トラネキサム酸（血液凝固を促進する薬剤）は、慢性鼻副鼻腔炎の内視鏡手術における出血を減少させるか？ 慢性鼻副鼻腔炎とは何か？ 慢性鼻副鼻腔炎とは、副鼻腔（顔の骨の中にあり、鼻腔とつながっている空洞）の炎症が12週間以上続いている状態である。慢性鼻副鼻腔炎になると、鼻づまりや鼻水、顔の痛みや圧迫感、嗅覚の低下や喪失などの症状が現れる。また、鼻の中にポリープができ、症状が悪化することもある。 慢性鼻副鼻腔炎はどのように治療されるのか？ 慢性鼻副鼻腔炎は、通常、生理食塩水のスプレーや洗浄液、抗炎症剤（ステロイド剤）の点鼻薬、抗菌薬、ステロイドの錠剤などを用いて治療される。このような治療を行っても症状が続く場合は、手術が行われることがある。 何を調べようとしたのか？ 血液凝固を促進する薬剤であるトラネキサム酸が、内視鏡を用いた副鼻腔手術（内視鏡下副鼻腔手術）における出血を減少させるか、また、合併症のリスクを低下させることができるかどうかを調査した。出血を少なくできるということは、手術時に外科医が副鼻腔の状態をよく観察することができるということである。 何を行ったのか？ トラネキサム酸を使用（静脈内投与、またはスプレーや点鼻薬による投与）した治療について、プラセボ（偽の治療）、またはトラネキサム酸を使用しなかった場合とを比較した研究を検索した。小児と成人両方の研究参加者を対象とした。研究結...

Monday, February 20, 2023

Friday, February 17, 2023

Cochrane China recently hosted a virtual event for the evidence-based medicine community that brought together many of its partners, local expertise, and international speakers. Here the team provides an overview of who was involved and what was covered at the event. 

The 3rd Beijing forum of evidence-based medicine and Cochrane China Network Symposium was successfully held virtually on January 15th, 2023. The host of this conference were Cochrane China Network and Beijing GRADE Center. The organizers are Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, affiliate of the Cochrane China Network; Beijing GRADE Center; and Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine. The co-organizers are affiliates of the Cochrane China Network, including Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong; Evidence-based Medicine Centre, Fudan University; Centre for Evidence-based and Translational Medicine, Wuhan University; Cochrane China Centre, West China Hospital, Sichuan University; Centre for Evidence-based Medicine and Clinical Research, Peking University; School of Public Health, Chongqing Medical University; Institute of Health Data Science, Lanzhou University; Evidence-based Medicine Centre, University of Nottingham Ningbo.

Professor Liu Jianping, director of the Centre for Evidence-Based Medicine of Beijing University of Chinese Medicine, and senior research fellow Fei Yutong at Beijing University of Chinese Medicine served as the chairmen of the conference. Meanwhile, the conference invited Professor Gordon Guyatt, McMaster University, Canada, senior management of the Cochrane China Network headquarters, a total of 5 internationally renowned scholars from the United Kingdom, the United States, Hong Kong and other countries and regions, as well as speakers from 9 member units of the Cochrane China Network. In total, 25 scholars gave academic reports.

The conference conducted in-depth exchange and discussions of cutting-edge evidence-based medicine topics, which was divided into four modules: interpretation of the Cochrane review publishing policy, translational evidence, research frontiers in systematic reviews and evidence synthesis, and research methods in clinical practice.

 To start,  Liu Jianping, the chairman of the conference, Centre for Evidence-Based Medicine of Beijing University of Chinese Medicine, and Chen Yingyao, Qian Huitang and Jin Yinghui, the rotating chairmen of the Cochrane China Network executive committee, delivered opening speeches, respectively.

Liu Jianping briefly introduced the origin and development of the Cochrane China Network, and hoped that everyone could communicate and exchange with each other on the progress and achievement in methodologies, as well as the opportunities and challenges faced through this conference.

Chen Yingyao, on behalf of the Cochrane China Network executive committee, warmly welcomed the presence of all experts and listeners attending the conference, and expressed heartfelt thanks to the hosts and organizers of the conference, as nine member units from eight regions could carry out academic exchanges through this cloud platform.

Qian Huitang stated that the conference invited experts and scholars from home and abroad to make academic reports, which provided a platform for communication and exchange among member units, and wished the conference a complete success. Jin Yinghui said that Cochrane China Network has been trying to participate in the production, dissemination and translation of evidence since the establishment of it two years ago, and hoped to attract more researchers and clinical workers to improve patients' health concepts based on the best evidence through the academic conference held biennially.

 On the morning of January 15th, the module of the conference was interpretation of the Cochrane review publishing policy. Catherine Spencer, the Cochrane’s chief executive officer, Gordon Guyatt, the founder of evidence-based medicine, McMaster University, Tiffany Duque, the central executive team of Cochrane, Liu Jianping, Beijing University of Chinese Medicine, and Liu Qin, Chongqing Medical University, were invited to explain the content Changes and New Strategies of Cochrane, GRADE for Network Meta-analysis, Communicating Science & Evidence during Health Emergencies, Cochrane Review of Traditional Chinese Medicine: Current Status and Challenges, and Interpretation of the Cochrane Review Publishing Policy in simple terms. The conference was hosted by Fei Yutong.

 On the morning of January 15th, with the module of “translational evidence–1”, Susan Wieland, director of Cochrane Complementary Medicine Department, Jin Yinghui, Wuhan University, Chen Yaolong, Lanzhou University, and Xia Jun with GRADE Center of university of Nottingham Ningbo were invited to separately report on Cochrane Complementary Medicine: The Global Benefit of Chinese Collaboration, Implementation Evaluation of Clinical Practice Guidelines, Scientificity, Transparency, Applicability and Rankings (STAR) Tool for Clinical Practice Guidelines, and Use of Cochrane's Reviews to Inform WHO Guidelines, which were focused on as a hot issue and frontier of research related to guidelines. The conference was hosted by Li Xun.

 On the afternoon of January 15th, the conference’s module was “translational evidence–2”. It invited Richard Hubbard, University of Nottingham Ningbo, Hao Yufang, Beijing University of Chinese Medicine, Tian Jinhui, Centre for Evidence-based Medicine of Lanzhou University, Li Xun, Beijing University of Chinese Medicine, and Wang Yongbo, Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, to reported on Using Routinely Collected Data for Clinical Research, Development and Adaptation of Nursing Guidelines for Integrative Chinese and Western Medicine, Progress and Challenges of the Research Methods on the Synthesis and Translational Evidence in Evidence Ecosystem, Enhancing Medical Students' Awareness of Evidence-based Medicine and Their Ability to Transform Knowledge Through Cochrane Evidence, Development of Clinical Practice Guideline Knowledge Graph, surrounding the key issues of interest in the process of developing and evaluating evidence-based medicine evidence. The conference was hosted by Wang Ping.

 In the module of “research frontiers in systematic reviews and evidence synthesis”, Zhan Siyan, Peking University, Nie Xiaolu, Beijing Children's Hospital, Capital Medical University, Wu Shanshan, Beijing Friendship Hospital, Capital Medical University, Yang Zhirong, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Mou Huanyu and Li Caixia, Chinese University of Hong Kong, and Huang Qiao, Wuhan University, were invited to introduce Progress in Evidence Synthesis, Umbrella Reviews: Strengths and Limitations, Evidence Synthesis of Predictive Models: A Case Study of Liver Cancer Risk Prediction, A New Method for Evidence Synthesis to Determine the Effectiveness of COVID-19 Vaccines, Effectiveness of Dyadic Psychoeducational Intervention for Stroke Survivors and Family Caregivers on Functional and Psychosocial Health: A Systematic Review and Meta-analysis, Effects of Nurse-led Interventions on Early Detection of Cancer: A Systematic Review and Meta-analysis, and Development and Promotion of An Online Helper for Systematic Reviews of Evidence-based Medicine. The conference was co-hosted by Han Mei, Beijing University of Chinese Medicine, and Sun Feng, Peking University.

 In the “research methods in clinical practice” module, Chen Shiyao, Fudan University, Shi Qiuling, Chongqing Medical University, Peng Xiaoxia, Beijing Children's Hospital, Capital Medical University, Tan Jing and Yu Jiajie, West China Hospital, Sichuan University, were invited to introduce Taking Clinical Practice to the Forefront of Research, Statistical Significance VS Clinical Significance: An Introduction to Minimum Clinically Meaningful Changes in Patient-reported Outcomes, Establishment of Reference Intervals and Clinical Decision Limits, The Development and Application of A RWD-based Method for Assessing the Effectiveness of Traditional Chinese Medicine in Pregnant Women, and Application of IDEAL in Surgical Clinical Researches. The conference was hosted by Xing Jingli.

This forum is another grand conference of the Cochrane China network two years after the founding conference of the Cochrane China Network. It is a high-level international conference in the field of Chinese evidence-based medicine. It is expected that Cochrane China Network will have better development in the work and research of Cochrane with the deeper and further academic collision and exchange.

A warm thank you and congratulations to everyone involved!

• Learn more about Cochrane China
• Get involved with Cochrane
• Learn more about events happening at Cochrane

Writen by Wang Ping and Li Xun. Reviewed by Fei Yutong, Liu Jianping, Li Feng, and Li Chenhui.

Friday, February 17, 2023

Overall lack of evidence raises questions about the benefits

People with chronic back pain may turn to spinal cord stimulation to ease their pain, but a University of Sydney led Cochrane Review found no sustained benefits to the surgery that outweigh the costs and risks.  

Spinal cord stimulation, a medical technology suggested to treat people with chronic back pain, does not provide long-term relief and may cause harm, according to a Cochrane Review released today.

Spinal cord stimulation is thought to work by planting a device that sends electrical pulses to the spinal cord to interrupt nerve signals before they reach the brain.

The study reviewed published clinical data on spinal cord stimulation. This included randomised controlled trials, considered to be the most robust method to measure the effectiveness of a treatment in medical research.

The researchers analysed the results of 13 clinical trials, looking at data from 699 participants, comparing spinal cord stimulation treatment with placebo or no treatment for low back pain.

Cochrane reviews are trusted by researchers, medical professionals and policymakers because they use robust methodologies to combine evidence from multiple sources, reducing the impact of bias and random error that can make individual studies less reliable.

The review concluded that spinal cord stimulation is no better than a placebo for treating low back pain, with probably little to no benefits for people with low back pain or improving their quality of life.

There was little to no clinical data regarding the long-term effectiveness of spinal cord stimulation, including the risk of side effects and complications.

The researchers also found that adverse side effects to the surgery were poorly documented overall, preventing them from concluding the level of risk involved. Harms from spinal cord stimulation could include nerve damage, infection, and the electrical leads moving, all of which may need repeated surgeries.

The review findings have been submitted to the Federal Department of Health and Aged Care prosthesis list review taskforce. The taskforce is reviewing the eligibility of current prostheses subsidised by Medicare.

In Australia, the devices' long-term safety and performance are also being re-accessed by The Therapeutic Goods Administration (TGA), the country’s regulatory authority for therapeutic goods.

“Spinal cord stimulation is invasive and has a great financial cost to people who choose surgery as a last resort to alleviate their pain. Our review found that the long-term benefits and harms are essentially unknown,” said lead researcher Dr Adrian Traeger from Sydney Musculoskeletal Health, an initiative of the University of Sydney, Sydney Local Health District and Northern Sydney Local Health District.

“Our review of the clinical data suggests no sustained benefits to the surgery outweigh the costs and risks.

“Low back pain is one of the leading causes of disability worldwide. Our findings further emphasise the urgent need to review funding arrangements for chronic pain care to help patients in their search for relief. There are evidence-based physical and psychological therapies for back pain; ensuring access to these is essential.”

The review team found multiple gaps in clinical data.

There were no studies that investigated the long-term (more than 12 months) impact of spinal cord stimulation on low back pain. The longest was a single six-month trial.

The majority of clinical trials only looked at the immediate impact of the device, which is a time frame of less than a month.

The review team provided a list of recommendations, which include future spinal cord stimulation clinical trials to be at least 12 months, clearly document the number of people who experience adverse events and comparison with other pain treatment options.

Professor Chris Maher, Co-Director of Sydney Musculoskeletal Health, said,

“Our review found that the clinical benefit of adding spinal cord stimulation to treat low back pain remains unknown. When coupled with the reality that these devices are very expensive and often breakdown there is clearly a problem here that should be of concern to regulators.”

A separate Cochrane review, in which the researchers were not involved, examined the effect of spinal cord stimulation versus placebo in people with chronic pain. Similar to this review, it concluded there was a lack of evidence to suggest long-term benefits in treating chronic pain.

• Read the full review in the Cochrane Library 
• Read the University of Sydney Press Release 

Tuesday, March 7, 2023

小児の機能性腹痛障害の管理のためのプロバイオティクス 小児の胃痛に対するプロバイオティクス 要点 プロバイオティクスは、プラセボ（ダミー治療）よりも機能性腹痛を持つ小児の胃の痛みを改善する効果がある可能性がある。 シンバイオティクスは、プラセボ（ダミー治療）よりも機能性腹痛を持つ小児の胃の痛みの改善する効果がある可能性がある。 機能性腹痛とは？ 機能性腹痛は、小児に多い問題である。症状に対して原因が見つからない場合に機能性腹痛という言葉が使われる。この症状は、半年以上続く頻繁な胃の痛みで、日常生活に支障をきたすものである。 プロバイオティクスとは？ プロバイオティクスとは、生きた細菌や酵母のことで、さまざまな利益があるとして推進されている。よく「善玉菌」と呼ばれるものである。これらのプロバイオティクスは、腸内細菌の自然なバランスを助け、特定の病気における症状を改善する可能性があると考えられている。また、プレバイオティクス（これらの細菌や酵母の増殖を助ける食品）と呼ばれる物質を加えることもでき、これらをまとめて一つの製剤にしたものをシンバイオティクスと呼んでいる。 何を調べようとしたのか？ プロバイオティクスやシンバイオティクスが小児の機能性腹痛の治療に使えるかどうか、また安全に使えるかどうかを調べたいと考えた。 何を行ったのか？ 機能性腹痛障害と診断された4歳から18歳の小児を対...

血管手術後の出血を抑える薬剤はあるのか ・要点 血管手術時の出血や輸血を減らすために、どの薬剤が最適なのかについては未だ不明である。 ・血管手術とは何か 血管手術とは、血管の破れや弱った部位を修復したり、詰まりを除去したりする手術のことである。本レビューでは、特に重度の出血につながりやすい血管手術に注目した。 ・血管手術中の輸血を減らすことがなぜ重要なのか 血管手術中、または手術後に大量に出血した場合、失った血液を補うために輸血が必要になることがある。輸血は害を及ぼす可能性があるため、できれば輸血を避けることが望ましい。これは、血液の供給が少ないときは特に重要である。 ・何を知りたかったのか 出血を抑えて輸血の必要性を減らすために役立つ薬物療法を知りたかった。また、そのような処置が血栓など副作用のリスクを高めるかどうかについて明らかにしたいと考えた。 ・本レビューで実施したこと 複数の電子ライブラリーを利用して、血管手術後の出血を防ぐ薬剤について、ランダム化比較試験と呼ばれる最も信頼性の高い研究を検索した。 ・わかったこと 出血量を減らすために手術前に注射された薬剤に関する研究が7件、薬剤を含んだドレッシング材（包帯材）や接着剤に関する研究が15件見つかった。このような薬剤は、手術中に出血を止めるために使用されるが、手術後も体内に残留する。血管手術中の出血や輸血を減少させるために...

小児における近視の進行を遅らせるための介入方法 要点 ・アトロピンなどの薬剤の点眼により、小児の近視の進行を遅らせたり、近視による眼球の伸長を抑制できる可能性がある。高用量のアトロピンが最も効果的であるが、低用量のアトロピンの効果については不確実である。 ・特殊なレンズを使用した眼鏡やコンタクトレンズを利用するなどの方法は、近視の進行を遅らせる可能性があるが、その効果は依然として不確実であり、また有害事象のリスクに関する情報も十分ではない。 ・また、近視の進行に対して使用される薬剤やレンズに関して、現在報告されている効果が、長年にわたって維持されるかどうかについても不明である。 近視とは何か？ 近視とは、遠くのものをはっきり見ることができないが、近くのものであればはっきり見ることができる状態のことである。近視は世界的に非常に多く見られ、中国や東南アジアにおいては半数以上の小児に見られると言われている。近視は、学習や仕事など、生活のさまざまな場面で障害をもたらす可能性がある。さらに、近視は目を伸長させるため、網膜が引き伸ばされる。そのため、将来的に、緑内障や黄斑症、あるいは網膜剥離などの眼疾患にかかるリスクが高くなる。 近視はどのように治療されるのか？ 従来の眼鏡やコンタクトレンズでも近視を矯正することはできるが、その進行を遅らせることはできない。近視の進行を遅らせることを目的とし...

妊娠糖尿病になることを防ぐために、妊娠中にミオイノシトールを栄養補助食品として摂取すること 要点 妊娠糖尿病になった女性は、妊娠中や出産時に合併症を起こしたり、その後糖尿病になったりするリスクが高くなると言われている。妊娠糖尿病の母親から生まれてくる赤ちゃんは、本来より大きくなりすぎて、出産時にけがをしてしまう可能性がある。また、子どもの頃や若いうちから、糖尿病になるリスクがある。妊娠糖尿病と診断される女性は世界中で増えており、妊娠糖尿病を防ぐための簡単で費用対効果の高い方法を見つけることが重要である。 ミオイノシトールは、穀類、とうもろこし、緑黄色野菜、肉類などに含まれる天然の糖質で、体内のインスリン感受性に関与している。 何を調べようとしたのか？ ミオイノシトールが、妊娠糖尿病を防ぐのに有効な妊婦用栄養補助食品であるかどうかを調べたかった。 何を行ったのか？ ミオイノシトール（単独投与または他の治療との併用）を無治療または他の治療と比較した試験を検索した。研究結果を比較、要約し、研究方法や研究規模などに基づいて、エビデンスに対する信頼度を評価した。 何がわかったか？ 妊娠10～24週の女性1,319人を対象とした7件の研究を確認した。 主な結果 ミオイノシトールの補給が妊娠糖尿病の発症率の低下と関連するかどうかは不明である。ただし、ミオイノシトールは、妊娠高血圧症候群の減少に...

Specifications: Permanent – Full Time
Salary: 28,000 per annum  
Location: UK – Remote/Flexible
Directorate: Finance and Corporate Services Directorate  
Closing date: 26 Feb 2023
 
Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters from more than 220 countries. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into five directorates: Evidence Production and Methods, Publishing and Technology, Development, and Finance and Corporate Services.

Your role will play an important part in ensuring that day-to-day finance is run smoothly. You will be someone who can learn new systems and processes quickly, is numerate and accurate in their work and has good attention to detail. This role sits within the Finance and Corporate Services Directorate. You will be one of four employees that make up the finance team. You will report to the Financial Accountant.

This is a work from home position, but you will have to attend meetings in London occasionally

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values: Collaboration: Underpins everting we do, locally and globally. Relevant: The right evidence at the right time in the right format. Integrity: Independent and transparent. Quality: Reviewing and improving what we do, maintaining rigour and trust.  

You can expect: 

• An opportunity to truly impact health globally  
• A flexible work environment  
• A comprehensive onboarding experiences
• An environment where people feel welcome, heard, and included, regardless of their differences

Cochrane welcomes applications from a wide range of perspectives, experiences, locations and backgrounds; diversity, equity and inclusion are key to our values.

How to apply

• For further information on the role and how to apply, please click here.
• The deadline to receive your application is 26th  Feb 2023.
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples. 
• Read our Recruitment Privacy Statement

Monday, February 13, 2023 Category: Jobs

Monday, February 13, 2023

Monday, February 13, 2023

In recognition of 2023 International Women's Day (IWD), Cochrane hosted a virtual event. The event featured a panel of accomplished women from diverse backgrounds discussing the IWD 2023 theme of #EmbraceEquity.

The panelists will shared their experiences and insights on topics such as gender equity in clinical trials, the impact of gender on health outcomes, and strategies for promoting equity in healthcare and in evidence synthesis. 

Tiffany Duque, Cochrane US Senior Officer and Panelist says, "The 2023 IWD event was run by our talented Cochrane US Mentees. This is the second cohort through the Cochrane Mentoree program. They come from 12 different countries and range from students to early career professionals; all with a shining future in Cochrane."

"We were excited to bring together this group of dynamic women to discuss issues of equity in healthcare," says Paola Andrencci, Cochrane US Mentor Program coordinator and lead on this event. "Their diverse perspectives and experiences will help us identify the barriers to equity and work towards solutions that benefit all patients. We thank everyone from the Cochrane community and beyond that joined us for this event!"

We welcome everyone to watch a recording of the event: 

Several other videos were recorded for IWD and shared on social media:

Rehab Emad Ashmawy (Cochrane US mentee, Egypt) interviews Senator Professor Randa Mostafa. Many thanks to Mohmed Gamal for his efforts and time in capturing and editing this video.

Dr. Manar Ahmed Kamal introduces herself and answers a few questions.
Many thanks to Yasmine Ayman, Rahma Sameh, and Rawan Osama for their time and effort in filming this video.

Dr Sara Nasser (Chief Executive Officer, Pan Arabian Society of Gynecologic Oncology Research) shares her work and speaks about the importance of courage.

Related resources:

• VIDEO: 2022 International Women's Day Panel on gender bias in health science and evidence synthesis
• VIDEO: 2021 International Women's Day Panel on diversity in health evidence synthesis
• Celebrating Anne Anderson and Cochrane diversity with new designs: an interview with artist Heather Tubwon
• Cochrane Indonesia’s Director reflects on her continued contributions to maternal and perinatal health and the work of Cochrane

Friday, March 10, 2023

リハビリテーションを必要とする人々に対する在宅リハビリテーションサービスの提供に影響を与える要因：質的エビデンス統合 このコクラン質的エビデンス統合の目的は、自宅で提供されるリハビリテーションサービスに影響を与える要因を探ることであった。この統合では、対面で提供されるサービスと、遠隔リハビリテーションで提供されるサービスについて検討した。この疑問に答えるため、53件の質的研究を分析した。 要点 在宅リハビリテーションは、対面または遠隔リハビリテーションによって提供され、施設でのサービスよりも身近で便利なものとして体験することができる。また、患者、サービスの提供者、家族は、在宅サービスを利用することで人間関係のあり方が変わり、実践的で資源的な意味合いがプラスにもマイナスにもなりうることを述べている。 エビデンスの統合で検討したことは何か？ COVID-19のパンデミックにより、在宅医療への注目度が高まった。在宅医療には、対面または遠隔リハビリテーションを利用して提供される在宅リハビリテーションサービスの提供が含まれる。在宅リハビリテーションサービスは、施設でのサービスの代わりに、あるいは施設でのサービスを補完するものとして、患者の回復過程における一般的な選択肢となる可能性がある。また、デジタル技術の利用が増えるにつれて、遠隔リハビリテーションも一般的になってきている。 レビューの主...

神経難病で長期肺感染症の小児への抗菌薬投与 「神経障害」とは、主に神経学的問題（脳性麻痺など）、神経筋の問題（筋ジストロフィーなど）、発達の問題（発達障害、ダウン症など）に起因する一群の状態を指す。これらの疾患を持つ小児や若年者は、移動、摂食、咳などの同様の問題を持つことがある。胸部や呼吸の問題（肺の感染症を含む）は、神経障害のある小児や若年者がよく経験し、病院での治療が必要となる原因となっていることが多い。 胸の分泌物を完全に取り除くことができない人や、頻繁に感染症を起こす人の場合、肺感染症は完全に取り除くことができず、「慢性感染症」となってしまうことがある。このような立場の小児や若年者にとって、どのような治療が最適なのかは不明である。 慢性肺感染症の小児と若年者を対象に、肺感染症の抗菌薬治療について検討したすべての臨床試験を系統的にレビューすることを目指した。2022年2月までに発表された合計1,968件の研究を、さまざまなオンラインデータベースから検討したが、本レビューに含めるべき関連性のあるものはなかった。2件の研究は進行中であったため、今回のバージョンに含めることができなかった。 この重要な問いに答える臨床試験が見つからなかったのは残念である。このような立場の小児や若年者が最善の治療を受けられるよう、今後の課題としていく。 このエビデンスがお役に立ちましたら、コクランへ...

The recently updated GOLD report includes evidence from 7 Cochrane Airways systematic reviews, helping to align it with the latest and best available evidence.  

Chronic obstructive lung disease (COPD) is usually caused by smoking or other airway irritants. COPD damages the lungs and causes airways to narrow which makes it difficult to breathe.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) works with healthcare professionals and public health officials worldwide to raise awareness of COPD and improve the prevention and treatment of this lung disease. The GOLD strategy document for diagnosing, managing, and preventing COPD and the corresponding pocket guide is developed for healthcare professionals based on the best scientific information available. This global evidence-based document is used as a tool to implement effective management programs based on local healthcare systems around the world.

"The GOLD Report is the most widely accepted and followed COPD guideline," explains Emma Jackson, Managing Editor of Cochrane Airways. "We were pleased to see that 7 Cochrane Airways systematic reviews were added to the GOLD Report 2023 recommendations for the first time; over 35 Cochrane Reviews are already referenced in the GOLD Report."

"Cochrane is a not-for-profit organization with collaborators from more than 190 countries working together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest,” says Rebecca Fortescue, Co-ordinating Editor for Cochrane Airways Editor. “Cochrane Reviews are known as the ‘gold standard’ when it comes to health evidence synthesis. We are delighted to see that 7 Cochrane Airway reviews were added in the 2023 GOLD Report to help align clinical practice with the latest and best available evidence.”

The seven reviews included in the 2023 Report for the first time are:

• Dual combination therapy versus long‐acting bronchodilators alone for chronic obstructive pulmonary disease (COPD)
• Inhaled corticosteroids for the treatment of COVID-19
• Interventions to improve adherence to pharmacological therapy for chronic obstructive pulmonary disease (COPD)
• Integrated disease management interventions for patients with chronic obstructive pulmonary disease
• Chronic non-invasive ventilation for chronic obstructive pulmonary disease
• Self-management interventions for people with chronic obstructive pulmonary disease
• Mucolytics for bronchiectasis

Lead author of the review on dual combination inhaler therapy, Yuji Oba says, “COPD is the third leading cause of death worldwide. Inhaler therapy is the mainstay treatment of COPD and the choice of inhalers is of paramount importance for patients and healthcare providers. The 2018 Cochrane review addressed which inhaler was the most efficacious and safe in the advanced form of COPD. We are proud to see the GOLD Report was updated and modified the first choice of inhaler treatment based on our Cochrane review. We are currently updating this Cochrane review and are looking forward to having our work contribute to future GOLD Reports." 

• See a list of all Cochrane reviews on COPD

Wednesday, February 8, 2023 Category: The difference we make

慢性疾患を持つ小児やティーンエイジャーの教育を支援するサービスは、彼らが学校活動にもっと参加し、学習結果を向上させるのに役立つか？ 要点 - 教育支援介入が、スクール・エンゲージメント、学習結果、（ウェルネス期間中の）生徒の学校復帰の可能性などに及ぼす影響については、まだ不明な点が多いのが現状である。 - 教育支援介入が、2件の研究で自尊心として測定されたように、精神的な健康をわずかに改善する可能性があるというエビデンスがいくつかあるが、生活の質は研究で測定されていない。 - これらの介入が有効かどうか、またベストプラクティスモデルがどのようなものかを知るためには、米国以外で行われた研究を含む、より質の高いエビデンスが必要である。 教育支援サービスとは何か、なぜ慢性疾患を持つ小児やティーンエイジャーに役立つ可能性があるのか。 一部の小児やティーンエイジャーにとって慢性疾患に罹患した場合、学校への出席、参加、取り組みに影響を与える可能性がある。そのため、仲間についていけず、自分の可能性を最大限に発揮できない可能性がある。慢性疾患を持つ小児や青少年の教育支援サービスは、病気によって学校を休んだ際に、学校や教育・学習から離脱してしまうことを防ぐことを目的としている。これらのサービスは、病院、通常の学校、地域社会で行われ、小児、家族、学校、病院、地域社会、またはこれらの組み合わせを対象と...

Title: Internal Communications Manager
Specifications: Permanent – Full Time
Salary: £52,508
Location: Ideally based in the UK, Germany or Denmark. Candidates from the rest of the world will be considered; however, Cochrane’s Central Executive Team is only able to offer consultancy contracts outside these countries (1-year fixed-term contracts)
Directorate: Development
Closing date: 20 Feb 2023
Interview date: 9 March 2023

Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters from more than 220 countries. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into five directorates: Evidence Production and Methods, Publishing and Technology, Development, and Finance and Corporate Services.

This is an exciting opportunity to build a new function from the ground up, as Cochrane’s first dedicated internal communications role. The first priority for this role will be to establish effective internal communications structures and processes for Cochrane’s~100 core staff, who are distributed across multiple countries and time zones. This includes developing an intranet and regular staff communications.

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values: Collaboration: Underpins everything we do, locally and globally. Relevant: The right evidence at the right time in the right format. Integrity: Independent and transparent. Quality: Reviewing and improving what we do, maintaining rigour and trust.

You can expect:

• An opportunity to truly impact health globally
• A flexible work environment
• A comprehensive onboarding experiences
• An environment where people feel welcome, heard, and included, regardless of their differences

Cochrane welcomes applications from a wide range of perspectives, experiences, locations and backgrounds; diversity, equity and inclusion are key to our values.

How to apply

• For further information on the role and how to apply, please click here.
• The deadline to receive your application is 20 Feb 2023.
• If you are invited for interview, this will take place on 9 March 2023 via Teams.
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples.
• Read our Recruitment Privacy Statement

Monday, February 6, 2023 Category: Jobs

Title: Future of Evidence Synthesis Administrative Support Officer
Specifications: Fixed Term – 2 Years
Location: UK – Remote/Flexible
Salary: £27,071
Directorate: Evidence Production & Methods
Closing date: 20 Feb 2023

Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters from more than 220 countries. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into five directorates: Evidence Production and Methods, Publishing and Technology, Development, and Finance and Corporate Services.

The Future of Evidence Synthesis (FES) is a critical programme of work for Cochrane over the next 3-5 years. Successful delivery is essential is Cochrane to achieve the Strategy for Change objectives and become a sustainable organisation. This role provides effective and efficient administrative support for the FES programme generally and supports the pilot phase of the Thematic Group pilot specifically.

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values: Collaboration: Underpins everything we do, locally and globally. Relevant: The right evidence at the right time in the right format. Integrity: Independent and transparent. Quality: Reviewing and improving what we do, maintaining rigour and trust.

You can expect:

• An opportunity to truly impact health globally
• A flexible work environment
• A comprehensive onboarding experiences
• An environment where people feel welcome, heard, and included, regardless of their differences

Cochrane welcomes applications from a wide range of perspectives, experiences, locations and backgrounds; diversity, equity and inclusion are key to our values.

How to apply

• For further information on the role and how to apply, please click here
• The deadline to receive your application is 20 Feb 2023.
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples.
• Read our Recruitment Privacy Statement

Monday, February 6, 2023 Category: Jobs

ビタミンDは重度の喘息発作のリスクを低減、または喘息症状の管理を改善するか？ 要点 1）このテーマに関する前回のコクランレビューとは対照的に、今回のレビューでは、ビタミンDの重度の喘息発作に対する予防効果や、喘息症状の管理に対する改善効果は明らかではなかった。 2）頻繁に重度の喘息発作を起こす患者や、平常時のビタミンD濃度が非常に低い患者について、また、25-ヒドロキシビタミンD（カルシジオール）の予防効果について、さらなる研究が必要である。 ビタミンDが喘息患者に有効であると考えられたのはなぜか？ ビタミンD（日光浴によって生合成されるため、「サンシャイン・ビタミン」とも呼ばれる）の血中濃度が低いと、経口投与によるステロイド剤の全身投与を必要とするような重度の喘息発作のリスクが上昇するとされている。 このテーマに関して、2016年に行われた前回のコクランレビューでは、ビタミンDが喘息発作のリスクを低下させることが明らかになったが、その後も議論は続いており、いくつかの研究ではビタミンDに効果がないことが報告されている。そこで、前回のレビュー以降に完了した新しい研究のデータを含む最新のメタアナリシスを実施した。 何を知りたかったのか？ ビタミンD補給の以下の項目における効果について明らかにすることを試みた： ・重度の喘息発作リスクの低減効果 ・喘息症状の管理の改善効果 ・有害作用の...