Introduction to The Cochrane Library. What is The Cochrane Library? A collection of databases that...

Introduction to The Cochrane Library

What is The Cochrane Library?

A collection of databases that include high quality, independent, reliable evidence from Cochrane and other systematic reviews, clinical trials and more.

• Brings together research on the effectiveness of healthcare treatments and interventions from around the world.

• Based on the practice of evidence-based medicine• Used by clinicians, policy makers, researchers, educators,

students, patients and others.

Evidence-based medicine is “The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”

Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. (1996)http://www.bmj.com/cgi/content/full/312/7023/71

www.thecochranelibrary.com

Who develops the Cochrane Library?

The Cochrane Library is published by Wiley for The Cochrane Collaboration.The Cochrane Collaboration is an international not-for-profit organization:

Aim: to help people make well-informed decisions about health care.How: by preparing, maintaining and promoting the accessibility of systematic reviews on the effects of healthcare interventions.


The Cochrane Collaboration

In early 2009 there were 23,815 contributors from 112 countries. Member groups of The Cochrane Collaboration include:A. Collaborative Review Groups (52) maintain and update Cochrane

Reviews.B. Cochrane Centres (13) support people in their geographic and linguistic

area.C. Fields (14) bring together healthcare issues impacting across review

groups.D. Method Groups (14) develop the methodology of Cochrane Reviews.E. Consumer Network represents the interests of healthcare consumers.

www.cochrane.org


Australasian Cochrane Centre Iberoamerican Cochrane Centre New Zealand Branch of the Australasian Cochrane Centre Venezuelan Branch of the Iberoamerican Cochrane Centre Singapore Branch of the Australasian Cochrane Centre Italian Cochrane Centre Thai Cochrane Network of the Australasian Cochrane Centre Croatian Branch of the Italian Cochrane CentreBrazilian Cochrane Centre Nordic Cochrane CentreCanadian Cochrane Centre Finnish branch of the Nordic Cochrane Centre Francophone Network of the Canadian Cochrane Centre Norwegian branch of the Nordic Cochrane Centre Chinese Cochrane Centre South African Cochrane Centre Hong Kong Branch of the Chinese Cochrane Centre Nigerian Branch of the South African Cochrane CentreDutch Cochrane Centre South Asian Cochrane Centre Belgian Branch of the Dutch Cochrane Centre UK Cochrane CentreGerman Cochrane Centre Bahrain Branch of the UK Cochrane Centre

US Cochrane Center San Francisco Branch of the US Cochrane Center

The Cochrane Collaboration global community

• The Cochrane Collaboration, through the Cochrane Library, facilitates a global community approach to healthcare by promoting education, research and accessibility to everyone.

• The Cochrane Collaboration reacts quickly to current health issues, such as the Haiti and Chilean earthquakes, making relevant reviews available for free.

• In addition they set up specific task forces to investigate and research high impact current issues such as the recent Swine Flu and the Indian Ocean tsunami in December 2004.


What can you do with The Cochrane Library?

Use: For improved patient care and outcomes. Based on the best available evidence which have been proven in practice.

Research: The Cochrane Library has an Impact Factor of 5.182 giving you confidence in quality and relevance.

Provide feedback: Did it work for you? Do you have information relevant to the review?

Contribute: Do you want to be a reviewer? Is there an issue you believe should be reviewed? Go to the “I am here to” tab and click on the “Get involved” link at www.cochrane.org


The Cochrane Library databases

1. The Cochrane Database of Systematic Reviews (Cochrane Reviews) A systematic review investigates the effectiveness of

interventions for prevention, treatment and rehabilitation in health care. Now includes reviews of diagnostic test accuracy studies. Now updated monthly!

2. The Database of Abstracts of Reviews of Effects (Other reviews)Complements Cochrane Reviews by quality-assessing and summarising reviews which have not been carried out by The Cochrane Collaboration.



3. The Cochrane Central Register of Controlled Trials (Clinical trials) Includes details of published articles taken from bibliographic databases – such as MEDLINE and EMBASE - and other published sources.

4. Health Technology Assessment Database (Technology Assessments)Brings together details of completed and ongoing health technology assessments from around the world.



5. Methodology Register (Methods Studies)Presents a bibliography of publications that report on methods used when conducting controlled trials.

6. NHS Economic Evaluation Database (Economic Evaluations) Systematically identifies economic evaluations of healthcare interventions from around the world, appraises their quality and highlights their relative strengths and weaknesses.


The Cochrane Database of Systematic Reviews

• The “gold standard” for systematic reviews • Combines results of the world’s best

medical research studies• Adhere to a strict process to make them

more comprehensive, thus minimizing bias and ensuring reliability

• Updated regularly - ensuring that treatment decisions can be based on the most up-to-date, reliable evidence.


What is a systematic review?

• A systematic review identifies an intervention or treatment for a specific disease or other problem in health care

• Identifies and includes all up-to-date and relevant studies and trials

• Determines whether or not the intervention or treatment works


10

One trial - provideslimited results

10

10 10

10

Trial is conducted

several times

Evaluating several trials* is more likely to provide a more valid and reliable result

*Each trial should meet same criteria, follow same methods and test against same conditions or parameters…

The benefits of a systematic review


What is a protocol?

• The plan or set of steps to be followed in the systematic review

• Should describe the rationale for the review, the objectives, and the methods that will be used to locate, select, and critically appraise studies, and to collect and analyse data from the included studies


Review TitleRank World -full text accesses

Interventions for preventing falls in elderly people 1

Interventions for preventing obesity in children 2

Cranberries for preventing urinary tract infections 3

St John's Wort for major depression 4

Interventions for enhancing medication adherence 5

Nicotine replacement therapy for smoking cessation 6

Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases

7

Water for wound cleansing 8

Support surfaces for pressure ulcer prevention 9

Exercise for improving balance in older people 10

Top 10 reviews – worldwide 2008


Authoring team

Expertise might include:• Clinical knowledge• Searching skills• Relevant statistics

Prepare protocol(3 months to one year)

Register title

Prepare review(one to five years)

The Cochrane Library(CDSR and About updated monthly other databases

updated quarterly)

Publishing reviews in The Cochrane Library


What to consider when reading reviews

• Do the studies address a sensible clinical question?

• Do the studies possess high quality designs and methods?

• Are the results from the studies similar or widely different?

• Are all relevant and important outcomes considered?

• Are the conclusions drawn consistent with the method employed?

• How do the results apply to the care of your patients?



If you would like to learn more about The Cochrane Library or any of our other products please go to www.interscience.wiley.com/tutorials

Explore The Cochrane Library at www.thecochranelibrary.com

Explore The Cochrane Collaboration at www.cochrane.org • Browse the Cochrane Handbook for Systematic Reviews of Interventions

www.cochrane.org/resources/handbook/index.htm

• Find your nearest Cochrane Centre www.cochrane.org/contact/centres

• The Australasian Cochrane Centre’s Guide to the Cochrane Library www.cochrane.org.au/libraryguide

Thank you...


http://www.thecochranelibrary.com/

http://www.interscience.wiley.com/tutorials

http://www.thecochranelibrary.com/

http://www.cochrane.org/

http://www.cochrane.org/resources/handbook/index.htm

http://www.cochrane.org/contact/centres

http://www.cochrane.org.au/libraryguide

• The Cochrane Library What works and what doesn’t? Assists healthcare decision making by bringing together research on the effectiveness of healthcare treatments and interventions.

• Essential Evidence Plus What tools are available? Provides evidence and tools to assist in critical patient care decisions. Download to PDA to access information at point of care.

• EBM Guidelines How do I apply the evidence to my patient? Clinical guidelines, graded evidence summaries, images, audio samples and videos to guide in applying evidence in practice.

• Health Economic Evaluations Database What are the costs involved? Provides comparative analysis of costs and consequences of health interventions to aid decision makers.

www.thecochranelibrary.com ebmg.wiley.com heed.wiley.comwww.essentialevidenceplus.com

Wiley-Blackwell’s Evidence-Based Medicine databases

Describes the odds of an experimental patient suffering an adverse event relative to a control patient. Size of blue or green square relates to weight % and diamond indicates overall odds.

Reading Odds Ratio Tables


1. When you have completed your search, tick the references that you wish to download.

2. Click on the "Export Selected Citations" button. 3. At the next screen, at "Export Type" select "Abstract and citation". 4. Click on the "Go" button. 5. Save results as a text file (cit-abs-plain-.....txt) 6. Go to EndNote - click on File/Import 7. When the Import dialog box opens, under the Import data file option click

on "Choose file" and select the text file that you saved.8. Under the Import Option, click on the drop down arrow and choose

"Other Filters". Then find Cochrane (Wiley). Click on "Choose".9. Click on "Import".10. Results will differ depending on which style you have selected in EndNote.11. If you are not happy with the results, you will need to edit manually.

Importing Cochrane citations to EndNoteTM


In Cochrane1. Select and mark records. 2. At the bottom left of the screen, select Export selected citations. 3. Change to Abstract and citation if you wish, and Mac if you use one4. You will get a text file that you can either save, or copy and paste into

RefWorks. (see red note below)

Go to RefWorks 5. Select References > Import. 6. Select The Cochrane Library as the import filter and database you used. 7. Select an import folder if you wish. 8. Click Import data from the following Text, and then either

9. browse for your saved file, select and click Import OR10. copy and paste the text into the box and click Import.

(I am not sure which step is the right one and am waiting on feedback)

Importing Cochrane citations to RefWorksTM


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