Helping people make well-informed decisions about health care: old and new challenges to achieving the aim of the Cochrane Collaboration

Oxman, Andrew D

doi:10.1186/2046-4053-2-77

Cited by 4 publications

(5 citation statements)

References 23 publications

(21 reference statements)

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“…The Cochrane model is one of encouraging wide participation in the conduct of reviews [51], with decentralised editorial support, core training and standardised methodological advice. The Cochrane Handbook underpins the methods and conduct of all reviews and, in the context of wide global participation, serves a critical educational purpose [52].…”

Section: Introductionmentioning

confidence: 99%

Supporting implementation of Cochrane methods in complex communication reviews: resources developed and lessons learned for editorial practice and policy

Ryan

Hill

2019

Health Res Policy Sys

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Every healthcare encounter involves some form of communication and there is growing recognition that effective health communication is central to the delivery of safe, high-quality healthcare. Conversely, poor communication has a range of adverse consequences for those receiving healthcare and the systems delivering care, including elevated patient safety risks. Increasing understanding and documentation of the key role that good communication plays in healthcare design and delivery has meant there is growing demand from policy-makers and other decision-makers for evidence on the effects of health communication interventions – that is, how best to communicate. While systematic reviews of such interventions are fundamental to building this evidence base, such interventions and reviews are often highly complex and pose considerable challenges for authors and editors. In this paper, we describe our experience as a Cochrane editorial group identifying common issues in reviews of communication interventions and developing resources to support authors to better meet these challenges. Our analysis found that issues typically fell into one or more of the following three stages of the review process: understanding and applying systematic review methods (e.g. selecting outcomes for analysis); reporting the review’s methods (e.g. describing key decisions made in conducting the review); and interpreting the findings (e.g. incorporating quality of the evidence into findings of the review). We also found that common issues reflected both practical difficulties (such as the typically large size of reviews and disparate measures for outcomes) and conceptual challenges (for instance, the difficulties of identifying comparisons). While extensive advice for Cochrane systematic reviewers exists, this standardised advice does not cover all of the issues emerging for complex communication reviews. In response, we therefore developed a collection of resources, both general and targeted to specific methodological issues. Here, we describe the types of resources developed and the aims of these, the rationale for why we needed to fill specific gaps in existing advice, and reflect on the lessons for future editorial practice, policies and research in relation to the implementation of Cochrane review methods in the area of health communication.

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Section: Introductionmentioning

confidence: 99%

Supporting implementation of Cochrane methods in complex communication reviews: resources developed and lessons learned for editorial practice and policy

Ryan

Hill

2019

Health Res Policy Sys

View full text Add to dashboard Cite

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“…3 Many see Cochrane reviews as the gold standard, and the collaboration has played a major role in promoting evidence based practice. The collaboration is clearly a success.…”

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confidence: 99%

“…It has mainly covered treatments, but should it be extended to, for example, diagnostic tests, qualitative studies of implementation, and products derived from the systematic reviews that might compete with tools like UpToDate and the BMJ's evidence products. 3 Clearly, extension would be desirable because all elements of healthcare need to be evidence based. In addition, evidence based tools beyond systematic reviews can promote evidence based healthcare and provide additional sources of revenue for the collaboration.…”

mentioning

confidence: 99%

“…The "methodological expectations of Cochrane intervention reviews" has 80 standards for conducting and 108 for reporting reviews, and few reviews meet all of these standards. 3 A recent audit showed some basic deficiencies in reviews, particularly in abstracts and plain language summaries. 8 Another worry is that only around a third of reviews have been updated in the past two years.…”

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confidence: 99%

“…4 Andy Oxman, who has been in the collaboration since the beginning, has listed 13 ways to improve reviews, starting with "Ensure that any important potential adverse effects of the interventions are addressed (whether the included studies report those outcomes or not)." 3 Brassey suggests that it might be possible to depend simply on the best trial or trials reported in core journals. 5 These strategies are unlikely to be acceptable, not least because if those core journals are the "top" journals, they would be most likely to exaggerate the benefits of treatments.…”

mentioning

confidence: 99%

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