Is switching to a different antipsychotic medicine better than continuing with the same one for people with non-responsive schizophrenia? Key messages • We do not know if people with non-responsive schizophrenia have better outcomes if they switch to a different antipsychotic medicine or continue with the same one because the evidence is very uncertain. • The few studies which looked at this question differed markedly from each other in terms of the antipsychotics used, study duration and definitions of initial non-response. • We need further large, well-conducted studies to shed light on...

Music-based interventions for people with chronic kidney disease undergoing haemodialysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of music-based interventions on fatigue, blood pressure, depression, pain, anxiety, stress, QoL, and sleep quality in people with CKD receiving HD. This is a protocol....

Does delaying the initiation or starting calcineurin inhibitors at a lower dose reduce the risk of delayed recovery of a transplanted kidney? Key messages • After kidney transplantation (a surgical procedure where a kidney is transferred from one person - the donor - to another person - the recipient), it may take a few days for the kidney to start working, especially if the kidney donor was older or the kidney was without blood flow for a long time. • The best treatment for people at high risk of this delayed recovery is still unclear. Current options include delaying the use of a...

Closure of defects or non-closure of defects: which works better to prevent internal hernia after bariatric surgery? Review question Does closing defects after Roux-en-Y gastric bypass (RYGB) in bariatric surgery prevent internal hernias? Key messages Due to a lack of evidence, it is unclear whether closing defects is better than not closing defects in preventing internal hernias after bariatric surgery. Closing defects may reduce the number of internal hernias compared to not closing them. Background An internal hernia is a serious problem that can happen after a type of weight-loss surgery...

Next-generation sequencing (NGS) techniques for pre-symptomatic identification of genetic diseases in newborns This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of using NGS techniques compared to conventional newborn screening alone for pre-symptomatic identification of genetic diseases in newborns. Secondary objectives: to explore equity and ethical issues in the application of the new techniques, to inform healthcare decisions by families, carers, and policymakers. This is a protocol....

Digital tracking, provider decision support systems, and targeted client communication via mobile devices to improve primary healthcare Key messages Using digital tools to help healthcare workers track patient information and make decisions has mixed results. These approaches may lead to benefits in some situations but may make little or no difference in others. We often do not know the full impact because there are not enough studies, or the studies do not provide clear answers. What did we want to find out? This review examined whether digital tools can help healthcare workers collect...

In-hospital motor interventions to reduce neurodevelopmental impairment in preterm infants: a scoping review This is a protocol for a Cochrane Review (prototype). The objectives are as follows: The aim of this scoping review is to map the quantitative literature about in-hospital motor interventions used to reduce neurodevelopmental impairment in preterm infants. We will collate information about the features, delivery mechanisms, objectives, providers, underlying theoretical frameworks, hypothesized or reported outcomes of these interventions, and equity characteristics of the population....

Medical cannabis for the treatment of insomnia This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of medical cannabis on adults with insomnia. This is a protocol....

Abdominal nerve block to prevent pain following minimally invasive gynaecologic surgery Is a transversus abdominis plane (TAP) block more effective than local anaesthetics or no block to treat post-surgical pain in women undergoing minimally invasive gynaecologic surgery? Key messages Women undergoing minimally invasive (key-hole) gynaecologic surgery who receive a TAP block to reduce the amount of pain felt after surgery are unlikely to experience large differences in pain or strong pain medicine needed when compared to those who do not receive the TAP block. What is a TAP block? A TAP...

Motivational interviewing for improving functional and psychosocial outcomes among stroke survivors This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of motivational interviewing for functional and psychosocial outcomes in stroke survivors, compared to no intervention, waiting list, or attention controls. This is a protocol....

Dual combination therapy versus long-acting bronchodilators alone for chronic obstructive pulmonary disease (COPD): a systematic review and network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the comparative efficacy and safety of fixed-dose dual inhalers (i.e. LABA/LAMA versus ICS/LABA) and combination therapies versus LABA or LAMA monotherapy in individuals with moderate to very severe COPD, using network meta-analysis, and to rank these treatments based on their efficacy and safety. This is a protocol....

What are the benefits and risks of stem cell injections for knee osteoarthritis? Key messages • Compared with placebo injection, stem cell injection for people with knee osteoarthritis may slightly improve pain and function. • We are uncertain whether stem cell injection slows down the progression of the disease, improves quality of life or the chance of treatment success, or whether stem cell injections are safe. What is osteoarthritis? Osteoarthritis is a disease of the joints. The joint loses cartilage and other changes to the structure of the joint may occur. This can lead to pain and...

Mucolytics (drugs that break down mucus) for children with chronic suppurative lung disease Key messages - Due to a lack of robust evidence, it is unclear if mucolytics are helpful for children with chronic suppurative lung disease (CSLD). We found only one small study with design limitations. - Larger, well-designed studies are needed to assess the benefits and potential harms of mucolytic medications in children with CSLD. What is chronic suppurative lung disease (CSLD)? Chronic suppurative lung diseases are conditions associated with chronic infection and inflammation of the airways with...

What are the effects of ultrasound versus anatomic landmark guidance for percutaneous common femoral artery access? Key messages • Ultrasound guidance may lead to a higher first-attempt success rate and improved time to successful common femoral artery (CFA) access, while reducing the venipuncture rate (unintentionally accessing the vein instead of the targeted artery) and number of access attempts, compared to anatomic landmark guidance. • Further research is needed to increase our confidence in the evidence. What is the condition, and how is it treated? Percutaneous (through the skin)...

Do amphetamines increase blood pressure? Key messages • Amphetamines are substances that increase activity in the brain and central nervous system. Taking them every day by mouth for at least 8 weeks increases blood pressure and heart rate. • In studies that gave participants amphetamines or placebo medicine (an inactive substance), more people given amphetamines quit the studies due to unwanted or harmful effects than people given placebo. What are amphetamines, and what are they prescribed for? Amphetamines are medicines that have a stimulant effect on the brain. They can make you more...

What are the effects of oral decongestants on blood pressure? Key messages – We found no evidence that taking oral decongestants (medicine taken by mouth to relieve a stuffy nose) daily for a week or more changes blood pressure or heart rate or causes people to stop taking them due to unwanted effects. – There were only a few studies, and they were not well designed. More well-conducted studies are needed. – Given that oral decongestants are sometimes taken daily for weeks or months, and have the potential to increase blood pressure, people should consider this potential risk alongside the...

What are the likely benefits and harms of non-medicine and non-surgical treatments for non-specific low back pain? Key messages For acute low back pain (pain lasting less than 6 weeks) • Advice to stay active probably reduces pain and improves function compared to advice to rest in bed. For subacute low back pain (pain lasting from 6 to 12 weeks) • Multidisciplinary therapies probably reduce pain compared to usual care. • Spinal manipulation probably does not improve function compared to placebo (a 'sham' or 'dummy' treatment designed to resemble the actual treatment but lacking active...

Can antibiotics clear or suppress infection with non-tuberculous mycobacteria in the lungs of people with cystic fibrosis? Key messages There is a lack of evidence to inform guidelines about antibiotic treatment for non-tuberculous mycobacteria in people with cystic fibrosis. Larger and more standardised studies looking at both laboratory results and symptoms are needed before we can make meaningful comparisons between different antibiotic treatments. What is cystic fibrosis? Cystic fibrosis is a genetic condition (when both parents pass the cystic fibrosis gene to their children) and people...

What are the benefits and risks of using a combination of treatments to manage cachexia (disease-related wasting)? Key messages: • We do not know if combinations of two or more treatments (of medication, diet, and exercise) benefit people who have or are at risk of developing cachexia (disease-related wasting). This is because there are currently not enough robust studies in this area. • We need future research to increase our confidence in the evidence by conducting better designed and larger studies. What is cachexia? Cachexia is a complex metabolic syndrome that occurs in people with...

Perceptions and experiences of the prevention, identification and management of pre-eclampsia and eclampsia: a qualitative evidence synthesis This is a protocol for a Cochrane Review (qualitative). The objectives are as follows: The overall objective of this qualitative evidence synthesis is to describe and explore the perceptions and experiences of key stakeholders who have experience with pre-eclampsia/eclampsia or its prevention, identification, or management. The key stakeholders are women who have experienced pre-eclampsia/eclampsia, people in the community, lay health workers, and...