Review of 10 years Hamid R Baradaran, M.D., PhD. Assistant Professor of Epidemiology Iran University...

Review of 10 years

Hamid R Baradaran, M.D., PhD.

Assistant Professor of Epidemiology

Iran University of Medical Sciences

October 2007

Review of 10 years

How to register your title in Cochrane

Review of 10 years

Evidence for up-to-date clinical dental practice – a review of 10 years of the Cochrane Oral Health Group

30th-31st May 2006, Manchester

Cochrane Oral Health Group - 10 years on

Own logo

Review of 10 years

Review of 10 years

Cochrane Oral Health Group

Include all randomised controlled trials of oral health broadly conceived to

include the prevention, treatment and rehabilitation of oral, dental and

craniofacial diseases and disorders

Review of 10 years

Oral Health Group: Background

Aug ‘96 UK Base established

Dec ‘96 Part-time Co-ordinator

appointed

Mar ‘97 New reviews underway

July ‘97 Funding secured

Feb ‘98 Official opening

May ’06 10 year symposium

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Editors

• Bill Shaw• Helen

Worthington • Jayne Harrison• Jan Clarkson• Marco Esposito

• Ian Needleman• Paul Coulthard• Valeria Marinho• Anne-Marie

Glenny• Lee Hooper

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Editorial Base Staff

• Review Group Co-ordinator

• Trials Search Co-ordinator (P/T)

• Administrator

• Lecturer in Evidence Based Oral Health Care

• Senior Research Fellow (Jan 06)

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Achievements• Worldwide network of 624 members from

40 countries• International panel of referees• Set up OHG Trials Register (approx 20,000 entries)• Established handsearching programme• Input into NICE, HTA, SIGN, vCOHI &

ADA• NIDCR award

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Funding

• Base- salaries (DoH)• NIDCR• Italian Government• NICE• DoH UK (vCOHI)

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NIDCR Funded Project

• To undertake

– New reviews on treatment of oral cancer

– Update/new reviews on oral care for patients with cancer

• First NIH funding of Cochrane Reviews

• Unusual to fund group totally outside US

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Progress of Oral Health Group

0

10

20

30

40

50

60

1998 - 1

1998 - 3

1999 - 1

1999 - 3

2000 - 1

2000 - 3

2001 - 1

2001 - 3

2002 - 1

2002 - 3

2003 - 1

2003 - 3

2004 - 1

2004 - 3

2005 - 2

Cochrane Library Issue

Nu

mb

er

of

Pu

blic

ati

on

s

Updates

Reviews

Protocols

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Number of Reviews by Collaborative Review Groups (CRGs)

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Status of OHG Reviews (The Cochrane Library, Issue 2, April 2006)

• 52 reviews published

• 9 reviews out with referees

• 69 protocols published

• 14 protocols out with referees

• 34 titles registered

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Systematic review

• Structured process involving several steps:– Well formulated question– Comprehensive data search– Unbiased selection and abstraction process– Critical appraisal of data– Synthesis of data

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OHG Editorial Process

• Register title• Prepare protocol• Editorial and external review of protocol• Protocol entered on Cochrane Library• Identify trials• Complete systematic review• Peer review of systematic review• Systematic review entered on Library• Regularly updated

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Title

[Intervention] for [disease] in [patients]

• Treating periodontal disease for preventing preterm birth in pregnant women

• Surgical techniques for the removal of mandibular wisdom teeth

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Objectives

• To assess the effects of treating periodontal disease in pregnant women in order to prevent preterm birth, with the primary aim of reducing fetal, infant, childhood and maternal morbidity and mortality.

• To compare the relative benefits and risks of different surgical techniques for removing mandibular wisdom teeth.

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Criteria for considering studies for this review

• Types of studies

• Types of participants

• Types of intervention • Types of outcome measures

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Search methods for identification of studies

• Searched databases

• Language

• Unpublished studies

• Handsearching

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Methods of the review

• Study selection

• Quality assessment

• Data extraction

• Data synthesis

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Potential conflict of interest

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Presentation objectives

• Provide an overview of Cochrane Collaboration

• Demonstrate The Cochrane Library

• Invite participation

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Cochrane Collaboration

• An international organisation that aims to help people make well-informed decisions about healthcare by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of health care interventions.

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“It is surely a great criticism of our profession that we have not organised a critical summary, by specialty or subspecialty, adapted

periodically, of all relevant randomised controlled trials.”

Archie Cochrane

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THE COCHRANECOLLABORATION

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Principles

• Collaboration

• Building on the enthusiasm of individuals

• Avoiding duplication

• Minimising bias

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Principles

• Keeping up to date

• Striving for relevance

• Promoting access

• Ensuring quality

• Continuity

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Cochrane Collaboration goals

• To ensure high quality, up-to-date systematic reviews are available across a broad range of health care topics

• To promote access to Cochrane reviews

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Cochrane Collaboration goals

• To develop an efficient, transparent organisational structure and management system for the Cochrane Collaboration

• To achieve sustainability of the Cochrane Collaboration

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Systematic reviewSystematic reviewSystematic review

• Structured process involving several steps:– Well formulated question– Comprehensive data search– Unbiased selection and abstraction process– Critical appraisal of data– Synthesis of data

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Collaborative Review Groups

Fields

The Consumer Network

Centres

Steering Group Methods

Groups

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Fields



Groups

Centres

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Cochrane Centres

South African

Australasian

Chinese

Brazilian

Nordic

German

San Antonio

ItalianIberoamerican

French

Dutch

UK

Canadian

New England

San Francisco

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Cochrane Centres

• Help organise and register review groups

• Facilitate collaboration among reviewers

• Provide training and consultation

• Establish liaisons

• Promote the Cochrane Collaboration

• Provide unique contribution

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Fields


Centres


Groups


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Review Groups48 registered, 1 possible

• Focus– Treatment of disease or health problems

• Emphasis on clinical outcomes• Emphasis on rigorous data

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Review Groups

• Acute respiratory infections• Airways• Anaesthesia• Back• Breast cancer• Colorectal cancer• Consumers and communication• Cystic fibrosis and genetic

disorders• Dementia & cognitive

improvement• Depression, anxiety & neurosis

• Developmental, psychosocial and learning problems

• Drugs and alcohol• Ear, nose and throat disorders• Effective practice and

organisation of care• Epilepsy• Eyes and vision• Fertility regulation• Gynaecological cancer• Heart• Hepato-biliary

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Review Groups

• HIV/AIDS• Hypertension• Incontinence • Infectious diseases• Inflammatory bowel disease• Injuries• Lung cancer• Menstrual disorders and

subfertility• Metabolic and endocrine

disorders• Movement disorders• Multiple sclerosis

• Muskuloskeletal • Musculoskeletal injuries• Neonatal• Neuromuscular disease• Oral health• Pain, palliative and supportive

care• Peripheral vascular diseases• Pregnancy and childbirth• Prostatic diseases and urologic

cancers• Renal• Schizophrenia

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Review Groups

• Sexually transmitted diseases• Skin• Stroke• Tobacco addiction• Upper gastrointestinal and

pancreatic diseases• Wounds• Haematological malignancies

(possible)

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Review Group products

• Reviews

• Specialised register

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Review Groups

• Reviewers– International group

– Review relevant trials on specified health care problems

– Long-term commitment

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Collaborative Review Group process

Review GroupCo-ordinator

Cochrane Database of Systematic Reviews

EditorEditorss

SystematicReviewer

SystematicReviewer

SystematicReviewer

SystematicReviewer

SystematicReviewer

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Review Manager (RevMan)

• Cochrane Collaboration software for:– Preparing and maintaining protocols and reviews– Data analysis– Submitting completed reviews to CDSR

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RevMan statistical options

• Peto Method– Odds Ratio

• Mantel-Haenszel fixed effect and Dersimonian/Laird random effects – Odds Ratio, Relative Risk, Risk Difference– Weighted and Standardised Mean Differences

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The Cochrane Library

• The Cochrane Database of Systematic Reviews (CDSR)

• The Database of Abstracts of Reviews of Effectiveness (DARE)

• The Cochrane Controlled Trials Register(CCTR)

• The Cochrane Methodology Register

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Fields


Centres


Groups

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Fields9 registered, 1 possible

• Represent a population, group, or type of care that overlaps multiple Review Group areas

• Examples: Primary Health Care, Health Care of Older Adults, Complementary Medicine, Vaccines, Rehabilitation and Related Therapies

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Methods Groups11 registered, 5 possible

• Develop methods and products integral to internal functioning of the Collaboration

• Develop state of the art methods for systematic reviews

• Examples: Statistical Methods, Economics, Placebo Effects, Informatics

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• Provides consumer input

• Helps set priorities

• Helps with dissemination

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Fields


Centres

Methods Groups

Steering Group

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Steering Group

• Function– Policy making body of the Cochrane Collaboration

• Who– Elected representatives of each of the

Collaboration entities (Review Groups, Centres, Fields, Methods Groups, the Consumer Network)

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Summary of The Cochrane Collaboration

• International collaboration

• Prepares, maintains, and disseminates systematic reviews

• Diverse internal structure (Review Groups, Centres, Fields, Methods Groups, the Consumer Network)

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How to participate

• Join a Collaborative Review Group

• Join a Field, Methods Group, or the Consumer Network

• Handsearch a journal

• Identify or provide funding

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The future...

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Future challenges

• Recruitment of large numbers of reviewers in all areas of health care

• Clinically useful presentation of the Cochrane Database of Systematic Reviews

• Efficient and effective communication within the Collaboration

• Financial solvency of the organisation

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THE COCHRANECOLLABORATION

Review of 10 years

Review of 10 years Hamid R Baradaran, M.D., PhD. Assistant Professor of Epidemiology Iran University...

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