What are the benefits and harms of patient navigation for children and adolescents with chronic diseases? Key messages – We are very uncertain about the effects of patient navigator programmes compared with usual care on the quality of life of children and adolescents; the quality of life of their families; how many times they are admitted to hospital or go to the emergency department; how many school, day care, or college days they miss; and how much this costs. – There is currently a lack of evidence to determine the effects of patient navigator programmes on children and adolescents with...

What interventions help to prevent or treat BK virus infection in kidney transplant recipients? Key messages • People who have received a transplanted kidney because of kidney failure (a condition where the kidneys no longer function well enough to keep a person alive) are at risk of infection. This is because they have to take strong medications to dampen down the body's immune system (immunosuppressants) to prevent their body from fighting (rejecting) this new kidney. This puts them at risk of developing infection, which may affect the way the new kidney functions. A virus (BK virus) with...

Are interventions aimed at people with schizophrenia and their families more effective than standard care? Key messages • Family interventions may reduce relapse in individuals with schizophrenia. • Family interventions probably reduce caregiver burden and may improve expressed emotion (i.e. adverse family environment including family relationships and interaction patterns) in families of individuals with schizophrenia. • Additional studies are needed to allow any strong conclusions about family interventions for people with schizophrenia and their families. What is schizophrenia and how...

Can psychological or educational interventions (or combinations of both) reduce falls in older adults who live at home? Key messages – A psychological intervention (involving motivational interviewing (a method that aims to change behaviours by addressing uncertainties and encouraging personal commitment) and coaching) combined with tailored education (for example, advice on exercise or medication) makes little to no difference in the number of people who fall (fallers), but likely reduces the number of times people fall (though it is unclear by how much). - There was not enough good-quality...

What are the benefits and risks of vitamin D supplementation for adults with obesity undergoing weight-loss surgery? Key messages – There is limited evidence on the benefits of vitamin D supplements for adults with obesity after weight-loss surgery. We are not confident that taking high or moderate doses of vitamin D after weight-loss surgery improves vitamin D levels or reduces the diseases of the parathyroid glands (four pea-sized glands in the neck that manage calcium levels in the body). – There are no data on the risk of bone fractures, and little information on changes in bone strength...

Psychological interventions for emotional well-being in adults with advanced progressive life-limiting illness This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the benefits and harms of psychological interventions compared to treatment as usual, waiting list, active control, or another psychological intervention to improve emotional well-being in adults with an advanced progressive life-limiting illness. This is a protocol....

Vitamin D to treat chronic obstructive pulmonary disease (chronic inflammatory lung disease) Key messages This Cochrane review does not find that vitamin D offers protection against acute flare-ups of chronic obstructive pulmonary disease (COPD), a chronic, inflammatory lung disease that causes breathing difficulties. It also does not find that vitamin D improves symptoms overall in people with COPD. Why did we think that vitamin D might benefit people with COPD? Low blood levels of vitamin D (the 'sunshine vitamin') have been linked to an increased risk of severe COPD flare-ups. In these...

What are the benefits and risks of exergaming for people with dementia or mild cognitive impairment? Key messages • Playing video games that involve physical activity ('exergaming') may help people with dementia and mild cognitive impairment to improve thinking skills such as learning and remembering items, but we are not totally sure about it. • There is little evidence at present to suggest exergaming might help improve the ability of people with dementia and mild cognitive impairment to walk, keep their balance, or handle daily tasks like paying bills or going shopping. What are dementia...

What are the benefits and harms of 'fertility-sparing' surgery to treat low-risk gestational trophoblastic neoplasia that has not spread to other parts of the body? Key messages • We are very uncertain about the benefits and harms of surgery that does not affect fertility ('fertility-sparing' surgical interventions), with or without chemotherapy, for low-risk gestational trophoblastic neoplasia that has not spread to other parts of the body ('non-metastatic'). • Larger, well‐designed studies would be needed to determine the benefits and harms of fertility-sparing surgery for women...

Can assistive technology help improve stiff joints caused by shortened muscles and tendons in adults after a stroke? Key messages • As we only found seven poor-quality studies, we cannot conclude with certainty whether treatment with assistive technology is better than conventional treatment. • Further research is needed to measure the benefits and harms of assistive technology for the management of contractures in adults who have had a stroke. What are contractures? After a stroke, many people develop limb deformities caused by muscles and tendons getting shorter and stiffer. The main cause...

Predictive value of homologous recombination deficiency status for survival outcomes in primary tubo-ovarian high-grade serous carcinoma This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To evaluate the predictive value of the prognostic factor HRD status, as determined by various clinically validated HRD assays at the time of staging laparotomy, compared to BRCA1/2 mutation status for progression-free survival and overall survival in patients with tubo-ovarian high-grade serous carcinoma treated in the first-line setting with a combination of surgery and...

Do long-term antibiotics help to reduce rheumatic fever recurrence and progression of rheumatic heart disease? Key messages In people who have had previous rheumatic fever (the body attacking itself in response to bacterial infection) or have rheumatic heart disease (long-term damage to the heart due to rheumatic fever): - long-term antibiotics (either injected into the muscle every month or taken as a tablet every day) probably reduce the risk of getting more episodes of rheumatic fever compared to no antibiotics; - intramuscular antibiotics probably reduce the progression (getting worse)...

Do medicines for anaemia help prevent acute kidney injury? Key messages • Acute kidney injury occurs when the kidneys suddenly lose their ability to filter waste from the blood. Erythropoietin-stimulating agents are medicines that are mainly used to treat problems with the production of red blood cells, and may be helpful for people at risk of developing acute kidney injury or when it is first detected. • In people at risk of developing acute kidney injury, erythropoietin-stimulating agents probably make little or no difference to the risk of developing acute kidney injury or in reducing the...

Endoscopic therapy for gastrointestinal angiodysplasia This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of the different endoscopic management approaches for gastrointestinal angiodysplasia in symptomatic adults. This is a protocol....

Do drugs that suppress the immune system improve outcomes in those with or at risk from atherosclerosis? Do drugs that suppress the immune system improve outcomes in those with or at risk from atherosclerosis? Key messages - We found some limited evidence that some agents may reduce the risk of developing heart failure, but we are very uncertain about the results. - We found no difference in death rates or any evidence that these agents reduce the risk of heart attack or stroke. - Due to the limitations of the available studies, more robust research is needed to draw firm conclusions about...

Immunotherapy for advanced and recurrent malignant pleural mesothelioma This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of immune checkpoint inhibitors (single-agent or combination therapy) in people with advanced malignant pleural mesothelioma in a first-line or salvage setting. This is a protocol....

What are the benefits and risks of occlusal treatment in people with temporomandibular (jaw) joint disorders? Key messages For people with temporomandibular disorders (TMD), using a type of mouth guard known as an occlusal splint may reduce pain in muscles when chewing compared to receiving no treatment, but the results are very uncertain. There is little or no evidence that occlusal splints can give other benefits, but these results are also uncertain. Further research is needed to find clear evidence of whether occlusal splints or occlusal adjustments (i.e. grinding down teeth) are...

Psychedelic-assisted therapy for treating anxiety, depression and existential distress in people with life-threatening diseases Key messages - In people with life-threatening diseases (e.g. cancer), we found that psychedelic-assisted therapy with “classical” psychedelics (i.e. psilocybin ('magic mushrooms'), LSD), may result in a reduction of anxiety and depression symptoms. - We also found that existential distress (such as feeling that life has no meaning) and quality of life may be improved by classical psychedelics, but the evidence is mixed and very uncertain. - Data regarding these...

What are the benefits and risks of different treatments that could delay or slow the progression of progressive multiple sclerosis? Key messages • Overall, we are very uncertain about the effects of treatments on relapses and slowing the worsening of disability. We did find evidence that rituximab after two years and interferon beta-1b after three years of treatment probably slightly reduce the number of people who experience relapses. • The number of people who stop taking a drug because of harmful events is slightly higher with interferon beta-1a, and probably slightly higher with...

What are the benefits and harms of lubricating eye drops for contact lens discomfort? Key messages • Lubricating eye drops, including saline, may help to reduce contact lens discomfort in adults. The drops do not appear to cause irritation or harm to the surface of the eye. • Treating contact lens discomfort with lubricating drops (including saline) is a viable option. However, more studies are needed to measure their effect and to determine which drops work best with different contact lenses and wearing schedules. What is contact lens discomfort? Contact lens discomfort means eye irritation...