The Targeted Updates project aims to provide policy-makers, in particular guideline developers, with up-to-date information from Cochrane Reviews, tailored to their needs and working to a fast timeline. Targeted Updates use Cochrane Reviews as their foundation, but focus on updating selected comparisons and outcomes, working in close consultation with key stakeholders. In this post, the team describes their next case study. For more information, please see the Targeted Updates project page.
Case Study C: Question identified in partnership with a Cochrane Review Group
1. Context
One of the first groups we worked with was the Gynaecology and Fertility Cochrane Review Group (CRG). We liaised with this CRG to identify priority topics for a Targeted Update. The CRG returned to us and suggested a number of topics that could be suitable for a Targeted Update, informed by their knowledge of the current needs of guideline developers. It was agreed that we would proceed with two of these topics, both produced by the Targeted Update team.
2. Process
The questions were agreed between the CRG and the Targeted Update team. We began this process by liaising with the original Cochrane Review’s author team, and by conducting an initial assessment of the latest version of the full Cochrane Review. It was agreed that one of the two reviews selected would be split into two Targeted Update documents, resulting in three Targeted Update documents in total. The Targeted Update team completed all tasks for all of the Targeted Updates with content expertise and peer review from the CRG. The first draft for all Targeted Updates were produced, and ready for peer review within seven weeks. The peer review process for these documents was completed a further four months later, in mid-December 2015. The CRG attributed the extended delay to unanticipated delays with authors, referees, and in the editorial office. This was a common finding throughout the project, as nearly all the CRGs experienced some difficulty participating in the process over the long term due to their existing workload.
3. Output
Links available here:
- Clomiphene citrate in combination with gonadotropins for controlled ovarian stimulation in women undergoing in vitro fertilization
- GnRH agonists for women with endometrioma prior to assisted reproductive technology
- Surgery for women with endometrioma prior to assisted reproductive technology
4. Feedback from the CRG
We asked the Managing Editor of the Gynaecology and Fertility Group for some feedback on the CRG’s experiences with this Targeted Update process, both positive and negative.
As the Gynaecology and Fertility Group were the first CRG involved, they acknowledged they were initially unclear about the purpose and outputs of the Targeted Update project, feeling that this had affected their own communication with authors (though they recognised this was primarily due to the pilot nature of the project).
“We had not understood at the beginning that the targeted updates would be additional documents and our author groups would still have to update the full reviews. I now see we may not have given review authors enough information to engage them fully in the process”.
The Gynaecology and Fertility Group thought that Targeted Update documents could be valuable as part of he published full reviews on the Cochrane Library.
“The summary PDF available now on the library for each review is OK but needs SoF and/or forest plots of the main review outcomes to be really useful”.
They also observed that the Targeted Update format only works for single comparisons, but that it could be integrated with RevMan to develop a relatively simple Targeted Update format summary when a review or update is ready for publication.
The Gynaecology and Fertility Group felt that the Targeted Update document did not have a large impact on the full updated review.
“Finishing the Targeted Updates, at least for us, turned out to be a separate process from actually updating the review. Our authors are still working on the reviews themselves, had to get new searches, incorporate newly selected studies into their review etc. So clearly we could have chosen better reviews for the pilot.”
They noted though, “it is always useful to have another perspective on screening and selection. We were encouraged to see that the Targeted Update team’s selections matched those of our authors.”
The use of a monetary incentive in the process did not appear to impact the CRG's motivation.
“The financial incentive did not really work for us, although we thought it would. We did think the amount was appropriate.”
Finally, the CRG noted that the final presentation of the document was liked by everyone.
“Our consumer reviewer in particular liked the way they summarised the evidence and were easy to understand.”
5. Feedback from you
We are very interested to know what you think about these Targeted Update documents, and the project in general. We would really appreciate it if you could take just 5 minutes to read through and answer this short list of questions. Thank you very much for your participation!
6. Who are the team
Targeted Update team involved in production
- Rosie Asher
- Hanna Bergman
- Antonio Grande
- Artemisia Kakourou
- Nuala Livingstone
- Nicola Maayan
- Rachel Marshall
Review authors
- Laura Benschop
- Ahmed Fathy
- Abha Maheshwari
- S. Bhattacharya
CRG team
- Cindy Farquhar
- Helen Nagels