37
DISCLAIMERS
• I am a member of the Cochrane Collaboration and have
attended Colloquia since 2011, but receive no pay from
Cochrane or Wiley, except…
• In 2012 I received a small honorarium for assisting with
Cochrane Systematic Review training in Halifax
LEARNING OBJECTIVES
• Understand the purpose and structure of the
Cochrane Library
• Identify the types of information in various databases
within the Cochrane Library;
• Create basic searches to meet information needs
• Identify what user groups will find the Cochrane
Library useful and for what purposes
COCHRANE AND SYSTEMATIC REVIEWS
Very brief intro
HISTORY AND PURPOSE OF THE COCHRANE COLLABORATION
• Professor Archibald Leman
Cochrane, CBE FRCP FFCM, (1909
- 1988)
• Collaboration and Colloquia: since 1993
• Cochrane Library: since 1995
• International organization (UK
headquarters + Centres around the globe)
• “Our vision is a world of improved health
where decisions about health and health
care are informed by high-quality, relevant
and up-to-date synthesized research
evidence.”
SYSTEMATIC REVIEWS
• Identify, appraise and synthesize
• All the empirical evidence that meets pre-
specified eligibility criteria
• Answer a specific research question.
• Use explicit, systematic methods
• Aimed at minimizing bias & to produce
more reliable findings
• Goal: inform decision making
Traditional reviews:
• Methods to find and select evidence may
not be specified
• Purpose is to generally describe what is
known on a topic
• May address a broad question such as
“What pharmaceutical options help
reduce nausea after chemotherapy?”
https://www.cochranelibrary.com/about/about-cochrane-reviews
BENEFITS OF A SYSTEMATIC REVIEW
• Provide a more precise estimate of the overall treatment effect
• SR can contribute to the generalizability of results
• Demonstrate areas where the available evidence is insufficient
COCHRANE REVIEWS
• Intervention reviews assess the benefits and harms of interventions used in
healthcare and health policy.
• Diagnostic test accuracy reviews assess how well a diagnostic test performs in
diagnosing and detecting a particular disease.
• Methodology reviews address issues relevant to how systematic reviews and clinical
trials are conducted and reported.
• Qualitative reviews synthesize qualitative evidence to address questions on aspects
of interventions other than effectiveness.
• Prognosis reviews address the probable course or future outcome(s) of people with
a health problem. https://www.cochranelibrary.com/about/about-cochrane-reviews
WHAT IS IN THE COCHRANE LIBRARY
And who might want to use it…
COCHRANE LIBRARY: TYPE OF QUESTIONS
• Treatment
• Prevention
• Diagnostic test accuracy (some and increasing)
• Prognosis (2 reviews so far!)
• Qualitative (experiences, barriers & facilitators – 6
reviews)
Cochrane Reviews, Clinical
Trials, Overviews of reviews
POLL: TYPES OF QUESTION
Summaries
Systems
Single Studies
Syntheses
Synopses of studies
Synopses of Syntheses
THE HAYNES 6S MODEL: LEVELS OF EVIDENCE
THE HAYNES 6S MODEL: LEVELS OF EVIDENCE
Summaries
Systems
Single Studies
Syntheses
Synopses of studies
Synopses of Syntheses
Expert opinion/commentary Cochrane Editorials?
As of May 6, 2019
COCHRANE CONTENTS
Cochrane Editorials
Full text; few records
Full text (short); some
records (increasing)
Full text; many records
Full text; few records
Citation info; MANY records
Citation info; many records
SEARCHING COCHRANE LIBRARY
The basics!
SEARCH QUESTION IN COCHRANE LIBRARY
COCHRANE LIBRARY, CONT’D
COCHRANE LIBRARY, CONT’D
Naltrexone for smoking cessation
WHY SYSTEMATIC REVIEW?
• Meta-analysis of multiple studies increases the confidence you can have in the results
• Included studies are assessed for quality
Naltrexone for alcohol dependence
PRACTICE!
• Common cold and zinc
• Cannabis and pain (can compare results to
marijuana and pain; pot and pain)
• Low back pain and exercise
POLL: CONTENTS
CDSR RECORDS
Understanding and saving
OTHER RESULTS
Clinical Answers and CENTRAL Trials
INTERVENTION CONTROL
There was a statistically significant
difference between groups, in favor of
cannabinoids (standardized mean
difference ‐0.47, 95% CI ‐0.90 to ‐0.04).
Sorted by publication
date, new to old
NO FULL TEXT!
POLL: USERS
