The Cochrane Anaesthesia Review Group (CARG) strongly believes that research does not finish when a paper is published and that without an audience engaging with a review then this amounts to research waste. Getting evidence into practice must therefore be a key aim - not only by disseminating reviews already produced, but also engaging with stakeholders to set priorities and direction for future reviews.
The Co-ordinating Editor Professor Andrew Smith has taken a unique approach to getting evidence into practice by asking two senior anaesthetic doctors with a clinical background to volunteer to become “dissemination fellows” - this blog post shares more about the project, what they achieved, and lessons for other Cochrane groups.
Dissemination Fellows – A strategy to getting evidence into practice
The role of a dissemination fellow is to promote engagement with an emphasis on modern clinical applications and develop strategies for time-effective dissemination. We were delighted to be appointed (Dr Muataz Amare and Dr Michael McEvoy) in this role, and set about trying to help with knowledge translation. Initially we found several difficulties, as we found that knowledge translation is an incredibly broad topic. Some of these difficulties were identifying opportunities, deciding which reviews we should focus on and which techniques would be successful in reaching our knowledge translation goals. We started with dissemination through social media, included important studies in Wikipedia articles, wrote blogs and we responded to relevant articles in journals where we felt the inclusion of a Cochrane review would further inform a discussion with letters to the authors
Over time we developed more strategic approaches with the help of the Cochrane KT mentoring scheme which encouraged us to target national guidelines, create a special collection and help inform the response to the covid-19 crisis.
What we achieved
As well as the activities described above, we have had many successes in promoting Cochrane reviews. We’ve published summaries of reviews for anaesthesia groups, attended meetings to provide reviews to groups coordinating the production of national guidelines, created a special collection on regional anaesthesia to avoid aerosol generating procedures and preserve drug supplies during covid-19 (which quickly had over 3500 unique views) and liaised with the Obstetric Anaesthetist Association when a drug supply issue caused concerns for caesarean sections. Throughout this process, we provided updates to the editorial board on ongoing dissemination efforts which kept them engaged with our activities. We will soon focus on planning for the future to ensure that the improvements we have made in being more strategic in our dissemination are not lost when others take over the role.
Summary of Successes
- Altmetric scores for reviews published before 2018 increased by 369 during our time in the post. When new reviews are included they increased to 554. The biggest increases in altmetric scores were from newer studies.
- Liaised with the group coordinating the upcoming guidelines on perioperative medicine for the Royal College of Anaesthetists to promote the use of Cochrane evidence in future national guidance.
- Special collection on regional anaesthesia to promote its use during COVID to reduce aerosol generating procedures and preserve drugs for general anaesthetic during supply shortages
- An editorial celebrating 20 years of the Cochrane Anaesthesia Review Group.
- Provided evidence to the Association of Anaesthetists from the Cochrane Anaesthesia Review Groups for Anaesthesia and Critical Care during the COVID-19 pandemic. Article published encouraging the use of best evidence based practice rather than rumour during a novel pandemic.
- British and American obstetric anaesthetist societies included evidence from a Cochrane review on intrathecal Isobaric vs hyperbaric bupivacaine in guidance during a drug supply shortage of hyperbaric bupivacaine.
- A blog written for the British geriatric society on anaesthetic options for hip fracture surgery
- Multiple other articles providing brief summaries of reviews for Anaesthesia News and the Royal College of Anaesthetists Bulletin.
What we learnt
Dissemination and knowledge translation is a huge task and it can seem overwhelming and directionless. We learnt that you could divide the dissemination up into background activities and big projects. Background activities include social media, letters to journals and writing blogs/summaries of papers. The big projects should focus on a clearly defined area or opportunity e.g. the production of a national guideline or a special collection. Background work can seem fruitless but can also become a big success for the strangest of reasons and so it is always worth carrying on. The big projects however can really ensure reviews become widely read and inform national and international opinion.
Key Learning Points
- Keep going – even if an attempt to engage with an audience does not work at first it might get traction with time.
- Use any connections you have to look for unique opportunities – other specialties often appreciate engagement from a different angle or might have their own interest in your review.
- Always check the latest news from your specialty and more widely look at healthcare regionally, nationally and globally – ask if you have a review that might relate to a current problem or safety issue being experienced.
- If there is a regular or upcoming event that relates to your specialty then mark it on a calendar and prepare a resource – even if its just a twitter post.
Where to find out more?
The Cochrane Anaesthesia Review Group is based in Denmark and the Co-ordinating Editor Prof Andrew Smith is based in Lancaster UK. We are contactable through this group and we would be happy to discuss the project with anyone interested in setting up a similar project.