Cochrane has joined other health and social care bodies in a pledge to improve public involvement in research.

Cochrane has signed up to the Shared Commitment to Public Involvement in Health and Social Care Research. The Shared Commitment aims to bring about changes which will drive up standards in health and social care research. The statement was developed in partnership with members of the public and was launched in March 2022 during Science Week. 

Public involvement refers to all the ways in which the research community works together with people including patients, carers, advocates, service users, and members of the community.

Dr Matt Westmore, Health Research Authority Chief Executive, said: “It’s great to have Cochrane joining our Shared Commitment to Public Involvement.

This shared statement, developed with patients, research participants and leaders in health and social care research, will ensure public involvement is embedded across the health and social care research system.

The entire research system is sending the same strong message. That public involvement is always important, always expected and always possible. The evidence is that better research results from involvement, and better research delivers benefits for patients.”

Cochrane is an international, not-for-profit network of clinicians, patients and careers, researchers, and policy-makers creating high-quality healthcare evidence synthesises.

Catherine Spencer, Cochrane CEO, said: “Cochrane provides high-quality, synthesized evidence for health decisions. Involving the public ensures that our focus is meaningful and our evidence is accessible. Signing this public involvement pledge makes a clear statement; the input and involvement of patients, carers, and the public is valued by Cochrane.”

Richard Morley, Cochrane’s Consumer Engagement Officer, explains: “Cochrane has a long and rich history of collaborating with healthcare consumers. The Cochrane Consumer Network has played a formal role since 1995 with over 2,000 members and 2 Consumer Executives serving on the Cochrane Council. We have recently launched a framework that will help guide Cochrane’s work to 2027. Signing this public involvement pledge solidifies Cochrane’s commitment to ensuring that healthcare consumers are embedded and central to our work.”

Maureen Smith, Chair of the consumers Executive, said: “Cochrane consumers have a long tradition of involvement to ensure that evidence is accessible, relevant, and responds to the needs of their communities all over the world. Signing this pledge signals Cochrane’s firm commitment to advancing and supporting the incredible potential of consumers in their roles as users of evidence and producers of evidence.”

Organisations who have signed the shared commitment include:

• The Academy of Medical Sciences
• The Association of Medical Research Charities
• The Association of the British Pharmaceutical Industry
• Cancer Research UK
• Cochrane
• Health and Care Research Wales
• Health and Social Care Northern Ireland
• Health Research Authority (HRA)
• Medicines and Healthcare products Regulatory Agency
• National Coordinating Centre for Public Engagement
• National Institute for Health Research
• NIHR Applied Research Collaboration (ARC) North East and North Cumbria
• NHS Research Scotland
• Universities UK
• UK Research and Innovation

The statement, signed by leaders at each organisation, reads:

Public involvement is important, expected and possible in all types of health and social care research.

Together our organisations and members fund, support and regulate health and social care research. This statement is our joint commitment to improve the extent and quality of public involvement across the sector so that it is consistently excellent.

People have the right to be involved in all health and social care research. Excellent public involvement is an essential part of health and social care research and has been shown to improve its quality and impact. People’s lived experiences should be a key driver for health and social care research.

When we talk about public involvement, we mean all the ways in which the research community works together with people including patients, carers, advocates, service users, and members of the community.

Excellent public involvement is inclusive, values all contributions, ensures people have a meaningful say in what happens and influences outcomes, as set out in the UK Standards for Public Involvement.

Working together we will support the research community to carry out excellent public involvement. We will provide or share guidance, policies, systems, and incentives.

We will:

• listen to and learn from the people and communities we involve and apply and share that learning 
• build and share the evidence of how to involve the public and the impact this has 
• support improvements in equality, diversity, and inclusion in public involvement 
• promote the UK Standards for Public Involvement.

We will embed this commitment into the decision-making processes of our organisations.

• Learn more about Cochrane’s commitment to healthcare consumers
• Join Cochrane’s work as a patient, carer, or member of the public

Monday, December 12, 2022

Specifications: Part time 30 hours per week (0.8 FTE) - 1 year Fixed term contract
Salary:  £41,000 per annum full time equivalent
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)
Application Closing Date: 20 November 2022

Cochrane has established a centrally-resourced Editorial Service to support the efficient and timely publication of high-quality systematic reviews in the Cochrane Library. The reviews that are published through the Central Editorial Service address some of the research questions considered to be the most important to decision makers.

Reporting to the Head of Editorial, the CES Information Specialist will provide post-submission search peer review as a member of the Central Editorial Service and to coordinate the Cochrane Information Specialists' Search Peer Review Team

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. An understanding of Cochrane’s work and health research more generally is an advantage, but not essential.

The majority of Cochrane Central Executive staff are located in London, UK, however flexible locations are possible for the right candidate. Please note, however, that we are only able to offer consultancy contracts outside of the UK, Germany or Denmark.

We will consider extended notice periods if required for applicants who wish to honour existing contracts. We fully support remote and flexible working arrangements.  

How to apply

• For further information on the role and how to apply, please click here.  
• The deadline to receive your application is by 20 November 2022.  
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples. Note that we will assess applications as they are received, and therefore may fill the post before the deadline.
• Read our Recruitment Privacy Statement

Tuesday, November 1, 2022 Category: Jobs

Specifications: Permanent Part time (0.5 FTE)
Salary: £43,000 per annum full time equivalent (pro rata to part time hours)
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)
Application Closing Date:  14 November 2022

Cochrane is a charity and 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. They do this by synthesising research findings to produce the best available evidence on what works. Their work has been recognised as the international gold standard for high quality, trusted information.

The core purpose of this role is to advise and contribute to the development of Cochrane information products and deliver on key projects for the Publishing & Technology Directorate (P&T).

The majority of Cochrane Central Executive staff are located in London, UK, however flexible locations are possible for the right candidate. Please note, however, that we are only able to offer consultancy contracts outside of the UK, Germany or Denmark.

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

We will consider extended notice periods if required for applicants who wish to honour existing contracts. We fully support remote and flexible working arrangements.  

How to apply

• For further information on the role and how to apply, please click here. 
• The deadline to receive your application is by 14 November 2022.  
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples.
• Note that we will assess applications as they are received, and therefore may fill the post before the deadline.
• Read our Recruitment Privacy Statement

Tuesday, November 1, 2022 Category: Jobs

Healthcare decision making can be complex – learn from Sarah’s personal story and make use of Cochrane resources.

Evidence-based healthcare is the integration of the best research evidence with clinical expertise and patient values. It is often represented with these three elements in a Venn diagram with these three equally important elements. However, decision making in healthcare isn’t always so neat and uncomplicated.  Cochrane systematic reviews contribute to the best available, current, valid, and relevant evidence in this process. Cochrane is also committed to helping others understand evidence-based healthcare and the role of evidence.

Sarah Chapman, a former nurse with a long career in health research, had progressive hearing loss since early adulthood. Recently she was faced with a life changing decision if she would like to go ahead with an optional cochlear implant. In this video with illustrations by Karen Morley, Sarah talks us through her personal story of healthcare decision making and how evidence and other factors fit into her thinking.

 

Sarah explains, “We are messy creature full of messy emotions, living complex lives, and it's in that space that we make our healthcare decisions. Understanding evidence and learning to spot which health information is trustworthy is important to all patients and caregivers – and Cochrane has the resources that can help with this.” You can learn more about Sarah’s in her personal blog, ‘From Ear to Eternity.’

Cochrane has a long and rich history of collaborating with healthcare consumers (patients, carers, and the public). Presenting our evidence in a way that is useful for people making decisions about healthcare and advocating for evidence in health and care is an important part of our work.

Cochrane’s Evidence Essentials is a free introduction to Evidence Based Medicine, clinical trials, systematic reviews, and how to use evidence when making decisions about your health. It was co-produced with patients and caregivers and it is presented a interactive and accessible manner.

Catherine Spencer, Cochrane CEO, says “For Cochrane to achieve its vision, producing high quality reviews of health evidence isn’t enough. Cochrane aspires to a world where all health decisions are informed by high-quality evidence – which means people need to first understand evidence and how to use it. As Sarah’s story shows, making health decisions can be complex. Cochrane’s Evidence Essentials helps people understand health evidence and how to use it. We hope that anyone new to the world of evidence-based healthcare will find this resource indispensable.”

• View the free online resource ‘Cochrane Evidence Essentials’
• Get involved in Cochrane’s work as a patient or carer

Friday, January 19, 2024 Category: The difference we make

避妊用インプラントや子宮内避妊具は、産後数日以内に挿入したほうがよいのか、4～6週間待ったほうがよいのか？ この要約で「人」という言葉を使うときは、現在妊娠する能力のある個人を意味する。 要点 - 避妊用インプラントや子宮内避妊具（IUD）の挿入を4～6週間待つ（遅延挿入）よりも、出産後数日以内に挿入する（即時挿入、入院中）方が、挿入される人の数が増える。 - 挿入のタイミングは、産後6か月または12か月にこれらの避妊法を使用する人の数にほとんど差をもたらさない。 - IUDの自然排出は、即時挿入した人の方が多いようである。 - インプラントやIUDの即時挿入と遅延挿入の両方における意図しない妊娠の割合については、さらなる研究が必要である。 避妊用インプラントや子宮内避妊具とは何か？ 避妊用インプラント（訳者注：2022年12月現在、日本では未承認）と子宮内避妊器具（IUD）は、出産後すぐに使用できる可逆的で安全な、非常に有効な避妊方法である。インプラントは上腕部に、IUDは子宮に、医師や看護師が挿入する。これらの避妊法を行う人は、インプラントかIUDのどちらかを使用する。 妊娠と妊娠の間隔が適度に空いていることは、妊娠中の人と新生児の両方の健康にとって望ましい。通常、避妊のための処置は産後最初の健診（通常、産後6週間前後）で行われる。しかし、この受診前に性行為をしたり、受診しな...

Wednesday, October 26, 2022

Sometimes people avoid talking about uncertainty in scientific findings…but they shouldn't! Gain insights and practical advice on how to communicate uncertainty in this free resource.

Science is complicated and inherently uncertain – it’s hard for scientists and researchers to know how to talk with diverse audiences about this. We are excited for the launch of ‘How to communicate scientific uncertainty’ – a free resource directed at communication professionals and scientists and researchers sharing their work.

Lifeology’s tagline is ‘The place where science and art converge’. They offer a platform that brings together scientists, artists, and storytellers to help people better understand and engage with science, health information, and research. One of the main ways they meet their objectives is through beautifully illustrated, evidence-informed, bite-sized ‘flashcard’ courses about science and health-related topics aimed at the general public and students. 

“Drawing on experiences of the COVID-19 pandemic, Cochrane Convenes brought together leaders from across the world to explore and then recommend the changes needed in evidence synthesis to better prepare for and respond to future global health emergencies,” explains Cochrane's Editor in Chief, Dr Karla Soares-Weiser. “The Cochrane Convenes Report has a strong call for action for the research community to communicate scientific uncertainty better – this Lifeology course is a fantastic resource to address this.”

Author Nicole Kelp from Colorado State University says, “Uncertainty is complicated for all humans to handle, myself included! It was helpful to consider science communication from this empathic perspective while writing this course.” The Harding Centre for Risk Literacy reviewed a pre-final version. The course was reviewed multiple times by Muriah Umoquit, Senior Communications Officer at Cochrane.

This course has 43 cards illustrated beautifully by Jordan Hunter who uses the analogy of a Park Ranger helping people navigate the terrain with signage. “This project was a fun one to work on, “says Jordon. “The imagery in this course highlights the diversity of audiences and instead of text, I used symbols in speech bubbles so that the course can be easily translated.”

"Science communication thrives through collaboration among scientists, topic thought leaders, communication professionals, and creative visionaries like storytellers and artists," emphasized Muriah Umoquit, Senior Communications Officer at Cochrane and reviewer for this course. "It was great to join forces once again with Lifeology. This is the third collaboration with Lifeology, following the creation of the impactful resources ‘What is an infodemic and how can we prevent it?’ and ‘How to talk about vaccines when you’re not an expert’. We are thrilled to present our latest endeavor: a free resource on communicating scientific uncertainty. This invaluable resource is packed with practical advice and utilizes accessible language, empathetic storytelling, and relatable imagery. Join us and explore its enlightening content today!"

View the Lifeology course 'how to communicate scientific uncertainty' in:

• English
• Malay 

Learn more about Lifeology:

• Interview with Lifeology
• Lifeology website
• Lifeology on Twitter
• Lifeology on Instagram
• Lifeology on Slack

Wednesday, May 31, 2023

授乳中の母親への支援 レビューの論点 世界保健機関（WHO）は、生後6か月までは母乳のみで育て、少なくとも2歳までは母乳育児を重要な食生活の一部として継続することを推奨している。母乳育児は、乳幼児と母親の短期的・長期的な健康に良いことが分かっている。母乳で育てられた赤ちゃんは、肺や腸の感染症になりにくい。太り過ぎや糖尿病になる可能性も低くなる。また、母親は糖尿病になりにくく、乳癌や卵巣癌にもなりにくいと言われている。いくつかの問題に直面した結果、希望していたよりも早く母乳育児を止めてしまう母親は多いかもしれない。良いケアと支援は、女性が困難を乗り越え、母乳育児を続けられるように自信をつけるのに役立つかもしれない。 このレビューでは、母乳育児中の母親に対して組織的な支援を提供することが、標準的な出産ケアと比較して、母親の母乳育児の継続を助けるかどうかを検討した。助産師、看護師、医師などの医療専門家、あるいはコミュニティ・ヘルス・ワーカーやボランティアなどの訓練を受けた一般市民からの支援に関心があった。 重要性 母乳育児のためにどのような支援ができるかを知ることで、母親がどこに住んでいても、望む限り母乳育児を続けることができるよう手助けすることができる。母乳育児を早期にやめると、母親は失望し、落ち込み、長期にわたる苦痛を味わい、自分自身と乳児の健康にも問題が生じる可能性がある。支援は...

子宮内膜を傷つけることで、性交や子宮内への精子注入をするカップルの妊娠率を向上できるか レビューの論点 性交や精子を子宮に入れる方法（子宮内人工授精）で妊娠を希望している女性に対し、子宮内膜に意図的に小さな傷をつけたときの効果や痛みの程度を評価する。 背景 体外受精（IVF）を行う女性に対して、意図的に子宮内膜に軽微な傷をつけると、妊娠の可能性が高まると言われている。この損傷は、pipelleのような柔軟性のあるプラスチック製の小さな器具を使った子宮内膜の小さな生検によって作ることができ、一般的で安全な婦人科的処置である。しかし、日常の臨床現場では、この処置はある程度の不快感や痛みを伴うことが知られており、追加の内診が必要になる。体外受精を行っていない女性、例えば、性交や人工授精で妊娠を試みている女性やカップルに対する、この手法の有効性はまだわかっていない。 研究の特徴 計3,703人の女性を含む22件のランダム化比較試験が、このレビューの対象基準を満たした。ほとんどの女性は、「原因不明不妊」と呼ばれるタイプの不妊症で、通常の検査をすべて行ってもこれまでに妊娠しなかった理由が明らかに説明できなかった。レビューの主な評価項目は、生児出産と妊娠継続（12週を超えた妊娠）と、処置中に経験した痛みである。エビデンスは2020年5月21日までのものある。 主な結果 意図的に子宮内膜を傷つけ...

中枢性睡眠時無呼吸症候群がある人に対する非侵襲的換気法 検討した内容 このレビューでは、中枢性睡眠時無呼吸症候群（CSA）がある人に対する非侵襲的換気（換気を補助する人工呼吸のこと、以下、NIV）の効果を、他の治療法や異なるタイプのNIVと比較検討した。CSAとは、睡眠中に脳が筋肉に空気を取り込むように指示を出せないため、呼吸が定期的に停止する疾患である。CSAは、男性や慢性心疾患がある人に多く発症する。CSAの人は、夜中によく目が覚め、日中はとても眠くなり、普段のように運動ができなくなる。睡眠時無呼吸症候群は、心臓発作や脳卒中など、他の疾患や死亡のリスクを高める可能性もある。 NIVでは、機械を使って呼吸を助ける。NIV療法では、フェイスマスクや鼻マスクを使用して、肺に空気を送り込み、呼吸努力の必要性を軽減させる。NIV療法にはいくつかのタイプがあり、呼吸を補助する方法が異なる。以下にいくつか例をあげる。 • CPAP（Continuous Positive Airway Pressure、シーパップ）：吸気と呼気で連続的に肺に空気を送り込む。 • 二重陽圧（BiPAP、バイパップ）：吸気時に呼気時よりも多く肺に空気を送り込む。 • ASV（Adaptive Servo Ventilation）：主に呼吸が止まった時に肺に空気を送り込む。 非侵襲的な換気により、空気が肺に入りや...

変形性関節症に対する抗うつ薬 背景 変形性関節症は、軟骨が減少し、関節の間が狭くなることを特徴とする関節の病気である。その結果、痛み、変形、障害などが生じることがある。 抗うつ薬は、中枢神経系の神経経路を調節することにより、痛みに影響を与えると考えられている。 変形性膝関節症および股関節症の痛みに対する抗うつ薬の臨床的有用性と有害性を評価することを目的とした。 研究の特徴 このレビューは2021年1月現在のものである。抗うつ薬とプラセボ（ダミー治療）および非ステロイド性抗炎症薬（痛みを和らげ、炎症を抑えるために広く使用されている）を比較した2,122人の参加者による9件の臨床試験を対象とした。参加者の多くは女性（70％）で、平均年齢は54.4歳から65.9歳であった。7件の試験は変形性膝関節症のみを検討したものである。また、2件には変形性股関節症がある人も含まれていた。すべての試験で、非ステロイド性抗炎症薬の併用または非併用で、抗うつ薬とプラセボが比較された。 主な結果 プラセボと比較して、抗うつ剤はわずかな利益をもたらす結果となった。 痛み 抗うつ剤を投与した場合、プラセボと比較して0点から10点の範囲の値を示すスケールでさらに0.59点の痛みが軽減された。 - プラセボ群では、1.73点の痛みの減少がみられた。 - 抗うつ剤投与群では、2.32点の痛みの軽減がみられた。 レス...

ドライアイの治療における副腎皮質ステロイド点眼薬の有効性と有害性は何か？ ドライアイとは何か？ ドライアイとは、涙が目を十分に潤すことができないときに起こる、よく見られる症状である。さまざまな理由により、涙の量が不十分になったり不安定になったりする。例えば、涙の分泌量が減少したり、涙の質が悪くなったりする場合に、ドライアイになることがある。涙の量が不安定になることで、目の表面に炎症が起きたり、傷がついたりする。ドライアイの症状は不快であり、しばしばチクチクする、あるいは焼け付くような痛みを感じたり、時には視界がぼやけることもある。 ドライアイの治療方法は？ ドライアイには、多くの治療法がある。涙の水層が相対的に不足しているために起こるドライアイに対しては、人工涙液、分泌刺激薬、血清点眼、涙点プラグ（涙の出口に栓をする）などの治療法がある。涙の油層の分泌が阻害されたドライアイに対する治療法としては、抗菌薬、温湿布、あるいは副腎皮質ホルモンやシクロスポリンAなどの抗炎症薬を使用する方法がある。副腎皮質ステロイドの点眼薬は、炎症を抑え、短期間に症状を緩和することを目的に使用されるが、長期的な使用により、眼圧の上昇あるいは白内障が発生することが懸念されている。 何を調査したのか？ 副腎皮質ステロイド点眼薬が、単独使用、または他の薬との併用により、ドライアイの症状や、ドライアイの診断あるい...

Cochrane's framework to 2027 builds on existing work leading to consumer involvement throughout the entire process of research and dissemination of Cochrane evidence. 

Healthcare consumers (patients, carers, and the public) play a vital role in making sure that Cochrane evidence addresses important questions and is produced, presented, and made available in a way that’s useful for people making difficult decisions about healthcare. 

Our consumer volunteers are a vital part of our evidence community, and we thank them for contributing their time, skills and lived experience to the organisation. 

Cochrane supports consumer involvement and engagement in health research because it promotes transparency, accountability, and trust in the way that research is produced; results in evidence that addresses consumers’ needs; reduces waste in research; improves the translation of research into policy and practice;  leads to improved benefits for health systems and better outcomes for patients; is consistent with current health research approaches; and is expected or mandated by our funders, partners, and consumers themselves.

Cochrane's framework for consumer engagement and involvement to 2027 is a result of significant involvement of stakeholders: a task group, consultations, surveys, prioritisation exercises, and drawing on central strategies and previous work with consumers.

We would like to thank all those people who contributed to creating this ambitious vision and we look forward to the work ahead to make this a reality. 

Richard Morley, Cochrane’s Consumer Engagement Officer, explains; “Cochrane has a long and rich history of collaborating with healthcare consumers. The Cochrane Consumer Network has played a formal role since 1995 with over 2,000 members and 2 Consumer Executives serving on the Cochrane Council. This framework will help guide Cochrane’s work to 2027; upscaling our existing efforts and ensure consumers are embedded and central to our work.”

The framework has five elements:

1. Engagement - a programme of communication about health research, evidence dissemination, recruitment and learning that helps more people use evidence in health decision making.
2. Co-production - increase the number of reviews prioritised and that involve consumers in the evidence production process to ensure that reviews are aligned with users’ needs and support consumer involvement in the governance of Cochrane.
3. Accessibility - a programme to improve health literacy amongst healthcare consumers that covers understanding evidence, health research, critical appraisal, and shared decision making, whilst working to make Cochrane evidence more accessible.
4. Partnership - establish a range of international strategic partnerships, including patient groups, to develop engagement, co-production, advocacy and health literacy activities leading to the dissemination of Cochrane evidence and improved engagement and involvement.
5. Evaluation and reporting - establish an observatory in order to ensure Cochrane’s work in engagement and involvement is evidence based, and to monitor and evaluate the impact of its work.

“Cochrane’s importance in the world of evidence-based medicine, its increasingly global reach, and growing membership, create an opportunity to significantly develop its work to engage with an international patient and public audience,” says Catherine Spencer, Cochrane CEO. “This framework ensures that patients, carers and the public are at the heart of what Cochrane does.” 

Chris Champion, Cochrane's Engagement, Learning and Support, explains how the framework fits in to Cochrane's engagement strategy and how you can get involved. 

Maureen Smith, Chair of the Cochrane Consumer Network Executive, explains how the framework fits into Cochrane's engagement strategy and is relevant to patients, carers, and the public.

• Read and download ‘Cochrane consumer engagement and involvement framework to 2027’
• Visit the Cochrane Consumer Network Website
• Get involved with Cochrane as a patient or carer

Friday, March 10, 2023

Monday, October 17, 2022

炎症の検査は、医師が呼吸器感染症に抗生物質を使うかどうかの判断に役立つのか？ 要点 1.呼吸器感染症の症状で受診した患者に対して、診察時に医師がC反応性蛋白（CRP）の迅速検査（ポイントオブケア検査）を行うと、患者の回復に影響を与えることなく、抗生物質の処方をする患者の数をおそらく減らすことができる。 2.プロカルシトニンのポイントオブケア検査が、抗生物質の使用や患者の回復に影響を与えるかどうかはわからない。 3.今後は、小児、免疫系の疾患を持つ人、併存疾患（現在かかっている別の疾患）を持つ80歳以上の人に焦点を当てた研究を行う必要がある。抗生物質処方の指針となる、プロカルシトニンや新しいバイオマーカーを評価する研究が推奨される。 ポイントオブケア検査とは何か？ ポイントオブケア検査では、診察時に数滴の血液を採取するだけで、3～20分以内に結果が出る。そのため、採血した血液を検査室に運ぶ必要がなく、診察の際に結果をすぐに治療法の選択に役立てることができる。炎症に反応して体内で作られる血液中のさまざまな物質を検出することができるポイントオブケア検査がある。このような物質をバイオマーカーと呼ぶ。 炎症とバイオマーカーとは何か？ 炎症とは、細菌やウイルス感染などの傷害に対する反応である。体は、炎症に反応して自然に物質を作り出すが、それは血液中で検出され、バイオマーカーと呼ばれている。バ...

乗り物酔いの予防および治療のための抗ヒスタミン薬 本レビューの目的は何か？ 乗り物酔いは、船酔い、車酔いなどとも呼ばれ、一連の症状（通常は吐き気と嘔吐）を伴う。これらの症状は、現実の動き（例えば、車の運転や船に乗っているとき）、または仮想の動き（例えば、仮想現実シミュレーション）や動く視覚環境（例えば、動いている電車の窓から外を見ているとき）にさらされたときの動きの錯覚に反応して、無意識的に体が動くことによって引き起こされる。抗ヒスタミン薬は、乗り物酔いの予防または治療のために一般的に用いられてきた薬の一つである。この研究の目的は、抗ヒスタミン薬が乗り物酔いに有効であるかどうかを調査することである。 要点 乗り物酔いを起こしやすい成人において、抗ヒスタミン薬は、プラセボ（偽の薬）と比較して、自然に発生する動きのある状況下（船や飛行機など）で、乗り物酔いを起こすリスクを低減する可能性があることがわかった。また、プラセボと比較した場合、抗ヒスタミン薬は眠気を起こしやすいことがわかった。なお、既に起こってしまった乗り物酔いの治療に抗ヒスタミン薬が有効かどうかを調査した研究はなく、18歳未満の小児等に対する影響についてはほとんど情報がなかった。その他、調査を行ったすべての知見について、他の薬を使用した場合や薬を使用しない処置を行った場合と比較した抗ヒスタミン薬の真の効果、他の副作用の有無...

変形性股関節症または変形性膝関節症に対する運動療法と並行して行う追加の治療 本レビューの目的 変形性関節症は、股関節や膝関節によくみられる慢性の変性疾患であり、痛みを生じ、歩行などの日常生活に支障をきたす。陸上での運動療法とは、水中ではなく陸上で行われる運動療法のことで、治療の第一選択とされる。このレビューの目的は、陸上での運動療法に別の治療を追加することによって、変形性股関節症または膝関節症を抱える人の痛みや身体機能、生活の質（QOL）、患者自身が思う全体的な変化、レントゲン上の所見が改善するかどうかを明らかにすることにある。追加の治療には、徒手療法（身体の上に軽く手をあてるもの）、心理療法、食事療法、物理療法（患部を温めたり、冷やしたり、神経を刺激したり、超音波やレーザーをあてるものなど）や鍼治療などがある。陸上での運動療法に別の治療を追加した場合と、1）陸上での運動療法に偽の治療を加えた場合を比べた研究、もしくは 2）陸上での運動療法のみを比べた研究をレビューの対象とした。 検索日 このシステマティックレビューは2021年6月10日現在のものである。 わかったこと ランダム化比較試験 62件（24か国、6,508人の参加者、ほとんどが女性）が見つかった。平均年齢は52～83歳、症状の継続期間は9か月から12年であった。変形性膝関節症の人を対象とした研究が59件、変形性股関節...

Thursday, October 13, 2022

The World Health Organization (WHO) is currently running two consultations which will shape the future of global clinical trials policy. We encourage the Cochrane Community to participate. 

The surveys are being carried out following the passing of a resolution on ‘strengthening clinical trials to provide high-quality evidence on health interventions and to improve research quality and coordination’ at the World Health Assembly in May 2022.

Cochrane is submitting responses to both consultations at the central level. We also encourage members of our community who work with clinical trial data to also take part and share their perspectives.

Consultation 1: World Health Assembly Resolution on strengthening clinical trials

This survey requests input on implementation of the clinical trials resolution on a wide range of issues related to trials including data sharing, ensuring more representative trial populations, and planning and conducting trials in emergency circumstances. This is an opportunity to share examples of best practice and recommendations for improvement. The questions are available in PDF form here to help with preparing responses.

Consultation 2: WHO International Clinical Trials Registry Platform – draft guidance on reporting results in trial registries

This survey is a key opportunity to ensure that the reporting of results in clinical trial registries are fit for purpose. It concerns recommendations on the minimum elements of studies which should be reported. The questions are also available in PDF form here to help with prepare responses.

Both consultations close on 11 November 2022 – please consider participating.

If you are interested in finding out more about and contributing to Cochrane’s advocacy in this area, please write to Emma Thompson, Cochrane’s Advocacy and Partnerships Lead.

Wednesday, October 12, 2022

Cochrane appointments of two new governing board members, Professor Gillian Leng and Professor Wendy Levinson and says farewell to two retiring Trustees, Rae Lamb and Marguerite Koster.

Cochrane is an international non-profit network, which sets the gold standard for synthesizing health research findings  to facilitate evidence-based health care.  Cochrane Reviews, found in the Cochrane Library, are up-to-date, follow a rigorous scientific methodology, and are free from commercial conflicts of interest. Health professionals, patients, and policy makers trust Cochrane Reviews for their healthcare decision-making. Cochrane works with researchers, health professionals, patients, policy makers, and media representatives from around the world to make Cochrane Reviews relevant and usable.

Cochrane's Governing Board is responsible for setting Cochrane's strategic direction and overseeing the work of the Chief Executive Officer, Editor in Chief, and Central Executive Team. Tracey Howe has recently been appointed for a second term as Co-Chair of the Cochrane Governing Board.  Along with Co-Chair, Catherine Marshall, Tracey Howe,  announced the appointment of two new governing board members, Professor Gillian Leng and Prof essor Wendy Levinson and farewell to two retiring Trustees, Rae Lamb and Marguerite Koster.

Gillian Leng, former Chief Executive of the National Institute for Health and Care Excellence (NICE), and current trustee of the Guidelines International Network, has over 30 years’ experience of working within the national and international worlds of guideline development and associated evidence and research functions. Her knowledge and understanding of the development and use of evidence based health advice, in the Uk and internationally, will be valuable as the Cochrane Board continues its work developing a secure and strong role for the future.

Gill Leng said, "Cochrane is hugely important for international healthcare and plays a vital function in ensuring effective, robust evidence is available at a global level. As the trend for ‘living guidelines’ increases, the role of Cochrane as an evidence provider will become ever more essential, bringing alignment where appropriate with the needs for guideline developers. I have been a strong ‘Evidence advocate’ since I was a junior doctor, I contributed as a Cochrane Editor for many years, and I welcome the opportunity to help shape the future of Cochrane."

Wendy Levinson, is a Professor of Medicine at University of Toronto, currently Chair of Choosing Wisely Canada. She has a wide range of experience from her volunteer roles as Chair or President of the boards of the American Board of Internal Medicine, the Society of General Internal Medicine, the Professors of Medicine, and the Canadian Association of Professors of Medicine and full-time positions including serving as the Chair of Medicine at the University of Toronto  and the Division head of General Internal Medicine and Geriatrics at the University of Chicago. 

Wendy Levinson said of her appointment, "I admire the work of Cochrane and use the reviews frequently. Cochrane is undergoing major changes and I look forward to using my skills in leadership of large organizations, strategic planning, and fundraising to help support Cochrane’s future. Furthermore, my international network through Choosing Wisely may also serve to support Cochrane and build a useful collaboration, especially as we continue our important work identifying low value health care."

Catherine Spencer, Cochrane CEO said, ‘Wendy and Gill both bring an inspiring range of professional experience, which we welcome to help us navigate a new future for Cochrane. Both new Trustees also bring links with organisations Cochrane has partnered with and that rely on Cochrane Evidence for their work – the Guidelines International Network and Choosing Wisely.

We would also like to warmly thank leaving Trustees, Rae Lamb and Marguerite Koster for their service to and support for Cochrane.

Rae Lamb, is the Chief Executive of Te Pou in NZ, a national centre for workforce and leadership development for the mental health workforce in New Zealand, specialising in the development of evidence-based mental health resources and Deputy Chair of the NZ Quality and Safety Commission.  Ms Lamb initially trained as a reporter and broadcaster, then undertook a Harkness Fellowship in Health Policy at the Harvard School of Public Health and Institute for Healthcare Improvements in the United States. Rae has also served as a former New Zealand Deputy Health and Disability Commissioner and Australian Aged Care Complaints Commissioner.

Catherine Marshall, Co-Chair, said "Rae brought a wealth of experience in governance, organisational leadership, change management, complaint resolution and working with diverse stakeholder groups nationally and internationally. Rae understands the importance of evidence-based health care and decision making, and her professional, ethical approach has made a significant contribution to the governing board. We thank her for her work on our Complaints Policy and with the Complaints Committee and as a member of the Governance Committee."

Rae Lamb said “Cochrane and the work of its community is more important than ever in this late pandemic world where misinformation is rife. I am humbled to have had the opportunity to be part of Cochrane. I strongly believe there are exciting opportunities and times ahead for the organistion, its work and its people.”

Marguerite Koster,  Director of Evidence-Based Medicine at Kaiser Permanente Southern California, one of the largest not-for-profit health plans in the U.S., serving 12.2 million members. She oversees the efforts of the Southern California Permanente Medical Group’s Evidence-Based Medicine Services Unit within Kaiser Permanente’s Southern California Region, which provides medical care to more than 4.5 million members.   Marguerite will continue to serve Cochrane as a member of the Future of Evidence Synthesis Oversight Committee.

Tracey Howe, Co-Chair Governing Board, said "Marguerite was appointed to the Cochrane’s Governing Board in 2016 as one of its first externally appointed members. Marguerite has played an invaluable role as a Co-Chair of the Governing Board, Treasurer, Chair of the Finance, Audit & Investment Subcommittee, a member of the Remuneration and Governance Subcommittees, and the Cochrane/Guidelines International Network Partnership Advisory Group. Cochrane has benefited from Marguerite’s valuable experience in using Cochrane evidence to develop clinical practice guideline development, and inform health technology assessment, knowledge translation and evidence-based implementation."

Marguerite Koster said,  “Cochrane’s systematic reviews have been invaluable in informing evidence-based health care decisions within Kaiser Permanente. It has been my pleasure to serve on the Governing Board, especially to emphasize the vital role of the Cochrane Library in influencing health care policy and practice within a large health delivery system.”

• Learn more about Cochrane's governance and management

Wednesday, October 12, 2022