Cochrane Multiple Sclerosis and Rare Diseases of the Central Nervous System recently launched an international priority setting exercise. Here, the Co-ordinating Editors, Dr Graziella Filippini and Dr Francesco Nonino, tell us about their experience with priority setting and plans for evaluation and implementation. 

Why do you think it’s important to identify systematic review priorities?

We need to identify priority questions to make sure that our systematic reviews would be as useful as possible to the people who need to use, or might be affected by, our research: people with multiple sclerosis and their carers, health and social professionals, researchers and the wider community. Moreover, we think it is important to identify and prioritise interventions that could potentially reduce inequity or health problems that are more relevant to disadvantaged groups.

How has your Review Group approached the priority setting process?

In our view, the process needs involvement of all stakeholders, therefore we started a wide-ranging consultation process through an online survey. People with multiple sclerosis, their carers, health and social professionals, researchers, are invited to tell us their ideas for research priority topics in multiple sclerosis by responding a short anonymous questionnaire, available in 12 languages (ms.cochrane.org/priority-setting-multiple-sclerosis-international-survey).
The survey will be open for participation until December 13, 2020.
We are asking respondents to choose and rank 3 high priority questions from a list of 16 questions and suggest additional free-text priority research topics that they think are missing from the list.
At the end of the survey we will start working on the first three Cochrane reviews, that will be produced on the 3 top-ranking priority questions, based on the answers of the respondents. The remaining questions and more additional questions, suggested as free-text by the respondents, will be grouped and consolidated into a new list that will be used in the second survey.

What have been the main challenges so far?

To date we have received 349 completed questionnaires, mainly from European high-income countries. We are concerned we will not be able to reach a wide diffusion of our survey, and responses by people from middle- and low-income countries.

When will the results be available?

We expect results of this first survey will be available in February 2021

How do you think the agreed priorities will shape future research?
We will publicly share the results of the survey, and we think that the agreed priorities will be most useful to the community. It will be an opportunity for a multi-stakeholder involvement in identifying areas in multiple sclerosis where evidence is lacking. At the end of the survey we will produce the first 3 Cochrane reviews on the 3 top-ranking topics.

Additional resources 

• Group’s survey/priority setting webpage   
• Cochrane Community webpage on priority setting exercises
• KT guidance note

Acknowledgements

This priority setting exercise was designed in collaboration with the Cochrane Neurological Sciences Field and Cochrane Italia.

We thank our Editorial Base team, Elisa Baldin (Affiliated Researcher) and Ben Ridley (Managing Editor).

We thank Maria Grazia Celani (Clinical & Research Committee, Cochrane Neurological Sciences Field), Kathryn Mahan (Field Co-ordinator) and Roberto D’Amico (Director Cochrane Italia)

We thank members of the Steering Group for their valuable comments on the project design and support in the dissemination of the survey, Cinzia Colombo (Laboratory of Research and Consumer Involvement, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy), Gavin Giovannoni (Blizard Institute, Barts and the London School of Medicine and Dentistry. Queen Mary University of London, London, UK), Fary Khan (Department of Rehabilitation Medicine Royal Melbourne Hospital, Victoria, Australia), Sascha Köpke (Institute of Nursing Science. University of Cologne, Germany), Joanna Laurson-Doube (Multiple Sclerosis International Federation, Hong Kong), Catherine Schvarz (Lay Member, Perugia, Italy), Carolyn A Young (The Walton Centre NHS Foundation Trust, Liverpool, UK).

We thank all persons who translated the questionnaire, in Albanian language (Jera Kruja, University of Medicine, Tirana, Albania), Arabic (Vanitha Jagannath, American Mission Hospital, Bahrian), Chinese (Dian He, Affiliated Hospital of Guizhou Medical University, Guiyang, China), French (Catherine Schvarz, Perugia, Italy), German (Sascha Köpke (Institute of Nursing Science. University of Cologne, Germany), Italian (Catherine Schvarz, Perugia, Italy), Norwegian (Trond Riise, Dept. of Global Public Health and Primary Care, University of Bergen, Norway), Portuguese (Filipe Brogueira Rodrigues and João Costa, Faculdade de Medicina da Universidade de Lisboa, Cochrane Movement Disorders group), Russian (Liliya Eugenevna Ziganshina, Director of Cochrane Russia), Serbian (Bojana Mozina, Belgrade, Serbia), Spanish (Juan C. Vázquez Niebla and Xavier Bonfill Cosp, Cochrane Iberoamerica).

We particularly thank Paolo Rosati (Web Operations Manager, Informatics & Technology (IT) Services, Cochrane Central Executive Team) for his major technical support by uploading all the translated questionnaires into the DRUPAL platform. 

Cochrane Heart has published the first Cochrane Review using Risk of Bias (RoB 2) as part of the formal pilot. Here Marianna Kaye, Assistant Managing Editor with Cochrane Heart, interviews two authors to find out more about the experience of using the tool. 

Cochrane Heart is excited to announce that Physical activity interventions for people with congenital heart disease has been published using the using the risk of bias 2 (RoB2) tool has now been published. 

Just prior to the publication of the review, we talked with the authors Craig Williams and Curtis Wadey from the Children's Health and Exercise Research Centre at the University of Exeter, UK, about the tool and their experience of using it. 

Authors Craig Williams and Curtis Wadey

Firstly, can you give us an overview of what your review was looking at and what the main findings were?

Your review was the first we have published using the new risk of bias 2 tool. What was your experience?

Were there any particular challenges?

And finally, any tips for authors on using the RoB2 tool in the future?

By Ella Flemyng (Methods Implementation Manager)

We are delighted to announce that the first Cochrane Review using Risk of Bias (RoB 2) as part of the formal pilot has published in the Cochrane Library. 

This Review, from Craig Williams, University of Exeter, and colleagues, examined the effects of physical activity interventions for people with congenital heart disease. The RoB 2 tool was used to examine results of the included trials in relation to five outcomes: maximal cardiorespiratory fitness, submaximal cardiorespiratory fitness, health related quality of life, physical activity and muscular strength. 

With the publication of this first Review using RoB 2 from the pilot, we have compiled a list of the key resources for the community on lessons learnt so far and what to expect going forward:

• The Cochrane Editorial Board has posted a position statement on RoB 2 in Cochrane and the expectations for Cochrane Review Groups going forward – a must read for any Cochrane Review Group staff
• An Editorial from the RoB 2 Pilot Team on RoB 2 has published in the Cochrane Library that reflects on this published Review and the phased approach for introducing a new methodology in Cochrane
• A ‘What we’ve learnt from Cochrane’s Risk of Bias 2 Pilot’ post collates developments since the beginning of the pilot and how we addressed concerns from our community as part of the development
• A podcast with William Curtis, lead author of this Review using RoB 2, on the author team’s experience with RoB 2 is available via the Cochrane Heart website
• An introductory leaflet with pre-recorded videos, a detailed Starter Pack, including protocol and review reporting checklists, and RoB 2 FAQs can be found via Cochrane Methods
• Editorial checklist for protocols and reviews are available for Cochrane Review Groups, please contact support@cochrane.org
• And of course, see what RoB 2 looks like in a published Cochrane Review, including the new designs for interactive, results-level tables for these assessments (found in the new ‘Risk of Bias’ section, after the Characteristics of Studies section)

The phased approach to implementing RoB 2 in Cochrane is a new way of introducing a method and was highlighted as a must by the Cochrane Review Groups at the start of this process. It has been insightful (and sometimes eventful!) and we would not have been able to do it without the wonderful people we’ve worked with. I’d like to thank the developers of the RoB 2 tool, Jonathan Sterne and Julian Higgins, their team at the University of Bristol, as well as the Convenors of the Bias Methods Group (Julian Higgins, Isabelle Boutron, Matt Page and Asbjørn Hróbjartsson) for their expertise and insights. We especially want to thank Cochrane Review Group editors and staff with Reviews using RoB 2 in the pilot and their authors, who have informed developments over the last 18 months to improve the experience of future review teams. In particular, Nicole Martin, Managing Editor for Cochrane Heart, who managed this first Review in the pilot. I would also like to thank my colleagues across the Cochrane Central Executive team who have coordinated developments in their areas to support RoB 2 in Cochrane Reviews. And last, but by no means least, I’d like to thank Kerry Dwan, who is co-lead of the Pilot with me, and Tess Moore, who has been an incredible deputy for the project!

What next?

The decision on whether a Cochrane Review should use RoB 2 is still that of the Cochrane Review Group. The position statement from the Editorial Board outlines the expectations for RoB 2 in Cochrane Reviews going forward:

1. RoB 2 is recommended as the preferred tool for assessing RCTs in new intervention reviews as per the Handbook, but RoB 1 may still be used;
2. Reviews using RoB 2 must be prepared in RevMan Web because the functionality to record and display RoB 2 will not be added to RevMan 5;
3. The decision of which tool to use should be made between authors and CRG staff before the protocol has been drafted (switching to RoB 2 after protocol publication is discouraged);
4. There is no expectation that reviews already in development will adopt the method retrospectively;
5. There is no expectation that updates will adopt the method at any point, and authors and CRG staff can decide whether to switch to RoB 2 at the point of update.

The following diagram showcases the process and support available for Cochrane Reviews using RoB 2, from title registration to publication of the Review (steps in darker color highlight the additional support available for the first Review in a Cochrane Review Group that uses RoB 2): (click here to view larger)

 
We are continuing to learn from those using RoB 2 in Cochrane and building this feedback into our plans. There are certain conditions that must be met before Cochrane considers making RoB 2 mandatory for all newly registered Cochrane Intervention Reviews, which are detailed in the position statement, and we’ll keep you in the loop with further posts as they develop.

If anyone has any questions about RoB 2 or the phased implementation, please contact support@cochrane.org. 

A recent observational study found that the Students 4 Best Evidence blog can be used as a clinical practice competences educational tool for students. Chiara Arienti, Cochrane Rehabilitation Coordinator and lead author, shares how this study came about and more on what it found. 

In 2017, during my abroad experience in Oxford, as PhD student of Cochrane Rehabilitation, Cochrane UK team, Selena and Emma, showed me the Students 4 Best Evidence (S4BE) blog, a fruitful tool for the evidence sharing inside health professionals students of all world.

I was enthusiastic of this blog and I studied how it worked and how it might be useful for the rehabilitation stakeholders. One day, while I was studying in the Bodleian Library, I found some papers that highlighted the importance of Evidence-Based Clinical Practice (EBP) competences for the health professionals. Indeed, EBP is a fundamental element in the delivery of high-quality care and healthcare professionals make clinical decisions based on the best available research. This highlights the need for healthcare professionals to possess adequate competencies for EBP. During the last 20 years, they have been increasingly integrated as a core component into the curriculum of undergraduate, postgraduate and continuing education health programmes worldwide.

So, when I went back to Italy, I spoke with my Cochrane Rehabilitation Director, Prof. Stefano Negrini, and we decided, as Cochrane Rehabilitation, to propose to Physiotherapy School of University of Brescia, to set up an EBP Laboratory for undergraduate physiotherapy students with the aim to learn EBP competencies using as digital tool, S4BE blog, that we can define as one of the Cochrane Knowledge Translation digital tools for health professional students.

We conducted an observational study between January 2018 and June 2019 at the School of Physiotherapy, University of Brescia, Italy, and it has been published in BMJ Evidence-Based Medicine Journal on 21st October 2020. Further, two our physiotherapy students published two articles on the blog.

The findings of our study show that an effective educational protocol based on a Digital Problem-Based Learning approach, using S4BE as a digital technology tool can improve the EBP competencies in physiotherapy students. The establishment of EBM laboratory could be a good way to implement the undergraduate curricula in physiotherapy school and could allow to have the future health professionals better trained and aware about the use of EBP in daily clinical practice decision making.

We think that this educational protocol, based on the using of S4BE as digital technology tool, might be an important Cochrane KT tool for the education of young researchers to EBP competences. Therefore, it might be integrated inside the educational programs proposed in Cochrane International Mobility by different Cochrane Groups and Fields. The idea could be to develop an unique “Cochrane educational EBP program” for the health professional students that join to Cochrane International Mobility.

• Read the BMJ article 'Students 4 Best Evidence as a digital Problem-Based Learning method to improve Evidence-Based Practice competencies in undergraduate physiotherapy students: an observational study'.
• Visit the Students 4 Best Evidence blog (En español)

The Cochrane Insurance Medicine Field has recently celebrated its fifth anniversary.  In this Cochrane Community blog, Adrian Verbel, Cochrane Insurance Medicine Coordinator talk about the successes and challenges of the past five years, their KT strategy, working in collaboration with partners and other Cochrane Group, and their plans for the future.

Insurance Medicine (IM) is about making health-related judgments on diagnosis, prognosis and effectiveness of interventions in the context of insurance coverage. It is important that these decisions are informed by the best available evidence, which is why Cochrane Insurance Medicine (CIM) was created!

Cochrane Insurance Medicine was established in 2015 with support of Insurance Medicine (IM) researchers from:

• the Dutch Research Center for Insurance Medicine,
• the unit Evidence-based Insurance Medicine, Research & Education (EbIM) at the University of Basel in Switzerland,
• the Division of Insurance Medicine at Karolinska Institutet in Sweden, and
• the McMaster University in Canada.

Since then, our aim has been to make IM more evidence-based, promoting the production, dissemination and use of scientific evidence to support IM practice. A central part of our work is the development of knowledge translation strategies and products.

We are proud of our Cochrane Corners
We established the ‘Cochrane Corners’ sections with the support from the TBV journal (the Netherlands) and Suva Medical (Switzerland). We work with Cochrane Work to publish evidence summaries of individual Cochrane reviews. We always start with a ‘practice case’ which is a scenario to which we apply the evidence. These practical examples support people in how to use scientific evidence for making health decisions in insurance medicine.  

Our target audiences are physicians, other health professionals, managers and decision-makers, the Cochrane Corners have been a very useful way to disseminate Cochrane evidence to them. We publish Cochrane Corners in different languages to reduce language barriers for the use of evidence (English, Dutch, German and French).

Our partners and collaborations are key!
The key word is synergy. Identifying common interests, overlapping areas of work and the capacity for team working, has been critical for generating synergies and productive collaborations with Cochrane Work and other partner institutions. A good example of this was our 2016 survey exploring the evidence and training needs of IM professionals in Europe. Collaborating with partners who knew our target audiences allowed us to develop tailored strategies and to progress faster. The results of the survey gave us a good overview of the needs and barriers that IM professional face when using scientific evidence –helping us address their needs better. The survey showed that 40% of 662 participants did not know what Cochrane is or what it does. After focusing our efforts on raising our profile we have seen a slow but continuous increase in the number of subscribers to our newsletter and the number of visits to our website.

Our knowledge translation strategy has helped
Using the results of the 2016 survey we developed a knowledge translation strategic plan. One of our main goals is to advocate for the production and use of IM evidence.  As one of the strategies, we developed a case description, showing the current limitations in the availability of IM evidence, the impact of the lack of evidence on social security systems and the society and finally, the role that scientific evidence plays addressing these issues.  We use this at in as many places as we can to present our case – to keep knocking on different doors.

The future looks bright

We are working with Cochrane Work on a number of exciting projects over the next few months and years, making the best use of the skills and enthusiasm across the Cochrane network, including:

• Developing an evidence map on work participation then using this to prioritize relevant topics for five new Cochrane reviews in the area of work participation.
• Developing a set of core outcomes on work participation to generate a more standardized measurement of work participation outcomes in future trials.
• Exploring different strategies to compile and disseminate relevant Cochrane and non-Cochrane evidence.

We are excited to see what the next 5 years brings.

Adrian Verbel, Cochrane Insurance Medicine Coordinator
Regina Kunz, Cochrane Insurance Medicine co-Director
Emilie Friberg, Cochrane Insurance Medicine co-Director
Jan Hoving, Cochrane Insurance Medicine co-Director

• Review of CIM activities over past 5 years
• CIM Cochrane Corners
• Cochrane Learning Live Webinar of experience of designing KT strategies: using online surveys to identify target audience needs

Information specialists within Cochrane generally work with their review authors and editorial staff, but rarely have a chance to work with another information specialist to produce a search strategy, or to collaborate on a review.

Samantha (Sam) Cox (Information Specialist at Cochrane ENT) and Anne Littlewood (Information Specialist at Cochrane Oral Health) report their experience of working together on three new Cochrane reviews.

The COVID-19 pandemic has brought unprecedented challenges to health-care providers. Both ENT specialists and the dental care teams face similar issues in the mitigation of aerosol-generating procedures (AGPs). Two Cochrane Review groups in the Musculoskeletal, Oral, Sensory and Skin (MOSS) Network (Cochrane ENT and Cochrane Oral Health) decided to join forces to co-produce evidence for three new reviews looking at whether mouth rinses and nasal sprays can reduce viral load before AGPs, the first co-produced reviews on the Cochrane Library.

Cochrane ENT is based in Oxford, UK, and Cochrane Oral Health is based in Manchester, UK. Editors from both groups came together via virtual meetings at an early stage in the pandemic to discuss how they could produce reviews of relevance to their stakeholders, and how this would work in practice. An author team was established from the two editorial bases. We also met to discuss how to work together to support the process in our roles as information specialists. We discussed:

• Where we might search for evidence;
• How we might design the search strategy;
• Who would do the searches;
• How we would write up the search methods in the protocol and final reviews

Designing the search
A rough draft of the protocol for what would develop into the three reviews had been produced by the authors; and we spent some time discussing whether to do one over-arching search to cover all three reviews, or whether each review should have it’s own search. We decided that as COVID-19 is such a new disease, one search to cover all three reviews was going to be adequate, although we might revisit that decision for updates as the evidence base develops.

We each talked to our respective teams about which agents might be used as mouth rinses and nasal sprays; Sam from an ENT perspective, and Anne from an Oral Health perspective. We then took the resulting list and did more research into the various terms and synonyms that might be used for each agent, splitting the work between us. Sam then developed a search in Ovid MEDLINE to share with Anne, and we discussed and refined it further. We sent that search to be peer reviewed by an information specialist colleague and actioned the resulting changes.

We also talked to the author team about where to search and developed a list of sources that might be useful. We ran test searches across some of these to see if searches would be practical and whether they were likely to yield results.

The reviews were to be done as quickly as possible, so we had to limit our searches to databases and resources that would be productive and allow us to send results to the authors quickly. After discussion and feedback, we settled on five sources: CENTRAL, MEDLINE, Embase, the World Health Organization (WHO) COVID‐19 Global literature on coronavirus disease database and Cochrane’s COVID-19 Study Register.

As the editorial process was managed by the ENT group, Sam wrote up the protocol search methods and shared with Anne for checking and feedback.

Running the searches
To facilitate the rapid review process, we undertook the searches before publication of the protocol. Sam had already entered the draft search strategy into MEDLINE, so she ran the search, and sent the results to Anne, who searched the other four databases and collated the results. The results were documented and shared with Sam and the author team. One update has been run since then, so that the results could be as up to date as possible before the publication of the three reviews. Sam then wrote up the search methods for the final reviews and dealt with requests for papers and referencing.

Working together
This collaboration of information specialists was a really positive experience. We worked well as a team, dividing tasks and discussing each stage. We believe that the search methods for these reviews are stronger as a result. We were able to meet practical difficulties, for example, because there were two information specialists involved, we could ensure that one of us was always present at the regular weekly meetings of the author team to discuss these reviews. This improved communication with the authors, and we kept in touch with each other to feedback any important developments. It also enabled us to respond quickly throughout this expedited process. Tasks could be assigned to the person who was available at the time and meant that we could support the rapid production of timely Cochrane Evidence.

We think that this is a great example of how Cochrane groups can work together in their Networks to co-produce evidence, and how members of the editorial team can share responsibilities

The three completed reviews were published on the Cochrane Library on 16 September 2020:

• Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking aerosol-generating procedures (AGPs) on patients without suspected or confirmed COVID-19 infection
• Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed COVID-19 infection to improve patient outcomes and to protect healthcare workers treating them
• Use of antimicrobial mouthwashes (gargling) and nasal sprays by healthcare workers to protect them when treating patients with suspected or confirmed COVID-19 infection

They were the first Cochrane Reviews published jointly by two Cochrane Review Groups in the Cochrane Library.

Post publication
Anne took responsibility for PICO annotating the three reviews, so the annotations appeared on the Cochrane Library as soon as the reviews were published. Both Anne and Sam were involved in discussions about how to disseminate the reviews. Anne wrote a blog and Anne and Sam tweeted the reviews from their Group’s respective Twitter Accounts: @CochraneENT and @CochraneOHG

Anne and Sam will continue to work together to keep these reviews up to date, as evidence to answer these important clinical questions are published

Karen Head is writing on behalf of Cochrane’s Knowledge Translation Evaluation Working Group. The working group is made up of people across Review Groups, Fields, Geographic Groups and the Central Executive Team. In 2020 the working group has been finding out how to support Cochrane Groups that want to evaluate their knowledge translation work.

Why look at whether Cochrane is making a difference?
Cochrane’s vision is a world of improved health where decisions about health and healthcare are informed by high-quality, relevant and up-to-date synthesized research evidence. We’re striving for this, but it might be difficult to know whether we are helping to achieve it.

The Cochrane community puts a lot of time and resource into knowledge translation, aiming to advocate for, share and support people to use evidence in policy and practice. But is this working? Organisations and researchers around the world have explored how to measure the impact of knowledge translation and the consensus seems to be … there is no easy answer!

But just because this is difficult doesn’t mean that we shouldn’t do something to move us in the right direction! It’s important to do this so we know what is working well, what to focus on more and how we can keep developing.

What Cochrane Groups say
During summer 2020, 70 Cochrane Groups shared how they evaluate their knowledge translation work and things that would help.

Groups said it is very important to evaluate knowledge translation work and that it would be useful to have some pointers and simple tools. So, from November 2020 we’ll have some templates available on the Cochrane Community webpages.

Here are some highlights of what Cochrane Groups said:

Get involved
If you want to find out whether your Group’s knowledge translation activities are making a difference, you can:

1. Take part in an introductory two-part webinar series about evaluation approaches:

• Webinar 1 is on 2nd November 2020
• Webinar 2 is on 1st December 2020

These are designed as a series for people to take part in both sessions. We’ll be recording these and sharing them online.

2. Express an interest in being part of a learning network / community of practice in 2021 to share skills, ideas and tools.

We look forward to continuing to learn together.

Karen Head
Knowledge Translation Project Manager
Cochrane Central Executive
khead@cochrane.org

Links:

• KT learning resources
• KT online learning module

Learn about Knowledge Translation in Cochrane with the launch of the KT online learning module!

Blog author Karen Head is the Cochrane Knowledge Translation Project Manager and a Cochrane author. She works to support KT projects and help share learnings about knowledge translation across Cochrane.

As someone who is more used to conducting meta-analyses and developing summary of findings tables, my first encounter with the term ‘Knowledge Translation’ was confusion! My thoughts ranged from, is it about translating Cochrane Evidence into different languages? Is it about sharing the results of Cochrane reviews? Is it about prioritising Cochrane review titles to make them relevant to end users? It turns out the answer is ‘yes’ to all of these things…and a lot more besides!

The confusion around the meaning of the term ‘knowledge translation’ was a concern shared by the Cochrane community working group looking at how we can build capacity for knowledge translation. With this, the idea for an online learning module explaining ‘KT in Cochrane’ was born!

We are delighted to launch the KT online learning module across Cochrane and for all our contributors! It is freely accessible to everyone, you just need to log in with a Cochrane account (free to register) and should take about 1 hour to complete.

The module aims to explain what knowledge translation is and how it relates to many of our Cochrane activities. You will meet characters from across Cochrane and see different interactive scenarios that we hope are relatable to your Cochrane roles. Whether you are an author, someone working in a Review Group, Geographic Group, Field, a member of Cochrane Consumer Network, translation team – or any other role that you might have in Cochrane – we hope that you will enjoy the module. We hope that you will see how, by keeping the needs of end users at the heart of what we do, we can use knowledge translation to promote evidence-informed health decision-making.

Go to the full module

It has taken so many wonderful knowledge translation experts, advisors, peer reviewers and learning experts from every corner of Cochrane to help produce this module, that it is difficult to name them all – but thank you! However, a huge special thanks should be given to Sarah Elliott (Cochrane Child Health) and Jess Hendon (Cochrane Common Mental Disorders) for their content expertise on the module, along with Dario Sambunjuak and Chris Watts from Cochrane’s Training team. This was the small group who met many months ago (when meeting in-person was allowed!) and provided the inspiration for the module. They have shown throughout the development of the module the collaboration, enthusiasm, sense of humour and above all, passion that makes working in Cochrane such a pleasure.

We hope that you enjoy the module and we are happy to hear any comments or thoughts that you might have.

• View the 'Introduction to knowledge translation (KT) in Cochrane' module
• See other KT learning resources
• Learn about Cochrane's KT mentoring scheme
• Find out about Cochrane’s KT community

Soumitra S Datta and Ajit Kumar are both child psychiatrists and Cochrane reviewers for more than 15 years with the Cochrane Schizophrenia Group. Rajendrani Mukherjee is a professional illustrator. Anisha Basu is passionate about art and is in her first year of medical school. Saranya Banerjee and Rhea Daruvala are both clinical psychologists.

Have you recently published a Cochrane systematic review? Would you want your review to be visible around the world but you do not know how? Don’t worry ! We will take you through the steps of producing attractive videos that you could share with the links to your review. A good video should make the key message of your review more accessible and easily understandable to lay audiences, policymakers, and service users.

Before beginning:

1. Build a team: As researchers, you may not have all the skills for producing audio-visual materials necessary. We would recommend you to harness local talent. Especially look for artists, young professionals and students who are good at translating concepts into visual medium.
2. Learn from others: Search for good examples of videos and graphics, especially from your field of work.
3. Distill your key message: Based on the abstract of your systematic review you need to be able to distill the key concepts that you want to convey to the broader audience. The key message should be brief and scientifically supported by the findings of your review. See the Dissemination Checklist for some help on what to include. 
4. Collaborate with service users: During the process of knowledge translation, you might want to collaborate with service users or patient advocates.
5. Understand the Cochrane branding guidelines: Familiarise yourself with the Cochrane Brand Guidelines, which provides direction on how to use of the Cochrane logo and the colour palette (which is specific to each review group). The three graphics in this blog are examples of sticking to the ‘teal palette’ of the Cochrane Collaboration. You may have to use other colours depending on which review group you belong to. We would strongly recommend you read the Cochrane branding guidelines and get in touch with the Cochrane Knowledge Translation Department. At first you may feel overwhelmed with the details given in the branding related documents.  But, if you pause for a minute, you will understand that the breadth of the documents is to do away with any ambiguity and ultimately help users.

Producing videos

1. Avoid stereotypes: It's important to avoid stereotyped depiction of patient’s illness experience e.g. image of a person holding his head between his hands (to depict psychological distress) or images of people with hair loss (to depict a person with cancer).  At best, these images do not encompass all the aspects of a person’s journey through the illness, and at worst, may contribute to the stigma related to the condition.  
2. Avoid busy slides: You should avoid a lot of texts in any videos as it defeats the purpose. Keep the videos short, preferably less than a minute in duration.

    

3. Use Graphics: Try to produce original graphics that are simple yet representative of the idea you want to convey. When borrowing graphics, be sure that you use non-copyrighted images with appropriate permissions and acknowledgments.
4. Get feedback: You should be prepared to share a draft version with the knowledge translation team or whoever will put up your visual abstract. You should be flexible to change according to their helpful suggestions.  If the platform where you aspire to put up the video is run professionally, you are likely receive prompt but very specific feedback. You need to incorporate the changes and revert back. If you are planning on multiple videos, we suggest that you get feedback on the first one so that the subsequent ones are already in line with the organisational guidelines.
5. Don’t fret about deadlines: Do not feel too pressured to finalise the visual abstracts on the same day your review is published. We understand that as authors you may be having several deadlines to deal with. You may not be sure of the exact date of publication of your review in advance. Don't worry . The video is not a part of your actual review. You can add the video along with a link to your review when you circulate it through social media, after publication.
6. Get others to share: Cochrane can host your videos on their YouTube and help share out through their various platforms. They can also share with in Comms Digest, so that other geographical groups can share and perhaps translate. Share your final version with Cochrane's Knowledge Translation Department so they can celebrate your success and share further!

We are still learning! Here are two examples we made recently:

 You can see more samples of videos  produced by our team here for our recent review 'Psychological interventions for psychosis in adolescents'. More guidance on creating videos is also available on Cochrane Training. 

Picture credits: Rajendrani Mukherjee
Video credits: Sourav Patra

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.

• Learn more about Knowledge Translation on Cochrane Training