What are the benefits and risks of using corticosteroid medicines in the treatment of fatigue related to advanced cancer? Key messages We did not find any good-quality evidence about the benefits and risks of corticosteroids in treating adults with advanced cancer and cancer-related fatigue (CRF). Future larger, well-designed studies are needed to determine if corticosteroids are of benefit or harmful in treating CRF. Why is this review important? Fatigue is a very common and troublesome symptom in people with advanced cancer, which greatly impacts their quality of life. Corticosteroid...

Predicting a second seizure after a single unprovoked seizure Why was this review performed? A single unprovoked seizure is fairly common, with estimates that up to 3% to 4% of the population will have one by age 85. This translates to approximately one in 25 people having an epileptic seizure during their lifetime. It is therefore of the utmost importance that accurate prognostic data are available so that clinicians can reliably counsel people on the risk of further seizures, and factors that predict the recurrence of seizures and therefore the development of epilepsy. What is the aim of...

Long-term prognosis of childhood language disorders and difficulties This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: Primary objectives Population Children between four and eight years of age, diagnosed with a language disorder, or determined to have low language proficiency before age eight. Intervention Not applicable, this is a review of observational studies and will not include active interventions. Comparator The comparison group will be peers or siblings with typically developing language skills, that is, no identified language disorder or low...

Positioning for lumbar puncture in newborn infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the success rate of the lateral decubitus, sitting and prone positions for lumbar puncture in newborn infants. This is a protocol....

What are the benefits and risks of neoadjuvant treatment (drug treatment prior to surgery to remove a tumour) for melanoma, a type of skin cancer? What did we want to find out? Cutaneous melanoma is a very aggressive form of skin cancer. It is generally fatal if detected at an advanced stage. Earlier treatment may allow for surgical removal of the tumour and an improved chance of long-term survival. Neoadjuvant treatment is drug treatment administered before surgery, to reduce the tumour size so that it is easier to remove, to reduce complications of surgery, and to reduce the risk of spread...

How effective and safe are systemic opioids for postoperative pain control and management in neonates? Review Question How effective and safe are systemic opioids for reducing newborn babies' pain after surgery? Background Neonates (babies in the first four weeks after birth) may undergo surgery (operations) or surgical procedures. Like adults, babies experience pain, and this pain must be managed (reduced) after surgery. Opioids are pain-relieving medications. Examples of opioids are codeine and morphine. Opioids work by interacting with opioid receptors in the body and reducing feelings of...

Medicines to increase foetal haemoglobin levels and reduce the need for blood transfusion in people with non-transfusion-dependent thalassaemia Review question Do medicines that increase foetal haemoglobin (HbF) levels in people with non-transfusion-dependent β-thalassaemia (NTDβT) reduce their need for blood transfusion? What is thalassaemia? Thalassaemia is a genetic (inherited) blood disorder that causes defects in adult haemoglobin (the oxygen carrying component of red blood cells) leading to destruction of the red blood cells and anaemia with different degrees of severity. Persistent...

Truenat MTB assays for pulmonary tuberculosis and rifampicin resistance in adults This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To determine the diagnostic accuracy of Truenat assays (MTB, MTB Plus, and MTB RIF Dx) for detecting pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis. Secondary objectives To compare the diagnostic accuracy of Truenat assays (MTB, MTB Plus, and MTB RIF Dx) with that of Xpert MTB/RIF Ultra for the detection of pulmonary tuberculosis and rifampicin resistance in adults with...

Placebo versus no treatment for people with schizophrenia This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare the effects of placebo versus no treatment in people with schizophrenia. This is a protocol....

Stimulating the baby's scalp as a test of the baby's well-being in labour We set out to look for evidence from randomised controlled trials on the effectiveness and safety of stimulating the baby's scalp as a second-line test of well-being when there are concerns about the baby's heart rate monitoring. What is the issue? Women with complicated pregnancies are recommended continuous monitoring of the baby's heart rate using an electronic recorder called a CTG. Babies commonly demonstrate abnormal features on the CTG during labour. In some cases the abnormal features are of...

Chances of developing blood clots for people who have COVID-19 and are taking hormonal birth control compared to people not taking hormonal birth control Review question We reviewed the evidence about the effects of hormonal birth control on developing blood clots, including heart attack or stroke, or other severe outcomes for people with COVID-19 disease. We wanted to look at people using combined forms of birth control (containing both an estrogen and a progestin hormone) compared to people using no hormonal birth control or people using birth control containing only the progestin hormone....

Are exercises for strengthening breathing muscles effective for people with chronic obstructive pulmonary disease? Key messages • Exercise combined with specific exercises to strengthen breathing muscles may not improve breathlessness, physical fitness and life quality. Strength of breathing muscles and endurance increased but not enough to make a difference to patients. • Specific exercises to strengthen breathing muscles compared to no exercise may improve breathlessness, physical fitness and life quality. Strength of breathing muscles and endurance increased, but we don't know if this...

Artificial intelligence for diagnosing exudative age-related macular degeneration This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To determine the diagnostic accuracy of artificial intelligence (AI) as a triaging tool for exudative age-related macular degeneration (eAMD). Secondary objectives To compare the performance of different AI algorithms with respect to eAMD diagnosis. To explore potential causes of heterogeneity in diagnostic performance according to the following: index test methodology (core AI method); sources of input to train algorithms...

Physical exercise for people with Parkinson's disease: what type of exercise works best? Background Parkinson's disease (PD) is a progressive disorder of the nervous system that mostly affects people over 60. Symptoms begin gradually and include movement issues, such as trembling, stiffness, slowness of movement and balance, and coordination issues. People with PD can also have emotional and mood problems, fatigue, sleep problems, and thinking difficulties. The disorder cannot be cured, but the symptoms can be relieved, for example, with medicine or surgery. Moreover, people with PD may...

Non-medicine interventions for sleep problems in dementia What are sleep problems in people with dementia? People with dementia frequently have sleep problems including an increase in the length and number of awakenings and an increased amount of light sleep. These cause a number of problems for the affected person, their relatives, and carers, possibly leading to carer distress and the admission of people with dementia to nursing homes or long-term care homes. Can non-medicine interventions help? As we do not know if medicines can help improve sleep in people with dementia, non-medicine...

Methods of induction of labour: a network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare the effectiveness and safety profiles for the different methods of cervical ripening and labour induction at or beyond term labour using network meta-analysis, and to provide rankings of the available treatments according to their effectiveness and safety profile. This is a protocol....

Low protein diets for adults with diabetic kidney disease What is the issue? For people with diabetic kidney disease (DKD) not requiring dialysis, it may be recommended to limit the amount of protein in the diet to slow the progression of chronic kidney disease. However, uncertainty remains about how much protein should be consumed. What did we do? We reviewed the evidence about the effect of low protein diets on the progression of kidney disease in adult patients with DKD, not on dialysis. The evidence is current to 17 November 2022. All studies were combined, provided that they compared a...

What are the benefits and risks of silicone gel sheeting for treating keloid scars? Key messages We are uncertain whether silicone gel sheeting improves a scar's appearance more than: - no treatment; - treatment with a dressing similar to silicone gel sheeting that does not contain silicone; - injections of triamcinolone acetonide (a medication) directly into a lesion or below the skin. We are uncertain about the effect of silicone gel sheeting on pain compared with no treatment. We do not know if silicone gel sheeting has an effect on pain compared with non-silicone gel sheeting or...

C-reactive protein, procalcitonin, and erythrocyte sedimentation rate for the diagnosis of lower urinary tract infection in older people This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: Secondary objectives To assess the influence of patient and study characteristics on the diagnostic accuracy of the index tests. To assess the influence of different reference standards for UTI on the diagnostic accuracy of the index tests. This is a protocol....

LipiFlow for the treatment of dry eye disease This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effectiveness of the LipiFlow Thermal Pulsation System on dry eye signs and symptoms compared to placebo or other commercially available treatments for meibomian gland dysfunction in adults. This is a protocol....