News from Cochrane

Suffolkres said:
I have only listen to 5 mins enough and am grappling wirh the Dr Spock issue. My son was born on 1984 and suffered a severe viral bacterial virus infection at 8 months old.
He was a persistent projective vomitter.
He had a foam mattress. I later wondered about dust spores being released from this perfect breeding ground for germs.
These mattresses were later implicated in sudden infant death syndrome.
My son had post Viral symptoms/ allergy and intolerances from birth.
He was diagnosed with ME in 1997, on my suggestion....
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I am sorry to hear this how terrifying!
How is your son doing now?

I’m just astounded at the hypocrisy of claims made to be saving us from harm through commitment to evidence, at the beginning.
 
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In the list of people awarded emeritus membership of Cochrane in 2023, a couple of familiar names:
Paul Garner
Hilda Bastian

From the minutes of the Governing Board, August/Sept 2023
https://community.cochrane.org/orga...e/governing-board/meetings/agenda-and-minutes

https://community.cochrane.org/site...23_09_01_restricted access_final draft OA.pdf

GB-2023-86. Emeritus and Lifetime membership awards

The Governing Board noted that the criteria for awarding Emeritus and Lifetime members were agreed in September 2022 and the first round of Emeritus and Lifetime membership awards was held in March and April 2023 It was agreed that in the future, nominees who are former Central Executive Team members will be considered by the Chief Executive Officer and Editor in Chief, rather than the Membership and Awards Committee. They will then be included in the list of names to be approved by the Board.

The Board also agreed that a 50/50 gender split in both award categories was an aspiration to be worked towards. The following awards were approved on the recommendation of the Membership and Awards Committee:

Lifetime Membership
Leon Flicker
Patricia Graves
Karen Steingart
Fiona Rowe
Maoling Wei
Linda Clare

Emeritus Membership
Martin Burton
Christopher Williams
Robin Grant
Paul Garner
Rob Scholten
Petra Macaskill
Mario Tristan
Nicky Cullum
Hilda Bastian
Gladys Faba
Fergus Macbeth
Malinee Laopaiboon

Rob Scholten subsequently turned down his award.
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I've now found the page on the Cochrane website with all their Emeritus and Lifetime members listed and a bit about each emeritus member:
https://www.cochrane.org/news/cochr...mbers:,standing commitment to Cochrane's work.

We are proud to recognise extraordinary contributions to Cochrane with Emeritus and Lifetime Memberships. These will be awarded to those who have contributed to Cochrane’s success over many years and are now reducing or ending their active time with Cochrane.

Emeritus members:
Individuals who made a significant long-standing contribution to the leadership of the organization.
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Hilda Bastian:
Hilda's impact on Cochrane is undeniable. Her advocacy for transparent reporting, rigorous analysis, and clear communication of research findings has greatly enriched Cochrane’s commitment to evidence-based health and care. Moreover, her dedication to demystifying scientific research has helped bridging the gap between researchers and the public. By fostering a culture of informed decision-making grounded in robust evidence, Hilda Bastian’s contributions have elevated the standards of evidence and ultimately enhanced patient care worldwide.

Hilda has become one of Cochrane's most influential and respected critical friends. She has consistently championed consumer involvement and has pushed Cochrane hard on its commitments to open access, transparency and patient engagement. She has provided advice to many people over the years, and made a virtue out of dispassionate (...and sometimes very passionate...) critique.
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Paul Garner
Paul has made a truly extraordinary contribution to Cochrane. This contribution spans from the formation of the Cochrane Infectious Diseases Group and his subsequent leadership of this Group, to his significant contributions to methods and Cochrane policies, and his enthusiastic involvement in the wider Cochrane community. Throughout his time with Cochrane, he has embraced the spirit of collaboration drawing new authors from all over the globe into evidence synthesis and building capacity in this field. His nose for high-priority topics has led to the production of some of the most impactful Cochrane reviews which add to his hugely impressive portfolio of work. His passion for evidence synthesis has been infectious (excuse the pun!) for many early career researchers, and he continues to be a hugely supportive mentor and friend to many within the Cochrane Collaboration
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Trish said:
In the list of people awarded emeritus membership of Cochrane in 2023, a couple of familiar names:
Paul Garner
Hilda Bastian

From the minutes of the Governing Board, August/Sept 2023
https://community.cochrane.org/orga...e/governing-board/meetings/agenda-and-minutes

https://community.cochrane.org/sites/default/files/uploads/inline-files/Governing Board meeting_ Draft_minutes_2023_09_01_restricted access_final draft OA.pdf
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Hilda has always maintained she is not and never will be a member of Cochrane whilst they fail to make all their content open access. She left Cochrane over this issue I believe, despite being a founder member. So she should have rejected the membership, as Rob Scholten did. I wonder why he did that. I have met RS a few times (he was the director of Cochrane Netherlands since the beginning of Cochrane, and he seemed very sensible to me. Very interested in patient involvement as far as I remember). I may have tried to get him interested in this at some point, as I did with Peter Gotzsche, who got kicked out of Cochrane, and Jos Verbeek, another person from the Netherlands, who was head of Cochrane Work (review group). I suggested Cochrane Work would be the best review group to manage a review of treatments for ME, as the ability to work or participate in education is such a key and objectively measurable outcome for people with ME. I did suggest that at some point certainly to Jos,, and maybe also to Hilda.
 
Sounds like Cochrane highly approves of Garner's method of evidence synthesis consisting of "my personal anecdote proves it beyond any doubt, and we should promote positive anecdotes and silence negative anecdotes about mind-brain-body-spiritual conjoinship healing, and also healing hands and neurolinguistic programming should get money shoveled at it while biomedical research that debunks it should be shut down".

It's impossible that they don't know of it, if you look at his twitter feed it's been an obsession for the last 3.5 years. Most of his posts since then are about this, and his only published work in that time, the Cochrane review on the triple therapy for microclots, wasn't even needed or made sense. In fact it makes a mockery of evidence-based medicine since there hasn't even been a single clinical trial of it yet, and the entire "evidence pyramid" of EBM depends on trials to make systematic reviews. It was, in effect, a review about nothing, highly motivated by politics, ideology and personal obsession, and he used his status at Cochrane to promote it.

Cochrane thinks that only promoting personal and other people's positive anecdotes of wishful thinking healing while silencing a far greater number of negative and neutral reports is good evidence synthesis, is the most Cochrane thing ever. Cochrane is to the original concept of evidence-based medicine what North Korea is to a democratic republic.
 
EndME said:
Cochrane UK will be closing its doors for the final time this Thursday 28th March 2024, due to the loss of NIHR funding.
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Good riddance!

This major cut in funding for Cochrane was the reason for the big reorganisation of Cochrane over the last few years, and the main excuse we were given for work stopping on the new Exercise for ME/CFS review.

I think having announced the new review process as a priority and only getting away with publishing the 2019 Larun review on the basis that it would soon be replaced, Cochrane had an obligation to continue to give it priority. Instead they abandoned it. And from Hilda's latest reply on her talk page, it still isn't regarded as a priority by Cochrane leaders.

A professional organisation that is forced to downsize should stick by its current commitments first before starting up new ones. Cochrane has published lots of other reviews in the intervening 4+ years. They could have stood aside from doing any Covid reviews - it was too early for most of them to show anything useful anyway and lots of other organisations were focused on Covid.
 
Thursday, October 24, 2024
Cochrane announces new scientific strategy
The Cochrane Collaboration is proud to announce our new scientific strategy, focusing on tackling the most pressing global health issues driving inequity.

Over the past 30 years, we have published over 9,000 systematic reviews and developed a reputation as one of the most trusted sources of health evidence. Our reviews set standards and improve lives, from offering premature babies the best start in life to preventing falls among older people. We now want to go further to address the devastating health inequalities that still persist worldwide.

The new scientific strategy will contribute to the United Nations Sustainable Development Goals (SDGs), which aim to bring about a more sustainable, equitable, and prosperous future by 2030. We will collaborate with partners both within and beyond the Cochrane community to tackle inequity across the world, building a healthier future for everyone and helping to achieve the SDGs.
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Our strategy focuses on four key research priorities to address the most pressing health challenges, underpinned by a foundation of four commitments. Our research priorities are:
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Maternal, newborn and child health: we will improve the health and wellbeing of mothers and children worldwide and tackle the vast health equity gap between different populations.
Multiple chronic conditions: we will improve the lives of people living with multiple chronic conditions, identifying effective approaches to provide person-centred care and prevent further illness.
Infectious diseases: we will equip people across the world with the evidence they need to protect themselves against both existing and emerging threats.
Climate change and sustainability: We will improve our understanding of the complex relationships between climate change and human health, helping people to better cope with the health impacts of climate change.
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Cochrane announces new scientific strategy | Cochrane
 
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Tuesday, October 8, 2024
Cochrane helps launch new WHO guidance on best practices for clinical trials
The World Health Organization (WHO) has recently launched new guidance on best practices for clinical trials. The document aims to reinforce global standards in the organization, design, conduct, analysis and reporting of clinical trials. It responds to calls in World Health Assembly resolution 75.8, which emphasized the urgent need to enhance both global and national clinical trial ecosystems to generate high-quality evidence on health interventions.

Cochrane’s Editor in Chief, Dr Karla Soares-Weiser, contributed to the technical advisory group established to support the resolution and this guidance.

The WHO guidance offers practical recommendations to assist national health authorities, regulatory authorities, funders and others in facilitating effective clinical trials and research. Key recommendations centre on improving trial design to ensure the relevance of research; an emphasis on scientific and ethical standards; strengthening of capacity and support for sustainable research infrastructure; enhancing clinical trial transparency; and reforms to enable underrepresented groups to participate in clinical trials.
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Cochrane helps launch new WHO guidance on best practices for clinical trials | Cochrane
 
If blinding of an allocated trial intervention is not feasible (for example in trials of different types of patient management or surgical procedures), blinded or masked outcome assessment should be pursued for objectively determined outcomes, for example through use of a prospective randomized open-label blinded endpoint (PROBE) design (see also Section 2.1.9 ascertainment of outcomes).

This suggests some confusion. If an endpoint is truly objective then there is no need to blind or mask. I have never heard of PROBE but it sounds dubious. Usually these acronyms are there to weasel through dodgy practices by making them sound respectable.

Recommending GRADE isn't good.

All the right words seem to be there, but the impression given is that as long as everyone follows a mindless recipe all will be fine (and you can cut a few corners if you really have to).
 
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