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< Volume 5 - August 2008 >
New affiliate
The CCNC
is pleased to announce the Canadian Partnership
Against Cancer Corporation as a new affiliate member. Cochrane will
work with CPACC to disseminate Cochrane reviews and build capacity in using
systematic reviews in their mandate of developing cancer control
strategies.
Balancing the good and bad
To make
balanced decisions, people need to know both the benefits of a treatment
and also the harmful effects. The Cochrane Adverse
Effects Group promotes the inclusion of adverse effects data in
Cochrane reviews and provides guidance on how to do this. Interested in
incorporating adverse effects into systematic reviews? Join a new
discussion list, whether your interest is in searching, inclusion criteria,
quality assessment and/or meta-analysis.
For more
details go to http://lists.cochrane.org/mailman/listinfo/aemg
ASQUS a question – qualitative syntheses
Qualitative
data, such as the results of focus groups or interviews, can help to
explain how treatments are experienced or what the barriers to introducing
new practices might be. The Cochrane Qualitative Research Methods Group
develops and supports methods to include qualitative results in Cochrane
reviews. A new discussion list for sharing methodological developments in
qualitative evidence syntheses is now available. If you have a question on
qualitative evidence synthesis ASQUS!
Cochrane Methods update
Find out
the latest in systematic review methods by reading the annual Cochrane
Methods newsletter. Articles by the 11 Cochrane Methods Groups and other
authors are now available at http://cochrane.org/newslett/MethodsGroups_June2008.pdf.
Therapeutics Initiative Podcasts
Subscribe
to the practical, as well as entertaining, podcasts produced
by the Therapeutics Initiative. Designed to provide a healthy dose of
evidence-based drug therapy information these podcasts also bring a
smidgeon (or more sometimes) of healthy skepticism. Discussions include
treating hypertension, cholesterol control and smoking cessation with an
evidence base such as Cochrane reviews and journal articles.
Specialist Library for ENT and Audiology
The Specialist Library
for ENT and Audiology is a unique resource that provides
healthcare professionals with access to the best available evidence in ENT,
audiology and thyroid disorders. Searchable by condition, specialty or
intervention, this database is complemented by Evidence Updates and an
e-newsletter. A product of the National Library for Health in the U.K., the
Specialist Library uses transparent and systematic methods to identify
content such as Cochrane reviews, and is updated regularly.
Reminders improve vaccination rates
Diseases
that are preventable by vaccines still occur due to low rates of
immunization. This Cochrane review assessed the effectiveness of various
types of patient reminder and recall systems to improve immunization rates.
In developed countries, multiple reminders by phone, letter, postcard, or
in person from primary care settings increased the number of people
vaccinated.
Patient reminder
and recall systems to improve immunization rates
Cochrane Library Spotlight - Issue 3, 2008
Asthma
Salmetrol
for chronic asthma: serious adverse events
People with asthma who regularly take salmetrol have an increased risk of
suffering serious adverse effects. While salmetrol, a long-acting
beta2-agonist, helps relieve asthma symptoms for up to 12 hours, a review
of clinical trials indicated that patients using the drug for 4-6 months
were at risk, especially if they were not taking inhaled corticosteroids.
Regular treatment
with salmeterol for chronic asthma: serious adverse events
Muskuloskeletal
Mobilize
ankle with care after surgery
Adults who use a removable splint or cast after surgery for a fractured
ankle may have increased mobility and less pain. According to a Cochrane
review, there is some evidence that encouraging the patient to use the
ankle as early as possible following the realignment of the bones will also
accelerate the healing process. However, caution should be used to not
damage the surgical wound.
Rehabilitation for
ankle fracture in adults
Orthoses
can help foot pain
Foot
pain can be disabling and affect a person’s quality of life. Wearing
custom-made orthoses can relieve foot pain caused by a high arches,
arthritis and prominent big toe joints. The reviewers of 11 trials
involving 1332 people found that relief from the pain caused by certain
conditions was alleviated within three to six months.
Custom-made foot
orthoses for the treatment of foot pain
Diabetes
Watch
what you eat and exercise to prevent diabetes
Individuals with an increased risk for type 2 diabetes can significantly
lower their risk through a combination of diet and exercise. This approach
was more effective than the standard recommendation for prevention of the
disease and diet-only and exercise-only measures. Type 2 diabetes occurred
less in people who followed a regiment of a low-calorie, low-fat and high
carbohydrate diet and 150 minutes of intense exercise (cycling or jogging)
per week.
Exercise or
exercise and diet for preventing type 2 diabetes mellitus
Dietary
advice may not be enough
People at risk for type 2 diabetes are often advised to follow a certain
diet to lower their risk of developing the disease. This Cochrane review
only found two relevant trials and concluded that, at this time, there is
not enough quality information to be able to say that dietary intervention will
lower a person’s risk of type 2 diabetes.
Dietary advice for
the prevention of type 2 diabetes mellitus in adults
Long-term
insulin has some benefit
The prospect of long-acting insulin has, in theory, promised better quality
of life and a reduction in diabetes-related complications. However, this
Cochrane review of long-acting versus intermediate-acting insulin does not
show any significant benefit from long-term insulin in overall diabetes
control. Long-term insulin was better at reducing nocturnal hypoglycemia,
however.
Intermediate
acting versus long-acting insulin for type 1 diabetes mellitus
Culturally
sensitive diabetes education improves outcomes
Members of ethnic minority groups who live in middle- to high-income
countries face barriers such as language and socio-economics in accessing
adequate healthcare and health information. Reviewers found that tailoring
the education approach about type 2 diabetes to the needs of a specific
community helped people to control their blood sugar levels and increased
their knowledge of the disease in the short term.
Culturally
appropriate health education for type 2 diabetes mellitus in ethnic
minority
Women’s Health
Caesarean
section – no consensus on best technique
Although
caesarean deliveries are commonplace, medical practitioners remain divided
as to which surgical techniques are best. A Cochrane review of surgical
techniques for uterine incision and uterine closure was not able to
recommend the most appropriate technique to use. This is due to a lack of
information on important health outcomes such as infection, pain and
subsequent complications for both mother and baby.
Surgical techniques
for uterine incision and uterine closure at the time of caesarean section
Routine
removal of ovaries with hysterectomy not supported
There
is no evidence that removing ovaries at the time of hysterectomy provides a
health benefit to women. Ovaries continue to produce hormones after a
hysterectomy; however half of all women have their ovaries removed along
with the uterus. The reason often cited is that removing the ovaries
prevents ovarian cancer but this has not been demonstrated.
Hysterectomy
versus hysterectomy plus oophorectomy for premenopausal women
Techniques
for identifying fetal distress
A decrease in the volume of amniotic fluid can be a sign of fetal distress.
A systematic review of trials comparing two methods of testing for amniotic
fluid levels recommends the single deepest vertical pocket (SDVP) method
over the amniotic fluid index (AFI) method. The AFI method indicated low
amniotic levels more often, but without satisfactorily identifying fetal
distress, which resulted in more frequent unnecessary induced deliveries.
Amniotic fluid
index versus single deepest vertical pocket as a screening test for
preventing adverse pregnancy outcome
Alternative Therapies
Herbal
remedy may help acute respiratory infections
There
is weak evidence to suggest that Pelargonium sidoides extract EPs(R) 7630,
also known as Umckaloabo(R), may be effective in alleviating the symptoms
of acute respiratory tract infections such as bronchitis and the common
cold. These results are of particular interest given increasing antibiotic
resistance and the over-prescribing of antibiotics for these types of
infections, which are most commonly due to a virus and not bacteria.
Pelargonium
sidoides extract for acute respiratory tract infections
Oxygen
therapy for migraine and cluster headaches
Hyperbaric oxygen therapy (HBOT) is the therapeutic administration of 100%
oxygen at increased environmental pressures, while for normobaric oxygen
therapy (NBOT) it is administered at normal pressure. A review of studies
showed that while HBOT may help people get rid of their migraines, the
availability and delivery of the treatment were challenging. It is possible
that NBOT may alleviate cluster headaches. Neither oxygen therapy helped to
prevent migraines or cluster headaches.
Normobaric and
hyperbaric oxygen therapy for migraine and cluster headache
Lost in Knowledge Transfer? Finding our Way Together
Health Research
Transfer Network of Alberta Conference
September
28 - 30, 2008
Banff, Alberta
Early-bird registration deadline: August 28
www.ahfmr.ab.ca/rtna/conference/
Knowledge Management in Public Health: Exploring Culture,
Content, Process and Technology
The
National Collaborating Centre for Methods and Tools
November 3 - 4, 2008
Hamilton, Ontario
www.nccmt.ca/events/nccmt_events-eng.html
CCNC co-sponsored Events
All About Evidence
Using
Cochrane Systematic Reviews and Health Technology Assessments in Healthcare
Practice
September 24-25, 2008
St. John’s, NL
Web site: www.nlcahr.mun.ca/news/e_bulletin/e-bulletin_July_24_2008.pdf
Unravelling the Literature: Understanding Evidence Based
Research and How it Can Improve Your Practice
October
25, 2008
Niagara College School of Dental Hygiene, Ontario
www.niagaracollege.ca/dentalevent/
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