Cochrane Collaboration

About: Cochrane Collaboration is a nonprofit organization based out in Oxford, United Kingdom. It is known for research contribution in the topics: Systematic review & Randomized controlled trial. The organization has 1995 authors who have published 3928 publications receiving 382695 citations.

Online health information seeking: how people with multiple sclerosis find, assess and integrate treatment information to manage their health

Abstract: Background and objective The Internet is increasingly prominent as a source of health information for people with multiple sclerosis (MS). But there has been little exploration of the needs, experiences and preferences of people with MS for integrating treatment information into decision making, in the context of searching on the Internet. This was the aim of our study. Design Sixty participants (51 people with MS; nine family members) took part in a focus group or online forum. They were asked to describe how they find and assess reliable treatment information (particularly online) and how this changes over time. Thematic analysis was underpinned by a coding frame. Results Participants described that there was both too much information online and too little that applied to them. They spoke of wariness and scepticism but also empowerment. The availability of up-to-date and unbiased treatment information, including practical and lifestyle-related information, was important to many. Many participants were keen to engage in a ‘research partnership’ with health professionals and developed a range of strategies to enhance the trustworthiness of online information. We use the term ‘self-regulation’ to capture the variations in information seeking behaviour that participants described over time, as they responded to their changing information needs, their emotional state and growing expertise about MS. Conclusions People with MS have developed a number of strategies to both find and integrate treatment information from a range of sources. Their reflections informed the development of an evidence-based consumer web site based on summaries of MS Cochrane reviews.

Amphotericin B lipid soluble formulations versus amphotericin B in cancer patients with neutropenia

Abstract: Background Patients with cancer who are treated with chemotherapy or receive a bone marrow transplant have an increased risk of acquiring fungal infections. Such infections can be life-threatening. Antifungal drugs are therefore often given prophylactically to such patients, or when they have a fever. Objectives To compare the benefits and harms of lipid soluble formulations of amphotericin B with conventional amphotericin B in cancer patients with neutropenia. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) Issue 4, 2007, PubMed (November 2007) and the reference lists of articles. We searched the proceedings of the ICAAC (from 1990 to 2007), General Meeting of the ASM (from 1990 to 2007), and the European Congress of Clinical Microbiology and Infectious Diseases (1995 to 2007) and contacted researchers in the field. For the 2011 update we searched PubMed from 1966 to 18 July 2011 and the reference lists of articles. Selection criteria Randomised clinical trials comparing lipid soluble formulations of amphotericin B with conventional amphotericin B. Data collection and analysis The two review authors independently assessed trial eligibility, risk of bias and abstracted data. Main results We found 12 trials (1895 patients). Lipid-based amphotericin B was not more effective than conventional amphotericin B for mortality (relative risk (RR) 0.83, 95% confidence interval (CI) 0.62 to 1.12), but decreased invasive fungal infection (RR 0.65, 95% CI 0.44 to 0.97), nephrotoxicity, defined as a 100% increase in serum creatinine (RR 0.45, 95%CI 0.37 to 0.54), and number of dropouts (RR 0.78, 95%CI 0.62 to 0.97). For the drug used in most patients, AmBisome (3 trials, 1149 patients), there was no significant difference in mortality (RR 0.74, 95% CI 0.52 to 1.07) whereas it tended to be more effective than conventional amphotericin B for invasive fungal infection (RR 0.63, 95% CI 0.39 to 1.01, P = 0.053). AmBisome, amphotericin B in Intralipid (6 trials, 379 patients), amphotericin B colloidal dispersion (ABCD) (2 trials, 262 patients), and amphotericin B lipid complex (ABLC) (1 trial, 105 patients) all decreased the occurrence of nephrotoxicity, but conventional amphotericin B was rarely administered under optimal circumstances. For the 2011 update no additional trials were identified for inclusion. Authors' conclusions It is not clear whether there are any advantages of lipid-based formulations if conventional amphotericin B is administered under optimal circumstances and their high cost prohibits routine use in most settings. There is a need for large trials comparing lipid-based formulations of amphotericin B with conventional amphotericin B given in the same dose, with routine premedication for prevention of infusion-related toxicity, and with supplementation with fluid, potassium and magnesium for prevention of nephrotoxicity.

Interventions for tears of the rotator cuff in adults

Abstract: Reason for withdrawal from publication This review was withdrawn, as of Issue 1, 2009, because it is substantially out-of-date. To view the published versions of this article, please click the 'Other versions' tab.

Psychosocial interventions for premature ejaculation

Abstract: BACKGROUND: Premature ejaculation (PE) is a very common sexual dysfunction among patients, and with varying prevalence estimates ranging from 3% to 20% Although psychological issues are present in most patients with premature PE, as a cause or as a consequence, research on the effects of psychological approaches for PE has in general not been controlled or randomised and is lacking in long-term follow up OBJECTIVE: To assess the efficacy of psychosocial interventions for PE CRITERIA FOR CONSIDERING STUDIES FOR THIS REVIEW: Trials were searched in computerized general and specialized databases, such as: MEDLINE by PubMed (1966 to 2010); PsycINFO (1974 to 2010); EMBASE (1980 to 2010); LILACS (1982 to 2010); the Cochrane Central Register of Controlled Trials (Cochrane Library, 2010); and by checking bibliographies, and contacting manufacturers and researchers SELECTION CRITERIA: Randomised or quasi-randomised controlled trials evaluating psychosocial interventions compared with different psychosocial interventions, pharmacological interventions, waiting list, or no treatment for PE DATA COLLECTION AND ANALYSIS: Information on patients, interventions, and outcomes was extracted by at least two independent reviewers using a standard form The primary outcome measure for comparing the effects of psychosocial interventions to waiting list and standard medications was improvement in IELT (ie, time from vaginal penetration to ejaculation) The secondary outcome was change in validated PE questionnaires MAIN RESULTS: In one study behavioral therapy (BT) was significantly better than waiting list for duration of intercourse (MD (mean differ ence) 40790 seconds, 95% CI 30242 to 51338), and couples’ sexual satisfaction (MD -2610, CI -5048 to -172) BT was also significantly bet ter for a new functional-sexological treatment (FS) (MD 41200 seconds, 95% CI 30588 to 51812), change over time in subjective perception of duration of intercourse (Women: MD 288, 95% CI 206 to 370; Men: MD 252, CI 165 to 339) and couples’ sexual satisfaction (MD -2510, 95% CI -4795 to -225), versus waiting list AUTHORS’ CONCLUSIONS: Overall, there is weak and inconsistent evidence regarding the effectiveness of psychological interventions for the treatment of premature ejaculation Three of the four included randomised controlled studies of psychotherapy for PE reported our primary outcome (Improvement in IELT), and the majority have a small sample size The early success reports (978%) of Masters and Johnson could not be replicated One study found a significant improvement from baseline in the duration of intercourse, sexual satisfaction and sexual function with a new functional-sexological treatment and behavior therapy compared to waiting list One study showed that the combination of chlorpromazine and BT was superior to chlorpromazine alone Randomised trials with larger group samples are still needed to further confirm or deny the current available evidence for psychological interventions for treating PE

Content area experts as authors: helpful or harmful for systematic reviews and meta-analyses?

Abstract: Peter Gotzsche and John Ioannidis argue that it is not always sensible to include subject experts as authors of systematic reviews and meta-analyses