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.

2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth

Abstract: The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), that produced its first Guidelines in 2005, felt the need to revise them and increase their scientific quality. The aim is to offer to all professionals and their patients an evidence-based updated review of the actual evidence on conservative treatment of idiopathic scoliosis (CTIS). All types of professionals (specialty physicians, and allied health professionals) engaged in CTIS have been involved together with a methodologist and a patient representative. A review of all the relevant literature and of the existing Guidelines have been performed. Documents, recommendations, and practical approach flow charts have been developed according to a Delphi procedure. A methodological and practical review has been made, and a final Consensus Session was held during the 2011 Barcelona SOSORT Meeting. The contents of the document are: methodology; generalities on idiopathic scoliosis; approach to CTIS in different patients, with practical flow-charts; literature review and recommendations on assessment, bracing, physiotherapy, Physiotherapeutic Specific Exercises (PSE) and other CTIS. Sixty-five recommendations have been given, divided in the following topics: Bracing (20 recommendations), PSE to prevent scoliosis progression during growth (8), PSE during brace treatment and surgical therapy (5), Other conservative treatments (3), Respiratory function and exercises (3), Sports activities (6), Assessment (20). No recommendations reached a Strength of Evidence level I; 2 were level II; 7 level III; and 20 level IV; through the Consensus procedure 26 reached level V and 10 level VI. The Strength of Recommendations was Grade A for 13, B for 49 and C for 3; none had grade D. These Guidelines have been a big effort of SOSORT to paint the actual situation of CTIS, starting from the evidence, and filling all the gray areas using a scientific method. According to results, it is possible to understand the lack of research in general on CTIS. SOSORT invites researchers to join, and clinicians to develop good research strategies to allow in the future to support or refute these recommendations according to new and stronger evidence.

Arcsine test for publication bias in meta-analyses with binary outcomes.

Abstract: In meta-analyses, it sometimes happens that smaller trials show different, often larger, treatment effects. One possible reason for such 'small study effects' is publication bias. This is said to occur when the chance of a smaller study being published is increased if it shows a stronger effect. Assuming no other small study effects, under the null hypothesis of no publication bias, there should be no association between effect size and effect precision (e.g. inverse standard error) among the trials in a meta-analysis.A number of tests for small study effects/publication bias have been developed. These use either a non-parametric test or a regression test for association between effect size and precision. However, when the outcome is binary, the effect is summarized by the log-risk ratio or log-odds ratio (log OR). Unfortunately, these measures are not independent of their estimated standard error. Consequently, established tests reject the null hypothesis too frequently. We propose new tests based on the arcsine transformation, which stabilizes the variance of binomial random variables. We report results of a simulation study under the Copas model (on the log OR scale) for publication bias, which evaluates tests so far proposed in the literature. This shows that: (i) the size of one of the new tests is comparable to those of the best existing tests, including those recently published; and (ii) among such tests it has slightly greater power, especially when the effect size is small and heterogeneity is present. Arcsine tests have additional advantages that they can include trials with zero events in both arms and that they can be very easily performed using the existing software for regression tests.

School feeding for improving the physical and psychosocial health of disadvantaged students

Abstract: Early malnutrition and/or micronutrient deficiencies can negatively affect many aspects of child health and development. School feeding programs are designed to provide food to hungry children and to improve their physical, mental and psychosocial health. This is the first systematic review on the topic of school feeding. Eighteen studies were included in this review; nine were performed in higher income countries and nine in lower income countries. In the highest quality studies (randomized controlled trials (RCTs) from low income countries, children who were fed at school gained an average of 0.39 kg more than controls over 19 months; in lower quality studies (controlled before and after trials (CBAs)), the difference in gain was 0.71 kg over 11.3 months. Children who were fed at school attended school more frequently than those in control groups; this finding translated to an average increase of 4 to 6 days a year per child. For educational and cognitive outcomes, children who were fed at school gained more than controls on math achievement, and on some short-term cognitive tasks.

Can We Systematically Review Studies That Evaluate Complex Interventions

Abstract: Background to the debate The UK Medical Research Council defines complex interventions as those comprising “a number of separate elements which seem essential to the proper functioning of the interventions although the ‘active ingredient’ of the intervention that is effective is difficult to specify.” A typical example is specialist care on a stroke unit, which involves a wide range of health professionals delivering a variety of treatments. Michelle Campbell and colleagues have argued that there are “specific difficulties in defining, developing, documenting, and reproducing complex interventions that are subject to more variation than a drug” [10]. These difficulties are one of the reasons why it is challenging for researchers to systematically review complex interventions and synthesize data from separate studies. This PLoS Medicine Debate considers the challenges facing systematic reviewers and suggests several ways of addressing them.