Evidence base for recommendations for writing evidence-based syntheses This is a protocol for a Cochrane Review (methodology). The objectives are as follows: To identify and assess studies of the effectiveness of interventions to create and implement recommendations for the writing of narrative summaries of evidence syntheses. We will do this separately for systematic reviews and CPGs. This is a protocol....

Antibiotics for otitis media with effusion (OME or 'glue ear') in children Key messages We are uncertain whether the use of antibiotics improves hearing for children with glue ear, due to a lack of robust evidence. The use of antibiotics compared to no treatment might slightly reduce the number of children who have glue ear at three months of follow-up. It is unclear whether this is a long-lasting effect, as few studies followed up children for more than three months. The studies included in this review did not report serious harms from treatment with antibiotics. However, there is...

Are higher or lower salt (sodium) supplements better for premature babies to prevent illness and improve growth and development? Key messages • During the first days after birth, premature babies need lower salt (sodium) intakes to prevent high blood sodium levels. However, we are uncertain if there are any effects on infant death or newborn health whilst in hospital. Growth and longer-term development were largely unreported in studies of early sodium supplementation. • After the first days following birth, premature babies need higher sodium intakes to prevent low blood sodium levels....

The impact of growth monitoring and promotion in children under five years of age in low- and middle-income countries What is growth monitoring and promotion? Many children under five years of age who live in low- and middle-income countries are not receiving adequate nutrition. This can lead to increased illnesses, impaired mental development (which diminishes school and work performance later in life) and death. Growth monitoring and promotion (GMP) is a complex intervention that involves measuring a child's growth at regular intervals and plotting the measurements on a chart, combined...

Which medications reduce irritability, aggression or self-harm in people with autism spectrum disorder (ASD)? Key messages • Only 3 classes of medications showed any reduction in irritability, aggression or self-harm when compared to placebo (a dummy medication). Atypical (second-generation) antipsychotic medications probably reduce irritability and aggression, but appear to have little to no effect on self-injury. Attention deficit hyperactivity disorder (ADHD)-related medications may reduce irritability, although the evidence is uncertain. Neurohormones (oxytocin and secretin) may also...

How can we communicate better with people and communities about measures which help to prevent and control COVID-19? Key messages - During a pandemic, governments and other authorities need to clearly communicate with the public about how people can keep themselves safe. This communication needs to be based on trust and well-planned. People and communities affected by the pandemic need to be involved in planning and delivering the communication. The communication should reach all people across the community, including those who have trouble reading and writing, people who speak languages...

Pain relief and side effects of a new regional anaesthetic technique (ESPB) Key messages Erector spinae plane block (ESPB) probably does not improve postoperative pain intensity 24 hours after surgery, but it may be performed without serious adverse events and may decrease requirements for oral pain relief as well as side effects associated with oral pain relief. What is regional anaesthesia? Acute postoperative pain is commonly treated with a combination of medications like opioids and regional anaesthesia. Regional anaesthesia is a way of specifically numbing nerves that carry pain signals...

Bladder training for treating overactive bladder in adults What did we want to find out? We wanted to compare the effectiveness of bladder training to other treatments for adults with overactive bladder (OAB). Background OAB is a common chronic condition involving daytime frequent urination, urination during sleep, and sudden urge to urinate with or without urinary incontinence (unintentional passing of urine). The disorder reduces quality of life and results in a significant economic burden on society. Bladder training is a behavioral therapy that establishes treatment goals and uses...

Superoxide dismutase in preterm newborns at risk of lung disease Key messages • We did not find enough good‐quality evidence about the use of superoxide dismutase in newborns born too early: only three studies for the prevention of lung disease. • The evidence is very uncertain about the effect of superoxide dismutase on bronchopulmonary dysplasia, also known as chronic lung disease, death, retinopathy of prematurity (eye damage which might cause blindness) compared to a placebo or no treatment. • No studies reported bronchopulmonary dysplasia or death at 36 weeks' postmenstrual age, need...

Immunotherapy versus chemotherapy for treating inoperable or metastatic bladder cancer Review question How does immunotherapy (a newer medicine that works through the body's immune system) compare to chemotherapy (a medicine that kills cancer cells) in people with cancer of the bladder or upper urinary system that has spread throughout the body or a surgical procedure is not feasible due to an advanced stage. Background Until a few years ago, the treatment of bladder cancer that has spread to other organs outside the urinary tract (metastatic bladder cancer) consisted of one of only a few...

Undernutrition as a risk factor for tuberculosis disease This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To determine the prognostic value of undernutrition in the general population of adults and children for predicting tuberculosis disease. Population Adults and children from the general population Index prognostic factors Undernutrition (wasting, stunting, underweight) Outcomes Incidence of tuberculosis (adjusted risk) Timing Short- and long-term follow-up Setting General population/outpatients Study design Cohort studies This is a protocol....

Diabetes as a risk factor for tuberculosis disease This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To determine the prognostic value of diabetes in the general population of adults and children for predicting tuberculosis disease. Population Adults and children from the general population Index prognostic factors Diabetes (type 1 and 2) Outcomes Incidence of tuberculosis (adjusted risk) Timing Short- and long-term follow-up Setting General population/outpatients Study design Cohort studies This is a protocol....

Children with chronic non-cancer pain and their families’ experiences and understanding of their condition, pain services and treatments: a meta-ethnography What is the aim of this synthesis? The aim of this Cochrane qualitative evidence synthesis was to find out how children and young people who have chronic pain and their families: 1) think about chronic pain; 2) live with chronic pain; 3) think of how health and social care services treated their pain; and 4) what they want from services and treatments. To answer these questions, we searched for, analysed and brought together the findings...

How helpful to recovery and healing are support and psychological interventions after exposure to sexual violence and abuse? Key messages • We found evidence that psychological or social (collectively known as ‘psychosocial’) interventions may reduce symptoms of post-traumatic stress disorder (PTSD) and depression in survivors of rape, sexual assault and abuse experienced during adulthood. • Our review suggests that interventions did not worsen symptoms or lead to unwanted effects. However, as large numbers of participants dropped out of treatments or did not complete studies’ assessments,...

Heliox for prevention of morbidity and mortality in ventilated newborn infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the effect of heliox on the rates of mortality, neurodevelopmental outcome, and chronic lung disease in invasively ventilated infants. This is a protocol....

Which common stimulant medicine is best for premature babies whose breathing pauses during sleep (apnea)? Key messages • Caffeine and other similar substances belong to a group of stimulants called methylxanthines. They are often used to prevent and treat apnea – when breathing repeatedly stops and starts – in newborn babies. • Caffeine may result in little to no difference in the frequency of death in babies born too early compared to other methylxanthines. • More studies are needed, especially in babies born extremely early, since these babies tend to be the most poorly. What is apnea of...

Is giving breathing support through the nose effective in babies that need help breathing at birth? Key message 1. In newborn babies who need help to breathe right after birth, in the delivery room, some studies have suggested that giving breathing support through the nose (nasal interface) is more effective than through a face mask (covers the nose and mouth) or laryngeal mask airway (LMA; a breathing tube, inserted through the mouth). 2. Giving babies breathing support through the nose compared with a face mask in the delivery room, may have little to no effect on the number of babies who...

Acupuncture for procedural pain in newborn infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of acupuncture in newborn infants undergoing painful procedures. This is a protocol....

Vitamin D for the treatment of inflammatory bowel disease Key messages The data we presently have for the use of vitamin D for the treatment of inflammatory bowel disease are of very low quality, and we do not know whether it works or if it is safe. What is inflammatory bowel disease? Inflammatory bowel disease is a life-long disease that affects the gut. Its two main types are ulcerative colitis and Crohn's disease. Ulcerative colitis only affects the large intestine. Crohn's disease can affect any part of the gut, from mouth to bottom. Common symptoms include bloody poo, diarrhoea, stomach...

Bisphosphonates for postmenopausal osteoporosis: a network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The aim of this systematic review is to investigate the direct and indirect evidence regarding the benefits and harms of bisphosphonates in the primary and secondary prevention of osteoporotic fractures for postmenopausal women. We will perform a network meta-analysis, which will estimate the relative effects and relative ranking of the competing interventions for the outcomes of interest. This is a protocol....