Presentation on theme: "LLafave 2010 10 studies (N=686 participants) included. Clinical improvement in clinical global state at short term (< 3months) and medium term (3 -6."— Presentation transcript:
LLafave 2010 10 studies (N=686 participants) included. Clinical improvement in clinical global state at short term (< 3months) and medium term (3 -6 months)(evidence quality - low) Fewer people receiving trifluoperazine left studies early due to relapse or worsening at medium term (2 RCTs, n=381, RR 0.34 CI 0.23 to 0.49, very low quality evidence). No difference between trifluoperazine and placebo for outcome of leaving the study early any reason/due to severe adverse effects (medium term). For economic outcomes, we valued outcomes for relapse and hospital discharge and presented them in additional tables (Grade C level of economic data from trials reporting limited information). To investigate whether motivated but inexperienced people, with a bit of support and training, follow a structured template and produce a high quality Cochrane review. 1. Heller J. Catch-22 / Joseph Heller. London: Corgi; 1974. 2. Koch K, Mansi K, Haynes E, Adams CE, Furtado V. Trifluoperazine versus placebo for schizophrenia. Cochrane Database Systematic Reviews 2013 (in press) Aims IntroductionResults of the review References Results of the project Catch 22: Is the future of systematic reviewing only for the experienced? Mahesh Jayaram 1, Kai Koch 2, Kamel Mansi 3, Euan Haynes 3, Clive E Adams 3, Vivek A Furtado 4 1 University of Melbourne, 2 School of Medicine, University of Nottingham, UK 3 Cochrane Schizophrenia Group, University of Nottingham, Nottingham, UK 4 Forensic Psychiatry, Rampton Hospital, Retford, UK Increasingly, calls are made for those undertaking systematic reviews to have highly specialist knowledge in the field. Some Cochrane groups prefer authors with previous experience of conducting reviews or statistical background. ….so, experience cannot be gained except by those with experience. The existing cohort of reviewers are getting older, there is lots of work to be done and we need young energetic reviewers! Materials * For free online training visit: https://sites.google.com/site/revmantutorial1/ The students need some help in understanding the process, data extraction, clinical application and write up. This took approximately 8 hours of one experienced reviewers time (CEA). The review was completed in 1 month (excluding editing time) Medical student (KK) now in final year of medical school. School student (EH) gained entry into medical school and KM gained lectureship in a leading UK university. VF provided economic analysis and MJ edited the review. The review process was helpful to the students. Discussion Sensitivity analyses Cost per day (£) Cost of actual relapse (£) Cost of relapse for study population (£)** TrifluoperazinePlaceboTrifluoperazinePlacebo Mean length of stay 1 and mean cost 3 18,049667,820974,5892,5596,815 Mean length of stay 1 and mean lower quartile cost 4 15,966590,764862,1372,2636,029 Mean length of stay 1 and mean upper quartile cost 5 20,078742,9011,084,1582,8467,582 Median length of stay 2 and mean lower quartile cost 4 4,784177,008258,3366781,807 Median length of stay 2 and mean upper quartile cost 5 6,016222,592324,8648532,272 1 53.4 days, 2 16 days, 3 £338, 4 £299, 5 £376 *Unlike the effectiveness data of this review, the included economic studies have not been weighted according to sample size; hence risk ratios (RR) of cost of relapse for the study population (if calculated) may not be equal to the RR as calculated by RevMan. **Cost attributed to each individual participant within each arm of the trial, irrespective of whether they relapsed or not. Lots of high quality reviews can be conducted by those with interest, who may not have a lot of experience but gain it in the process. These can be done relatively quickly. A supportive environment is necessary but is available within the Collaboration. Results of the review show that trifluoperazine is an effective drug compared to placebo for treating schizophrenia. The unit cost of relapse is a novel way of calculating economic costs. Outcome: Global state - Clinical improvement (as defined by each study) Economic outcomes: Sensitivity analysis*
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