1. The Cochrane Library

2. What is The Cochrane Library? How do you know if one healthcare intervention works better than another, or if it will do more harm than good? Information about health is everywhere, but how can health professionals and consumers make sense of all the research going on around the world? Health care in the 21 st Century relies not only on individual medical skills, but also on the best information on the effectiveness of each intervention being accessible to practitioners, patients, and policy makers. This approach is known as “evidence-based medicine”.

3. What is The Cochrane Library? The Cochrane Library is the single most reliable source for evidence on the effects of health care. The Cochrane Library brings together in one place research on the effectiveness of healthcare treatments and interventions. It is the gold standard in evidence-based medicine and provides access to the most objective information on the latest in medical treatment.

4. The Cochrane Library provides information and evidence to support decisions taken in health care and to inform those receiving care.

5. The Cochrane Library incorporates not only hundreds of medical conditions but also diverse topics such as injury prevention, alternative remedies, and natural treatments to alleviate ill health.

6. Who produces The Cochrane Library? Wiley-Blackwell publishes The Cochrane Library for The Cochrane Collaboration an international not–for–profit organization, providing up–to–date information about the effects of health care. It aims to help people make well- informed decisions about health care by preparing, maintaining and promoting the accessibility of systematic reviews on the effects of healthcare interventions. Who produces The Cochrane Library? Wiley-Blackwell publishes The Cochrane Library for The Cochrane Collaboration an international not–for–profit organization, providing up–to–date information about the effects of health care. It aims to help people make well- informed decisions about health care by preparing, maintaining and promoting the accessibility of systematic reviews on the effects of healthcare interventions.

7. The Cochrane Collaboration Structure - established as an international organisation in 1993, registered as a charity in the U.K. Aim - to help people make well-informed decisions about health care. How - by preparing and promoting access to systematic reviews of the effects of healthcare interventions. Publishing Output – The Cochrane Library

8. What is in The Cochrane Library? Cochrane Database of Systematic Reviews (Cochrane Reviews) Database of Abstracts of Reviews of Effects (Other Reviews) Central Register of Controlled Trials (Clinical Trials) Cochrane Methodology Register (Methods Studies) Health Technology Assessment Database (Technology Assessments) NHS Economic Evaluation Database (Economic Evaluations) It also contains information about The Cochrane Collaboration and The Cochrane Collaborative Review Groups

9. The Cochrane Database of Systematic Reviews Cochrane Systematic Reviews investigate the effects of interventions for prevention, treatment and rehabilitation in a healthcare setting. They are designed to facilitate the choices that doctors, patients, policy makers, and others face in health care. Each review addresses a clearly formulated question; for example: can antibiotics help in alleviating the symptoms of a sore throat? The research is reviewed using stringent guidelines to establish whether or not there is conclusive evidence about a specific treatment.

10. The Cochrane Database of Systematic Reviews Also includes: Methodology reviews and protocols: Full-text Reviews that examine the benefit of methodological studies e.g. Does editorial peer-review improve the quality of reports of biomedical studies?

11. The Cochrane Database of Systematic Reviews Each of these groups uses information in different ways, according to their different purposes. As Cochrane reviews have become known internationally as a source of high quality, reliable health information, many have also begun to interpret, adapt and disseminate Cochrane Reviews and information derived from them: The impact of Cochrane Reviews The Cochrane Library is used by a broad range of people interested in evidence-based health care, including consumers, clinicians, policy makers, researchers, educators, students and others. Clinical guidelines and health technology assessment organisations Electronic databases Journals Health related websites

12. The Cochrane Database of Systematic Reviews Why are Cochrane Reviews so important? Cochrane Reviews are conducted to the highest standard of methodological quality. They have been found to be of comparable or better quality and are updated more frequently than reviews published in print journals. 1 1 Source: Jadad AR, Cook DJ, Jones A, Klassen TP, Tugwell P, Moher M, Moher D. Methodology and reports of systematic reviews and meta-analyses: a comparison of Cochrane reviews with articles published in paper-based journals. JAMA 1998;280:278-280.

13. The Cochrane Database of Systematic Reviews How large is The Cochrane Reviews database? It comprises over 3464 complete reviews and 1856 protocols (Reviews in progress) in html & PDF format How often is the database updated? All Reviews are regularly updated with the latest evidence and the database is updated and expanded every 3 months

14. The Cochrane Database of Systematic Reviews What is different about Cochrane Systematic Reviews? Cochrane reviews address clearly formulated questions such as ‘does fluoride help prevent tooth decay in children’ or ‘can antibiotics help in alleviating the symptoms of a sore throat’. Comprehensive and explicit methods are used to track down, select and determine the quality of relevant research. This includes searches for unpublished and non-English records to provide as complete a picture as possible to try to answer the question considered.

15. The Cochrane Database of Systematic Reviews Cochrane Reviews are know as the “gold standard” for systematic reviews in such key publications as The Lancet, New England Journal of Medicine, British Medical Journal, and the Journal of the American Medical Association and routinely appear there as well as in specialised medical journals for various specialty areas. Source: Chart by Paul Glasziou

16. Database of Abstracts of Reviews of Effects Database of Abstracts of Reviews of Effects (Other Reviews). Complements the Cochrane Reviews by quality-assessing and summarising reviews which have not been carried out by The Cochrane Collaboration. DARE is unique in that it is the only database to contain abstracts of systematic reviews that have been quality assessed. Each abstract includes a summary of the review together with a critical commentary about the overall quality. Produced by the CRD in York.

17. Central Register of Controlled Trials Cochrane Central Register of Controlled Trials (Clinical Trials). Includes details of published articles taken from bibliographic databases and other published resources. CENTRAL records include the title of the article, information on where it was published and, in many cases, the abstract.

18. Cochrane Methodology Register The Cochrane Methodology Register (Method Studies). Presents a bibliography of publications that report on methods used when conducting controlled trials. It includes journals articles, books and conference proceedings. Articles are taken from MEDLINE and from hand searches.

19. Health Technology Assessment Database Health Technology Assessment Database (Technology Assessments). Brings together details of completed and ongoing health technology assessments (studies of the medical, social, ethical and economic implications of healthcare interventions) from around the world. The aim of the database is to improve the quality and cost effectiveness of health care. Produced by the CRD in York.

20. The NHS Economic Evaluation Database The NHS Economic Evaluation Database (Economic Evaluations). As healthcare resources are finite, information about costs and effects are essential to making evidence- based decisions about competing healthcare interventions. Information about cost- effectiveness can be difficult to identify, appraise and interpret. NHS EED assists decision- makers by systematically identifying economic evaluations from around the world, appraising their quality and highlighting their relative strengths and weaknesses. Produced by the CRD in York.

22. “searching for all text schizo, drugs, atypical and antipsychotic. in All Fields in The Cochrane Database of Systematic Reviews" An Advanced Search of The Cochrane Library…

23. … Returns the following results: You can toggle between results listed for the different databases in The Cochrane Library here Use these links to restrict your search results to Reviews only, or Protocols (reviews in progress) only. Save or edit your search using these links.

24. MeSH (Medical Subjects Heading Search) Let us look at an example MeSH search

25. Use the Thesaurus to search for MeSH descriptors MeSH (Medical Subjects Heading Search)

26. Or use qualifiers. MeSH (Medical Subjects Heading Search)

27. Search History Select Search History to combine searches, enter their number together with Boolean operator of choice (AND, OR, NOT).

28. Combine searches by entering their number together with Boolean operator of choice (AND, OR, NOT). Search History

30. Your combined search will then appear in your Search History. Search History

31. COCHRANE REVIEWS - improved STATUS FLAGS

32. This information appears at the top of the review. Author Affiliations and Contact details Explicit Review Status dates displayed here

34. Review authors have the option to include a risk of bias table as an extension of the ‘characteristics of included studies table’

36. This new section will feature additional information and documents, where relevant.

37. Links to MEDLINE Abstracts and ISI Web of Science® Easy navigation from a reference in a review to the cited journal article Wiley InterScience™ alerting services based on keywords, authors and other parameters Links from many CENTRAL records to the corresponding record in PubMed

38. Health Professionals at all levels, Health Researchers, Health Policy Makers, Care Givers and patients.

39. What is on the world’s health agenda? Health or ill-health is a common concern of the 6.7 billion individuals on the planet. With over half the world’s consumers and health professionals having free or institution/government funded access to Cochrane Evidence around the world, a list of the top 20 most accessed Cochrane Reviews gives a view of the most common ailments and the interventions we are seeking.

40. The list of the top 20 globally accessed Cochrane Systematic Reviews and the evidence for or against specific healthcare interventions extends far beyond drugs, and includes some big questions facing many countries; whether it is caring for an ageing population or preventing obesity in children.

41. 1.Interventions for preventing falls in elderly people 2.Interventions for preventing obesity in children 3.Beta-blockers for hypertension 4.Low glycaemic index or low glycaemic load diets for overweight and obesity 5.Nicotine receptor partial agonists for smoking cessation 6.Support surfaces for pressure ulcer prevention 7.Interventions to improve hand hygiene compliance in patient care 8.Vitamin C for preventing and treating the common cold 9.Rosiglitazone for type 2 diabetes mellitus 10.Exercise therapy for treatment of non-specific low back pain 11.Interventions for enhancing medication adherence 12.Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke 13.Physiotherapy interventions for shoulder pain 14.Exercise for overweight or obesity 15.Screening for breast cancer with mammography 16.Nicotine replacement therapy for smoking cessation 17.Early skin-to-skin contact for mothers and their healthy newborn infants 18.Continuous support for women during childbirth 19.Glucosamine therapy for treating osteoarthritis 20.Pulmonary rehabilitation for chronic obstructive pulmonary disease

42. Half the world population now have access to The Cochrane Library