Peritoneal dialysis versus haemodialysis for people starting long-term dialysis Key messages - The existing research does not provide sufficient evidence to draw confident conclusions regarding the relative effects of peritoneal dialysis and haemodialysis on health outcomes for people with kidney failure. - As most results came from observational rather than randomised studies, it remains uncertain what are the relative benefits and harms of peritoneal dialysis and haemodialysis. - The results are limited in generalisability due to very diverse clinical practice patterns, eligibility...

Using evidence from civil society in national and subnational health policy processes: a qualitative evidence synthesis This is a protocol for a Cochrane Review (qualitative). The objectives are as follows: To explore the use of evidence from civil society in national and subnational health policy processes. The specific research questions will include the following. How is evidence from civil society incorporated into health policy processes and what types of evidence are (or are not) incorporated? How do civil society actors perceive and experience the use of their evidence in health...

Ultrasound and blind endometrial sampling for detection of endometrial cancer in women with postmenopausal bleeding This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To assess the diagnostic accuracy of endometrial sampling with histology in the diagnosis of endometrial cancer in women with postmenopausal bleeding and thickened endometrium on ultrasound. Diagnosis will be verified by the reference standards, hysteroscopy with histology, obtained by targeted (such as grasp biopsy of the endometrium or resection of focal pathology) or global sampling (with...

Management of intractable constipation in children Key messages • There may be little to no difference between lubiprostone and placebo (dummy treatment) in achieving treatment success in children with intractable constipation. We also found that lubiprostone is probably as safe as placebo. • There is probably little or no difference between prucalopride, also a laxative, and placebo in frequency of defecation per day, treatment success, and safety. • It is unclear whether any of the other treatments we looked at are helpful. The evidence is uncertain because of the very low number of study...

Ultra-early versus early surgery for hip fracture This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects (benefits and harms) of ultra-early versus early surgery for hip fracture in adults. This is a protocol....

What are the benefits and risks of interventions to increase time spent outdoors for preventing the incidence and progression of myopia (nearsightedness) in children? Key message An intervention of spending more time outdoors may potentially reduce the onset of myopia. However, we are uncertain if the intervention might reduce the progression of myopia. What is myopia? Myopia, or nearsightedness, is a disease in which individuals see near objects clearly, but distant objects appear blurred. In recent years, myopia has become a major public health problem all over the world. Myopia is the...

Immunosuppressive therapy for treating of IgA nephropathy in children Key messages - It is unclear if corticosteroid (steroid) therapy or any other immunosuppressive therapy prevents kidney damage in children with IgA nephropathy. - The included studies do not provide information on the risks of steroid therapy in children with IgA nephropathy. What is IgA nephropathy? IgA nephropathy is a kidney disease that can cause a decrease in kidney function and kidney failure. The cause of the disease is unknown, but we know that the immune system is involved, and treatment targets the immune system....

Does undernutrition increase the risk of tuberculosis? Key messages Having undernutrition doubles the risk of getting tuberculosis. These results apply to the general adult population; the risk for other groups, such as adolescents and children, is uncertain. What is tuberculosis? Tuberculosis (TB) is an infection caused by a bacteria (Mycobacterium tuberculosis). It primarily affects the lungs but can also affect other sites in the body. TB spreads through the air when an infected person coughs or sneezes. Some people do not develop symptoms after infection, while others progress with the...

Anticoagulation during extracorporeal membrane oxygenation This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the efficacy and safety of anticoagulation for maintaining extracorporeal membrane oxygenation in people of all ages with cardiac or respiratory failure, or both. This is a protocol....

Effects of kidney removal in combination with medicine in people with kidney cancer that has spread to other parts of the body Key messages • People who have kidney removal surgery after receiving interferon immunotherapy (medicine that helps the immune system fight cancer) probably live longer than those who receive interferon immunotherapy without kidney removal surgery. • People who have immediate kidney removal surgery then receive tyrosine kinase inhibitor therapy (medicine that identifies and attacks specific types of cancer cells) may live shorter than those who receive tyrosine...

What are the benefits and risks of using sympathetic nerve blocks for treating pain caused by cancer in the belly and/or pelvis? Key messages We did not find enough evidence to say if sympathetic nerve blocks provide more pain relief than 'usual care'. The risk of harm with sympathetic nerve blocks is unclear. We did not find enough evidence to say if sympathetic nerve blocks improve or reduce quality of life. Future research should focus on the different types of sympathetic nerve blocks not well represented in the current studies. What is persistent pain due to inoperable abdominopelvic...

What are the treatments for postburn itch and how effective are they? Key messages Neuromodulatory agents, such as gabapentin and pregabalin, are drugs that can help manage how the body senses and responds to itch. These drugs may reduce postburn itch compared with oral antihistamines. Physical modalities showed variance in their effectiveness at reducing postburn itch. Massage therapy and extracorporeal shock wave therapy probably reduce postburn itch compared with relevant controls, while therapeutic touch may increase postburn itch compared with nursing presence. Topical interventions...

Surgery and minimally invasive treatments for uterine fibroids This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of surgery and minimally invasive treatments for uterine fibroids. This is a protocol....

Gene therapy for people with hepatocellular carcinoma What are the benefits and risks of gene therapy (treatment) (replacing abnormal or defective genes with normal genes) for treating people with resectable (operable) or unresectable (unable to be removed surgically/inoperable) hepatocellular carcinoma? Key messages — We found six small trials. Overall, there were problems with trial design, low numbers of trials and participants, and variability in results. The trials included 364 people with unresectable hepatocellular carcinoma (primary liver cancer). We found no trials with people with...

Factors that influence physical activity in bipolar disorder Key messages We found few studies that explored factors that influence participation in physical activity for people with bipolar disorder. The studies we found suggested that regular physical activity can be beneficial for people with bipolar disorder, but there are some obstacles and challenges to as well as effective ways of promoting being active. What was the aim of this synthesis? The aim of this qualitative evidence synthesis was to explore the factors that promote physical activity for people with bipolar disorder. We...

What are the benefits and risks of using metformin in the treatment of chronic kidney disease? Key messages - This study did not find enough evidence to show that metformin had any effect on kidney function. Our findings may have been limited by the fact that most of the studies we looked at were conducted in two specific patient populations (those with cystic kidney disease or diabetes) and often did not fully report effects on kidney function. - Further evidence in the form of large, well-designed randomised trials is needed to more robustly assess whether metformin can be a long-term...

Do imitations of anti-VEGF medicines (biosimilars) work as well as the original anti-VEGF medicines for people with neovascular age-related macular degeneration (nAMD)? Key messages Imitations (biosimilars) of anti-vascular endothelial growth factors (anti-VEGFs) work as well as the original anti-VEGF medicines when used to treat neovascular age-related macular degeneration (nAMD) for up to a year. Anti-VEGF biosimilars cause similar unwanted effects to the original anti-VEGF medicines for up to a year. Future research should take place over more than one year to understand the desired and...

Aerobic exercise therapy for chronic low back pain This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of aerobic exercise on pain, function, quality of life, psychological functioning, and adverse events, compared with placebo, sham treatment, attention control, or no treatment. This is a protocol....

Electrical shocks (electrical cardioversion) and drugs (pharmacological cardioversion) for restoring normal rhythm in patients with atrial fibrillation or atrial flutter Key Messages - Electrical cardioversion and some drugs can be used to restore the normal rhythm in patients with atrial fibrillation (AF) and atrial flutter. While electrical cardioversion is highly effective in dealing with all arrhythmias, the efficacy of drugs varies, with some being only moderately effective or not working at all in persistent AF and atrial flutter. - Electrical cardioversion seems to be a very safe...

What do we know about the impact of comprehensive care programmes for children with medical complexity? What is the aim of this review? The aim of this Cochrane review was to find out if comprehensive care programmes that provide care coordination and other services for children with medical complexity improve outcomes for this group of children and their families, and whether they have an impact on the use and cost of healthcare services. Key messages The research relating to comprehensive care programmes for children with medical complexity is limited, and the findings should be treated...