Help! Where do I begin? A troubleshooting guide to updating a Cochrane intervention review as a new review author

Article type
Authors
Carter E1, Elstub L2, Wallace S3, Vale L3
1Cochrane UK
2Cochrane Incontinence
3Cochrane Incontinence
Abstract
Background: Cochrane Reviews can appear to be a daunting undertaking for new review authors. There are multiple stages involved which may not be immediately apparent: revisiting the protocol, updating the search, piloting revised eligibility criteria, inclusion assessments, piloting (revised) data collection forms, application of GRADE to assess the certainty of the body of evidence and rewriting the main text. Updating reviews is vital to maintain the Cochrane Library. The promise of mentorship and support of a review group can act as a strong motivator for a variety of new reviewers to get involved with Cochrane, thus helping to diversify the organization.

Objectives: to provide a troubleshooting guide and helpful tips for undertaking a review update for a new review author.

Methods: using our current work on an active Cochrane Review update as a case study, we discuss key components of the process, challenges faced, solutions, and lessons learned.

Results: benefits of undertaking an intervention review update include the opportunity, with the benefit of new patient and consumer involvement, to ensure that the study question, comparisons and outcomes remain clinically pertinent in the light of new research. New review methods may now be in use that were not in place for the original review. Full risk of bias assessment and application of GRADE can be performed if not previously attempted, and a relevant core outcome set may now be available. Targeting these issues will enhance the review quality.

Potential challenges include: the time-consuming process of revisiting the original study papers to produce a full risk of bias assessment or extract data on a new outcome; loss of data such as original data extraction forms; engagement of the original study authors with the update; and the potential volume of combined new and old studies. Synthesis of new and existing data in light of revised comparisons and outcomes requires careful planning.

Conclusion: our troubleshooting guide and helpful tips focus on the specific challenges faced for review updates. These are a helpful way for new reviewers to get involved with Cochrane, providing the opportunity for comprehensive training in systematic review with the support of a review group within an established organisation. Reviewers will additionally benefit from recognized training courses and the Cochrane library of resources, fostering a culture of lifelong involvement.

By encouraging new reviewers to get involved with Cochrane and supporting them through the review process, the organization will be diversified internationally, particularly in relation to the engagement of those with restrictions on their time, e.g. clinicians, who provide valuable guidance with steering the direction of future research. This enables continuing worldwide clinical input into Cochrane Review Groups, who may benefit from the use of technology initiatives such as Covidence and RevMan Web.