Updating the evidence for German geriatric medicine: an approach inspired by Cochrane Living Systematic Reviews

Article type
Authors
Bollig C1, Denkinger MD2, Bauer JM3, Voigt-Radloff S1
1Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center Faculty of Medicine, University of Freiburg
2Agaplesion Bethesda Clinic, Germany Geriatric Research Unit Ulm University
3Center for Geriatric Medicine, University of Heidelberg and Agaplesion Bethanien Hospital, Heidelberg
Abstract
Background:
The evidence-based medical treatment of older adults is challenging, as clinical trials evaluating the effects of interventions in this specific population are still scarce. The situation is further aggravated by outdated systematic reviews in this area. Our cooperative project between Cochrane Germany and the German Society of Geriatric Medicine intends to overcome the evidence-practice gap in geriatric medicine.

Objectives:
To develop and establish a knowledge translation system providing German physicians who care for geriatric patients with up-to-date evidence on major research issues in this field.

Methods:
A number of Cochrane Reviews on prioritized geriatric topics will be selected by a panel of German experts in geriatric medicine. A systematic (automatic alert) literature search will then be conducted to update the reviews. New publications will be checked on a monthly basis by two reviewers. If trials fulfill the inclusion criteria of the Cochrane Review, data will be extracted and the risk of bias will be evaluated. Finally, we will assess whether the new study results would change the conclusion of the Cochrane Review. Results will be made available on the website of Cochrane Germany and interested clinicians will be informed via an email newsletter. In addition, we plan a series of articles for the German Journal of Gerontology and Geriatrics (ZGG). Each article will include two parts:
1) the German translation of the Cochrane Review abstract; and
2) an expert commentary on the new evidence.

Results and conclusion:
First experiences with this approach will be reported at the Cochrane Colloquium. We intend to establish a long-term and efficient co-operation with Cochrane Review author groups by dividing the procedures of updating into three work packages:
1) monthly searches for new trials (Cochrane Review Author Group);
2) assessing trials for eligibility, extracting data and assessing for risk of bias (Cochrane Germany or trained geriatric experts);
3) publishing translated review abstracts and commentaries on new evidence (German Society of Geriatric Medicine).
This approach might become a model for other medical specialties.

Patient or healthcare consumer involvement:
This knowledge translation system will support older patients to receive evidence-based geriatric treatment according to current standards.