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Finola Delamere, Finola Delamere, Managing Editor Managing Editor Cochrane Skin Group Cochrane Skin Group Centre of Evidence Based Centre of Evidence Based Dermatology (CEBD) Dermatology (CEBD) Nottingham, UK Nottingham, UK 1

An introduction to the Cochrane Collaboration & the Cochrane Skin Group

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Finola Delamere, Managing Editor Cochrane Skin Group Centre of Evidence Based Dermatology (CEBD) Nottingham, UK. An introduction to the Cochrane Collaboration & the Cochrane Skin Group. Rationale for Cochrane Collaboration. Collective ignorance about effects of healthcare - PowerPoint PPT Presentation

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Page 1: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

Finola Delamere,Finola Delamere,Managing Editor Managing Editor

Cochrane Skin GroupCochrane Skin Group

Centre of Evidence Based Dermatology Centre of Evidence Based Dermatology (CEBD)(CEBD)

Nottingham, UKNottingham, UK

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Page 2: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

An introduction to theAn introduction to the

Cochrane Collaboration & the Cochrane Collaboration & the Cochrane Skin GroupCochrane Skin Group

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Page 3: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

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Rationale for Cochrane CollaborationRationale for Cochrane Collaboration

Collective ignorance about effects of healthcare Collective ignorance about effects of healthcare

Overwhelming amount of clinical informationOverwhelming amount of clinical information

A systematic approach needed to organising A systematic approach needed to organising and evaluating clinical trial dataand evaluating clinical trial data

The Cochrane systematic reviewThe Cochrane systematic review

Page 4: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

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What is the Cochrane What is the Cochrane Collaboration?Collaboration?

An international organisationAn international organisation

It prepares and maintains the Cochrane Library It prepares and maintains the Cochrane Library which is published onlinewhich is published online

The principle source of The principle source of up-to-dateup-to-date high quality high quality evidence on the effects of healthcare interventionsevidence on the effects of healthcare interventions

Page 5: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

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Cochrane Centres

South African

Australasian

Chinese

Brazilian

Nordic

German

ItalianIberoamerican

Dutch

UK

Canadian

US

South Asian

French

Page 6: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

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Cochrane Collaboration - structureCochrane Collaboration - structure

Collaborative Review Groups

Fields

The Consumer Network

Centres

Methods Groups

Steering Group

Page 7: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

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Why the ‘Cochrane’ Collaboration?Why the ‘Cochrane’ Collaboration?

Archie Cochrane, a British epidemiologist, pointed out the Archie Cochrane, a British epidemiologist, pointed out the deficiencies of current reviews of the medical literature in deficiencies of current reviews of the medical literature in Cochrane AL (1972). 'Effectiveness and Efficiency: random Cochrane AL (1972). 'Effectiveness and Efficiency: random reflections on health services'.reflections on health services'.

Iain Chalmers -an obstetrician in Cardiff,UK. The first Iain Chalmers -an obstetrician in Cardiff,UK. The first ‘Cochrane Centre’ opened in Oxford 1992.‘Cochrane Centre’ opened in Oxford 1992.

Page 8: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

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What makes a Cochrane review?What makes a Cochrane review?

Structured process involving several stepsStructured process involving several steps

Well formulated questionWell formulated question Team effortTeam effort Comprehensive data searchComprehensive data search Unbiased selection and abstraction processUnbiased selection and abstraction process Critical appraisal of dataCritical appraisal of data Synthesis of dataSynthesis of data

Page 9: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

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Why is a Cochrane review different Why is a Cochrane review different from any other review?from any other review?

Rigorous, open, published research methodsRigorous, open, published research methods

More exhaustive search for trials than a conventional More exhaustive search for trials than a conventional reviewreview

Two stages - protocol and full review - both peer reviewedTwo stages - protocol and full review - both peer reviewed

Highlights both implications for practice and for researchHighlights both implications for practice and for research

Only systematic review to be updated regularly.Only systematic review to be updated regularly.

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Stages of a Cochrane ReviewStages of a Cochrane Review

Submit a title-the ideaSubmit a title-the idea

Write the protocol-the planWrite the protocol-the plan

Write the review-the productWrite the review-the product

Page 11: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

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Cochrane Skin GroupCochrane Skin Group

Currently we have published 48 reviews-which we Currently we have published 48 reviews-which we aim to update every 2 yearsaim to update every 2 years

Currently we have published 40 protocols- which Currently we have published 40 protocols- which are under development to reviewsare under development to reviews

Currently 20 registered titles under development to Currently 20 registered titles under development to published protocolspublished protocols

Page 12: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

Cochrane Skin GroupCochrane Skin Group Some of the reviews & updated reviews we haveSome of the reviews & updated reviews we have

published in The Cochrane Library in 2010published in The Cochrane Library in 2010

Interventions for vitiligo (updated review) by Whitton ME, Pinart Interventions for vitiligo (updated review) by Whitton ME, Pinart M, Batchelor J, Lushey C, Leonardi-Bee J, González UM, Batchelor J, Lushey C, Leonardi-Bee J, González U

Interventions for bullous pemphigoid (updated review) by Interventions for bullous pemphigoid (updated review) by Kirtschig G, Middleton P, Bennett C, Murrell DF, Wojnarowska Kirtschig G, Middleton P, Bennett C, Murrell DF, Wojnarowska F, Khumalo NPF, Khumalo NP

Interventions for melasma (new review) by Rajaratnam R, Interventions for melasma (new review) by Rajaratnam R, Halpern J, Salim A, Emmett CHalpern J, Salim A, Emmett C

Interventions for cellulitis and erysipelas (new review) by Interventions for cellulitis and erysipelas (new review) by Kilburn SA, Featherstone P, Higgins B, Brindle RKilburn SA, Featherstone P, Higgins B, Brindle R

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Page 13: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

Cochrane Skin GroupCochrane Skin GroupSome of the protocols we have published in Some of the protocols we have published in

The Cochrane Library in 2010The Cochrane Library in 2010

Specific allergen immunotherapy for the treatment of atopic Specific allergen immunotherapy for the treatment of atopic eczema by Calderon MA, Boyle RJ, Nankervis H, García eczema by Calderon MA, Boyle RJ, Nankervis H, García Núñez I, Williams HC, Durham S Núñez I, Williams HC, Durham S

Interventions for preventing and managing radiation-induced Interventions for preventing and managing radiation-induced skin reactions in cancer patients by Chan R, Webster J, skin reactions in cancer patients by Chan R, Webster J, Battistutta D, Chung B, Brooks L Battistutta D, Chung B, Brooks L   

Topical interventions for genital lichen sclerosus by Chi C-C, Topical interventions for genital lichen sclerosus by Chi C-C, Baldo M, Kirtschig G, Brackenbury F, Lewis F, Wojnarowska FBaldo M, Kirtschig G, Brackenbury F, Lewis F, Wojnarowska F

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Page 14: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

Cochrane Skin GroupCochrane Skin GroupSome of the reviews currently in the editorial processSome of the reviews currently in the editorial process

Interventions for ingrowing toenails (U) Interventions for impetigo (U) Interventions for nail psoriasis (R) Interventions for infantile haemangiomas (R) Venom immunotherapy for preventing allergic reactions to

insect stings (P) Balneophototherapy for chronic plaque type psoriasis (P) Interferon alpha for the adjuvant treatment of cutaneous

melanoma (P) Interventions for mycosis fungoides (P)

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Page 15: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

Impact of Skin Group reviewsImpact of Skin Group reviews

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About half of our reviews make recommendations to help clinical practice by for example being used in guidelines:

Interventions for vitiligo –Clinical Knowledge Summary

Topical treatments for chronic plaque psoriasis – the subject of a publication to help clinicians put evidence into practice

Interventions for American cutaneous and mucocutaneous leishmaniasis- 1st prize from Pan American Health Organisation for its relevance to a neglected disease in the Americas

Page 16: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

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Other skin reviews highlight research gaps:Other skin reviews highlight research gaps:

Interventions for basal cell carcinoma – Interventions for basal cell carcinoma – SINS trial SINS trial

(Surgery vs Imiquimod for Nodular & Superficial BCC)(Surgery vs Imiquimod for Nodular & Superficial BCC)

RCT of excisional surgery vs imiquimod 5% cream for nodular and RCT of excisional surgery vs imiquimod 5% cream for nodular and superficial basal cell carcinoma (SINS)superficial basal cell carcinoma (SINS)

Patient 3 year follow up has been completed, analysis due to start on Patient 3 year follow up has been completed, analysis due to start on primary outcomesprimary outcomes

Interventions for bullous pemphigoid – BLISTER trial Interventions for bullous pemphigoid – BLISTER trial

(The Bullous Pemphigoid Steroids and Tetracyclines Study)(The Bullous Pemphigoid Steroids and Tetracyclines Study)

RCT to compare the safety & effectiveness of doxycycline (200 mg/day) with RCT to compare the safety & effectiveness of doxycycline (200 mg/day) with prednisolone (0.5 mg/kg/day) for the initial treatment of bullous pemphigoid.prednisolone (0.5 mg/kg/day) for the initial treatment of bullous pemphigoid.

64 of 256 bullous pemphigoid participants currently recruited64 of 256 bullous pemphigoid participants currently recruited

Page 17: An introduction to the  Cochrane Collaboration & the  Cochrane Skin Group

Cochrane Skin GroupCochrane Skin Group

www.skin.cochrane.orgwww.skin.cochrane.org

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How you can get involvedHow you can get involved

Read our reviewsRead our reviews

Comment on published reviews via the Comment on published reviews via the feedback facility on the Cochrane Libraryfeedback facility on the Cochrane Library

Be a peer referee for usBe a peer referee for us

Become a Skin Group review author!Become a Skin Group review author!

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2020

The Cochrane LibraryThe Cochrane Library

www.thecochranelibrary.orgwww.thecochranelibrary.org

Electronic publication published onlineElectronic publication published online Issued monthlyIssued monthly Database called ‘Cochrane Reviews’Database called ‘Cochrane Reviews’ Database called ‘Clinical Trials’Database called ‘Clinical Trials’

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Rationale for Cochrane CollaborationRationale for Cochrane Collaboration

Collective ignorance about effects of healthcare Collective ignorance about effects of healthcare

Overwhelming amount of clinical informationOverwhelming amount of clinical information

A systematic approach needed to organising A systematic approach needed to organising and evaluating clinical trial dataand evaluating clinical trial data

The Cochrane systematic reviewThe Cochrane systematic review