project was used to consider unused trials, prioritise new review topics and identify those reviews that need to be updated, thereby identifying the gaps in evidence for women with gynaecological problems.

Author(s):  
Marian Showell ◽  
Kate Stedman ◽  
Cindy Farquhar ◽  
Vanessa Jordan

Objective The aim of this project was to identify gaps and research waste in the dissemination of fertility evidence in the Cochrane database of systematic reviews (CDSR). Design A research article. Setting The Cochrane Gynaecology and Fertility (CGF) Group’s specialised register of random controlled trials (RCTs). Sample Infertility trials contained in the CGF specialised register, published between the years 2010-2011. Methods Infertility trials from the CGF specialised register were matched, by the specific fertility issue and treatment, to existing Cochrane reviews. Unmatched trials were categorised to develop and prioritise new review topics. Main outcome measures Proportions Results 564 trials, published from 2010 to 2011, were exported from the specialised register and after removing duplicates, 318 trials were found to be already included in a Cochrane review. 187 (37%) of trials were found to be unused, however 115 (23%) of these could be included in an existing CGF SR, if it were updated. 72 trials (14%) were not matched to any review topic and from these, eight new Cochrane review titles were developed. The topic with the largest number of associated ‘unused’ trials, was ‘Traditional Chinese Medicine for women undergoing assisted reproductive techniques’. Conclusions This project was used to consider unused trials, prioritise new review topics and identify those reviews that need to be updated, thereby identifying the gaps in evidence for couples with fertility problems. Keywords research waste, gaps, fertility, infertility, randomized controlled trials, systematic reviews, prioritisation.


2009 ◽  
Vol 25 (S1) ◽  
pp. 182-195 ◽  
Author(s):  
Mark Starr ◽  
Iain Chalmers ◽  
Mike Clarke ◽  
Andrew D. Oxman

The Cochrane Database of Systematic Reviews (CDSR) evolved in response to Archie Cochrane's challenge to the medical profession to assemble “a critical summary, adapted periodically, of all . . . relevant randomized controlled trials”. CDSR has been an electronic publication from its inception and this has meant that Cochrane reviews (i) need not be constrained by lack of space; (ii) can be updated as new information becomes available and when mistakes or other ways of improving them are identified; and (iii) can be cross-linked to other, related sources of relevant information. Although CDSR has become widely cited, it must continue to evolve in the light of technological and methodological developments, and in response to the needs of people making decisions about health care.


2019 ◽  
Vol 5 (2) ◽  
pp. 00072-2019 ◽  
Author(s):  
Alexander G. Mathioudakis ◽  
Mia Moberg ◽  
Julie Janner ◽  
Pablo Alonso-Coello ◽  
Jørgen Vestbo

Randomised controlled trials (RCTs) evaluating the management of acute exacerbations of chronic obstructive pulmonary disease (COPD) report heterogeneous outcome measures, thus rendering their results incomparable, complicating their translation into clinical practice. As a first step in the development of a core outcome set that will aim to homogenise outcome measures in future RCTs, we assessed the outcomes reported in recent relevant RCTs and systematic reviews.We conducted a methodological systematic review (https://www.crd.york.ac.uk/prospero/ registration number CRD42016052437) of RCTs and systematic reviews on COPD exacerbation management indexed on Medline and PubMed during the last decade. We evaluated their methodology, specifically focusing on the reported outcome measures.Based on 123 RCTs and 38 systematic reviews, we found significant variability in the outcomes reported and in their definition. Mortality, which was assessed in 82% of the included trials, was the most frequently assessed outcome, followed by the rate of treatment success or failure (63%), adverse events (59%), health status, symptoms and quality of life (59%), lung function (47%), and duration of exacerbations (42%).The significant heterogeneity in the selection and definition of outcome measures in RCTs and systematic reviews limits the interpretability and comparability of their results, and warrants the development of a core outcome set for COPD exacerbations management.


BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017737 ◽  
Author(s):  
Hedyeh Ziai ◽  
Rujun Zhang ◽  
An-Wen Chan ◽  
Nav Persaud

ObjectivesWe audited a selection of systematic reviews published in 2013 and reported on the proportion of reviews that researched for unpublished data, included unpublished data in analysis and assessed for publication bias.DesignAudit of systematic reviews.Data sourcesWe searched PubMed and Ovid MEDLINE In-Process & Other Non-Indexed Citations between 1 January 2013 and 31 December 2013 for the following journals:Journal of the American Medical Association,The British Medical Journal,Lancet,Annals of Internal Medicineand theCochrane Database of Systematic Reviews. We also searched the Cochrane Library and included 100 randomly selected Cochrane reviews.Eligibility criteriaSystematic reviews published in 2013 in the selected journals were included. Methodological reviews were excluded.Data extraction and synthesisTwo reviewers independently reviewed each included systematic review. The following data were extracted: whether the review searched for grey literature or unpublished data, the sources searched, whether unpublished data were included in analysis, whether publication bias was assessed and whether there was evidence of publication bias.Main findings203 reviews were included for analysis. 36% (73/203) of studies did not describe any attempt to obtain unpublished studies or to search grey literature. 89% (116/130) of studies that sought unpublished data found them. 33% (68/203) of studies included an assessment of publication bias, and 40% (27/68) of these found evidence of publication bias.ConclusionA significant fraction of systematic reviews included in our study did not search for unpublished data. Publication bias may be present in almost half the published systematic reviews that assessed for it. Exclusion of unpublished data may lead to biased estimates of efficacy or safety in systematic reviews.


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Jie Wang ◽  
Xingjiang Xiong

Objective.The aim of this overview was to summarize the outcome measures of Chinese herbal medicine (CHM) for the treatment of hypertension based on available systematic reviews (SRs), so as to evaluate the potential benefits and advantages of CHM on hypertension.Methods.Literature searches were conducted in the Cochrane Database of Systematic Reviews, MEDLINE, and 4 databases in Chinese. SRs of CHM for hypertension were included. Two independent reviewers (J. Wang and X. J. Xiong) extracted the data.Results.10 SRs were included. 2 SRs had primary endpoints, while others focused on secondary endpoints to evaluate CHM for hypertension such as blood pressure (BP) and Traditional Chinese Medicine (TCM) syndrome. 6 SRs have reported the adverse effects, whereas the other 4 SRs have not mentioned it at all. Many CHM appeared to have significant effect on improving BP, TCM syndrome, and so on. However, most SRs failed to make a definite conclusion for the effectiveness of CHM for hypertension due to poor evidence.Conclusion.Primary endpoints have not been widely used currently. The benefits of CHM for hypertension need to be confirmed in the future with randomized controlled trials (RCTs) of more persuasive primary endpoints and high-quality SRs.


2014 ◽  
Vol 133 (2) ◽  
pp. 109-114
Author(s):  
Antonio José Grande ◽  
Tammy Hoffmann ◽  
Paul Glasziou

CONTEXT AND OBJECTIVE: The current paradigm of science is to accumulate as much research data as possible, with less thought given to navigation or synthesis of the resulting mass, which hampers locating and using the research. The aim here was to describe the number of randomized controlled trials (RCTs) and systematic reviews (SRs) focusing on exercise, and their journal sources, that have been indexed in PubMed over time. DESIGN AND SETTING: Descriptive study conducted at Bond University, Australia. METHOD: To find RCTs, a search was conducted in PubMed Clinical Queries, using the category "Therapy" and the Medical Subject Headings (MeSH) term "Exercise". To find SRs, a search was conducted in PubMed Clinical Queries, using the category "Therapy", the MeSH term "Exercise" and various methodological filters. RESULTS: Up until 2011, 9,354 RCTs about exercise were published in 1,250 journals and 1,262 SRs in 513 journals. Journals in the area of Sports Science published the greatest number of RCTs and journals categorized as belonging to "Other health professions" area (for example nursing or psychology) published the greatest number of SRs. The Cochrane Database of Systematic Reviews was the principal source for SRs, with 9.8% of the total, while the Journal of Strength and Conditioning Research and Medicine & Science in Sports & Exercise published 4.4% and 5.0% of the RCTs, respectively. CONCLUSIONS: The rapid growth and resulting scatter of RCTs and SRs on exercise presents challenges for locating and using this research. Solutions for this issue need to be considered.


2019 ◽  
Author(s):  
Hilda Bastian ◽  
Jenny Doust ◽  
Mike Clarke ◽  
Paul Glasziou

ABSTRACTBackgroundThe Cochrane Collaboration has been publishing systematic reviews in the Cochrane Database of Systematic Reviews (CDSR) since 1995, with the intention that these be updated periodically.ObjectivesTo chart the long-term updating history of a cohort of Cochrane reviews and the impact on the number of included studies.MethodsThe status of a cohort of Cochrane reviews updated in 2003 was assessed at three time points: 2003, 2011, and 2018. We assessed their subject scope, compiled their publication history using PubMed and CDSR, and compared them to all Cochrane reviews available in 2002 and 2017/18.ResultsOf the 1,532 Cochrane reviews available in 2002, 11.3% were updated in 2003, with 16.6% not updated between 2003 and 2011. The reviews updated in 2003 were not markedly different to other reviews available in 2002, but more were retracted or declared stable by 2011 (13.3% versus 6.3%). The 2003 update led to a major change of the conclusions of 2.8% of updated reviews (n = 177). The cohort had a median time since publication of the first full version of the review of 18 years and a median of three updates by 2018 (range 1–11). The median time to update was three years (range 0–14 years). By the end of 2018, the median time since the last update was seven years (range 0–15). The median number of included studies rose from eight in the version of the review before the 2003 update, to 10 in that update and 14 in 2018 (range 0–347).ConclusionsMost Cochrane reviews get updated, however they are becoming more out-of-date over time. Updates have resulted in an overall rise in the number of included studies, although they only rarely lead to major changes in conclusion.


Author(s):  
Nadja Taumberger ◽  
Anna-Maria Schütz ◽  
Klaus Jeitler ◽  
Andrea Siebenhofer ◽  
Holger Simonis ◽  
...  

Abstract Introduction and hypothesis We conducted a systematic review of the effectiveness of local preemptive analgesia for postoperative pain control in women undergoing vaginal hysterectomy. Methods MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews were searched systematically to identify eligible studies published through September 25, 2019. Only randomized controlled trials and systematic reviews addressing local preemptive analgesia compared to placebo at vaginal hysterectomy were considered. Data were extracted by two independent reviewers. Results were compared, and disagreement was resolved by discussion. Forty-seven studies met inclusion criteria for full-text review. Four RCTs, including a total of 197 patients, and two SRs were included in the review. Results Preemptive local analgesia reduced postoperative pain scores up to 6 h and postoperative opioid requirements in the first 24 h after surgery. Conclusion Preemptive local analgesia at vaginal hysterectomy results in less postoperative pain and less postoperative opioid consumption.


Sign in / Sign up

Export Citation Format

Share Document