Cochrane UK has been educating High Schoolers about evidence-based medicine. In this blog post Lynda Ware, Senior Fellow in General Practice, and Selena Ryan-Vig, Communications and Engagement Officer, share with us how they got started and what they have learnt.

Since 2016 we have been visiting secondary schools in and around Oxford to talk about Evidence-Based Medicine (EBM) and its relevance in our everyday lives. We already had an established community programme, known fondly as the 'Women's Institute (WI) talks', and the schools project evolved from this. To be more precise, the venture was suggested by two WI ladies, who questioned why Cochrane wasn't speaking to young people, whose deep-rooted aversion to seeking medical help and reliance on Dr Google are well known.

In November 2016 we faced our first audience of students in an after-school Science Club. We realised immediately how hard it is to teach well and that we would have to learn quickly if we were to survive. Nevertheless, our first foray into the world of education was well received and we can now boast a growing portfolio of schools who welcome us into their classrooms.        

  
In our talks and workshops we aim to bring an awareness of why it is important to question the evidence behind medical claims. We use topical newspaper headlines to illustrate how medical evidence can be misrepresented in the media - how it can sometimes be inaccurate and sometimes just plain wrong. We illustrate the relevance of EBM on a personal, everyday level by looking at how we choose cold remedies. We consider medical interventions at national and global levels, using the HPV vaccination programme as an example. We look at what constitutes a randomised controlled trial and how a systematic review is produced.

With the unfailingly generous encouragement and feedback from the teachers we met, we soon appreciated that just talking at the students quickly lost their attention and that we needed to use interactive activities to make our points effectively. Different forms of communication, such as animations and videos, also hit the spot.

We have taught pupils from Years 9 -13 in formal lessons and in extracurricular science and medical clubs. Recently we organised our second half day workshop on EBM for sixth formers applying to read medicine. This took place in June with twenty five Year 12 students attending from local schools. An interactive session with Anna Noel-Storr was included to introduce Cochrane Crowd and to give a taste of what systematic reviewers do. You can read more about the first workshop we ran, in October 2018, here.

The schools outreach project now has a momentum and we are getting known in and around Oxfordshire. We discovered that contact with schools is most successfully achieved by a posted letter (teachers are bombarded with emails and are unlikely to read them), followed by phone call to the headteacher or head of science. We have found that it is important to emphasise that the sessions are free of charge.

In addition to our schools visits, Science Oxford invited Cochrane UK to take part in their 2019 STEM programme and we held a workshop for a group of Year 10 pupils in the Cochrane UK office. We have also contributed for the last three years to the annual Medics' Conference, hosted by Magdalen College School.

We are very keen to extend the programme across the UK and would love to hear from others who might be interested in getting involved. We would be happy to give support and training, and would also share our various slide-sets and resources. Equally, we would be delighted to hear from anyone who has undertaken similar teaching to learn about your experiences.

We can be contacted via Cochrane UK.

general@cochrane.nhs.uk

uk.cochrane.org

Lynda Ware,

Senior Fellow in General Practice
Cochrane UK

Selena Ryan-Vig

Communications and Engagement Officer
Cochrane UK

With the recent launch of the new guidance for producing and translating blogshots we have spent a lot of time thinking about the way dissemination products are stored. Previously, in January 2017, the guidance was that blogshots in English and other languages should be sent to the Knowledge Translation Department where they were stored centrally on both the Tumblr site and a central Dropbox. However, as the number of blogshots has increased the task has become overwhelming and so changes were needed.  We had to ask ourselves….

What is the purpose of saving blogshots?  

Simply put, we store blogshots to minimise duplication of effort!  Ensuring other members of Cochrane community can see what blogshots have been produced in different languages means that blogshots can be translated, updated, adapted for different audiences and shared more effectively. We looked at the different options, asked a few people and came up with a solution….

Dropbox!

Whilst this isn’t the ideal solution, Dropbox provides a place where blogshot producers can upload their documents themselves.  It also allows everyone in Cochrane to be able to see which Cochrane reviews have blogshots and in which languages. Dropbox works with the translation software Memsource which means that integration into the language translation teams’ processes is simplified.

Groups producing and translating blogshots should ensure that the files are saved in the ‘blogshots’ folder of the ‘Cochrane Dissemination Products’ Dropbox. The files saved here should be the only version of the blogshot, rather than a copy. By avoiding saving other versions locally, we can make sure that the version in the Dropbox is the up-to-date blogshot.

The Blogshot Dropbox folder is arranged by Review Group but using the search facility means that blogshots for a specific review should be easy to locate. We have written up guidance to help with labelling, storing, searching for and updating blogshots which we hope will support the process. But as we mentioned, while it may be more practical, it isn’t very pretty, which leaves some people asking…

What will happen to blogshots on Tumblr?

The Cochrane Tumblr site has always been ‘owned’ by Cochrane UK and they have decided to continue using this platform to host their own blogshots for external audiences – in addition to using the Dropbox. Others in Cochrane are welcome to continue to use this Tumblr account, if they wish. However, this should not be a substitute for using the Blogshot Dropbox folder.

Now that all Groups should be using the Dropbox folder, you do not have to use Tumblr. However, if you do, please ensure that you keep the blogshots uploaded there up-to-date and replace out-of-date versions. If you no longer wish to use Tumblr, you are welcome to delete existing blogshots. You can also let the Cochrane UK team know and they can remove them for you.

Spreading the word!

We are happy to help you share your blogshot! You can send the blogshot to Muriah Umoquit (mumoquit@cochrane.org) who will promote your blogshot through the weekly Comms Digest and central Cochrane social media accounts. The following information is needed: Name of Review, URL to Review, URL to Dropbox folder, Suggested tweet/Twitter Handles to tag, and the language if not in English.

But this isn’t the end of the story!  We are still looking for more elegant options for storing blogshots and other future dissemination products. We would love to hear your ideas!

Emma Thomas, Fast-Track Administration Assistant and Helen Wakeford, Fast-Track Managing Editor, share some recent Fast-Track Service successes.

We are delighted to announce some recent successes of The Cochrane Fast-Track Service, which provides a rapid ‘journal-like’ editorial process for some of Cochrane’s highest priority reviews.

Since the Fast-Track Service launched in September 2018, we have received 30 enquiries, published 3 reviews, rejected 4 applications, and have 7 applications currently in the editorial process or pending submission. All reviews published thus far have had an editorial process of between 11 and 17 weeks from acceptance to publication.

The impact of Fast-Track Service reviews (both published or in progress) include: informing WHO and NICE guidelines, supporting applications to the WHO Essential Medicines List or meeting deadlines for NIHR Incentive Awards.

Fast-Track Service Reviews include prognosis reviews, network meta-analyses, reviews of complex interventions and a qualitative evidence synthesis.

The Cochrane Fast-Track Service, Cochrane Bone, Joint and Muscle Trauma, and Cochrane Urology would like to share the results of their work together:
 
Exercise for preventing falls in older people living in the community

This review had been allocated funding from a new NIHR Cochrane Reviews of NICE Priority scheme and so the authors were working to a tight deadline to incorporate the additional data requested by NICE, and the publication deadline was met within 17 weeks. The review included 108 RCTs with 23,407 participants in 25 countries. Amongst other findings the authors concluded that exercise reduces the number of falls over time by around a quarter (23% reduction) and the number of people experiencing one or more falls by around a sixth (15%) compared with control.

Interventions for treating wrist fractures in children

This review was published within 12 weeks in order to meet the deadline for an NIHR Incentive Award. As this review was produced by members of the editorial base of the CRG, independent editorial overview and approval was organised at the Network (Acute and Emergency Care) level. The review included 30 studies with 2930 children. Although there was not enough evidence to inform on the best way of treating wrist fractures in children, the review did provide support for the current use of removable splintage for buckle fractures.

Extended versus standard lymph node dissection for urothelial carcinoma of the bladder in patients undergoing radical cystectomy

This review, assessing the first RCT comparing extended to standard resection for bladder cancer, was published within 11 weeks. The study included 401 participants with bladder cancer and the review authors found that having an extended node dissection may make people less likely to die for any reason or to die from bladder cancer over time. However, both results included the possibility of no effect. More studies are required to determine the effect of extended resection on adverse effects, and cancer progression and recurrence.

For any further information or to enquire about submitting a review, please see Fast-Track Service webpage or contact the team at fast-track@cochrane.org

As well as serving as Director of Cochrane South Africa, Charles Shey Wiysonge is active with WHO work, both on health research in the WHO African Region and advising on immunization guidelines globally. In this interview, he gives an overview of this work.

Could you give a quick introduction to yourself and your work within Cochrane?

I have been the Director of Cochrane South Africa for two years. I also produce reviews with several review groups and am an editor with the Cochrane Infectious Disease Group.

My first contact with Cochrane was seeing an advert for the Cochrane Aubrey Sheiham fellowship in 2000, which was part of an effort to get more people from low-and-middle-income countries involved with Cochrane activities and evidence-based healthcare. I applied and was the first recipient, spending 4 months at the UK Cochrane Centre learning how to do systematic reviews. The two reviews I did during the fellowship were among my first publications – along with a Lancet article I wrote with Jimmy Volmink, then Director of Cochrane South Africa, about the importance of systematic reviews in research capacity development. It was a great start!

You are also quite engaged with WHO activities, particularly with the WHO African Region offices. Which groups and committees are you involved in?

I have been part of the African Advisory Committee on Health Research and Development since 2012 – initially as an advisor, and now as a full member. In 2013, I became a member of what is now called the Regional Immunization Technical Advisory Group. Then, in 2015, I got involved in the Strategic Advisory Group of Experts on Immunization (SAGE), which is based at WHO HQ.

Could you tell us about your work with the African Advisory Committee on Health Research and Development?

The African Advisory Committee on Health Research and Development is a regional reflection of the former WHO Advisory Committee on Health Research and advises on research related to health policies and development strategies in Africa.

One of the key things I have learned from being part of the Committee is the importance of active participation in whatever is happening. I have led a few documents for the Committee.

For example, I prepared a document on the importance of research to universal health coverage and the Sustainable Development Goals (SDGs) in the African Region. The paper highlighted knowledge translation, implementation research and the importance of ensuring that research is relevant to our region. This was one of the background documents for the First African Regional Forum for Strengthening Health Systems for Universal Health Coverage and the SDGs

I also supported the development of Research For Health: A Strategy for the African Region, 2016-2025. I helped prepare the background documentation and we did a bibliometric analysis on the health publications coming from Africa, looking at how they were distributed and how Africa compares worldwide.

I was also part of a small group that developed the African national health research systems barometer to monitor the development and performance in the region.

And, of course, I have given presentations for the Committee about Cochrane and the Cochrane Africa Network.

Can you give an overview of your work in SAGE and the different working groups you have participated in?

SAGE is WHO’s advisory committee for anything related to immunization. I became a member in 2015 and have just come to the end of my term.

SAGE has adopted the GRADE approach for rating evidence. While I am stepping down from the main SAGE committee, I will stay involved in the methodology working group, which includes both SAGE members and people involved in methods work around vaccines, ensuring that SAGE stays at the forefront of what is happening in methodology and using evidence to develop guidance.

Apart from that, I chaired the SAGE working group on the BCG vaccine. Until recently, the WHO BCG position paper was the oldest, so this group reviewed the evidence to update it.

I was also part of a group on tetanus. Tetanus was supposed to be eliminated in mothers and their newborn babies by 2015, yet there are still some countries yet to achieve this. This group is looking at what went wrong and what can be done to energise that global work.

In addition, I am part of the SAGE group on Ebola, which was set up during the outbreak in West Africa in 2014 to review the data on vaccines and what recommendations could be made. SAGE has been producing interim recommendations, the latest of which were discussed at the main SAGE meeting in April and published.

I led a session at the April 2016 SAGE meeting on missed opportunities for vaccination – where those eligible to receive a vaccine come into contact with the healthcare system yet do not get it. Based on this, WHO produced guidance on what countries can do to assess missed opportunities and how to intervene, and a lot of activity has taken place over the last couple of years.

I am also part of the Measuring Behavioural and Social Drivers (BeSD) of Vaccination group, which WHO HQ launched in November 2018. The group’s objective is to advance the development of tools and guidance that enable immunization programmes to measure and address local reasons of under-vaccination, and to track consistent and comparable data over time at a national and global level.

Cochrane Africa recently started a project with the WHO African Region to support evidence-based decision making in Member States. What will this involve?

WHO has contracted Cochrane Africa to work with the WHO African Regional Office to develop evidence-based health policy briefs for Member States in the region. These briefs will serve to guide actions towards the attainment of universal health coverage and other SDGs. In addition, through this project, Cochrane Africa will build the capacity of WHO staff on how to conduct and, especially, how to use Cochrane reviews in decision making.

During the first week of June 2019 we held a Cochrane Africa–WHO joint meeting to discuss and lay the groundwork for this project. The week ended with a two-day Cochrane workshop on systematic reviews and policy briefs. In his closing remarks, the Director of Programme Management at the WHO African Regional Office emphasised that WHO is committed to using the best available evidence to optimise its support to countries. WHO considers Cochrane Africa as an indispensable stakeholder on that journey.

How does Cochrane evidence inform the different WHO activities you have been involved in?

Cochrane is seen as the pinnacle of evidence and is the go-to source. Cochrane Systematic Reviews are well-respected; before anything is done, we often make sure that reviews are commissioned if there is no up-to-date Cochrane review.

I was also asked to represent SAGE within the Evidence-Based Recommendations Group of the Advisory Committee on Immunization Practices in the US, where we looked at adapting the evidence to decision frameworks for use in recommendations for the US. I think I was chosen to represent SAGE in that group partly because of my work and experience with Cochrane.

What advice would you give to members of the Cochrane community interested in getting involved in WHO work?

I would really recommend that Cochrane colleagues get involved with reviews requested by WHO, where possible. These reviews need to be done especially well because the findings are taken very seriously and are used to inform WHO recommendations.

Another way of engaging is through working groups – both content and methodological expertise is needed, so if there is a working group in your area of interest, try to get involved.

Welcome to the second edition of the TaskExchange Champs series, where we showcase the great people using TaskExchange and how they’re making the most of the platform

This month our TaskExchange Community Engagement and Partnerships Manager Emily chatted to Cochrane Information Specialist Sheila Wallace. Sheila talks about how she uses the platform to find translators, and how the platform has improved the quality of Cochrane Systematic Reviews.

Hi Sheila! Thanks so much for catching up with me today. I would like to start with a little orientation. Where are you and what time is it? It looks very light and bright!

Hi Emily, great to chat. I’m in Newcastle upon Tyne, in the UK and it’s midday here. Yes it is quite a bright day! How about you?

It’s 9pm here in Melbourne Australia, and a little cold I must say! Thank goodness for tea and interesting conversation. Some TaskExchange members don’t work for Cochrane. For their benefit, could you tell us about your role as Cochrane Information Specialist?

As a Cochrane Information Specialist (CIS) my main responsibility is to look after the evidence needs of review authors. I liaise with them in the early stages of the review process to help get them on the right track gathering evidence, and support them throughout the process. Some of my tasks are developing and running literature searches, importing records into software, tracking down papers that are difficult to find, and organising translations of papers (thanks to TaskExchange!). There are many more aspects but I could talk about this all day and you probably have other questions to ask!

Ha! Thanks Sheila. So, how do you use TaskExchange?

I’ve been using TaskExchange to look for translators to screen non-English papers for potential inclusion in our group’s systematic reviews. If a paper is deemed eligible, we also ask the translator to extract data for the review.

Has TaskExchange been successful for you?

Yes, it’s been brilliant. I’ve posted 14 tasks looking for translators and I’ve found someone quickly every time. Before TaskExchange it could be very difficult tracking down a translator, in which case a non-English study would languish in a list of ‘Studies Awaiting Classification’ until a translator could be found.

So how has TaskExchange impacted findings of your group’s systematic reviews?

TaskExchange is improving the quality of the review at the end of the day.

Now I can quickly access the pool of TaskExchange translators and if the non-English study(ies) are eligible, their data becomes available for the review. TaskExchange has meant the findings of Cochrane Incontinence reviews are less biased and more accurate than they used to be, because we’re able to include all the non-English studies that are eligible.

That’s a pretty great claim to fame for TaskExchange! How long has it taken to find helpers on TaskExchange?

Goodness, it’s often immediate! I remember once I posted a task and then happened to take the next day off work. Well I got back to my emails and I’d been flooded with applicants! But I think that’s a good “problem” to have.

Have you been able to find appropriate helpers on TaskExchange?

Yes I have. All the translators I’ve found through TaskExchange have been reliable and to the best of my knowledge, accurate with their work.

You mentioned you’ve been flooded with responses at times. How do you screen the responses to choose the best applicant?

Good question. When I receive a response, I ask myself, ‘have they told me enough about their background and experience to allow me to judge if they are the right person?’ If the response is scanty or vague, it is not very convincing. Then, it’s obviously better for me if they’ve been involved in translation for systematic reviews before, so I am looking specifically for that information in their response. I also check their TaskExchange profile for additional information, and in particular, I’m looking to see if they have been recommended by people they’ve previously helped. Last, I administer the full Cochrane conflict of interest procedure and that screens out anyone with a conflict of interest for the particular review.

In actual fact, most times I’ve been able to take the first person who has applied, and they’ve been brilliant.

Thanks for that and wow, it’s great to hear the calibre of translators on TaskExchange is high! How do you use the TaskExchange rewards system?
Note: you can offer acknowledgement, payment and/or authorship to helpers.

For a Cochrane Review it is standard practice to acknowledge a translator in the published review, if they consent to this. So in every TaskExchange translation post, I offer acknowledgement.

Do you have any final words for people considering TaskExchange to find translators?

Why aren’t you using it yet!? It’s been brilliant for us and as I said we don’t bother with any other strategy in terms of finding a translator. It’s quick, easy and the work has always been of high quality.

We recently had to put in a business plan to funders and one of the questions was how many translators do you have? After checking the number with you, Emily, I was able to put on there that I have access to 450 translators through TaskExchange. It’s just amazing having access to so many talented people!

And because we’re not ALL about work… what is something fun that you’re doing out of work?

The only problem with being lucky enough to be involved with Cochrane is you can become too engrossed and sit for just a bit too long at your computer. Some postgraduates in our Institute are encouraging us all to adopt a healthier lifestyle by starting a Walking Challenge.  In teams of four we are using our (smart)phones to count our steps – there is a weekly count on a Friday to see which team has accumulated the most. This is definitely working for me and it’s a good excuse to do more walking in the Scottish Highlands at the weekends. Well done Newcastle University postgraduates – it’s amazing what a bit of friendly competition can do to get people motivated.

Thanks Sheila. I love the sound of a collegial Walking Challenge! Maybe it’s time to instigate one at Cochrane Australia, where I’m based.  And…… that’s a wrap.

It is me who should be thanking you Emily, as well as Tari and the TaskExchange designer and developers. And of course all those people who very generously contribute their skills on TaskExchange.

Shucks! You’re making me blush.

To find translators on TaskExchange, sign up here. And remember, you don’t have to be working for Cochrane to use TaskExchange! You might also like to read six tips on finding helpers on TaskExchange and as always, feel free to email us with any queries or feedback on taskexchange.cochrane.org.

Related articles

• TaskExchange champ: Stephana gains skills and finds collaborators

Here is a series of blog posts that will provide you with news about improvements happening to the Cochrane Library. Daniel Shanahan, Product Lead of the Cochrane Library, tells us more about what has been worked on and what is coming up.

The Cochrane Library was relaunched last August to help improve the dissemination of Cochrane evidence, and provide a platform for innovation. Since then the product team (Dan, Viola, and Graham) have been working to fix some issues that weren’t quite right at launch and start building some of the new features that will move the Cochrane Library into its next phase. All of these fixes and updates are linked to the five key product themes for the Cochrane Library:

• Discoverable
• Accessible
• Credible
• Usable
• Sustainable

We wanted to send a quick note to introduce you to some new features and functionalities we have implemented during this time (as well as some of the old issues we’ve been working to resolve).

We have fixed lots of bugs, including a quite a few related to access - most notably, we have migrated to a new API for authentication and authorization of users, to ensure that our evidence is always accessible. [Sustainable]

The Updating Classification System has now gone live for the first Cochrane Review Group – Infectious Diseases. You can now see at a glance if a review is up to date, likely to be updated in the future, or does not need updating at the current time. Available as both a filter on the search page and from the article page itself, it is very neat way of keeping our readers up to date. We are giving some time for the dust to settle before expanding this across other CRGs. [Accessible]

Working with Cochrane UK, we now highlight the number of clinical guidelines that a Cochrane Review has informed, as this is a key impact metric for Cochrane evidence to ensure that we really are improving global health. These numbers will be updated monthly to ensure readers always have the latest information. [Credible]

DOI displays were updated for all Cochrane content to meet industry best practice, ensuring we are adherent to all Crossref guidelines and consistent in our design. [Credible]

We have changed the way reference links are added to articles – this is now done after the article has been published, saving valuable time and ensuring our content gets to users ASAP. Currently, links are available for PubMed and Google Scholar, with Crossref links coming in the next few weeks. [Sustainable]

We’ve made some great changes to make our content more discoverable. We’ve added a related content section for CENTRAL records and expanded the related content for Cochrane Reviews to include Special Collections, providing even more ways for users to explore our content. We’re now working on an exciting new feature to better signpost linked content types for Cochrane Reviews (including CCAs, Editorials, Special Collections and Podcasts). [Discoverability]

There have been further improvements to saved searches, search alerts and search manager. These make search even more intuitive to our users to help drive and refine their strategies to find the right content. [Accessibility]

Browse by Topic and Browse by Cochrane Review Group now apply to all relevant content (Reviews, Protocols, etc), both enriching the browse experience and allowing for future developments, including alerts by topic, etc. [Discoverable]

We changed the citation export function for CENTRAL, closing a loophole which enabled unauthenticated users to systematically mass export records. [Sustainable]

The site now remembers your preferences after accepting cookies, so you will no longer be asked every time you visit Cochrane Library (which got very annoying!) [Sustainable]

As you can see, there has been a huge amount of work done since launch and we are looking to keep the momentum going. We will be providing new updates once a quarter regarding Cochrane Library developments and will have some really exciting things to introduce at the Cochrane Colloquium in October. Come find us at the Cochrane Library stand if you are there, else watch this space!

'Cochrane at the WHO' is a blog series that highlights the partnership between Cochrane and the World Health Organization. If you would like to share a story about how your Cochrane Group is working with WHO, please contact Emma Thompson, Advocacy and Partnership Officer.

In this blog post, Stefano Negrini from Cochrane Rehabilitation explains how the Field is supporting WHO’s Rehabilitation 2030 programme, which is developing tools to help Ministries of Health to plan and integrate evidence-based rehabilitation programmes.

Could you give a short overview of Rehabilitation 2030?

"Achieving universal health coverage (UHC) is currently a major focus for the World Health Organization (WHO). One of WHO’s “triple billion” targets is for a billion more people to benefit from UHC by 2023.

Rehabilitation is a key health service area within this remit. With an ageing population, a rise in noncommunicable diseases and people more likely to survive injuries and need support, rehabilitation needs are high and are expected to increase. However, there is a gap between need and access to services, especially in low- and middle-income countries (LMICs).

In this context, WHO launched Rehabilitation 2030: a call for action at the start of 2017 under the leadership of Alarcos Cieza, Coordinator of the Blindness and Deafness Prevention, Disability and Rehabilitation Unit (WHO-BDD). Through this initiative, WHO aims to produce tools that can be used by Ministries of Health to plan and integrate rehabilitation programs, and that these tools can also be applied in LMICs. This includes a guide for action, a rehabilitation competency framework and a package of minimum rehabilitation interventions – which is what we are supporting.

How is Cochrane Rehabilitation involved?

WHO-BDD approached Cochrane Rehabilitation for methodological support for the package of minimum rehabilitation interventions. This work is bringing together the best evidence on rehabilitation and the expertise of key stakeholders to produce a list of essential rehabilitation interventions. The aim is to produce something that is evidence based, but also feasible to implement.

It is being carried out in five stages, as outlined in this article:

• Select priority health conditions and establish technical working groups for each
• Identify best evidence for rehabilitation interventions
• Develop health condition specific packages (expert-based selection from evidence-based interventions)
• Review and feedback on the recommendations
• Production of draft, testing and dissemination

We are mostly involved with the technical working groups, where we provide methodological support, and in the identification and appraisal of evidence for rehabilitation interventions.

Cochrane Rehabilitation Headquarters team: Stefano Lazzarini, Michele Patrini, Roberta Bettinsoli, Maria Chiara Carrozza (Scientific Director of Don Gnocchi Foundation), Stefano Negrini, Chiara Arienti

What stage is the project currently at?

We started work on the project at the end of 2018. 20 different health conditions were prioritized, and we helped recruit experts for the technical working groups for half of these. Each group involves one expert in rehabilitation for the condition, two researchers representing different rehabilitation professions and representatives that offer methodological support – one from Cochrane Rehabilitation (in 10 of the groups) and one from WHO (in the other groups).

WHO’s original plan was to review professional guidelines to develop recommendations, but we encouraged them to supplement this with Cochrane Systematic Reviews. We also helped WHO to strengthen their guideline selection process: they must be evidence-based, have no conflicts of interest, and be checked using the Appraisal of Guidelines for Research & Evaluation Instrument (AGREE II) tool.

Each group is currently checking the evidence for their specific health conditions. We are reviewing all the related Cochrane evidence. In July 2019 the second “Rehabilitation 2030: a call for action” Meeting will be held at WHO and the preliminary results of the first two health conditions will be presented and discussed. The idea is to possibly present the full package at the World Health Assembly in 2020.

Have there been any challenges so far, and how have you addressed them?

We have about 8 months to do the work, which is quite challenging for a global network of volunteers – it is our biggest project to date. We previously did an analysis of the Cochrane Library and found that around 9.5% of Cochrane Systematic Reviews have a rehabilitation component. Overall, we will look at around 250 Cochrane Systematic Reviews done in the last 10 years, which cover 17 of the 21 selected health conditions. However, around a third of these do not have summary of findings tables with GRADE, so we are having to create these at the same time.

Another issue is the attention of this project also to LMICs, yet Cochrane Systematic Reviews are often rooted in high income countries. To try and overcome this, each group that will be selected by WHO-BDD for the second phase after evidence extraction will have representation from LMICs to appraise each recommended intervention from their perspective.

Is there anything else you would like to add?

This is a unique and exciting project that aims to define, for the first time, a minimum set of evidence-based rehabilitation interventions and to create a common base for research and practice in rehabilitation. In the past, rehabilitation has frequently been neglected in healthcare – often thought of as a minority social issue about the inclusion of people with disabilities. We are really happy to have the chance to collaborate with WHO in such a great endeavor.

We hope to do more work with WHO in the next steps of the project and will publish all the results of our work."

Do you work with WHO?

We would love to hear more about how members of the Cochrane community are working with WHO so that we can help publicise these activities.

Please email Emma Thompson, Cochrane Advocacy and Partnership Officer, and let us know.

Yes, it is possible to do social media with just 10 minutes a day! Kerry Harding, the Assistant Managing Editor to Cochrane Pain, Palliative and Supportive Care, shares with us how!

We are the Pain, Palliative and Supportive Care (PaPaS) CRG and we produce Cochrane Reviews of acute and chronic pain, headache and migraine, and palliative and supportive care. We use social media to help disseminate both our own and Cochrane’s work. We have 4700+ followers on Twitter and we are growing our following on our new Facebook page. We use Hootsuite, a social media management tool, which allows users to post to different platforms from one place, and to schedule posts in the future. We find it an invaluable tool for our social media activity.

We are a busy CRG managing a portfolio of over 300 reviews but we increasingly recognise the importance of dissemination (a key aspect of Knowledge Translation) in helping our work to reach a wider audience. We’d like to share with you what our week in social media looks like.

Days 1 and 2: Scheduling Posts

We schedule tweets and Facebook posts for any newly published reviews or updates using Hootsuite. We will schedule several posts per publication. Posts will be directed at different audiences, e.g. clinicians, patients, and will be scheduled to be sent out at various times, being mindful of different time zones. We will include key information about outcomes and quality of the evidence, keeping in mind the intended audience and that a tweet is only 280 characters long. We will also always include a link to the published review, and if there are enough characters left, we will also try to include our own hashtag #painevidence. The scheduling nature of Hootsuite means that once you have composed a tweet, you can copy and paste it to schedule posts in the future. You can find training resources on presecudling social media posts here.

The example below shows tweets for a new review and an update.

One of our goals for 2019 is to ensure that every PaPaS review has its own dissemination plan. We work with the author team to identify the review’s key messages and the best ways to reach the target audience. Having these conversations early in the process gives us plenty of time to plan our dissemination activities. For our high impact, high priority reviews in particular, having more time allows us to work closely with the Knowledge Translation team who can help us to maximise our ‘packaging and push’.

We browse our Twitter feed on a daily basis for any relevant news stories which we think our followers may find interesting and we will retweet and like these tweets. Each group will have their own specific interests but @CochraneUK, @cochranecollab and @CochraneLibrary are all good places to start. You can also look for relevant charities, key people (influencers) in the topic area, government bodies and support groups. We also find it is effective to tag the Twitter handle of individual people or groups to direct them to a specific review or any other relevant information.

Day 3: Use the Comms Digest

When the Cochrane Communications Network Digest lands in our inbox we will read through the information and see what we think will be of interest to our Twitter and Facebook Community and schedule some tweets using the helpful templates provided.  This might include information about a survey, webinar, meeting or other such Cochrane event. You can learn more about the Digest here and sign up to receive the weekly email.

Day 4: Contribute to Awareness Days

We think it is important to contribute to relevant health awareness days, e.g. Dying Matters Awareness Week, National Fibromyalgia Awareness Day and World Cancer Day. We keep a list of such awareness days and schedule some tweets accordingly highlighting relevant reviews. It’s a good idea to find out what the hashtag will be and on the day (or week) keep an eye out for interesting tweets to retweet and like. These events are a great opportunity to share our blogshots, which are an effective way of giving a quick summary of a review in an image (see Cochrane UK’s blog about blogshots).  We are building our collection of blogshots across all of our topics so that we can respond quickly to relevant events.

The example below shows a tweet where we shared one of our blogshots to help highlight Dying Matters Awareness week.

Day 5: Measure Impact

We’ll check to see if we’ve received any notifications that our reviews have been shared or summarised by another group, for example published as podcasts, highlighted on the front page of the Cochrane Library, translated into other languages, used in a blogshot, or included in Cochrane Clinical Answers or Cochrane Corners. These will then be tweeted and posted on Facebook to increase their potential reach.

It is really important for us to measure the impact of our reviews. When we see our reviews being shared by other groups we always try to capture the story, and so we will save the link or take a screenshot to save on file. Our funders, the NIHR, ask us to provide these impact stories in our annual report, and we also provide a collection of these on our website.

What works for you? Do you have any tips to share which have helped your group? You can email Karen Head at khead@cochrane.org who will compile these and make available in future posts.

Want to know more about using social media more effectively?  There is lots guidance for using social media effectively, which is available on the KT learning resources website.

The CRG Networks Innovation Fund was launched earlier this year and here Tarang Sharma, Editorial Officer for the CRG transformation highlights its aims, the process and the successful applications.

The Cochrane Review Group (CRG) Networks have published their strategic plans, which identifies their individual priorities and goals to guide their work until 2020. An important role of the CRG Networks is to work to improve the review production process and continue the advancement in methods to improve the content of the Cochrane Library. For this to be done consistently across all the CRGs across all Networks, they need to work together to achieve harmonisation of processes.

The CRG Networks Innovation Fund was launched in 2019 to support projects that lead to harmonization of processes of review production and/or editorial procedures and improvements in content or quality across the CRG Networks and the Cochrane Library.

Application process

A call for applications was made in February 2019 which invited CRG Networks to submit applications that fit with the scope of the fund:

• The project should demonstrate how it improves or harmonizes review production or editorial processes within Cochrane or improves the content or quality of the Cochrane Library.
• The project should be innovative and develop or expand the service we provide to evidence users and decision makers (this could include activities around prioritisation, gap analysis (such as gap-maps), programmes of content, review process automation, KT activities etc).
• The project could involve more than one CRG Network with elements that would be useful across different CRG Networks.

We received 10 applications from across the CRG Networks and the applications were assessed by an external Committee from the community consisting of Gert van Valkenhoef (Cochrane CET, ITS), Jimmy Volmink and Paul Garner (Editorial Board), Joanne McKenzie and Miranda Langendam (Methods Executive), using a pre-defined evaluation criterion.

The fund is supporting the top five projects as judged by the external Committee in 2019 and you can read more about them below.

Successful projects

Obesity Gap Analysis & Prioritisation
Abdomen and Endocrine Network (in collaboration with Public Health and Health Systems Network)
Cindy Farquhar, Lisa Bero, Bernd Richter, Luke Wolfenden, Celeste Naude, Solange Durao, Liz Bickerdike, Rachel Richardson, Lee Yee Chong

Obesity is a significant public health problem: the Global Burden of Disease 2015 Obesity Collaborators estimate that since 1980 the prevalence of obesity has doubled in more than 70 countries and has increased in most other countries. This project is a collaborative prioritization initiative and will be carried out jointly with the members of the Cochrane Abodomen and Endocrine Network, the Cochrane Public Health and Health Systems Network and the Cochrane Nutrition Field.

The project aims to:

• produce a comprehensive list of obesity titles published in the Cochrane Library,
• map these to international consensus documents and establish evidence gaps, and
• consult with key external stakeholders to identify priority titles in the field of obesity.

Read more about this project.

Using Microsoft Academic Graph and automation tools to establish and maintain new CRG Specialised Registers of Economic Evaluations
Children and Families Network
Luke Vale, James Thomas, Ian Shemilt, Lindsey Elstub, Eugenie Johnson, Sheila Wallace

Using conventional searching and study selection methods to identify economic evaluations for consideration in Cochrane Reviews is a resource-intensive task. This project will make the process of incorporating economic evidence into Cochrane intervention reviews more efficient, by reducing the study identification workload for review authors and editorial base staff.

It will achieve this aim by designing, evaluating and implementing a semi-automated workflow for establishing and maintaining CRG Specialised Registers of Economic Evaluations alongside existing CRG Specialised Registers of controlled trials. The project builds on current pilot work on using Microsoft Academic Graph (MAG) for study identification in Cochrane Tobacco Addiction, and on the methods, tools and workflows developed for Evidence Pipeline (part of Project Transform). It will work with Cochrane Incontinence using a similar approach – harnessing MAG’s graph structure in conjunction with machine learning classifiers – to support the efficient identification of economic evaluations for:

• inclusion on new CRG Specialised Registers of Economic Evaluations; and
• consideration in Cochrane Reviews.

This will create a step change in Cochrane’s capability to identify economic evaluations for reviews in a reliable, low-cost manner.

Read more about this project.

Public health relevance in Cochrane reviews
Public Health and Health Systems Network
Lisa Bero, Lee Yee Chong, Newton Opiyo, Celeste Naude, Dr Rebecca Ryan, Sophie Hill, Simon Lewin, Paul Garner, Luke Wolfenden, Hilary Thompson, Paul Aveyard, Jos Verbeek

It is important for Cochrane to ensure reviews on public health topics are produced using optimal methods and perspectives that are relevant to various stakeholders. The complexity, scope, source of evidence and relevant outcomes of these public health questions pose significant challenges for authors and CRGs. They often need to use relatively new methods. A prioritisation exercise done suggested that author support tools that are pragmatic (user friendly, with examples) which help to clarify and connect various sources of guidance are critical to facilitate the production of high quality, timely and relevant public health reviews.

This project aims to improve the content, quality and relevance of the Cochrane Library by providing user-friendly author resources to optimise our reviews for public health-relevant questions. This project will deliver:

•  author resources with illustrative best practice examples. This includes a series of flow charts to guide framing of questions, and deciding what study designs are appropriate for the perspective, context and PICO of the review question, and
• (mapping of existing Cochrane author resources to the newly developed flow charts to existing Cochrane author resources/methodological guidance.

Read more about this project.

Instructions for inclusion and presentation of time-to-event outcomes in Cochrane Intervention Reviews – development of training resources
Cancer Network
Nicole Skoetz, Elvira van Dalen, Fergus Macbeth, Marius Goldkuhle, Catrin Tudur-Smith, Philip Dahm, Newton Opiyo

Time-to-event outcomes are widely used in Cochrane systematic reviews of interventions. The analysis of time-to-event outcomes is methodologically complex and the results are prone to misinterpretation by review authors and editors. This project aims to improve the quality of Cochrane systematic reviews that include time-to-event outcomes by supporting authors and editors to avoid common mistakes in their inclusion and presentation.

The project will:

• Provide introductory learning materials to enhance the correct use of time-to-event outcomes and guidance how to avoid frequent mistakes (e.g. what are time-to-event outcomes, common methods to extract data and underlying assumptions need to be considered to analyse data).
• Provide guidance for communicating results of time-to-event outcomes in Cochrane systematic reviews (e.g. in terms of absolute effects or median survival).

Read more about this project.

Optimal methods for the use of ‘pain’ as an outcome in systematic reviews of postoperative pain management
Musculoskeletal, Oral, Skin and Sensory Network
Christopher Eccleston, Andrew Moore, Emma Fisher, Neil O Connell, Nuala Livingstone, Anna Erskine

Many disease states are characterised by aversive physical sensations only observable by the patient. Pain, fatigue, itch, dizziness, and anxiety, amongst others, have no objectively definable referent and are only available as ‘private mental events’. The measurement of private mental events is the cause of much confusion in the fields of clinical trials and evidence synthesis. Pain as an outcome is a deceptively simple endpoint. To the lay-person it may seem simple; one wants to reduce pain. There are, however, multiple reasons why the decisions one makes about pain as an outcome are far from simple. Multiple sources of variance in the treatment of pain as an outcome translate into inconsistency and confusion.

The project will produce expert guidance on how to manage pain as an outcome in systematic reviews of post-operative care focusing on:

• sources of heterogeneity in methods and reporting,
•  the use of primary and secondary endpoints, including surrogate and indirect measures, (c) drafting a template and decision-making flowchart, and
• testing that template and flow-chart with different reviews across the network.

Read more about this project.

Welcome to our new TaskExchange Champs series, where we showcase the great people using TaskExchange and how they’re making the most of the platform.

This month our TaskExchange Community Engagement and Partnerships Manager Emily, chatted to PhD student and TaskExchange helper Stephana.

Name: Stephana Cherak (on twitter @sjcherak)
Age: 25
Occupation: PhD Student, Epidemiology
Program: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary Critical Care Research Network

Hi Stephana, what a joy to connect with you over Twitter recently! Thank you so much for your wonderful, hilarious tweets. And thanks for making the time to chat today.

My pleasure on both counts!

So you’re a PhD student in Epidemiology? Can you tell us a bit about that?

Sure. I’m a PhD Student in Epidemiology at the University of Calgary in the O'Brien Institute for Public Health and the Hotchkiss Brain Institute. My research focuses on the epidemiology of delirium in the critically ill, and involves a randomised clinial trial which is really exciting! I’ve got two years to go on the PhD. I am also a Statistical Assistant for Statistics Canada at the Calgary Research Data Centre.

Wow, sounds amazing and also busy! I see you’ve responded and completed a lot of tasks on TaskExchange. Which makes me think you’re the most organised person I know! How do you use TaskExchange?

Sub out organized for passionate, and I agree. ;-)

I read through the weekly task alert email every Monday to see what tasks may be available for me to apply for that week. In addition, I follow both TaskExchange and Cochrane on Twitter and both accounts frequently post new and revised tasks that are available for application.

What motivates you to respond to tasks?

It is through systematic reviews and meta-analyses that we change health care. That’s where clinicians get their information. I am fortunate to possess strong analytical skills and I have a burning desire to be involved in large-scale systematic reviews. I spoke to my PhD supervisors Dr. Kirsten Fiest and Dr. Tom Stelfox  about this, and they encouraged me to sign up to TaskExchange as a means of gaining experience in conducting systematic reviews.

I’m also motivated by the opportunity to foster collaborations and relationships with other trainees and world-class researchers. Through TaskExchange I have broadened my research network, shared my research interests and ideas with other members, and collaborated on projects that contribute to the objectives and efforts of Cochrane and other health evidence groups.

What sort of tasks do you apply for? I’m guessing you’ve done some data extraction, some screening…?

The tasks that I apply for really depend on what my week looks like and what time I have available aside from my thesis research commitments. Some tasks require only 30 minutes of time while others may require 3 days. The great thing about TaskExchange is that there is bound to be something to suit everyone’s schedule. I’ve done data extraction, screening, protocol reviews, I’ve reviewed completed projects as a consumer, and also done translation tasks.

Translations tasks as well! What language do you speak?

I speak three languages other than English: French, Italian and German.

Goodness me! I don’t feel inadequate in the slightest! ;-) What is something fun you’re doing out of work?

I love to run! Sometimes even away from work (kidding). During my undergraduate degree I competed on the University of Calgary Varsity X-Country and Track & Field team. After my undergrad, I furthered my passion for running by competing as an elite runner for Adidas and obtained high national and international rankings in the half- (2nd Nation) and full-marathon (1st Nation, 18th World). Ultimately I’d love to develop a running program to support girls in sport, with the purpose to empower girls through running.
 

I might just repeat ‘Goodness me! I don’t feel inadequate in the slightest!’ Ha! And our final question, what would you say to someone thinking about helping out on TaskExchange?

I highly recommend TaskExchange for graduate trainees and people at the early stage of their research career. It offers a fantastic network of hugely talented researchers that can teach us so much!

Are you a student or early career researcher interested in helping on TaskExchange? Sign up here. You might like to also read Six tips for helping out on TaskExchange and join us on Twitter.