Systemic lupus erythematosus, or SLE, is an autoimmune disease that can affect any part of the body. About half the people with it develop lupus nephritis. In the June 2018 update of their Cochrane Review, David Tunnicliffe from the Centre for Kidney Research in the Children’s Hospital at Westmead and the University of Sydney’s School of Public Health in Australia and colleagues brought together the studies that have tested a range of treatments.

"Lupus nephritis is a serious condition, leading to end-stage kidney disease in 15% of patients after 10 years. It mainly affects women of child-bearing age, and is more common in some groups, such as those of Hispanic and Asian ethnicity, who also experience more aggressive disease. In the 1950s, most patients survived less than five years, but newer treatments mean that more than 90% of patients will now live a normal lifespan. Cyclophosphamide-containing regimens became established as first line therapy for inducing remission in the 1970s and 1980s, but the drug has a high incidence of adverse events, such as serious infection, hair-loss, and infertility. Furthermore, response to treatment is often slow, and even if remission is achieved, the risk or relapse or flare remains considerable.

In the past ten years, mycophenolate mofetil (MMF) emerged as a less toxic alternative to cyclophosphamide but there is uncertainty about which agent is more effectie. Over recent years, randomized trials have been done to compare these drugs and to test other therapies such as the combination of low-dose MMF and tacrolimus and newer biologic agents.

Our updated Cochrane Review evaluates the relative effects of these various drugs, looking at all available trials of immunosuppressive therapies for the induction and maintenance treatment of proliferative lupus nephritis, the most serious form of the disease.

We have now identified 74 randomized trials, involving more than 5000 participants but these trials differ in many ways and only relatively small numbers are available for the various comparisons.

For the induction of disease, eight trials, with a total of about 800 patients, compared MMF with intravenous cyclophosphamide and two trials, with 402 patients, compared low dose MMF and tacrolimus against intravenous cyclophosphamide. Our analyses show that patients receiving short term treatment of up to six months with MMF or intravenous cyclophosphamide may have similar rates of complete remission. There was less leucopenia and alopecia with MMF, but an increased risk of diarrhoea. The addition of data from some recent trials shows that the effect on ovarian failure is unclear, because of the fragility in the effect estimates. This contrasts with the general medical consensus and observational data suggesting a risk of ovarian failure from repeated cyclophosphamide doses. When tacrolimus and low-dose MMF are used together, this may increase complete remission, but the safety of this therapy is uncertain, and the generalizability of these findings is unclear because they come from just two trials, both done in China.

There are only a small number of trials evaluating the safety and efficacy of biological therapy in patients with lupus nephritis. For example, four trials, including 452 patients, have compared MMF with azathioprine for maintenance therapy and these showed a significantly lower risk of renal relapse with MMF than with azathioprine.

The best duration of therapy remains unclear and longer-term outcome data are sparse, with patients followed up for an average of 12 months in the induction therapy trials and 30 months for maintenance therapy. This is not long enough to examine critical and important outcomes, such as death and end-stage kidney disease. So, the power of the existing studies to detect significant differences among interventions is limited, even when their findings are combined in meta-analyses.

In summary, the main messages from this review are that there are similar effects for induction of remission with MMF and cyclophosphamide, but with fewer toxic effects for MMF. This supports MMF over cyclophosphamide as induction therapy for lupus nephritis. Combining low-dose MMF with tacrolimus may increase complete remission but we are cautious about this because the findings comes from few trials, restricted to patients of Asian ethnicity. Despite the small amount of data on maintenance therapy, MMF appears more effective than azathioprine at preventing renal relapse with less leucopenia and doubling of serum creatinine.

However, in conclusion, despite identifying 74 trials for our review, there are still lots of unanswered questions about the treatment of lupus nephritis. Many interventions, including rituximab and other biologics, and tacrolimus and cyclosporin, have only been tested in small studies with inconsistent outcome reporting and we see two main implications for future research: the need to make better use of existing data, and to plan new studies in a strategic way. Multi-centre collaboration and trials of longer follow-up and in a wider range of ethnic groups are needed. This research would also benefit from registry-based randomized studies, which use efficient data linkage between hospital records, and national registries, to clarify the potential benefits and harms of therapies for this uncommon disease.”

• Read the Cochrane Review
• Listen to more Cochrane Podcasts
• Get Cochrane Podcasts on iTunes
• Visit the Cochrane Kidney and Transplant Group Website

The Cochrane Pregnancy and Childbirth Group has produced several hundred reviews on the effects of interventions for women who are pregnant, giving birth or with a newborn baby. They also assess the evidence on how to help after pregnancy loss, and one of their new reviews from December 2018 looks at care during pregnancies following a stillbirth. Lead author, Aleena Wojcieszek from the Mater Research Institute in the University of Queensland in Brisbane, Australia, tells us what they found.

"Women who have had a stillborn baby are up to five times more likely to have a stillbirth in their subsequent pregnancies. They are also at higher risk of other complications, such as preterm birth and growth problems for the baby. On top of this, women and their families often experience high anxiety in pregnancies after stillbirth, which can be particularly intense at significant pregnancy milestones and in the lead up to, and during, antenatal care visits. However, although these women and their families clearly have increased medical and psychosocial needs, there is currently little evidence to guide clinical practice and provide optimal care.

We did this broad systematic review to bring the existing evidence together, aiming to capture any interventions or models of care that might be provided before and during pregnancies following stillbirth. These could include medical interventions, as well as psychosocial support targeting anxiety, depression or complicated grief. We focussed on interventions for mothers or their partners whose previous stillbirth occurred 20 weeks or more into the pregnancy.

The lack of research is highlighted by the fact that we were able to include just 10 trials, with data from only 222 women and their babies. All these trials assessed drug therapies and presented us with nine different comparisons, including looking at the effects of low dose aspirin, low molecular weight heparin, third‐party leukocyte immunisation, intravenous immunoglobulin G, and progestogen.

With so few participants, such a small number of trials, and so many comparisons, this relatively small amount of evidence means that it is uncertain whether any of the interventions had an effect on most of the outcomes we looked at. Although there was some suggestion that low dose aspirin and third‐party leukocyte immunisation may increase the birthweight of babies, even these findings were unstable due to the very small sample sizes.

One of our greatest challenges was when assessing the articles for eligibility. There was a lot of inconsistency in the terminology used to describe pregnancy loss, and reports often did not define words like ‘miscarriage’, ‘abortion’, or ‘stillbirth’ by gestational age. We often had to contact the original researchers to determine if a trial was eligible, and we also found that in many cases women whose previous pregnancy loss occurred 20 or more weeks into their pregnancy were recruited alongside women who had earlier pregnancy losses. This lead to the further complication of needing the researchers to split up their data, so that we could use only data from the former women in our analyses. We are very grateful to the researchers who did this and provided data, but it’s also important to note that not all trials in the review necessarily targeted the pathophysiology of stillbirth specifically, and we had to leave out some potentially eligible trials because researchers did not respond to our queries or for other reasons.

In summary, we were not able to capture sufficient evidence to inform clinical practice for care in subsequent pregnancies following stillbirth. Carefully-designed trials are urgently needed, and these trials should specifically address the prevention of recurrent stillbirth, and be large enough to detect differences in rare, but vitally important outcomes such as stillbirth and death of the newborn baby. We would also like to see the prioritisation of trials of psychosocial support interventions, which are currently lacking from our review."

• Read the Cochrane Review
• Listen to more Cochrane Podcasts
• Get Cochrane Podcasts on iTunes
• Visit the Cochrane Pregnancy and Childbirth Website

Cochrane Sweden recently hosted a 1-week course on Cochrane Methodology at the Lund University. The course was mainly aimed at PhD students from the Faculty of Medicine but was open for everyone. 

This 40-hour course  used Cochrane Interactive Learning modules, lectures, and discussion to cover the following topics: 

• Introduction to conducting systematic reviews
• Writing the review protocol
• Searching for studies
• Selecting studies and collecting data
• Introduction to study quality and risk of bias
• Analysing the data
• Interpreting the findings
• Reporting the review

• Looking for training in your country? Search our Training Events!
• Want online learning? Cochrane offers that too!

 The World Health Organization's latest guideline on risk reduction of cognitive decline and dementia has been published. This guideline provides global, evidence-informed recommendations on how to reduce the risk of cognitive decline and dementia.

It features evidence from reviews of the Cochrane Dementia and Cognitive Improvement group in 3 of the guideline’s  evidence profiles - Physical activity interventions, Management of diabetes and Management of dyslipidaemia. The featured reviews are:

• Aerobic exercise to improve cognitive function in older people without known cognitive impairment.
•  Effect of the treatment of Type 2 diabetes mellitus on the development of cognitive impairment and dementia.
•  Statins for the prevention of dementia. 

Cochrane Dementia and Cognitive Improvement remit includes producing systematic reviews of both global cognitive impairment and focal cognitive impairments occurring in the context of brain disease. We are pleased to see Cochrane evidence being highlighted in this important guideline.

• Visit the Cochrane Dementia and Cognitive Improvement website
• See 'Dementia Awareness Week' evidence

 This Friday (31st May, 2019) will mark my final day as your Editor in Chief. I want to express my gratitude to you all for your forbearance, support, challenge and friendship over these past 10 years. Believe me when I say that having the privilege of serving you all has been the highlight of my working life. Life has never been easy, but I have learned such a great deal from you, had experiences I couldn’t have imagined, and found myself stretched (in a good way) every day.

I wish you all, and Cochrane, every success in the coming years, and hope to continue to contribute in different ways. I leave you in the excellent hands of Karla Soares-Weiser who has been a fantastic deputy and will be an even better leader. She will be fully supported by the other members of the Editorial and Methods team, who have all at various times provided me with inspiration, rescued me from danger and have simply been a joy to lead.

I have been lucky to have had the support of some wise and inspiring Co-Chairs, Steering Groups and the Governing Board. I owe particular thanks to Cochrane’s Chief Executive Officers, Nick Royale and Mark Wilson, my colleagues on the Senior Management Team, and the wider Central Executive Teams. I have enjoyed working with the various representative groups across the Editorial and Methods communities, and the new Editorial Board and Scientific Committee. The members of the Cochrane Library Oversight Committee have quietly provided guidance and wise counsel.

I want to finish by repeating my debt to all those of you who toil at Cochrane’s coalface as authors, editors, peer reviewers, information specialists and so on. If Cochrane handed out 200 Chris Silagy prizes every year, it would still not be possible to reward all of those who have earned it. You are the true heart of Cochrane, and I will join your number now with pride.

David Tovey

Cochrane is made up of 13,000 members and over 50,000 supporters come from more than 130 countries, worldwide. Our volunteers and contributors are researchers, health professionals, patients, carers, people passionate about improving health outcomes for everyone, everywhere.

Cochrane is an incredible community of people who all play their part in improving health and healthcare globally. We believe that by putting trusted evidence at the heart of health decisions we can achieve a world of improved health for all. 

Many of our contributors are young people working with Cochrane as researchers, citizen scientists, medical students, and volunteer language translators and we want to recognize the work of this generation of contributors as part of this series called, Cochrane’s “30 under 30." 

In this series, we will interview 30 young people, 30 years old or younger who are contributing to Cochrane activities in a range of ways, all promoting evidence-informed health decision making across the world. 

We will be hearing from them in a series of interviewees published over the coming months.

We're keen to hear from you. Would you like to take part in this series? Do you know someone you'd like to see interviewed? Contact lparsonson@cochrane.org.  Or if you want to know more about Cochrane’s work contact membership@cochrane.org where our community support team will be happy to answer your questions.

Name: Stephen Surace
Age: 27
Occupation: Doctor
Program: Cochrane Musculoskeletal

How did you first hear about Cochrane?
From very early on in medical school you start hearing the words “Cochrane review” used with a fair amount of reverence. If they aren’t appearing as a reference in a lecture note or your tutors aren’t talking about a new publication, they are used as the real-life example of the pinnacle of the evidence pyramid.

How did you become involved with Cochrane? What is your background?
I am a doctor, but I first became involved as a medical student. I was looking to use my epidemiology and research methods classes for a practical purpose, and after asking around my hospital I was given the name of someone to speak to who was involved in “some research”. I was just incredibly lucky that my rotations at the time brought me into contact with people who worked with Cochrane.

What do you do in Cochrane?
I have helped with data collection and synthesis on two published reviews and am a primary author on a third.

What specifically do you enjoy about working for Cochrane and what have you learnt?
Working with Cochrane has taught me an incredible amount about research. There are the obvious lessons, such as how to critically appraise trials, a better understanding of different biases and their consequences, and an appreciation of just how much work goes into each and every review. However, there were also unexpected lessons. Examining bias and trial method actually taught me a lot about how to construct trials and investigating evidence and data quality allowed me to realise how there are many ways not only to interpret, but also to present and modulate results. This has real and continuing implications for my work as a doctor, and my experience with Cochrane eventually lead me to undertaking a research degree in addition to my medical studies. Beyond the review, working with Cochrane is also a great opportunity to work with and learn from a group of experienced research mentors.

What are your future plans?
I’d love to keep working with Cochrane and keep working on reviews. I’d especially like to come back when I’m further through my training, so that I can provide analysis and commentary not just from the point of view of an enthusiastic researcher, but also from the view of a specialist in my field.

In your personal experience, what one thing could Cochrane do better to improve its global profile?
I think more people should know how they could get involved with Cochrane.  The first question from so many of my colleagues when I said I was helping to write a Cochrane review was to ask me how in the world I managed to arrange that.

What do you hope for Cochrane for the future?
I hope that they can find the time and expertise to expand their number of reviews. If I have to answer a question in medicine, I can always breathe a sigh of relief if there is a recent Cochrane review to guide me.

How important is it that young people get involved in Cochrane? Why is this, do you think?
There is no better time to get involved than right now. The earlier you start, the more opportunities you have to implement the skills you learn from working with Cochrane, whether they relate to research methods or the lessons you learn from your supervisors and mentors. As for the organisation, young people are always a source of new ideas and fresh perspectives, so it’s really a win-win situation.  

What would your message be to other young people who want to get involved with Cochrane’s work but not sure where to start….?
As I said, it’s never too early to get involved, but it’s also never too late. I thought for sure when I was looking around in medical school that I had left it too late to ever find any research to help out with. Yet it was really only just the beginning. Think of a field of interest, even if that is just a broad type of research you want to become familiar with and start looking up contact details. Google the relevant Cochrane group page, email the contact person, phone around. You can even try the old-fashioned way and knock on their office door like I did when I first started. The Cochrane people are happy to provide help and are also always looking for help. If you have the enthusiasm and drive to volunteer your time, then you have something invaluable to offer.

The Belgian Red Cross specializes in the development of evidence-based first aid guidelines and materials. After the update of its basic first aid manual for Sub-Saharan Africa in 2016 (freely downloadable following registration), a brand new manual with advanced first aid techniques, contextualized to Sub-Saharan Africa, is currently being developed. The manual will be used during first responder training programs of several African Red Cross societies, including those of Malawi, South-Africa and Zimbabwe. First responders are laypeople who are trained to be the first line of support within their community when disaster strikes. The guideline features evidence from 13 Cochrane Reviews of 8 different Cochrane groups:  Cochrane Acute Respiratory Infections (1); Cochrane Airways (2); Cochrane Back and Neck (1); Cochrane Eyes and Vision (1); Cochrane Injuries (3); Cochrane Vascular (1); Cochrane Work (2) and Cochrane Wounds (2).

The First Aid for First Responders Manual will be available by the end of 2019. The evidence included will be available through the evidence summary database of the Belgian Red Cross’ Centre for Evidence-Based Practice (CEBaP). CEBaP recently also launched Cochrane First Aid and will further advocate for the inclusion of Cochrane reviews in first aid guidelines.

• Visit the Cochrane First Aid website

The Cochrane Rapid Review Methods Group is leading an important piece of methodological research and need your help.

Does it make a difference whether abstracts are screened by one or two people to find relevant studies for a systematic review? How many relevant studies will be missed when abstracts are reviewed by only one person? Can the Cochrane RCT-classifier, a machine-learning tool for classifying RCTs and the Cochrane Crowd, do this accurately? The Cochrane Rapid Review Methods Group and the Cochrane Crowd Team have developed a study to try to answer these questions.

The study is made up of three ‘arms’ – three different groups that participants to the study could be assigned to. If you already have experience screening search results for a review, you will be randomly assigned to review a set of 100 abstracts and classify them as "Relevant" or "Not Relevant" to a particular research question from a search for either a pharmacological review or for a public health review. If you have no experience screening for reviews, you will be assigned to the "Crowd" arm where you can screen as many records as you like for the pharmacological review.

More details about the study can be found here.

We are looking for participants:

• with and without experience of screening search results for a review
• willing to spend around 2 to 3 hours screening 100 abstracts over the next three weeks
• over 18 years of age

To join, just follow these 4 steps:

1. If you don't have a Cochrane Crowd account yet, register here first and continue with step 2. If you already have a Cochrane Crowd account, you can go straight to step 2:
2. Click on this link that will launch the brief participant questionnaire
3. Once you have completed the questionnaire, log in to Cochrane Crowd as usual
4. Near the top of your task dashboard you will see the task called Rapid, Rapid, Rapid. This is the task you will have been randomly assigned to. Complete the training and get screening your 100 records!

You don’t have to screen all 100 records in one go. We will keep the study running until Friday 14th June so there should be plenty of time for you to chip away at your 100 records.

If you are able to take part, you will be named on a conference poster about the study at the Cochrane Colloquium, receive a certificate of participation, and enter a prize draw for one of five gift vouchers worth $100.

Happy citation screening!

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Cochrane launches a new network of US institutions to promote evidence-based health care and public health  

The Cochrane US Network made up of some of the country’s leading institutions in the research and practice of evidence-based medicine, and they join Cochrane’s 70 existing geographic Groups around the world. The Cochrane US Network will promote evidence-informed decision making in health care in the US by supporting and training systematic review authors and users of Cochrane Reviews, as well as working with clinicians, professional associations, policymakers, patients, healthcare provider organizations and the media to encourage the dissemination and use of Cochrane evidence.

The Cochrane US Network is initially made up of the existing Cochrane US West Associate Center based at Oregon Health & Science University; three Cochrane Review Groups producing systematic reviews in neonatal health, fertility regulation and urological conditions; three US satellites of Cochrane Review Groups focusing on eyes and vision, pregnancy and childbirth and musculoskeletal disease; one Field specializing in complementary medicine; and 11 new Affiliate institutions, including:

• AcademyHealth
• American College of Physicians
• Central Michigan University
• Cornell University
• Mayo Clinic Evidence-based Practice Center
• Penn Medicine Center for Evidence-based Practice
• RTI International – University of North Carolina Evidence-based Practice Center
• Texas Christian University
• University of Chicago Medicine
• University of Colorado Anschutz Medical Campus; and
• University of Maryland School of Medicine

Mark Wilson, Cochrane CEO, said: “I am delighted to see such a prestigious and committed group of US institutions and leaders in evidence-informed health care join Cochrane’s global family of collaborators.

Many of these researchers and clinicians are leaders in the field, and I am excited by the expertise, innovation and knowledge they will bring to our mission of delivering trusted evidence into health policy and clinical decision-making. The US health system is the largest and most sophisticated in the world, yet suffers from huge inequalities in health outcomes and tremendous wastefulness. We believe a vibrant Cochrane Network promoting greater use of evidence showing what health interventions work and what don’t can make a real difference to this; and I hope that this new – already extensive – Network will grow further and welcome many more partners in the years to come.”

These new Cochrane Affiliates each have their own specific areas of expertise and focus. Collectively, the Network will focus on producing high quality evidence on priority topics for the US; providing training to systematic review authors and health care practitioners, policymakers and others in the interpretation of Cochrane Reviews; as well as raising general awareness of the Cochrane evidence available to make well-informed health and health care decisions.  The new Network will build on the work of the former US Cochrane Center based at Johns Hopkins University, Baltimore.

Marguerite Koster, co-chair of the Cochrane Governing Board adds: “The establishment of the US Network is an important development for Cochrane as well as the health care community in the US. Coordination and collaboration are core values of the Network because we strongly believe we can add value by working  together as a consortium. I very much look forward to the start of the Network and to seeing it develop and grow as a platform for anyone interested in evidence-informed health and health care in the US.”

A formal launch of the new ‘Cochrane US Network’ was held onJune 4, at the Marriott Marquis Washington DC, immediately after AcademyHealth’s 2019 Annual Research Meeting at the same location.

During the launch meeting Cochrane CEO, Mark Wilson, and Governing Board co-chair, Marguerite Koster, introduced the US Network. Additionally, representatives from the Network introduced their institutions and planned work, and spoke to the value of being part of the Network.

The Cochrane US Network is part of Cochrane,  global independent network of researchers, professionals, patients, carers and people interested in health. Cochrane produces reviews which study all of the best available evidence generated through research and make it easier to inform decisions about health. Cochrane is a not-for profit organization with over 65,000 members and supporters from more than 130 countries working together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. Cochrane’s work is recognized as representing an international gold standard for high quality, trusted information.

•   Visit the Cochrane US Network website

We are delighted to announce that Dr Christopher Bunt, MD, FAAFP has been appointed as the inaugural Editor in Chief of Cochrane Clinical Answers (CCAs), reporting to Karla Soares-Weiser, Editor in Chief of Cochrane. Chris has been a practicing Family Medicine physician in the US since 2004 and has recently added Medical Acupuncture to his clinical duties. Chris has also been a Clinician-Educator since 2007, focusing on teaching and designing evidence-based medicine curricula for interprofessional students, residents and faculty colleagues. Chris has worked with the CCA team as an Associate Editor since 2012, writing 56 CCAs. He also has extensive editorial experience as a Contributing Editor for American Family Physician, the largest primary care journal in the US, since 2016.

CCAs form a key strand of Cochrane’s Knowledge Translation strategy, providing concise, evidence-based answers to Patient, Intervention, Comparison, Outcome (PICO) clinical questions based on Cochrane Reviews. The product was developed in partnership between Cochrane and Wiley and in 2018 became part of the suite of databases available to all Cochrane Library subscribers. The Editor in Chief of CCAs is a new honorary role that has been created to oversee the development and implementation of editorial policies for CCAs, guide editorial strategy decisions and ensure the quality of CCA content.

We are thrilled to welcome Chris to the team; we are convinced that he will be a great asset to Cochrane and will be instrumental in the development and future strategy of CCAs. Karla also welcomes Chris’ appointment: “We are excited to welcome Chris into this new post. We look forward to working with him to further develop CCAs and reach out to clinical communities around the world to promote the use of this important Cochrane resource”. And Chris highlights: “CCAs are the ‘point-of-care home’ for busy clinicians. I am thrilled to continue to work with the CCA team as we further evidence-based medicine practice around the world.”   

Chris is currently the Associate Dean for Student Affairs in the College of Medicine at the Medical University of South Carolina in Charleston, South Carolina. He will be contributing two days a month as Editor in Chief of Cochrane Clinical Answers. He can be reached at cbunt@cochrane.org.

• Read a sample of Cochrane Clinical Answers

Cochrane Hong Kong is celebrating it's first Symposium on 23-24 May, with workshops following on 27-28 May. The theme of the Cochrane Hong Kong Symposium is ‘Paving the Way for and Achieving Excellence in Evidence-informed Health Care in the Belt and Road Regions’. The symposium aims to provide an international multidisciplinary platform for discussion and debate among health care providers, policy makers, academics, and researchers on contemporary strategies and issues in evidence-informed health care and policy formulation.

Co-Directors of Cochrane Hong Kong, Professor Wai Tong Chien and Professor Professor Pak Chun Janita Chau were joined by Mark Wilson, Chief Executive Officer to open the Symposium. Professor Martin Burton, Co-Chair of the Cochrane Governing Board, gave the Keynote Address

Professor Sek Ying Chair, Director and Professor at The Nethersole School of Nursing, Faculty of Medicine, the Chinese University of Hong Kong said: "Over the past two decades, Cochrane has significantly contributed to the promotion of evidence-informed health care decision-making through producing high quality and accessible systematic reviews and other synthesised research evidence. Cochrane evidence is internationally regarded as a powerful tool to enhance health care knowledge and practice. With the establishment of Cochrane Hong Kong, our School is committed to working hand in hand with other Cochrane centres around the world especially those in Asia and the Belt and Road regions towards a shared vision for better health."

• Visit the Cochrane Hong Kong website

Specifications: Full-time, initially as a one year fixed-term contract. Secondments considered.
Salary: £40,000 to £45,000
Location: Flexible
Application Closing Date: 12th June 2019 (12 Midnight GMT)

This role is an exciting opportunity to use your experience as a Methodology Editor to make a difference in the field of health care research. 

As Systematic Review Methodology Editor, you will provide support, general systematic review methods advice and methods peer review as requested by Network Editorial Teams (Network Senior Editor, Associate Editor or Network Support Fellow) or field queries from the Community Support Team as needed. The role will require an understanding of methods such as the assessment of risk of bias, application of GRADE and interpretation of findings in the review. An understanding of statistical meta-analysis methods is advantageous in the role, although specialist statistical editors in the unit will be able to provide this advice.

We are looking for a self-motivated and highly organised individual who is able to work effectively and collaboratively with a diverse range of contacts across the world.  The successful candidate will also have:

• Familiarity with Cochrane guidance and standards on the design, conduct and reporting of systematic reviews (MECIR), including GRADE methods.
• Familiarity with systematic review methods relevant to the synthesis of non-randomised evidence
• An understanding of the importance of systematic reviews to clinical decision making
• Intermediate level IT skills, including Word, Excel and PowerPoint
• Computing experience with a statistical software (such as Stata, R, SAS)
• Knowledge and skills relevant to the systematic review process
• An ability to develop and maintain working relationships with key stakeholders
• Strong organization and prioritization skills
• Attention to detail
• Excellent written and verbal communication skills
• Ability to work methodically and accurately
• A pro-active approach to problem-solving

Cochrane is a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesizing research findings to produce the best available evidence on what can work, what might harm and where more research is needed. Our work is recognised as the international gold standard for high quality, trusted information.

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with “Systematic Review Methodology Editor” in the subject line.  The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples.  List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

For further information, please download the full job description from here.

Deadline for applications: 12th June 2019 (12 midnight GMT)
 
Interviews to be held on: (TBC)

Specifications: Part time (0.5 FTE) initially as a one year fixed-term contract, secondments considered
Salary: £44,000 to £48,000 (FTE)
Location: Flexible
Application Closing Date: 12th June 2019 (12 Midnight GMT)

This role is an exciting opportunity to use your experience as a Statistical Editor to make a difference in the field of health care research.  

As Statistical Editor, you will provide statistical support and advice as requested by Network Editorial Teams (Network Senior Editor, Associate Editor or Network Support Fellow) or field queries from the Community Support Team as needed. The post holder will also provide independent statistical review of high-profile reviews, including those intended for press release.  In addition to this he or she will support the implementation of established and more complex methods in Cochrane reviews and work on monitoring the quality of statistical methods and analysis in Cochrane reviews to inform priorities for training and guidance. The role will require a formal qualification in biomedical statistics, and a good understanding of methods used in meta-analysis.

We are looking for a self-motivated and highly organised individual who is able to work effectively and collaboratively with a diverse range of contacts across the world.  The successful candidate will also have:

• Post-graduate degree in medical statistics
• Involvement in statistical research
• Familiarity with statistical methods used in pairwise and network meta-analysis
• Familiarity with methods used for the synthesis of non-randomised studies
• Understanding of the importance of systematic reviews to clinical or policy decision-making
• Familiarity with Cochrane guidance and standards on the design, conduct and reporting of systematic reviews (MECIR) and GRADE methods.
• Familiarity with Cochrane technology systems (e.g. Review Manager Software) or process (e.g. experience as a statistical editor)
• Computing experience with a statistical software (such as Stata, R, SAS)
• Intermediate level IT skills, including Word, Excel and PowerPoint
• Strong organization and prioritization skills
• Attention to detail
• Excellent written and verbal communication skills
• Ability to work methodically and accurately
• A pro-active approach to problem-solving

Cochrane is a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesizing research findings to produce the best available evidence on what can work, what might harm and where more research is needed. Our work is recognised as the international gold standard for high quality, trusted information.

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with “Statistical Editor” in the subject line.  The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples.  List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

For further information, please download the full job description from here.

Deadline for applications: 12th June 2019 (12 midnight GMT)
 
Interviews to be held on: (TBC)

Cochrane, producer of the Cochrane Library, the world’s pre-eminent collection of high quality evidence to inform healthcare decisions, today announces the launch of a competitive tender to establish its future publishing partner from 2021 for the next decade.

Cochrane wants to identify a publishing partner that will increase the accessibility, awareness, impact and use of the Cochrane Library, and put Cochrane evidence at the heart of health decision-making globally; whilst also ensuring long-term financial sustainability of the organization, and innovation and development of other derivative products. Cochrane’s ‘Request for Proposal’ documents are available on request and proposals can be submitted up to 1 July 2019.

Cochrane’s Chief Executive Officer, Mark Wilson, welcomed launch of the tender: “This is a hugely exciting time for Cochrane. Over the past 25 years, Cochrane has transformed the way health decisions are made through the production and dissemination of our systematic reviews. But there are many challenges ahead including moves towards open access and open data publishing models, and the opportunities provided by new technology and machine-readable data to change the way we produce and deliver our content. I am confident that through this tender Cochrane will find the best publishing partner for these challenges: a partner who will help us get evidence into the hands of patients, clinicians and practitioners, researchers and policy-makers in ways that they can use it better.”

Cochrane Editor in Chief Elect, Karla Soares-Weiser, commented: “The Cochrane Library is pivotal in delivering Cochrane’s mission of producing high-quality, relevant, up-to-date systematic reviews and other synthesized research evidence to inform health decision making. Future publication and dissemination of our content are key to meeting Cochrane’s strategic goals and the long-term financial health of our global organization.”

Charlotte Pestridge, Head of Cochrane’s Innovations, Research & Development Department – and responsible for leading the competitive tender - said: “We are now inviting proposals from suitable partners so that Cochrane can decide with whom, and under what terms, this unique and world-renowned product in the health and healthcare sector will be published in the future.”

• Find out more about Cochrane and our health evidence: https://www.cochrane.org/
• Organizations and providers interested in responding to the RFP need to contact Charlotte Pestridge, cpestridge@cochrane.org

Cochrane does not make clinical recommendations, instead it provides unbiased and high-quality health evidence so that health decisions, policies, and clinical guidelines can be informed by the best available evidence. ‘Cochrane Evidence in Practice’ series collects stories about clinical professionals using Cochrane evidence - the everyday healthcare professional making sure their patients and clients are getting the best care!

Kristy's story:

 Name: Kristy Goodman, MS, MPH, PA-C
Location: Los Angeles, CA 

"I’m trained as a PA (physician assistant) and have a Master of Public Health with a focus on Health Education and Behavorial Science. As a healthcare provider I rely on resources like Cochrane Reviews to stay up-to-date on current research. This allows me to provide my patients with evidence-based information so that they can feel empowered to make the best decisions for themselves and their families. The plain language summaries are a great educational tool to provide to patients at the end of our visits to reiterate the information we’ve discussed in a language that they can understand.” 

Cochrane does not make clinical recommendations. ‘Cochrane Evidence in Practice’ series collects stories about clinical professionals using Cochrane evidence. Would you  like to add your story of using Cochrane evidence? Please contact mumoquit@cochrane.org to share your story. 

Cochrane is made up of 13,000 members and over 50,000 supporters come from more than 130 countries, worldwide. Our volunteers and contributors are researchers, health professionals, patients, carers, people passionate about improving health outcomes for everyone, everywhere.

Cochrane is an incredible community of people who all play their part in improving health and healthcare globally. We believe that by putting trusted evidence at the heart of health decisions we can achieve a world of improved health for all. 

Many of our contributors are young people working with Cochrane as researchers, citizen scientists, medical students, and volunteer language translators and we want to recognize the work of this generation of contributors as part of this series called, Cochrane’s “30 under 30." 

In this series, we will interview 30 young people, 30 years old or younger who are contributing to Cochrane activities in a range of ways, all promoting evidence-informed health decision making across the world. 

We will be hearing from them in a series of interviewees published over the coming months.

We're keen to hear from you. Would you like to take part in this series? Do you know someone you'd like to see interviewed? Contact lparsonson@cochrane.org.  Or if you want to know more about Cochrane’s work contact membership@cochrane.org where our community support team will be happy to answer your questions.

Name: Norah Essali (on Twitter @norahessali7)
Age: 27
Occupation: Psychiatry Resident
Program: Department of Psychiatry and Health Behavior - Medical College of Georgia

How did you first hear about Cochrane?
I was a medical student when first introduced to Cochrane through the work of my father, Adib Essali. I participated in one of his many workshops in Syria that focused on training medical students, and other healthcare professionals, on the concepts of evidence based medicine, critical appraisal of research and writing Cochrane reviews.

How did you become involved with Cochrane? What is your background?
I first became involved in medical school, when the UK Cochrane centre, directed by Martin Burton, led an initiative to start Students 4 Best Evidence, a global community run by students that aims to engage students in learning about the concepts of evidence based health care.

What do you do in Cochrane?
I was one of the pioneers who helped start students4bestevidence.net while I was in medical school.
 
I'm also an author in the Cochrane Schizophrenia Group. Currently, I'm working with a group of wonderful, Syrian medical students on 2 systematic reviews.

What specifically do you enjoy about working for Cochrane and what have you learnt?
I've enjoyed working for Cochrane because I believe in their message of spreading high quality evidence to inform medical decision making. Additionally, in my interactions with various Cochrane members, I have always felt the enthusiasm and dedication to achieve this goal in the most creative and inclusive manner possible.
 
In working with Cochrane, I have learned to be a smarter consumer of evidence and have utilized this skill to ensure my patients receive evidence-based care.

What are your future plans?
I'm currently in training to become a Psychiatrist. I plan to specialize further in Addiction Psychiatry as I'm interested in working with dual diagnosis patients, especially in emergency settings. I also hope to continue to contribute to research in my field.

In your personal experience, what one thing could Cochrane do better to improve its global profile?
I believe that an online initiative to engage students is a wonderful starting point. Cochrane could expand upon this by building curriculums for health sciences schools, worldwide, to utilize in teaching students about EBM.

What do you hope for Cochrane for the future?
My hope is that Cochrane will continue to grow, conflict free, continue to engage young people and continue to produce high quality evidence.

How important is it that young people get involved in Cochrane? Why is this, do you think?
Very important. If evidence-based practice is instilled early on, it will increase the likelihood of producing healthcare professionals that use EBM daily to inform their practice. This will then ensure patients have access to well informed providers and thus the best available care.

What would your message be to other young people who want to get involved with Cochrane’s work but not sure where to start….?
I would highly encourage their interest and recommend they start with students4bestevidence.net to learn about the basic concepts of EBM. Also, go to cochrane.org/join-Cochrane to find out different ways they can get involved with Cochrane, based on their interests.

After leading Cochrane South Asia since 2005, first as a Branch of the Australasian Cochrane Centre, and from 2008 as a standalone Cochrane South Asia Centre, Professor Prathap Tharyan is retiring from his role as Director.

Under Prathap’s leadership, Cochrane South Asia, based at the Prof BV Moses Centre for Evidence Informed Health Care and Health Policy at CMC, Vellore, has contributed enormously to Cochrane's global efforts to increase the uptake of reliable evidence to inform health decisions. In the early years of the Centre, Prathap organized several very successful annual conferences on evidence-based health care at CMC Vellore, drawing delegates from around the region to hear from internationally renowned experts. In 2014, the Cochrane South Asia Centre, also hosted Cochrane’s annual Colloquium in Hyderabad, bringing the international Cochrane community to India. Prathap has also been instrumental in working with the Indian Council of Medical Research to ensure a national subscription to the Cochrane Library from 2007-2015, which has since then been taken over by the National Library of Medicine. 

Prathap’s research interests are wide, covering issues involving the ethics of clinical trials in India (as protection against commercially-focused research organizations) and promoting the conduct of pragmatic trials – reflecting a concern that research should benefit those who volunteer as participants and the wider community they come from. Through his involvement with the Cochrane Infectious Disease Group’s Effective Health Care Research Consortium, Prathap contributed substantially to important reviews, including in malaria that informed WHO guidelines and influenced policy nationally and regionally, and in the area of TB helping develop the INDEX-TB guidelines by the Ministry of Health. 

A few days after the South Asia Cochrane Network was set up in December 2004, the Indian Ocean tsunami struck the region. Prathap was closely involved in relief efforts and providing support to affected villages along the coast of Tamil Nadu; Prathap later became one of the founding members of Evidence Aid in 2005, championing evidence-based approaches in humanitarian action.

For many Cochrane people, their very memorable first impression of Prathap was on stage at the 2002 Stavanger Colloquium singing the virtues of systematic reviews to REM’s iconic song, “Losing my Religion.”

Sally Green and Steve McDonald (co-directors Cochrane Australia) say: “It took a special kind of person to believe that Cochrane could take hold and flourish in a region as populous and diverse as South Asia. Prathap was undaunted by the task ahead – always optimistic, full of energy and huge reserves of perseverance. Prathap was bursting with ideas and so could immediately see where a person’s talents and enthusiasm could make a difference. He was also extremely generous with his time, forever travelling around the region to lend a hand and committing himself to one too many things. It was our good fortune to be Prathap’s guide in those early days (not that we had much guiding to do) and a privilege to spend time at his home base in the peaceful surrounds of CMC Vellore or on cramped overnight train trips from one meeting to another. You always felt with Prathap that the opportunities were boundless – Cochrane got lucky in finding someone so accomplished at exploiting them.”

Cochrane’s Chief Executive Officer, Mark Wilson, said: ‘I would sincerely like to thank Prathap for his outstanding contributions to Cochrane’s work, and for his advocacy for evidence-informed health care in India. We will miss Prathap’s insights, commitment and support to advance our work in India, and will still count on him to guide Cochrane towards a new chapter of our work with key partners in India. Prathap, we wish you all the best for the future.’

Staff at the BV Moses Centre (BVMV) will continue their activities, including training for evidence-based medicine using Cochrane methods, translation work, maintaining the South Asian Database of Controlled Clinical Trials. They will also be involved in exploring new opportunities for Cochrane in the region including the development of a Indian Cochrane Network.

Cochrane thanks Professor Prathap Tharyan for his outstanding contributions over the last 14 years and we wish him every happiness and success for the future.

Hear more about what has driven Professor Prathap Tharyan all these years to invest in evidence-informed health care: Recommended dose podcast .

The 2019 Research Excellence Awards were held at Old Government House at the University of Auckland on Tuesday, 7 May. The theme of the awards was ‘The future world of work: Te ao mahi ā mua’.

The annual Awards recognise the outstanding contributions made by researchers from those beginning their career to those whose work has earned them national and global standing. The Awards celebrate excellence at all stages of research across the faculties and institutes at the University of Auckland.

Four Research Excellence medals are presented annually, up to two for individuals and up to two for teams, who have made an outstanding contribution to one or more disciplines. Along with the medal, an individual winner receives $5,000 and winning teams $10,000. The award is judged and supported by the University Research Committee.

Cochrane Gynaecology and Fertility Group were awarded a Research Excellence Award for clinical trials and systematic reviews of fertility treatments.

Congratulations to Cindy Farquhar who led the team which consisted of Marian Showell, Vanessa Jordan, Lynn Sadler, Jane Marjoribanks, Helen Nagels and Sarah Lensen.

• Visit the Cochrane New Zealand website
• Visit the Cochrane Gynaecology and Fertility website

Specifications: Full Time, Fixed term for 2 years or a secondment
Salary: Competitive
Location: Flexible
Application Closing Date: Friday 7th June 2019

This role is an exciting opportunity to use your experience as a Projects Officer to make a difference in the field of health care research. 

This new role, as part of Cochrane’s Knowledge Translation (KT) department, will be responsible for supporting the delivery of specific KT activities and implementation projects; and to assist colleagues across Cochrane’s global community by providing training, tools and guidance in order for them to implement their KT activities and wider strategic plans.

The successful applicant will work across a range of project areas within the KT department that includes: supporting and coordinating the work of the KT Working Groups, support to external and internal communications, multi-lingual strategies, partnerships and advocacy, brand marketing and events, and KT training requirements.

We are looking for a self-motivated and highly organised individual who is able to work effectively and collaboratively with a diverse range of contacts across the world.  The successful candidate will also have:

• A degree or equivalent experience in health policy or science background
• An understanding of knowledge translation and experience of delivering implementation projects
• Ability to work alongside varied teams in different cultural and linguistic settings
• Proven experience of building productive working relationships, both internally and externally, in a geographically dispersed environment
• Strong written and verbal communication skills
• Ability to manage multiple projects and work assignments
• Willingness to work flexibly including outside normal working hours to accommodate different time-zones, when needed, and sporadic international travel
• Commitment to Cochrane’s mission and values

Cochrane is a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesizing research findings to produce the best available evidence on what can work, what might harm and where more research is needed. Our work is recognised as the international gold standard for high quality, trusted information.

If you would like to apply for this position, please send a CV along with a supporting statement to recruitment@cochrane.org with “KT Projects Officer” in the subject line.  The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples.  List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post.

For further information, please download the full job description from here.

Deadline for applications: Friday 7th June 2019
 
Interviews to be held on: TBC
 

Cochrane Sweden is celebrating their 2nd anniversary. The Centre was established on the 16th May 2017 and is located in the city of Lund. It is affiliated with the Department of Research & Development / Section for HTA Analysis, Skåne University Hospital, in collaboration with the Faculty of Medicine at Lund University and with the Nordic Cochrane Centre in Copenhagen led by Karsten Juhl Jørgensen.

Over the last two years, Cochrane Sweden has been busy promoting-evidence based decision making in healthcare in Sweden. Some accomplishments, so far, have been providing learning tools on how to conduct, edit and read systematic reviews. This has led to Cochrane Interactive Learning being a part of the curriculum at the Medical Faculty at Lund University. The Centre is also actively working with key stakeholders across Sweden to assist in the use of Cochrane reviews in research and practice. Matteo Bruschettini along with his colleague Minna Johansson, and in collaboration with Cochrane Norway and Cochrane Nordic, have been touring the country giving talks at conferences and hosting workshops and seminars about Cochrane.

More recently, the Director and the Communications Consultant of Cochrane Sweden, Matteo Bruschettini and Dina Muscat Meng, have spearheaded an initiative to support anyone interested in learning about our efforts at Cochrane to have the opportunity to participate in an international exchange programme, which has been named The Cochrane International Mobility Programme. So far, the Centre has already arranged 5 exchange experiences for people interested in learning more about Cochrane evidence at Cochrane Sweden with other centres and groups in Cochrane.

Peter Brattström from Lund University visiting Cochrane Austria and learning about Cochrane methodology for his master thesis in neonatology.

Matteo Bruschettini, Director of Cochrane Sweden, says: "Two years ago, we could not expect such a positive and immediate response to the establishment of a Cochrane Centre in Sweden. Despite a huge delay compared to the other Scandinavian countries and the lack of a national subscription to the Cochrane Library, our workshops and courses have been attended by so many enthusiastic people. Moreover, we’re working at full speed, with junior and senior researchers visiting our Centre and contributing to relevant studies (a few to be published in 2019). We’re very grateful to professor Ingemar Petersson, Head of Research at the University Hospital in Lund, for his wise and generous support. In addition, we aim to further expand the successful and strategic collaboration with the Cochrane Centres in Norway and Denmark and to facilitate the launch of a new Cochrane Field in Sweden."

• Visit the Cochrane Sweden website
• Learn more about the International Mobility Programme