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9 results

  • 21a - New Efforts towards Evidence-Informed Practice and Practice-Informed Research: Commentary on Recent Developments in the Pharmacologic Management of Personality Disorders

  • from Part V - Treatment
  • Edited by Carl W. Lejuez, University of Kansas, Kim L. Gratz, University of Toledo, Ohio
  • Book:
    The Cambridge Handbook of Personality Disorders
    Published online:
    24 February 2020
    Print publication:
    07 May 2020, pp 514-516

  • Summary

    This commentary focuses on the current state and recent developments within the field of research on drug treatments for borderline personality disorder. From an evidence-based medicine perspective, the relevance of the currently available evidence for clinical practice is critically discussed. Some research/practice gaps are highlighted, like polypharmacy and the widespread use of quetiapine, which both lack supporting, sufficiently reliable evidence. Sources for the lack of practically relevant research are outlined, and the example of recent research on Olanzapine for patients with borderline personality disorder is amplified. Last, new initiatives are presented which aim at improving the value of research, like the REWARD alliance, the AllTrials campaign, and the James Lind alliance that guide, inform, and support the design, conduct, and publication of studies that are of relevancy to consumers and clinicians, and have the potential to transform healthcare. Some first encouraging results of these endeavors are presented.

  • Coverage of mental health and substance misuse topics in the Cochrane review system

  • S. Green-Hennessy
  • Journal:
    Epidemiology and Psychiatric Sciences / Volume 22 / Issue 2 / June 2013
    Published online by Cambridge University Press:
    29 August 2012, pp. 155-162
  • Aims.

    To assess the breadth of mental and substance coverage in the Cochrane review system.

    Methods.

    All mental health and substance entries were identified from the 2005 to April 2012 Cochrane Database of Systematic Reviews.

    Results.

    A total of 1019 entries focused on mental health or substance misuse, with 698 (68.5%) being completed reviews. One out of every five entries focused on serious mental illness/psychosis. Systematic reviews addressing unipolar depression, dementia and certain substance disorders also appeared well-represented. In contrast, a number of impairing disorders frequently seen in practice received less attention, with bipolar disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and autism spectrum disorders each accounting for less than 2% of the entries. The majority of interventions reviewed involved medication (57.1%), although this was not the case for a number of childhood-onset disorders. Some diagnostic areas (sleep, anxiety, mood and substance) were addressed by multiple Cochrane review groups (CRGs).

    Conclusions.

    The Cochrane Collaboration is well poised to be a strong guiding influence to those seeking to employ evidence-based mental health care. Broadening its diagnostic coverage and diversifying types of intervention reviewed would probably further maximize its impact. A more centralized and directed approach of prioritizing topics could help ensure more comprehensive coverage.

  • The Cochrane Collaboration as key player in the struggle for better and more relevant patients- and system-oriented research

  • A. Liberati
  • Journal:
    Epidemiology and Psychiatric Sciences / Volume 20 / Issue 3 / September 2011
    Published online by Cambridge University Press:
    25 May 2011, pp. 225-230
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  • The Cochrane Collaboration represents a quite successful example of a grass roots international effort aimed at contributing the growing demand for valid and reliable information on the effects of health care intervention, eagerly sought by consumers, patients, doctors and policy makers worldwide. The Cochrane Collaboration is fully aware that part of its success is due to the originality of its founding principles and that the challenge ahead is to maintain its ‘Cochrane Collaboration brand’ while understanding how a mature organisation can cope with the expectations of the relevant stakeholders with whom it seeks to collaborate. In this editorial reference is made to the strategic reflections emerged from the internal review that the organisation has recently completed to guide its years ahead.

  • The origins, evolution, and future of The Cochrane Database of Systematic Reviews

  • Mark Starr, Iain Chalmers, Mike Clarke, Andrew D. Oxman
  • Journal:
    International Journal of Technology Assessment in Health Care / Volume 25 / Issue S1 / July 2009
    Published online by Cambridge University Press:
    01 July 2009, pp. 182-195
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  • The Cochrane Database of Systematic Reviews (CDSR) evolved in response to Archie Cochrane's challenge to the medical profession to assemble “a critical summary, adapted periodically, of all . . . relevant randomized controlled trials”. CDSR has been an electronic publication from its inception and this has meant that Cochrane reviews (i) need not be constrained by lack of space; (ii) can be updated as new information becomes available and when mistakes or other ways of improving them are identified; and (iii) can be cross-linked to other, related sources of relevant information. Although CDSR has become widely cited, it must continue to evolve in the light of technological and methodological developments, and in response to the needs of people making decisions about health care.

  • 9 - The Cochrane Collaboration and the Cochrane Anaesthesia Review Group

    • By Tom Pedersen, The Cochrane Anaesthesia Review Group, Centre of Head-Orthopaedics, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark, Ann Møller, The Cochrane Anaesthesia Review Group, Department of Anaesthesiology, Herlev University Hospital, Herlev, Denmark
  • Edited by Ann Møller, KAS Herlev, Copenhagen, Tom Pedersen, Rigshospitalet, Copenhagen
  • Book:
    Evidence-based Anaesthesia and Intensive Care
    Published online:
    05 September 2009
    Print publication:
    09 October 2006, pp 77-87

  • Summary

    The Cochrane Collaboration is an international non-profit and independent organisation, dedicated to making up-to-date, accurate information about the effects of health care readily available worldwide. The Collaboration is supported by hundreds of organisations from around the world, including health service providers, research funding agencies, departments of health, international organisations and universities. It is a major focus of activity, and a rich source of information within the evidence-based medicine (EBM) movement. The main goal of Cochrane Anaesthesia Review Group (CARG) is to conduct systematic reviews of randomised controlled trials and other controlled clinical trials of interventions. The CARG maintains a register of more than 25000 randomised controlled trials and clinical controlled trials related to anaesthesia, perioperative medicine, intensive care medicine, pre-hospital medicine, resuscitation and emergency medicine. The necessity of The Cochrane Collaboration and EBM has become widely recognised by health professionals and lay people alike.

  • 26 - Rehabilitation for aphasia

  • from Section B3 - Cognitive neurorehabilitation
  • Edited by Michael Selzer, University of Pennsylvania, Stephanie Clarke, Université de Lausanne, Switzerland, Leonardo Cohen, National Institute of Mental Health, Bethesda, Maryland, Pamela Duncan, University of Florida, Fred Gage, Salk Institute for Biological Studies, San Diego
  • Book:
    Textbook of Neural Repair and Rehabilitation
    Published online:
    04 August 2010
    Print publication:
    16 February 2006, pp 413-423

  • Summary

    This chapter presents an overview of aphasia rehabilitation and deals only with acquired aphasia due to focal brain damage in adults. It discusses some principles explicitly or implicitly underlying the rationale of aphasia rehabilitation. The endeavour to treat language disorders has a long history, and the approaches are extremely heterogeneous. Among interventions for acquired cognitive deficits, the rehabilitation of speech and language disorders following brain damage has the longest tradition, dating back to the 19th century. A variety of approaches have been applied to the rehabilitation of aphasia. The emphasis of the behavioural approach is on the learning process, and is an application to aphasia treatment of programmed instruction based on operant conditioning. A meta-analysis of studies dealing with the effectiveness of language rehabilitation, limited to aphasia as a result of stroke, has been performed by the Cochrane collaboration.

  • Increasing International Collaboration through the WADEM

  • Frank Archer
  • Journal:
    Prehospital and Disaster Medicine / Volume 20 / Issue S1 / April 2005
    Published online by Cambridge University Press:
    28 June 2012, p. 28
    Print publication:
    April 2005
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  • THE TYPICAL COCHRANE REVIEW: How Many Trials? How Many Participants?

  • Susan Mallett, Mike Clarke
  • Journal:
    International Journal of Technology Assessment in Health Care / Volume 18 / Issue 4 / December 2002
    Published online by Cambridge University Press:
    23 December 2002, pp. 820-823

  • Objectives: To describe the number of trials and participants in a typical systematic review from The Cochrane Database of Systematic Reviews.

    Methods: The number of trials in 1,000 Cochrane systematic reviews in issue 1, 2001 of The Cochrane Database of Systematic Reviews was counted for three categories of trial: included trials, ongoing trials, and trials awaiting assessment for inclusion. (The term trial is used in this paper, although a small number of Cochrane reviews include studies that are not trials.) The total number of participants in included trials was extracted from a sample of reviews.

    Results: A total of 9,778 trials were included in the Cochrane reviews. There were a further 356 ongoing trials and 1,138 trials awaiting assessment for inclusion. A typical review contained six included trials. Forty percent of the reviews listed ongoing trials and/or trials awaiting assessment for inclusion. Based on a sample of 258 reviews, the median number of participants per review was 945 (interquartile range, 313 to 2,511) per review and 118 (interquartile range, 60 to 241) per trial.

    Conclusion: This report is a descriptive study of the number of trials and participants in a typical Cochrane review from The Cochrane Library, issue 1, 2001.

  • A STUDY OF THE REFERENCES USED IN COCHRANE PROTOCOLS AND REVIEWS: Three Bibles, Three Dictionaries, and Nearly 25,000 Other Things

  • Mike Clarke, Teresa Clarke
  • Journal:
    International Journal of Technology Assessment in Health Care / Volume 16 / Issue 03 / July 2000
    Published online by Cambridge University Press:
    25 May 2001, pp. 907-909

  • Objectives: To describe the types of report that are cited by protocols and reviews included in the Cochrane Database of Systematic Reviews.

    Methods: The citation for each reference included in the Cochrane protocols and reviews published in the Cochrane Database of Systematic Reviews in issue 1, 1999 of The Cochrane Library were categorized by reference type (e.g., journal article, conference proceeding, book chapter, personal communication, Cochrane review).

    Results: Of a total of 24,913 citations, 21,694 (87.1%) were references to journal articles. There was a significant difference between the proportion of references to studies that were journal articles (12,348 of 13,472; 91.7%) and the proportion of other references in this category (9,346 of 11,441; 81.7%).

    Conclusion: The great majority of studies included in Cochrane reviews at the beginning of 1999 had been published as journal articles.