20-21 November 2019 Cochrane Sweden, Cochrane Norway and Cochrane Nordic welcome you to a 2-day workshop on basic Cochrane Methodology.
Location: The workshop will be held at the University of Lund, Sweden. The exact venue details will be announced later.
Who should attend: The workshop is primarily aimed at health professionals, researchers and academics with an interest in healthcare research, but is also open for anyone to join. The level is basic and prior experience from conducting systematic reviews is not a requirement.
Objectives: The workshop will provide an introduction on practical and methodological issues of how to prepare a Cochrane systematic review of the effects of interventions. Topics will include;
How to register a Cochrane title
Research question and PICO
Structure and importance of the protocol
Search strategy
Interpretation of results and meta-analysis
Risk of bias assessment
GRADE
Challenges that evidence-based medicine is facing
Format: The workshop will use a combination of lectures, small group learning based on worked examples, and plenary discussion. Participants will also be provided with a short reading list in advance of the workshop. The workshop will be taught in English.
Participant fee: 2000 SEK (approximately 190 euros). The workshop is free for authors of Cochrane reviews (the Title has to be registered on Archie).
REGISTER HERE within 30th September 2019. In October you will receive additional information.
Contact: For more information about the course please see Contact us.
Systematic Reviews of Diagnostic Test Accuracy Studies Workshop -
21-22 January 2020
This 2-day workshop is targeted at people who need to make decisions about diagnostic tests. It forms a coherent basis for systematically reviewing , analysing and interpreting diagnostic evidence.
Who should attend: The workshop is directed to review authors, healthcare professionals, clinicians, researchers (statisticians and epidemiologists), guideline developers and policymakers, who wish to know more about systematically reviewing and understanding diagnostic evidence.
Prerequisites for workshop participants
Basic knowledge of the methodology and statistical analysis of primary studies of diagnostic test accuracy.
Familiarity with the methodology and conduct of systematic reviews.
Feature review about latest Cochrane evidence on the effect of malignant melonama screening
Cochrane interviews author behind latest review on malignant melanoma screening
The Cochrane Review Screening for reducing morbidity and mortality in malignant melanoma has been recently updated. Researchers from Cochrane Sweden and The Nordic Cochrane Centre are behind this recent review. Read the full interview with Karsten Juhl Jørgensen, Director of the Nordic Cochrane Centre and author of the review to learn what the evidence says and why it is important.
Can you tell us about this Cochrane Review?
We reviewed the evidence for the benefits and harms of screening for malignant melanoma (a type of skin cancer) compared with no screening. We included all types of screening (e.g. skin self‐examination, or examination by a health professional) of any person not suspected of having malignant melanoma, i.e. people with no known suspicious mole or lesion, irrespective of age or gender. Studies in people thought to have a high risk of developing malignant melanoma were included, but not those known to previously have had melanoma.
What does the evidence tell us about the current available evidence for screening?
We found two randomised trials that met our inclusion criteria, but no data on any important outcomes where reported. This means that we do not have sufficient evidence to determine the benefits and harms of screening for malignant melanoma. Both international and national health organisations such as WHO and the UK National Screening Committee have outlined specific criteria to implement screening programmes on a population level (UKNSC 2015; WHO 2008), underlining the importance of solid evidence for both benefits and harms. Current screening practices for melanoma do not live up to these required evidence standards.
Why is this such an important topic?
Malignant melanoma is a skin tumour, which can cause death by spreading to other parts of the body; the number of malignant melanomas is rising sharply, while the risk of dying from the disease has been virtually stable. Currently, Germany has a national skin cancer screening programme and many interest groups campaign for melanoma screening.
Screening has the potential to reduce deaths from melanoma through earlier detection. However, there are also potential harms from screening people without symptoms of melanoma, such as finding melanomas and other skin lesions that would not have caused symptoms if they had remained undetected (i.e. overdiagnosis), unnecessary surgery, and possible psychological stress. There is also the risk that healthcare resources and finances are not being utilised optimally and could provide greater benefits if allocated to other interventions with a stronger evidence base. It is therefore important to establish the evidence base for both benefits and harms of screening for melanoma.
What does this tell us about screening programmes in current use?
We do not know whether current screening initiatives for malignant melanoma results in any benefits, or whether such potential benefits are outweighed by the potential harms, or if it is reasonable in relation to the resources used. We do know that current screening programmes and campaigns do not fulfil established general criteria for screening.
What is needed to determine the benefits and harms of screening?
To determine the benefits and harms of screening for malignant melanoma, a rigorously conducted randomised trial is needed. As malignant melanoma is a comparatively uncommon cause of death, such a trial would need to be quite large to provide useful answers.
Since opportunistic screening is already widespread in many countries, a challenge to any trial would be to make sure that the control group is not subject to such screening (i.e. to avoid contamination of the control group), since this may dilute both potential benefits and potential harms of screening estimated from the trial. Apart from a potential effect on mortality from melanoma, other important outcomes to consider in future trials include less aggressive treatment, overdiagnosis, psychosocial consequences, and resource use.
Why is this important?
This review shows that adult general population screening for malignant melanoma is not supported or refuted by current evidence from randomised controlled trials and therefore does not fulfil well-established screening criteria. Yet screening for malignant melanoma is currently practised in many countries in a more or less organised form. This is problematic since data from randomised trials demonstrating that benefits outweigh harms is considered mandatory before the introduction of screening programmes for cancer (UKNSC 2015; WHO 2008). The case of screening for malignant melanoma reinforces the importance of this requirement. First, non‐randomised studies of the effects of screening may lead to seriously misleading results. Second, screening has important harms, such as overdiagnosis and overtreatment of malignant melanomas, and robust trials would need to be performed to quantify them and enable us to weigh them against the benefit. Third, the majority of people who take part in the screening programmes cannot benefit from screening as they will never develop the disease. Fourth, screening programmes have a high potential for opportunity costs (Harris 2014). Fifth, when offering screening, healthcare systems invite asymptomatic people to an intervention that they have not asked for, which leads to ethical considerations that differ from those in regular health care (Sackett 2002).
Would you like to be a part of the Cochrane community? We have over 68,000 supporters from around the world and 11,000 members. There a number of ways that you can contribute. You can find out more from our Join Cochrane page on how you can be a part of Cochrane.
At Cochrane Sweden, we also regularly host and train people who would like to work with Cochrane through the Cochrane International Mobility Programme. Some of the people participating on this programme have kindly shared their stories, which can be read on the Join Cochrane webpage. Chiara Nava, a junior medical doctor from Italy has shared her experience of her three month visit at our Centre, as part of CIM, with Students 4 Evidence. You can read her story here.
