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Cochrane Library Editorial: It’s time to increase the global relevance of Cochrane Reviews by applying an ‘equity lens’

Wed, 10/27/2021 - 20:55

Health inequities, defined as avoidable and unfair differences in health, have been worsening within and between countries. This has been brought to the forefront by the COVID-19 pandemic. 

A newly published Cochrane Library Editorial puts forth that it is time to increase the global relevance of Cochrane Reviews by applying an 'equity lens'. An equity lens is defined as a focus on health equity to ensure that the most hard-to-reach groups within a population benefit, while avoiding intervention-generated inequalities.

To support review authors in applying an equity lens, Cochrane has created a number of useful resources, including: 

The editorial also provides additional suggestions to authors to create a Cochrane Review that help equip decision makers to determine the applicability of evidence to their setting,  resulting in facilitating the implementation of programs and policies that may contribute to reductions in global health inequities.

 

 

Thursday, October 28, 2021

Cochrane India Network launches in online event

Mon, 10/25/2021 - 19:56

Cochrane is pleased to announce the launch of a new network of institutions from across India that will promote evidence-informed health care and policy in the country.

The Cochrane India Network launched in an online event today featuring keynotes from prominent national and international presenters, including the Director General of the Indian Council of Medical Research Dr Balram Bhargav; Dr Vinod Paul who is a member of NITI Aayog; WHO Chief Scientist Dr Soumya Swaminathan and Cochrane’s Editor in Chief Karla Soares-Weiser. Presentations from each of the affiliate institutions followed, and the event concluded with plenary sessions related to resources available for contributors of the Network. 

The Cochrane India Network is chaired by Dr. Meenu Singh and Dr. Anju Pradhan Sinha, and comprised of teams from nine affiliate institutions, including: 

  • All India Institute of Medical Sciences, New Delhi
  • Christian Medical College Vellore
  • India Council of Medical Research, New Delhi
  • Indian Institute of Public Health, Hyderabad
  • Institute of Dental Sciences, Bhubaneshwar
  • King George’s Medical University, Lucknow
  • Manipal Academy of Higher Education, Manipal
  • Postgraduate Institute of Medical Education and Research, Chandigarh
  • Tata Memorial Centre, Mumbai


The Network Affiliates each have their own strategic plan with Cochrane activities they wish to implement. Activities vary from training in the use of Cochrane systematic reviews, sharing information about new reviews published by Cochrane and advocating for their use in policy and practice, to the production of systematic reviews.

Judith Brodie, Cochrane’s Interim Chief Executive Officer, said of the Network’s launch: “I am excited by the expertise and diverse focus of the Affiliates in the Cochrane India Network, and so pleased to see them join together to advocate for evidence-informed health and care in India.”

Speaking about the launch, Dr. Meenu Singh, Co-Chair of the Network, said, “The launch of Cochrane India Network is a long-cherished dream of all the ‘Cochranites’ from India. Working with Cochrane for more than 20 years, it has provided an opportunity for development of in-house Cochrane products with global applications for evidence-based healthcare. The institutions involved in the Network will act as vehicles of Cochrane methodology for carrying out systematic reviews and help translate evidence into policy and practice.”

Dr. Anju Pradhan Sinha, Network Co-Chair, added, "The establishment of the Cochrane India Network is a significant milestone in India's journey on the path of evidence-informed decision making. The activities coordinated through the Network will lead to the effective implementation of evidence in clinical practice and policy making."

Tuesday, October 26, 2021

Featured review: Mindfulness‐based interventions for substance use disorders

Thu, 10/21/2021 - 09:54
Thursday, October 21, 2021

Cochrane Live: Discuss the next chapter of Cochrane live in Sweden

Wed, 10/20/2021 - 16:18

Cochrane Sweden is hosting a free face-to-face event on the 7th of December to discuss and reflect over the next chapter of Cochrane and the future of review production.

The event will take place in Malmö, Sweden, a 20-minute train ride from Copenhagen Airport. Karla Soares, Editor in Chief of the Cochrane Library and Toby Lasserson, Deputy Editor in Chief are invited to present and facilitate the discussions. Having coffee and a Swedish "fika" will hopefully lead to great conversations!

Where: Malmö Live Clarion Hotel, Malmö, Sweden. 
When: 7th of December 2021, 10.00 - 16.30.  
More: For available participants interested in further follow-up discussions, the day after the event (8th of December) is open for discussions at Cochrane Sweden's office in Lund (10-minute train ride and a 15-minute walk or tram from Malmö Central station). 

Who: 
All Cochrane members and contributors are invited.
How: We hope that the starting time (10.00) opens up the possibility to travel directly to the event in the morning for participants within Europe. Our suggestion would be to travel to Copenhagen Airport and take the train from the airport to Malmö Central Station which takes 20 minutes. The location is a 5-minute walk from Malmö Central Station. It is also possible to travel to Malmö Airport and take a bus or taxi to Malmö Central Station. After 16.30 on the 7th we will plan to have a joint dinner in Malmö for available participants.
Content: The meeting will be facilitated by Karla Soares and Toby Lasserson combined with face-to-face discussions about the next chapter of Cochrane and the future of review production. The topics will center around the Community Engagement Workshop Series and futurecochrane.space.

Cost: The event is free for all Cochrane Members and contributors and includes lunch. Accommodation and travel expenses to the event are not included and have to be covered by the participant. 
Accommodation: For participants who plan to stay from 6th to 7th of December, and/or 7th - 8th of December the event venue (Malmö Live) might be a convenient accommodation solution, although it is not a cheap option. 
Travel restrictions: You can find the latest updates on current travel restrictions and Covid-19-measures FOR SWEDEN from https://www.krisinformation.se/en/ or by visiting the Swedish Police website or by checking this FAQ from the Swedish Government. If you travel to Copenhagen Airport (Denmark) and after that to Sweden, there are special rules for different countries regarding Covid-passports and sometimes the need to show a test before entering. More information is available from the Copenhagen Covid-19 Travel Guide or from https://www.oresunddirekt.se/. 

Registration: You need to have a Cochrane Account, and sign in using THIS LINK. The last day to register is November 8th 2021. Please note that we have a limited number of attendees due to the size of the venue. 

 

Wednesday, October 20, 2021

What factors influence parents’ and carers’ decisions on routine vaccinations for their children?

Wed, 10/20/2021 - 11:46

This recently published Cochrane Review, published by Cochrane Effective Practice and Organisation of Care, explores how parents and carers make decisions regarding vaccinating their children. Cochrane EPOC have also produced a short implementation guide related to this review. 

Key messages

  • Many factors influence parents’ vaccination views and practices, including those related to individual perceptions, social relationships, and the wider social and political context in which parents live.
  • When parents make decisions about vaccination for their children, they are often communicating not just what they think about vaccines, but also who they are, what they value, and with whom they identify.

Why is it important to understand what affects parents’ and carers’ decisions around vaccinating their children?
Childhood vaccination is one of the most effective ways to prevent serious illnesses and deaths in children. To be successful, vaccination programmes depend on high levels of vaccination uptake.

However, worldwide, many children do not receive all recommended vaccinations. There are several potential reasons for this. Vaccines might be unavailable, or parents may experience difficulties in accessing vaccination services; for instance, because of poor-quality health services, distance from a health facility, or lack of money. Some parents may not accept available vaccines and vaccination services.

Increasing our understanding of what influences parents’ views and practices around childhood vaccination, and why some parents may not accept vaccines for their children will allow healthcare services to tailor their programmes and information to particular groups of people. This should help to promote acceptance and uptake of childhood vaccination and improve child health worldwide.

What did we want to find out?
We wanted to know what factors influence parents’ views and practices around routine childhood vaccination and how these factors influence  parents. We were interested in factors that may ‘enhance’ or ‘reduce’ acceptance of vaccination.

What did we do?
We searched for studies that assessed parents’ views, experiences, and practices of childhood vaccination. Studies could take place anywhere in the world where childhood vaccination is provided. People in the study had to be parents or carers who were responsible for deciding whether a child should be vaccinated.



What did we find?
We found 145 relevant studies and analysed the results from 27 of them. Studies took place in Africa, the Americas, South-East Asia, Europe, and the Western Pacific, and included urban and rural locations, as well as high-, middle-, and low-income settings.

Main results
Many complex factors influence what parents think about vaccination and what actions they take. We divided these into 4 themes.

  1. Parents’ vaccination ideas and practices may be influenced by their broader ideas and practices about health and illness generally, and specifically about their children and the role of vaccination in their health care.
  2. Many parents’ vaccination ideas and practices were influenced by the people they mix with socially. At the same time, shared vaccination ideas and practices helped some parents establish social relationships, which in turned strengthened their views and practices around vaccination.
  3. Parent’s vaccination ideas and practices may be influenced by wider political issues and concerns, and particularly their trust (or distrust) in those associated with vaccination programmes.
  4. Parent’s vaccination ideas and practices may be influenced by their access to and experiences of vaccination services and their frontline healthcare workers.

We developed two concepts for understanding possible pathways to reduced acceptance of childhood vaccination.

  1. Neoliberal logic’, suggests that many parents, particularly from high-income countries, understood health and healthcare decisions to be matters of individual risk, choice, and responsibility. Some parents experienced this understanding as in conflict with vaccination programmes, which emphasise generalised risk and population health. This perceived conflict led some parents to be less accepting of vaccination for their children.
  2. Social exclusion’, suggests that some parents, particularly from low- and middle-income countries, were less accepting of childhood vaccination due to their experiences of social exclusion. Social exclusion may damage trustful relationships between government and the public, generate feelings of isolation and resentment, and give rise to demotivation in the face of public services that are poor quality and difficult to access. These factors in turn led some parents who were socially excluded to distrust vaccination, to refuse vaccination as a form of resistance or a way to bring about change, or to avoid vaccination due to the time, costs, and distress it creates.

What are the limitations of the evidence?
Our confidence in the evidence is mainly moderate to high. Some studies did not report their findings or methods very well, and some focused on one vaccine, type of participant or country, so were not relevant for other vaccines, participants or countries.  All of the included studies were published in English, so we we may have missed findings not published in English. The studies were often quite long with a lot of data, so we had to make practical decisions about how best to manage our analysis, which may have affected interpretations of the evidence.

How up to date is this evidence?
The evidence is up to date to July 2020.

Wednesday, October 27, 2021

What is an infodemic and how can we prevent it?: a Lifeology and Cochrane collaboration

Tue, 10/19/2021 - 16:43

In this free Lifeology course, learn what an infodemic is and what you can do to slow and prevent the spread of misinformation. 

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 and health information and research. One of the main ways they meet their objectives is through beautifully illustrated, science-backed, bite-sized ‘flashcard’ courses about science and health-related topics aimed at the general public and students.

Image from the Lifeology 'What is an infodemic and how can we prevent it?' course

For World Evidence-Based Healthcare (EBHC) Day, with the 2021 campaign theme of  'the role of evidence in an infodemic', they collaborated with Cochrane to create a free course. The 41 slides walk the user through the  story of Ronald who has been misguided by misinformation and teaches what an infodemic is and how to slow the spread of misinformation.

Image from the Lifeology 'What is an infodemic and how can we prevent it?' course

Paige Jarreau, co-founder of Lifeology, said "At Lifeology, we believe that science communication in any format, including our flashcard courses, is far better when it is the product of collaboration between scientists and professional creatives like storytellers and artists. We were pleased to be able to work closely with people from Cochrane to create this course on infodemics. We've produced a beautifully illustrated free course that is practical in its tips to combat misinformation and accessible through its plain language, empathetic storytelling and relatable imagery  - it's also available in both Spanish and English!"

Image from the Lifeology 'What is an infodemic and how can we prevent it?' course

Jordan Collver, the illustrator of the Lifeology course, said "This was an exciting project to work on. We had some fun with metaphors and with well known memes in this course while keeping the story empathic and relatable in a global context.'

  • View the Lifeology course 'what is an infodemic and how we can prevent it?' in English or Spanish

 

Learn more about Lifeology: 

Tuesday, October 19, 2021

Visualizing an infodemic and approaches to countering misinformation: Lifeology SciComms Challenge

Mon, 10/18/2021 - 19:28

On 20 October it is World Evidence-Based Healthcare (EBHC) Day with the 2021 campaign focusing on the 'the role of evidence in an infodemic'. For the month of October, Cochrane is co-hosting a Science Communication challenge with Lifeology to get people to create a visual to explain what an infodemic is or an approach to countering misinformation. 

The COVID-19 infodemic is a WHO-declared pandemic that is running parallel with the COVID-19 pandemic. This infodemic, according to Tiffany Duque at Cochrane US Network, is “too much information, including false or misleading information, in digital and physical environments during a disease outbreak” that causes confusion and risk-taking behaviors, and can lead to mistrust in health authorities. An infodemic can be compared to a barrage of information spreading like wildfire across the globe through social media platforms, or waves of (both good and bad) information that overwhelm and confuse people. 

This month, Lifeology is challenging people create a visual metaphor to explain what an infodemic is or how people can help to counter misinformation and fight the infodemic.  Give people something to relate to or empower them by creating a visual metaphor for an action they can take to protect themselves or others from misinformation!

Featured submissions: 

Carrie Ekeroth @Sketchimal

 

Monday, October 18, 2021

The world must learn from pandemic lessons to avoid future catastrophes. Millions of lives could be saved through increased use of evidence.

Wed, 10/13/2021 - 15:59

Hundreds of health leaders and experts meet today to recommend the international community urgently mount stronger evidence-based responses to global health emergencies.

Led by Cochrane, co-sponsored by the World Health Organization (WHO), and co-organized with partners of COVID-END (COVID-19 Evidence Network to support Decision-making), Cochrane Convenes brings together leaders in health care and evidence synthesis to discuss the global healthcare challenges created by COVID-19.

COVID-19 created a once-in-a-generation focus on health evidence for governments, businesses and non-governmental organizations as well as many types of professionals and the public. The pandemic fast-tracked collaboration among decision-makers and researchers but also laid bare shortfalls in the systems of producing and sharing evidence.

Introducing Cochrane Convenes today, WHO Director-General Dr Tedros Adhanom Ghebreyesus said,

“During the COVID-19 pandemic, WHO’s Science Division has worked closely with the Health Emergencies Programme to produce and quality-assure more than one thousand six hundred guidance documents. This would not have been possible without our partnership with Cochrane, the partners of the COVID-END network, and our WHO Evidence Collaborative for COVID-19.”

Watch the full welcome message from Dr Adhanom Ghebreyesus on the Cochrane Convenes website

The recommendations and learning from Cochrane Convenes will form an action plan to advocate for change across the global health evidence community including those who produce evidence, share health messages and those who use evidence to make decisions in policy and practice. Participants include scientists, researchers, funders, public health decision makers and practitioners, patient and consumer advocates as well as health and science editors.

The recommendations include:

  •  The pandemic evidence response has been weighted towards high-income countries. Funders should invest more in research carried out by low and middle-income countries, support training and communication needs, and address the inequity in what is funded
  •  Building expertise in conveying uncertainty about what is known and not known during a health emergency
  • Stronger connections are needed across sectors; this involves building and incentivising institutions, partnerships and networks to be better prepared for future emergencies

Leading WHO’s involvement in Cochrane Convenes, Dr. John Grove, WHO Director of Quality Assurance, Norms and Standards explained,

“As a community of evidence producers and users we had a huge amount to take stock of. We needed to harvest what we’ve learned and Cochrane Convenes has given us the opportunity to start this. It has come out loud and clear that we need to remain connected as a community around our aim to shore up good practice in evidence production and use - for the good of all our health across the world.

Promisingly, the participants have shown the collective will exists to get us fit for purpose and now we need to move towards putting these recommendations into action.”

Cochrane’s Editor in Chief, Dr Karla Soares-Weiser said:

“Cochrane’s unique perspective placed us well to host these strategic discussions and we’ve been pleased to see a global community of evidence producers and users come together. We know we need to support the World Health Organization and its member states with the best possible evidence and guidance to ensure that local decision-makers and frontline healthcare professionals have the most trusted, high-quality evidence and information they need – but the question has been how to improve and do this better.”

She added, “What we have learned today is that the focus lies not only in maintaining the rigour of the science but also investing in our global networks and partnerships. We need to build a system we can all trust, that caters for all users of evidence wherever they are in the world.”

A summary of recommendations will inform an action plan due out later this year and will be used to advocate for change ensuring better preparedness for future global health emergencies.

Thursday, October 14, 2021

Cochrane launches new focus on diversity and inclusion

Mon, 10/11/2021 - 10:20

Cochrane wants to welcome people, no matter who they are or where they live. The more varied perspectives we have, the better we can provide evidence to help inform health and healthcare decisions.
 
We have contributors, supporters and members from all over the world, but we know very little about our community and what is important to you. This is an opportunity to learn from our community and hear your ideas about how Cochrane can become a more diverse and inclusive organisation.
 
We’ve launched a survey and are also running small online meetings. You can take part by:

  1. completing the short survey here now.  It only takes a few minutes. You don’t need to give your name
  2. AND letting us know if you are interested in attending a small group meeting to talk about your experiences of diversity and inclusion in Cochrane. If you are interested sign up here to stay informed.

We want to hear from you whether you are involved a lot in Cochrane or not much at all.  Your feedback will help to create a Diversity and Inclusion Strategy in 2022.
 
Chris Champion, Head of People Services, says

“Cochrane is a worldwide organisation that aspires to be diverse and inclusive. We want everyone to be able to participate in Cochrane, regardless of who they are and where they come from. This matters to Cochrane, because if we are more inclusive, we will be able to provide better and more relevant evidence to our users who are at the heart of our vision.”

If you want to know more about this work then please contact Chris Champion, cchampion@cochrane.org.

Friday, October 15, 2021

Author Q&A: Ketamine as a treatment for depression

Thu, 10/07/2021 - 14:01

In this interview with Doctoral Researcher Rebecca Dean and Professor Andrea Cipriani we learn more about two reviews investigating the use of ketamine as a treatment for depression recently published through Cochrane’s Common Mental Disorders Group.

Tell us about this Cochrane Review
This review is an update of a Cochrane review published in 2015, investigating the use of ketamine and other glutamate receptor modulators as a treatment for unipolar depression (also known as major depressive disorder).

Since 2015, a lot of research has been published in this area and the FDA has recently licensed esketamine (Spravato) for use in treatment resistant depression, so we realised it was time to update the review with the most recent evidence.

And we understand you recently published Ketamine and other glutamate receptor modulators for depression in adults with bipolar disorder. How do these reviews complement each other?
Both reviews look at the use of ketamine and other glutamate receptor modulators in the treatment of depression, but they are reviewed separately as these drugs may work differently according to diagnosis.

What can we learn about the role of ketamine in treating depressive disorders because of these studies?
Ketamine and esketamine may be effective in the short-term at reducing symptoms of depression for people with unipolar depression. Both of these drugs can cause side effects, which may be a consideration for treatment.

For depression in bipolar disorder, we did not find data on esketamine, but ketamine was efficacious in reducing depressive symptoms, again only in the short-term. There was no difference in side effects between ketamine and placebo for people with bipolar disorder, but this was based on very limited evidence.

There was no evidence that any other glutamate receptor modulators that we included in these reviews (such as memantine, lanicemine, and N-acetylcysteine) were more effective in treating depression over placebo in either unipolar depression or bipolar disorder.



Is there a strong message for people with depressive disorders, clinicians or policy makers?
Ketamine (and possibly esketamine) can be used to treat depression, however there wasn’t enough certainty in the evidence to be able to take away a strong message, as there were many limitations in the data available.

Further research needs to focus on the long-term effects of ketamine and other glutamate receptor modulators, so we can have enough evidence to assess whether these drugs are good at treating depression over longer periods of time and what the side effects are.

We also need more trials to compare ketamine and other glutamate receptor modulators with active drugs (not just placebo), so we can compare them and know whether they are better than current treatments for depressive symptoms.

With more evidence in a future update of this review, we hope we will be able to make stronger conclusions that can reliably inform policy and practice.

Are there any more Cochrane reviews planned on this topic OR do you plan to update these reviews in the future?
We will update these reviews as more evidence becomes available to help us better understand the role of ketamine and other glutamate receptor modulators in depressive disorders in future. There is a need for effective treatments for mood disorders, supported by robust evidence and implemented in the NHS.

Monday, October 11, 2021

Cochrane UK seeks Public Health Consultant, Oxford UK

Tue, 10/05/2021 - 14:37

Cochrane UK is seeking a dynamic, self-motivated, public health consultant with an interest in evidence-based practice to work with us one day per week. You should be on the GMC/GDC Specialist Register or the UK Public Health (Specialist) Register and be an accredited educational supervisor for public health trainees. The role can be offered as a secondment from your current employer or on a consultancy contract. 

 

You will join the small friendly team at Cochrane UK, supporting the global work of Cochrane and maximizing the use and impact of Cochrane Reviews for the UK and Ireland. You will provide expert public health advice and leadership on a range of public health issues relevant to Cochrane UK and lead on the development of links between Cochrane UK and National Public Health NHS bodies. You will play an active role in teaching and training, developing current initiatives, and supervising public health trainees and trainees in medical specialities on placement at Cochrane UK.

Download the job description and person specification (word doc).

If you would like more information, please contact Therese Docherty, Business & Programme Manager therese.docherty@cochrane.nhs.uk. Our Director, Martin Burton, is happy to discuss the role with interested candidates.

 

To apply for this post, please send a covering letter and CV to therese.docherty@cochrane.nhs.uk

Closing date 1st November 2021.

Interviews will be held virtually on the afternoon of 11th November.

Tuesday, October 5, 2021 Category: Jobs

NICE seeks Technical Analyst - Manchester, UK

Fri, 10/01/2021 - 20:42

Job Type: Fixed term (12 months),  Full time
Specialty/Function: Technical Analyst
Employer: National Institute for Health and Care Excellence
Department: Centre for Guidelines
Location: Manchester, UK
Salary: £40,057 - £45,839 per annum
Closing Date: 17/10/2021

The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and advice on promoting high quality health, public health and social care.

We are looking for a Technical Analyst to support the organisation through a period of dynamic transformation.

Reporting to the Research associate – Strategic Engagement, the Technical Analyst will be a key member of the team responsible for establishing and building on existing collaborative partnerships with external organisations to facilitate the delivery of efficient and sustainable systems and processes to enable the delivery of dynamic, living guideline recommendations.

The post holder should be able to demonstrate the following:

  • Advanced theoretical and practical knowledge of a range of work procedures and practices related to process and methodology for evidence synthesis in guidelines or health services research
  • Understanding of the principles of evidence-based health care, critical appraisal and the interpretation and synthesis of health care research evidence
  • Ability to think and plan strategically and to exercise sound judgement in the face of conflicting pressures
  • An understanding of the social, political, economic and technological context in which the NHS and the Institute operates
  • Ability to establish effective working relationships with a range of professionals both within and outside the Institute
  • Effective and persuasive communicator demonstrating oral, written and presentation skills with a high degree of personal credibility and sensitivity

Learn more and apply before 17 October

Friday, October 1, 2021

Celebrating the UN International Day of Older Persons 2021

Fri, 10/01/2021 - 12:54

Cochrane Global Ageing: “Let's build an evidence-based world for all ages.”

The UN International Day of Older Persons (IDOP), this year October 1, 2021, is a special date that marks the United Nations (UN) recognition of the opportunities and challenges of population ageing in the 21st century. A day when we can celebrate increases in life expectancy and raise awareness of the need for action to ensure good health in older ages. The year 2021 also marks the beginning of the UN Decade of Healthy Ageing, which is an unprecedented opportunity to foster healthy ageing and to promote the health, wellbeing, and quality of life of older adults around the world.

High-quality evidence is critical to ensure informed decision-making at all levels of societies, contributing to achieving the goals set for the decade.

We would like to join the celebration of this special day by sharing some of the high-quality evidence from the Cochrane Library and the Campbell Collaboration produced over the past twelve months. The COVID-19 pandemic remained a top priority, but relevant evidence was also produced regarding other several key topics for older adults.

We pledge to continue contributing to this global effort, whilst integrating a social and healthcare interdisciplinary perspective.

Happy International Day of Older Persons!

Acknowledgements: We would like to thank the authors and Review groups for producing the reviews in this blog. The image used on this blog  is from the Centre for Ageing Better free library of images. We would also like to thank the Centre for Ageing Better for creating this age positive resource. 

Blog written by Monserrat Conde, Director, Cochrane Global Ageing. 

Friday, October 1, 2021

Featured review: Colchicine for Covid

Thu, 09/30/2021 - 12:01

Is colchicine an effective treatment for people with COVID-19?

Colchicine was debated to be a potential treatment option for COVID-19, hoping that the medication’s anti-inflammatory properties could prevent or reduce a dysregulated immune response.

Although there are completed studies without publication and diverse ongoing studies that could change our findings, the current evidence taken from 3 studies is moderate that colchicine makes no difference for people with moderate to severe disease. The safety of the medication remained unclear- given the restricted dosage range and the inconsistent reporting of (serious) adverse events.

For outpatients, we found data from one study retrieving that colchicine probably results in a slight reduction of combined risk of admission to hospital or death within 28 days and serious adverse events, but we are uncertain about the isolated risk of death at up to day 28.

If further studies are planned, especially for the outpatients, the measurement of the quality of life and more detailed reporting of adverse events would be essential.

Key messages

  • In hospitalised people with moderate to severe COVID-19, colchicine probably has little to no benefit; we are uncertain about its side effects.
  • In non-hospitalised people with no symptoms or mild COVID-19, we are uncertain whether colchicine prevents deaths or side effects, however it probably reduces the need for hospitalisation or death and serious side effects slightly.
  • Future studies should assess quality of life in people with no symptoms or mild COVID-19 and non-serious side effects and compare colchicine to other medicines for COVID-19, such as corticosteroids.

What is colchicine?
Colchicine is a medicine used to reduce swelling and inflammation and may consequently relieve pain. It is often used to treat gout, a condition where people’s joints become swollen and painful. On the other hand, colchicine can be harmful to people with some health conditions, such as kidney or liver problems, or if you take too much of it.

How might colchicine treat COVID-19?
Since colchicine is an anti-inflammatory drug; researchers are interested in whether it might help with reducing inflammation caused by COVID-19.



What did we want to find out?
We wanted to know whether colchicine is an effective treatment for people with COVID-19 compared to placebo (a treatment that looks and tastes the same as colchicine but with no active ingredient) or usual care alone. We looked at people with moderate or severe disease being treated in hospital or with mild disease being treated in the community. We were particularly interested in the effects of colchicine on:

  • number of deaths;
  • whether people’s condition worsened or improved;
  • quality of life;
  • serious and non-serious side effects

What did we do?
We searched for studies that compared colchicine together with usual care to usual care (plus/minus placebo). Studies could take place anywhere in the world and include people with mild or no symptoms, moderate or severe COVID-19, of any age, sex, or ethnicity.

We compared and summarised the results of the studies and rated our certainty in the evidence, based on factors such as study methods and sizes.

What did we find?
We identified four eligible randomised trials. Three included 11,525 hospitalised people and one included 4488 non-hospitalised people. For hospitalised people, the average age was 64 years, and for non-hospitalised people, the average age was 55 years. Two studies compared colchicine and usual care with usual care alone and 2 studies compared colchicine with usual care and placebo. None of the studies reported quality of life. We also found 17 ongoing studies and 11 completed but unpublished studies.

Main results

Hospitalised people with moderate to severe COVID-19 (3 studies, 11,525 people)

  • Colchicine probably does not reduce deaths in the 28 days after treatment (2 studies, 11,445 people).
  • Colchicine probably does not prevent the worsening of patients’ condition (2 studies, 10,916 people) and probably does not improve it (1 study, 11,340 people).
  • We are very uncertain about the effect of colchicine on side effects and serious side effects (2 studies, 177 people).

Non-hospitalised people with no symptoms or mild COVID-19 (1 study, 4488 people)

  • We are uncertain whether colchicine prevents deaths up to 28 days after treatment.
  • Colchicine probably slightly reduces the risk of hospitalisation or death.
  • We are uncertain about the effect of colchicine on side effects, but it probably slightly reduces serious side effects.

What are the limitations of the evidence?
Our certainty in the evidence is limited. Two studies did not use a placebo, so everybody knew who was treated with colchicine, which could influence the results. There were too few events for non-hospitalised people, such as admissions to hospital and deaths, to be certain about the evidence. Studies used different ways to assess and report unwanted effects, so we could not combine studies into a single result to make a judgement.

How up to date is this evidence?
The evidence is up to date to 21 May 2021.

Editorial note: this is a living systematic review. We search for new evidence every week and update the review when we identify relevant new evidence. Refer to the Cochrane Database of Systematic Reviews for the current status of this review.

Monday, October 18, 2021

NICE seeks Research associate - Manchester, UK

Wed, 09/29/2021 - 23:43

Job Type: Fixed term (12 months),  Full time
Specialty/Function: Research associate – Strategic EngagementEmployer: National Institute for Health and Care Excellence
Department: Centre for Guidelines
Location: Manchester, UK
Salary: £54,764 - £63,862 per annum
Closing Date: 06/10/2021

The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and advice on promoting high quality health, public health and social care.

They are looking for a skilled Research Associate – Strategic Engagement to support the organisation. Reporting to the Senior Technical Adviser- Methods the Research associate – Strategic Engagement will be a key member of the team responsible establishing and building on existing collaborative partnerships with external organisations to facilitate the delivery of efficient and sustainable systems and processes to enable the delivery of dynamic, living guideline recommendations.

The post holder should be able to demonstrate the following:

  • Advanced theoretical and practical knowledge of a range of work procedures and practices related to process and methodology for evidence synthesis in guidelines or health services research
  • Extensive knowledge of the principles of evidence-based health care, critical appraisal and the assessment, synthesis and interpretation of health care research evidence
  • Ability to effectively plan and manage highly complex projects and deliver work of a high standard often against competing demands with tight timeframes and deadlines
  • An understanding of the social, political, economic and technological context in which the NHS and the Institute operates
  • Experience of working with a wide range of stakeholders, including stakeholders and academia in health, public health and social care
  • Excellent oral and written communication skills, including the ability to communicate complex ideas to a range of audiences and to generate trust and confidence in individuals at all levels both within and outside the organisation

Learn more and apply before 6 October 

Thursday, September 30, 2021 Category: Jobs

Cochrane Convenes: interview with John Grove

Wed, 09/29/2021 - 17:28

Cochrane Convenes will bring together key thought leaders from around the world to discuss the COVID-19 evidence response and develop recommendations to help prepare for and respond to future global health emergencies. Cochrane Convenes is co-sponsored by The World Health Organization.

In this interview, we talk to Dr. John Grove, Director of Quality Assurance, Norms and Standards at The WHO about Cochrane Convenes.

Why do you think it is important to hold Cochrane Convenes now?
I think at this point in the pandemic we have a huge amount of experience to take stock of. We have experienced an unprecedented historical event where we all needed to step in and do the best we could. Now we have a chance to see what we've learned and what we might harvest from that to inform future plans.

The World Health Organization, has joined Cochrane and COVID-END as co-sponsors of this initiative, tell us about your motivation for being involved?
At the start of the pandemic, we formed a very early partnership with COVID-END, and Cochrane called the Evidence Collaborative for COVID-19, hosted by WHO. The purpose was to get all of the partners working in the evidence retrieval and/or synthesis space to get together to share learnings and specifics about what we were all doing. This was also an opportunity for WHO to share our own priorities. As a result, we were able to engage more fully with the community and to leverage the various skills needed to feed right into the response that we were managing. I think we also helped to reduce waste and duplication of efforts.

The motivation for being involved in Cochrane Convenes is to continue that spirit of partnership beyond the pandemic response, and to solidify this way of working not only between the three entities, but with all of the partners doing this kind of work in the field. It is critical for all of us to leverage that expertise for future pandemics, and, put simply: it is also just good practice.



What do you hope will come from Cochrane Convenes?
The plan is for it to inform an action plan which is exactly what we need right now. We need very practical recommendations to come out of this event, that are actionable right away, but that will help build towards the future.

In operational terms this should be about ways of working, ways to share information, ways to leverage technology together and how as a community we can remain connected for the good of global health.

Moreover, I’m hoping for a continued commitment to stay in communication, for the WHO to continue to share priorities, and for the sharing of information in a way that engages all of the partners in this space.

Which challenges do you think are critical for the evidence community to address in this forum?
There are three things I can immediately think of:

  • How can this community better marshal itself in the fight against misinformation? This means getting good solid evidence to decision-makers in understandable formats they can use in an expedited fashion.
  • Secondly, to work more on the open science agenda, to continue to share information, and to promote the sharing of publications. We also need to be able to pull that material together across the community.
  • The third one, is how do we become ready for future emergencies, and have standard operating procedures that allow us to always be on standby?

Who would you like to see attending Cochrane Convenes?
I think first and foremost I’d like to see the emerging talent we have out there in the community attending and that must include bright professionals from lower and middle-income countries. I think we also need to be a lot more intentional about building networks in those countries.

I’d like to have those there who are a bit radical in their willingness to change course, those who are interested in a living approach towards evidence and harnessing technology to do this work more efficiently.

Also, those who design the products for policymakers, the ones that are actually being referenced in the political sphere. I’d like them to be in the room with us, helping us think through the best ways to get information out to people in a way that changes their behaviour.

And finally, policymakers themselves, who can bridge policy and science, to help build up their literacy in weighing up trustworthy, actionable evidence.

Wednesday, September 29, 2021

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