Specifications: Part time 22.5 hours (Permanent/Consultancy role considered)
Salary: £45,000 per annum full time equivalent
Location: Flexible
Application Closing Date:  27 June 2022

The Evidence Production and Methods Directorate in Cochrane is made up of three departments that are responsible for the efficient and timely publication of high-quality systematic reviews in the Cochrane Library. One of the three departments is the Methods and Evidence Synthesis Development team.

The Methods Support Unit (MSU) sits in the Methods and Evidence Synthesis Development team. The MSU provides hands on statistical and methods support to people preparing Cochrane systematic reviews. As Statistical Editor, you will provide advanced methods support and advice as requested by the Methods Support Unit Manager, from members of the Cochrane community directly or via  the Community Support Team as needed. The post holder will also provide independent methods review of high-profile reviews, including those intended for press release. In addition to this you will support the implementation of established and more complex methods in Cochrane reviews and work on monitoring the quality of statistical methods and analysis in Cochrane reviews to inform priorities for training and guidance. The role will require a formal qualification in epidemiology or biomedical statistics, and a good understanding of methods used in meta-analysis.

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 location or a part-time appointment are possible for the right candidate.

How to apply

• For further information on the role and how to apply, please click here. 
• The deadline to receive your application is by 27 June 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.
• Interviews to be held on: w/c 11 July 2022
• Read our Recruitment Privacy Statement 

Tuesday, June 14, 2022 Category: Jobs

Specifications: Permanent
Salary: £52,000 per annum
Location: UK
Application Closing Date:  27 June 2022

The Evidence Production and Methods Directorate in Cochrane is made up of three departments that are responsible for the efficient and timely publication of high-quality systematic reviews in the Cochrane Library. One of the three departments is the Methods and Evidence Synthesis Development team.

The Methods Support Unit (MSU) sits in the Methods and Evidence Synthesis Development team. The MSU provides hands on statistical and methods support to people preparing Cochrane systematic reviews. As lead for the Methods Support Unit, you will be responsible for ensuring that people preparing reviews for publication in the Cochrane Library have access to current advice about the implementation of systematic review methods, including searching, statistical analysis, and bias assessment. The team comprises a Systematic Review Methodology Editor, a Statistical Editor and an Information Specialist. Additional budget will be made available to fund additional methods expertise as may be required.

The Methods Support Unit Manager will be responsible for ensuring that methodological and statistical queries from the Evidence Synthesis Development Editors, Editorial Service or Cochrane Support Team are addressed. The role will require a formal qualification related to systematic review methods.

How to apply

• For further information on the role and how to apply, please click here. 
• The deadline to receive your application is by 27 June 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, June 14, 2022 Category: Jobs

Monday, June 13, 2022

Cochrane is made up of 11,000 members and over 67,000 supporters come from more than 130 countries, worldwide. Our volunteers and contributors are researchers, health professionals, patients, carers, people passionate about improving health outcomes for everyone, everywhere.

Getting involved in Cochrane’s work means becoming part of a global community. The Cochrane International Mobility programme connects successful applicants with a placement in a host Cochrane Group, learning more about the production, use, and knowledge translation of Cochrane reviews. The programme offers opportunities for learning and training not only for participants but also for host staff.

In this series, we profile those that have participated in the Cochrane International Mobility Program and learn more about their experiences.

Name: Filip Wikström
Location: Lund, Cochrane Sweden
CIM location: Barcelona, Cochrane Iberoamerica

How did you first learn about Cochrane?
The Cochrane Learning Modules are integrated into the Medicine Programme in Lund University, so I was gradually exposed to the Cochrane Methodology over several semesters. I think reading and assessing past research is an invaluable skill to have, so I was very glad to get the opportunity to do my Master’s Thesis with Cochrane.

What was your experience with Cochrane International Mobility?
My experience with the international mobility program was fantastic. The researchers at Cochrane Iberoamerica were very welcoming and I look back very fondly to the weeks I spent there. I learned a lot about systematic reviews but I also got to know amazing researchers and the projects they were working on.

What are you doing now in relation to your Cochrane International Mobility experience?
Currently I am contributing to a Cochrane Review on Tumor Necrosis Factor alpha inhibitors, under the supervision of Michele Compagno and Matteo Bruschettini (both based at Lund University). In the future I aspire to collaborate on more Cochrane projects.

Do you have any words of advice to anyone considering a Cochrane International Mobility experience?
Based on my own experience, I would advise anyone who likes systematic reviews to consider the program. It is a great opportunity to meet passionate researchers and work in an international environment. I got new perspectives on Cochrane methodology but also experiences that I think are important on a personal level.

 

 

Monday, June 20, 2022

Cochrane is made up of 11,000 members and over 67,000 supporters come from more than 130 countries, worldwide. Our volunteers and contributors are researchers, health professionals, patients, carers, people passionate about improving health outcomes for everyone, everywhere.

Getting involved in Cochrane’s work means becoming part of a global community. The Cochrane International Mobility programme connects successful applicants with a placement in a host Cochrane Group, learning more about the production, use, and knowledge translation of Cochrane reviews. The prgramme offers opportunities for learning and training not only for participants but also for host staff.

In this series, we profile those that have participated in the Cochrane International Mobility Program and learn more about their experiences.

Name: Agata Stróżyk
Location: Warsaw, Poland
CIM location: Lund, Cochrane Sweden

How did you first learn about Cochrane?
I first got a chance to better know what systematic reviews are and what the role of Cochrane is when I was participating in the Evidence-Based Medicine faculty at my university. Systematic reviews are critical in summarizing clinical evidence and Cochrane is the most methodologically rigorous at doing it! In Poland, we call the Cochrane Handbook our Bible for systematic reviews.

What was your experience with your virtual Cochrane International Mobility?
To be a part of a Cochrane systematic review was definitely on my to-do list. I was looking for any opportunity to be involved in Cochrane for about two years. I was a supporter at Cochrane TaskExchange and Cochrane Crowd. Finally, I contacted Matteo at Cochrane Sweden, who involved me in a systematic review that was already ongoing. Thus, I didn’t have to go through all process, but from the beginning of my traineeship, I had to do specific tasks. Matteo and Giovanni Cagnotto (also based at Lund University) were my supervisors and are very friendly, kind, patient, and supportive at each step, but also very motivating and fast-working – that was a great experience!

What are you doing now in relation to your Cochrane International Mobility experience?
At the moment, we hope to complete our systematic review, “Tumor necrosis factor (TNF) inhibitors for the treatment of psoriatic arthritis”, in a couple of weeks. For sure, I will use what I’ve learned to do methodologically better systematic reviews in the future. Moreover, I will still look for other opportunities to be a part of the Cochrane community, and maybe one day to prepare a new Cochrane systematic review within my area of expertise.

Do you have any words of advice to anyone considering a Cochrane International Mobility experience?
If you are interested in systematic reviews, I think it is a highly desirable step to participate in any kind of traineeship supervised by Cochrane. For any medical practitioners and researchers who would like to better understand the critical appraisal of evidence and its translation into practice, I think it’s a great option too. My personal advice: do not give up, if you do not get any response for the first time! Be persistent in chasing your dreams

 

Monday, June 13, 2022

全身投与のヤヌスキナーゼ阻害剤は、COVID-19の患者にとって有効な治療法か？ 要点 入院患者におけるコロナウイルス感染症2019（COVID-19）に対して、全身投与のヤヌスキナーゼ（JAK）阻害剤は、死亡数が少なく、臨床的な悪化率が低いことから、有効な治療であると結論づける6件の研究を特定した。それらのエビデンスの確実性は中等度から高度であった。全身投与のJAK阻害剤の評価は13件の試験で進行中であり、さらに9件の試験では結果の公開待ちの状態である。それらの結果が利用可能になったときに、このレビューを更新して結論を変更する可能性がある。 JAK阻害剤とは何か？ JAK阻害剤は、時に問題となる免疫システムの特定の部分の活動を阻害する薬である。これらは経口投与（全身投与）され、通常、免疫系が身体そのものを攻撃する自己免疫疾患を患っている人が服用する。JAK阻害剤は吸入での投与も可能であるが、今回は対象としていないため、レビュー全体を通して「全身投与のJAK阻害剤」と表記した。 JAK阻害剤はCOVID-19をどのように治療するのか？ COVID-19では、時に免疫系が過剰に反応し、重篤な経過をたどることがある。JAK阻害剤は、免疫系の一部を阻害することで、臨床的な悪化を防ぐことができる。 何を知りたかったのか？ COVID-19の患者に対して、通常のケアに加えて全身投与のJAK...

喘息がある人が処方通りに薬を服用するのに役立つデジタル技術 臨床疑問の背景 喘息は、世界中で最も一般的な長期疾患の一つである。症状を抑えるために、ステロイドを含んだ吸入薬など有効な薬がある。しかし、最良の効果を得るために、維持療法では処方箋通りに薬を服用する必要がある。多忙なスケジュールや、薬は短期間しか必要ないという考えから、薬を飲まない人が多くいる。これはノンアドヒアランス（不遵守）と呼ばれ、より多くの症状や発作を引き起こす可能性がある。ノンアドヒアランス（不遵守）は健康上の大きな問題であり、アドヒアランスを達成することは、発作の予防や死亡リスクの低減のために非常に重要である。ヘルスケア分野では、携帯電話やテキストメッセージ（SMSやメール）、服薬に関する情報をフィードバック（軌道修正を促すこと）できる「スマート（システムが内蔵された）」吸入器など、デジタル介入の利用が増加している。しかし、これらの技術が喘息の服薬改善や症状改善に有効であるかどうかについては、限られたエビデンスしかない。 このレビューでは、デジタル技術が本当に喘息の服薬改善に効果があるのか、また、この服薬改善の効果が喘息症状の改善やその他のメリット（利益）につながるのかを明らかにすることを目的とした。 研究の特徴 検索の結果、喘息を抱えた15,000人以上の大人と子どもを含む40件の研究が見つかった。研究期間...

成人のがん疼痛治療薬オキシコドン 背景 がん患者の多くは、オピオイドに分類される強力な鎮痛薬による治療を必要とする中等度から重度の痛みを経験する。 オキシコドンおよびモルヒネは、このオピオイド系鎮痛薬であり、がん疼痛（がんによる痛み）を和らげるために使用される。しかし、強力な鎮痛薬がすべての人の痛みに必ず効くわけではなく、またそのような薬は誰に対しても忍容性（薬に耐えられること）が良好というわけではない。本レビューでは、成人のがん疼痛に対して、オキシコドンが他の強力な鎮痛薬よりも痛みの緩和に優れており、副作用が少ないと考えられるかどうかを評価することを目的とした。 研究の特性 この更新版では、2021年11月の時点で追加の研究19件が見つかった。合計では、研究42件、参加者4,485人をレビューの対象とした。いずれの研究も、鎮痛作用（有益性）と副作用（有害性）について、さまざまな種類のオキシコドンを相互比較するか、オキシコドンを他の強力な鎮痛薬と比較していた。 主な結果 全体として、レビューの対象とした研究では、4～6時間ごと（即放性）または12時間ごと（徐放性）に服用したオキシコドン製剤の間に差は認められなかった。同じく全体として、対象とした研究では、モルヒネなど他の強力な鎮痛薬とオキシコドンの間に差は認められなかった。 各研究で検討された強力な鎮痛薬のいずれにも、嘔吐、便秘、...

New Review published: Digital technologies to help people with asthma take their medication as prescribed

Asthma is one of the most common long-term conditions worldwide. There are effective medicines available to treat symptoms, such as inhalers containing steroids. However, for best effect, maintenance medication need to be taken as prescribed. Many people do not take their medication, due to busy schedules and the belief that medication is only needed short-term. This is known as 'non-adherence', which can lead to more symptoms and attacks. Non-adherence is a major health problem; achieving adherence is very important to prevent attacks and reduce the risk of death. In healthcare there is increasing use of digital interventions such as mobile phones, text messages, and 'smart' inhalers that can feed back information about medication-taking. However, there is limited evidence on whether these technologies work to improve asthma medication-taking or improve symptoms.

This review aimed to find out whether digital technologies really work to improve asthma medication-taking, and whether this improved adherence leads to improvements in asthma symptoms and other benefits.

Study characteristics

We found 40 studies including more than 15,000 adults and children with asthma. Studies ranged from about 2 weeks to 24 months' duration, so we cannot say whether these methods are effective in the long term (a long period of years). We searched multiple information sources to identify relevant studies. This review is current as of June 2020. Looking at the data, we aimed to find out whether digital technologies helped people with asthma to take their medication as prescribed, and whether people who used the technology had better asthma control, and fewer asthma attacks, than those who did not use the technology.

Key results

People with asthma who were given the digital technology to support asthma medication-taking were better at taking their medication as prescribed compared to people who did not get the technology; 15% more people (likely to be somewhere between 8% and 22%) took their medication as prescribed when they received the digital technology, compared to those who did not (who took their medication on average 45% of the amount prescribed).

Importantly, people who got the digital technology had much better asthma control and half the risk of asthma attacks (likely somewhere between 32% and 91%), which has direct benefits for reducing the risk of asthma-related deaths. We saw improvements in quality of life and lung function, but the effect on lung function was small and may be of limited clinical relevance.

No improvements were seen in unscheduled healthcare visits. There was not enough information to tell us about the effect of digital technologies on time off work or school or the cost-benefits, nor whether there are any harms. Technologies were generally acceptable to patients. Certain types of technologies such as 'smart' inhalers and text messages seemed to be better for improving medication-taking than other technology types, although the small number of studies means we cannot be certain that these technologies definitely work better than others.

Quality of the information

There is some uncertainty about our results because the studies were quite different from each other. These differences mean that we cannot be completely sure what the real benefit is, as the benefits may be due to other factors not directly related to the technology - for example, being involved in a study can improve medication-taking. Sometimes the studies did not give us enough information for us to include them with the other studies to work out their effectiveness. We had concerns about a quarter of the studies where people did not finish the study, and we were uncertain whether studies reported everything they measured.

Practising GPs and authors on this Cochrane review Anna De Simoni and Chris Griffiths discuss using apps and digital tools with patients with asthma, they explain,

"The evidence in this review gives us more confidence to discuss their use. From this review we know electronic adherence monitors and text messages can help patients make more informed choices."

Key message

The studies we found suggest that digital technologies may help people with asthma take their medication better, improve their asthma control, and potentially halve their risk of asthma attacks, compared with people who did not get the technology. Certain types of digital technologies, such as text-message interventions, may work better than others. However, we have some uncertainties about the quality of the information reported in some studies, and the small number of studies for the different technology types, which means we cannot be 100% certain of their benefits.

Author Amy Chan explains,

 “Digital technologies that aim to improve medication taking can increase people taking their medication in way it has been prescribed by 15%, and improve asthma control and quality of life. Technologies that use text messages or electronic adherence monitors appear to be particularly effective for improving people taking their medication as prescribed.”

• Read the full review
• Visit the Cochrane Airways website

Monday, June 13, 2022

Tuesday, June 7, 2022

Monday, June 6, 2022

パーキンソン病における転倒予防のための介入 レビューの論点 本レビューでは、パーキンソン病（PD）患者の転倒を減らすために設計された介入の効果に関するエビデンスを評価した。介入方法は、運動、薬物療法、転倒予防教育、運動と教育を組み合わせたものであった。意識消失（めまいや失神など）による転倒を減らすことを目的とした介入は除外した。本レビューのエビデンスは、2020年7月16日現在のものである。 背景 パーキンソン病（PD）の患者において、頻繁に起こる転倒の出現は最も深刻な病気の進行過程の一つである。効果的な転倒予防策に関する情報は、転倒予防のための介入の実施に役立てることができる。 研究の特性 3,370人の参加者を含む32件の無作為比較試験を対象とした。このうち、2,700人の参加者を含む25件の試験は運動による介入試験であった。242人の参加者を含む3件の研究は、薬物療法による試験であった。53人が参加した1件の試験は、教育による試験であった。375人が参加した3件の研究は、運動と教育を併用した試験であった。全体として、運動単独および運動と教育を併用した研究は、軽度から中等度のPDの人々を対象としていた。 主な結果 12件の研究では、運動と転倒を減少するとは考えられない対照となる介入を比較していた。運動は、おそらく転倒の数を約26％減らすことができる。運動は、おそらく1回以上の...

COVID-19パンデミックを抑制するための学校での対策の予期せぬ結果 なぜこの論点が重要なのか？ COVID-19の原因となる感染力の強い呼吸器系ウイルスSARS-CoV-2の蔓延を防止・抑制するため、世界各国では多くの公衆衛生および社会的な対策がとられている。学校や地域社会では、SARS-CoV-2の感染を最小限に抑えるため、さまざまな対策が実施されている。学校は、近接した人々の間で長時間の交流が行われるため、ウイルスの感染率が高い環境となる可能性がある。前回のレビューでは、SARS-CoV-2感染に関する学校での対策の有効性に関する研究を探し出し、検討した。政策立案者や保護者が十分な情報を得た上で決断できるように、健康や社会に及ぼす予期せぬ影響に目を向けることも同様に重要である。公衆衛生対策の予期せぬ影響は、有益な場合もあれば有害な場合もある（あるいはその両方が混在する場合もある）。公衆衛生対策は益と害を混在させる可能性がある。本レビューでは、学校におけるSARS-CoV-2の感染拡大を防止・抑制するための対策が予期せぬ影響をもたらしたかどうかを検証することを計画した。そのため、本レビューは、そうした対策の有効性に関する前回のレビューを補完するものであると考えられる。 本レビューで行ったことは何か？ 最初に、学校（小学校、中学校、またはその両方）で実施されているウイルス感染...

2022 marks the 5 year anniversary of  Cochrane Sweden. The center was established on the 17th of May 2017, in the city of Lund. For this milestone, Cochrane Sweden shares some of their many highlights. 

Over the past five years, Cochrane Sweden has been busy promoting evidence-based decision-making in healthcare in Sweden. Some accomplishments have been providing learning tools on how to conduct, edit and read systematic reviews. Cochrane Sweden launched Cochrane Interactive Learning as part of the curriculum for medical students at Lund University to support training in evidence-based health care. Cochrane Sweden is also the first Cochrane group to get unlimited access to Cochrane Interactive Learning. This has led to Sweden having the highest number of users per inhabitant in the world. Moreover, the strategic and fruitful collaboration with Lund University has provided unlimited access to Covidence and, in the coming days, to RevMan Web.

Each year Cochrane Sweden also provides many workshops, courses, and lectures about Cochrane, systematic reviews, evidence-based medicine, and more specialized topics, such as reviews of non-randomized studies, diagnostic test accuracy reviews and complex meta-analyses. We have trained hundreds of PhD students in the Cochrane methodology, and some of them have become Cochrane authors. Eleven master medical students have prepared their master theses at our centre. In 2017, Cochrane Sweden launched the Cochrane International Mobility program. Since then, more than 20 people have participated in this international exchange program to learn more about evidence-based medicine through collaborations between Cochrane Sweden and other Cochrane centers. You can read some examples of the researchers experience with the program here. We are much grateful to all members of our Advisory Board, which includes Swedish health professionals and Cochrane staff from six different groups, for their generous and qualified guidance.

For the past five years, Cochrane Sweden has been busy producing new research. So far, researchers affiliated to our center have completed 22 new or updated Cochrane Reviews, published 25 new Cochrane protocols and 38 other journal articles and reports. This has led to us often being mentioned in international and Swedish media. Currently, we also have 19 protocols and reviews in preparation. Several of these reviews have been commissioned by national and international stakeholders, including the World Health Organization.

 Cochrane Sweden has also collaborated with other centers through the Scandinavian GRADE Network. In 2022, we led the establishment of the network together with Cochrane Denmark, Cochrane Norway, SBU, the Danish Health Authority and the Norwegian Institute of Public Health.  

Our team has also grown up! In 2020, Martin joined as project coordinator, and indeed is coordinating lots of projects, from training to research and dissemination; Katarina is brilliantly delivering administrative support to our activities and contributing to develop new projects; in 2022, also Lea became part of the staff: she contributes to daily operations and ongoing research, such as the Swedish trial transparency report.

We have also produced a lot of content on social media. You can follow us on Twitter, LinkedIn, and Instagram, or register to our monthly newsletter. 

Visit the Cochrane Sweden website here, or drop-in at our office!

Vi ses!

Lea, Martin, Katarina, and Matteo

Tuesday, May 31, 2022

Candidates with experience in accounting and financial management are encouraged to apply

Cochrane is a diverse, global organization committed to informing healthcare decisions with the best available evidence from research. Organizationally, we are an international network of autonomously funded groups and a registered charity in the United Kingdom. Members of the Governing Board come from around the world and provide strategic leadership for the whole organization, as well as acting as Trustees of the UK charity.
 
Governing Board members work as a team, with complementary skills and backgrounds. They are a mix of elected members - who must be Cochrane Members - and appointed members, who bring an external perspective to the Board. Appointed members can be anyone with the relevant skills and experience and will not normally be Cochrane Members.

The Treasurer is a member of the Governing Board who supports their fellow Trustees to fulfil their obligation to provide financial oversight for the organization. Our current Treasurer, Karen Kelly, will step down from her position at the end of August 2023. To ensure a smooth handover and to increase the number of Board members with financial expertise, we are looking to appoint a new Board member who can act as Deputy Treasurer until August 2023, taking over as Treasurer from September 2023.

This is an exciting opportunity to join the board of an internationally renowned healthcare organization as we embark on a program of substantial change in how we are organized as a global collaboration, and seek to complete our transition to become a fully Open Access source of health evidence.

Appointed members serve an initial three-year term and may be reappointed. Board membership is a voluntary, unpaid role, although expenses will be paid.
 
The deadline for applications is 15 July 2022. To find out how to stand for appointment, please visit elections.cochrane.org.

 

Tuesday, May 31, 2022

Candidates with experience in digital product development, business development, or publishing are encouraged to apply

Cochrane is a diverse, global organization committed to informing healthcare decisions with the best available evidence from research. Organizationally, we are an international network of autonomously funded groups and a registered charity in the United Kingdom. Members of the Governing Board come from around the world and provide strategic leadership for the whole organization, as well as acting as Trustees of the UK charity.
 
Governing Board members work as a team, with complementary skills and backgrounds. They are a mix of elected members - who must be Cochrane Members - and appointed members, who bring an external perspective to the Board. Appointed members can be anyone with the relevant skills and experience and will not normally be Cochrane Members.
 
To replace current Board members retiring this year, we’re looking for two new appointed members with experience and expertise in one or more of the following areas:

• Digital product development
• Fundraising and business development
• Publishing and Open Access

The Board is running a separate appointments process for a new Treasurer. If you have expertise in accounting or financial management, particularly in a UK context, you should consider applying for the role of Treasurer instead. More information is available here.

This is an exciting opportunity to join the board of an internationally renowned healthcare organization as we embark on a program of substantial change in how we are organized as a global collaboration, and seek to complete our transition to become a fully Open Access source of health evidence.

Appointed members serve an initial three-year term and may be reappointed. Board membership is a voluntary, unpaid role, although expenses will be paid.
 
The deadline for applications is 15 July 2022. To find out how to stand for appointment, please visit elections.cochrane.org.

 

Tuesday, May 31, 2022

川崎病の治療に副腎皮質ステロイドを使用すること 要点 副腎皮質ステロイド(薬）（以下、ステロイド）は、重要な副作用を引き起こすことなく、川崎病後の心臓疾患のリスクを軽減すると思われる。また、症状（発熱や発疹）の長さ、入院期間、体調不良に伴う血液検査結果の異常を減らすことができる。 川崎病とはどのような病気で、どのように治療するのか？ 川崎病は、血管に炎症が起こる病気である。川崎病の治療薬としては、静脈内投与の免疫グロブリン製剤（IVIG）やアスピリンなどが標準的である。この治療法は通常効果的であるが、すべての子どもに効果があるわけではない。現在、川崎病に関する病態は不明な部分があり、どのように対処するのが最善であるかは分かっていない。川崎病は、長期的には心臓に影響を及ぼし、命を縮める危険性があるため、この病気に対する治療は重要である。 本レビューで行ったことは何か？ 川崎病の子どもたちにステロイド（薬）を投与し、将来の心臓病の可能性を減らすかどうかを調べたランダム化比較試験を探した。また、発熱期間、血液中の感染徴候、入院日数への影響も調査した。ランダム化比較試験では、人々が受ける治療や検査が無作為に決定されるため、通常、治療効果について最も信頼できるエビデンスが得られる。 レビューの結果 川崎病の小児患者を対象に、ステロイド（薬）の使用と非使用を比較した、1,877人が参加した8...

Thursday, May 26, 2022

妊娠初期に中絶をするための薬物療法は有効か、また好ましくない影響があるか？ 要点 - 薬による中絶は、妊娠12週までの妊娠を終了させる安全で効果的な方法である。 - ミフェプリストンとミソプロストールの併用は、これらの薬を単独で使用するよりも効果的である。 - ミソプロストールは、口から飲むよりも腟に入れた方が効果的で、舌の下や頬に入れるよりも不快感がない。 薬による中絶とは？ 薬による中絶は、1種類以上の薬を単独で、あるいは組み合わせて用いて、妊娠を終わらせる。最も一般的な薬は、プロスタグランジンやミフェプリストンというホルモン剤である。その他、抗がん剤の一種であるメトトレキサートや、エストロゲンというホルモンの産生を抑えるレトロゾールなどの薬もある。これらの薬は、子宮頸部（子宮の入口）を柔らかくしたり、子宮を収縮させたりして、効果を発揮する。口から飲む、舌の下や頬に入れる、腟に入れるなどの方法がある。病院で看護師や医師が投与することも、女性が自宅で服用することも可能である。 薬による中絶の方法は、大量出血、痛み、吐き気、嘔吐、下痢などの望ましくない影響を引き起こす可能性がある。 中絶の失敗は、頻度は低いが、薬による中絶の重要な合併症である。初期の中絶のための薬は、すでに一部の国で広く利用されており、新しい薬も開発されている。 何を知りたかったのか？ 妊娠初期（妊娠12週まで）...

尋常性乾癬と呼ばれる皮膚疾患の治療には、経口投与と注射のうち、どの薬が最も効果的か？ 要点 - 6か月の治療の後、「生物学的製剤」と呼ばれる薬が、皮膚の乾癬の斑点を消すために最もよく効くようである。 - 乾癬の治療のために注射または口から服用する薬による長期間の治療の利益と潜在的な有害性を評価するために、より長期間の研究が必要である。 - これらのタイプの医薬品を直接比較する、より多くの研究が必要である。 乾癬とは？ 乾癬は、皮膚や、時には関節に影響を及ぼす免疫疾患である。乾癬は、新しい皮膚細胞の産生を早め、それが蓄積して「プラーク」と呼ばれる皮膚上の盛り上がった斑点を形成する。また、プラーク(局面)は、白い肌では赤く、黒い肌色では黒く見えることがある。 尋常性乾癬は、最もよくみられる乾癬である。 乾癬はどのように治療するか？ 乾癬の治療法は、症状がどの程度ひどいかによって異なる。中等度または重度の乾癬患者の約10％～20％は、乾癬をコントロールするために、免疫系に作用する薬を服用する必要がある。これらの薬は全身に作用するため、全身治療薬と呼ばれている。これらは通常、口から摂取する（経口）か、注射で投与される。 コクランレビューを行った理由 乾癬には、3種類の全身用治療薬がある。 - 「生物学的製剤」-インターロイキンやサイトカインと呼ばれる生物学的標的（細胞の挙動に影響を与える...