Five evidence ‘game changers’ in 2013 and what this means for Cochrane Reviews

Article type
Authors
Alper B1, Fedorowicz Z2
1Founder of DynaMed VP of EBM Research & Development, Policy and Content Quality EBSCO Information Services, USA
2Director Bahrain Branch The Cochrane Collaboration, Bahrain
Abstract
Background:
Reviewing the best evidence is especially challenging when the research is unpublished, when the published evidence is not reliable (for reasons not apparent through routine critical appraisal methods), and when the research framework differs from common clinical practice. Understanding relevant examples can provide insight for the planning and updating of Cochrane Reviews.

Discussion:
In 2013 there were five high-impact changes in systematically synthesized evidence for guiding clinical practice: sodium restriction for heart failure (January 2013), gliptins for diabetes (February 2013), iImiquimod for molluscum contagiosum (July 2013), perioperative beta blockers for noncardiac surgery (July 2013), threshold for recommending statins for primary prevention (November 2013).

We will share the “behind the scenes” efforts to better understand and convey these changes, and discuss what can be learned from these experiences. These will be presented in terms of: what we thought we knew, what we found out, and the challenges faced. These five experiences represent unique cautions for Cochrane reviewers and we will provide five corresponding strategies that can be used to enhance the validity, relevance, and currency of Cochrane reviews.