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.

On the benefits and harms of screening for breast cancer.

Abstract: claim that our critique of the randomized screening trials has little merit; that there is no reason to believe that the Canadian study was of better quality than the New York Health Insurance Plan (HIP) study or the Two-County study; and that the prior consensus on mammography was correct. However, their review suffers from erroneous assumptions and biased statistical analyses, and their quotations are often selective and misleading. In my discussion of the issues, I will follow when possible the sequence of arguments used by FPR. FPR claim in their abstract that early detection leads to less invasive therapy. This could have been true, if the only effect of screening had been to detect the same tumours earlier that are detected later if women are not screened. FPR naively believe that screening does just that, i.e. does not lead to overdiagnosis. They note, for example, that the incidence of breast cancers in the New York HIP study is the same in the control group as in the screening group 5–7 years after screening started (their table 2), as they expected. I will explain under the HIP study below why this argument is faulty. The level of overdiagnosis can be studied reliably in the trials from Canada and Malmö which did not differentially exclude women with prior breast cancer after randomization and did not introduce early, systematic screening of the whole control group. 2–4 There was an overdiagnosis of 30% 5,6 which corresponds closely to the 31% excess surgery we have previously described 2,3 (Table 1). A similar result was seen for the trials that screened the whole control group when only cancers before this screen were included 7–9 (Table 2). The excess surgery rate was 20% for mastectomies. 2,3 We have discussed in detail why it is likely that even today, there would be about 20% more mastectomies when women are screened than if they are not screened. 3 In Southeast Netherlands, for example, when screening was introduced from 1990 to 1998, the number of women who underwent breast-conserving surgery increased by 71%, and the number of women who underwent mastectomy increased by 84%. 10 If the study had included carcinoma in situ there would have been even more mastectomies. 3,11 A study from Italy claimed that screening had not led to an increase in mastectomies, 12 but this study had no control group and the premises for the study …

Method and apparatus for deploying data among data destinations for website development and maintenance

Abstract: A method and apparatus are provided for dynamically organizing and tracking website content during its deployment (100). Organizing and tracking may be done internally to a website development system during development and externally to outside destinations such as production servers (120) that provide access to websites via the Internet or intranet (124). The method of internal deployment includes the process of deploying data among workstations (102), storage areas (104), such as a backing store, staging areas, editing areas and other internal areas during the development of website content. According to the invention, a tracking system is able to track such changes as the content is being created, including information regarding their source and history. The method of external deployment includes different schemes for deploying the finished website content to one or more destinations, such as production servers. The invention also includes a method and apparatus for creating templates for use in deploying data, both internally and externally.

New clinical guidelines on the spinal stabilisation of adult trauma patients - consensus and evidence based.

Abstract: Traumatic spinal cord injury is a relatively rare injury in Denmark but may result in serious neurological consequences. For decades, prehospital spinal stabilisation with a rigid cervical collar and a hard backboard has been considered to be the most appropriate procedure to prevent secondary spinal cord injuries during patient transportation. However, the procedure has been questioned in recent years, due to the lack of high-quality studies supporting its efficacy. A national interdisciplinary task force was therefore established to provide updated clinical guidelines on prehospital procedures for spinal stabilisation of adult trauma patients in Denmark. The guidelines are based on a systematic review of the literature and grading of the evidence, in addition to a standardised consensus process. This process yielded five main recommendations: A strong recommendation against spinal stabilisation of patients with isolated penetrating trauma; a weak recommendation against the prehospital use of a rigid cervical collar and a hard backboard for ABCDE-stable patients; and a weak recommendation for the use of a vacuum mattress for patient transportation. Finally, our group recommends the use of our clinical algorithm to ensure good clinical practice.

Development of the ACTIVE framework to describe stakeholder involvement in systematic reviews

Abstract: ObjectivesInvolvement of patients, health professionals, and the wider public (‘stakeholders’) is seen to be beneficial to the quality, relevance and impact of research and may enhance the usefulne...