CDCF open meeting Auckland 2012 pack

Describing the new CDCF project for tagging Systematic reviews - synergistic plan with the MASCOT (

  1. Mario Tristan
    Describing the new CDCF project for tagging Systematic reviews - synergistic plan with the MASCOT (
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    CDCF open meeting Auckland 2012 pack
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    • 1. Welcome to the CDCF meeting 20th Cochrane Collaboration Colloquium / Auckland - New Zealand Tuesday 2 October 2012 - 15:30 - 17:00 Location: Regatta D Dr. Mario Tristan CDCF Coordinator from IHCAI Foundation presented by Dr. Regina El Dib Faculdade de Medicina de Botucatu (FMB) Universidade Estadual Paulista "Júlio de Mesquita Filho” – Brazil
    • 2. The new CDCFIn December 2006 the group was officially registered as Cochrane DevelopingCountries Network (CDCN) which became the Cochrane DevelopingCountries Field (CDCF) in 2010.The CDCF is based in IHCAI FOUNDATION -COSTA RICA- since 2007.This decision was taken during the XV Cochrane Colloquium in Sao Pablo,Brazil, 2007.
    • 3. The new CDCF the decision and the challengeDuring some years we need to admit, the production of the CDCNand after CDCF was very limited …Given this we analyzed the situation and some considered that thefiled should be closed.However during the Madrid 19 Cochrane Colloquium we discussedthis during the fields meeting and closed meeting with theparticipation of Mario Tristan, L. Susan Wieland from Monitoring andRegistration Committee, Ashraf Nabhan from Egypt and DamianFrancis from Jamaica agreed to keep the CDCF for one more year –All agreed that was needed to re-launching the CDCF and making iteffective accordingly with the inspirational aim of the field.
    • 4. The agreement ….“After a meeting held in Costa Rica in 2008, the group was trying to strengthen and motivate itself, but itsactions were severely limited by a lack of resources and a previous weak strategic plan that contained noconcrete short-term goals that could be useful for other Cochrane entities.This was particularly important, as it would have proved the importance of our field.In October 2011, a meeting was held in Madrid, regarding the state of the CDCF and whether or not it wasadvisable to continue it in the same way it was created, given the difficulties the CDCF was experiencing inachieving its goals.The core functions of Cochrane Fields were reviewed at this meeting, and ways in which the CDCF couldmeet these core functions were discussed. It was decided that the best course of action would be tocontinue the Field, as the proposed activities of the CDCF related to the core functions are of greatimportance to global health issues.Through this and other meetings held digitally, we have continued this project, developing a working planthat has a high resource production without the high cost. It was also agreed to name a coordinatingcommittee that, for the span of one year, will work together to identify several measurable short-term goalsthat will serve as the foundation of long-term success in meeting core functions and goals of the CDCF. Inthis way we hope to support the future development of our Field. As such, the current committee wasstarted with the people present.”Taken from Current State and 2012 Module =>
    • 5. This year 2012…
    • 6. This Year 2012 cont..CDCF is currently led by Dr. Mario Tristan, along with anexecutive assistant and regional coordinator from thefollowing regions: China, Eastern Europe, Latin America,Middle East and North Africa, South East Asia and thePacific, and South Asia. However, the actions andresponses to the secretariat calls have obviouslydecreased, probably because of the changes occurredduring 2008, the lack of funding to convey the originalaction plan, and of course to some extend the lack ofeffective communication between the secretariat andthe regional representatives during 2009.
    • 7. Tagging Systematic Reviews for low and middle income countriesImage taken from =>
    • 8. 2012 Module the crucial task…“This year we have re evaluated our methods, and decided that the bestcourse of action is the creation of criteria for the identification of CochraneReviews that are important for developing countries.After this criteria is stated a framework must be produced to tag Cochranereviews with a stated level of importance , which will allow us to both focusefforts in dissemination of existing Cochrane evidence that is relevant todeveloping countries, and to identify geographical and topic gaps whereCochrane evidence has yet to be produced, This will facilitate the contentrelevance of The Cochrane Library content in Developing Countries, sinceeven though the research production of developing country authors hasincreased to 38%,meny topic relevant to the developing world and the bestway to address problems that affect large populations, still remain neglected.To initiate tagging, we need to produce a list of possible, reliable contributorswilling to go along with the project”.Taken from =>
    • 9. First, we need to make us visible …We are now in …LINK:
    • 10. The CDCF newsletterFIND it at :
    • 11. And we have BLOGLINK:
    • 12. The rationale for tagging systematic reviews:Responding the needs of LOW andMIDDLE income countries burden ofdiseases.
    • 13. “Having those numbers helps health authorities determine whether they are focussing on theright kinds of public health actions that will reduce the number of preventable deaths anddisease. Globally, around 57 million people die each year. Almost 15% of these deaths occur inchildren under the age of 5. Most of these preventable deaths in children occur in low- andmiddle-income countries.” Source => Global Health Observatory (GHO). Consulted August 14 2012.
    • 14. Source Global Health Observatory (GHO) August 14 -2102
    • 16. THE HIGHER EVIDENCE QUALITY THE HIGHER THE RELEVANCE !!!THERE ARE SYSTEMATICS REVIEWS THAT BECAUSE OF THE QUALITY OF FINDINGS ARERELEVANT FOR ANY COUNTRY.THERE IS VARIATION ON HTE POWER OF SYSTEMATICS REVIEWS MUTS OF THE TIMESFOR LACK OF GOOD QUALITY STUDIES .WE ARE USING THE SAME GRADE GROUP CATEGORIES FOR SCORING TAGGEDSYSTEMATIC REVIEWS.HIGH => Further research is very unlikely to change our confidence in the estimate ofeffect.MODERATE => Further research is likely to have an important impact on our confidencein the estimate of effect and may change the estimate.LOW => Further research is very likely to have an important impact on our confidencein the estimate of effect and is likely to change the estimate.
    • 17. THE TOPICS BASED ON THE BURDEN OF DISEASES HIGH PRIORTY THEMES Child and women health. Infectious diseases in adults. Chronic diseases in children and adults Occupational diseases . Disaster mitigation . Health care services. Behavioural and learning disorders in adults. Other no included in these topics.
    • 18. WE STARTED: CHILD AND MOTHER (WOMEN) HEALTH RELEVANT TOPICS beyond health care... Antibiotics reviews“1- Irrational prescribing and drug resistance make an important, but overlooked,contribution to the inequities of the medical poverty trap. For example, in India, 52%of out-of-pocket health expenditure went towards medicines and fees, as did 71% ofin-patient expenditure...2-Vietnam’s high frequency of antibiotic resistance is a clear indication of the adversehealth effects of inappropriate drug sales and irrational consumption.32 In a poorregion of Mexico, 74% of health-care visits resulted in inadequate treatment oradvice, especially from traditional healers or retail drug sellers.33 On average, theequivalent of 13 days minimum wage was spent unnecessarily per patient, in 1month, because of inadequate prescribing…Poor people receive ineffective, or even dangerous treatment, including inappropriateor inadequate antituberculosis treatment regimens, …” Source => Whitehead, M et all “Equity and health sector reforms: can low-income countries escape the medical poverty trap? THE LANCET • Vol 358 • September 8, 2001
    • 19. T he following Cochrane groups were included in this first stageand are shown in order of relevancy according to burden of diseases in very low-income countries…
    • 20. 1. Neonatal Group -291 Active published reviews.2. Cochrane Pregnancy and Childbirth Group- 471 Active published reviews.3. Cochrane Infectious Diseases Group- 126 Active published reviews.4. Cochrane HIV/AIDS Group- 117 Active published reviews.5. Sexually Transmitted Infections Group- 12 Active published reviews.6. Public Health Group – 23 Active published reviews.7. Menstrual disorders and Fertility group- Active 210 published reviews.8. Cochrane Cystic Fibrosis and Genetic Disorders Group-Active 129 published reviews.9. Cochrane Breast Cancer Group- 44 Active published reviews.10. Cochrane Childhood Cancer Group- 31 Active published reviews.11. Pain, Palliative and Supportive Care Group- 195 Active published reviews.12. Cochrane Gynaecological Cancer Group- Active 129 published reviews.13. TOTAL : 1778 SOURCE : ARCHIE, MAY-AUGUST , 2012
    • 21. Examples of tagged (1) Systematic reviewsAntibiotic regimens for suspected early neonatal sepsis (Review)Mtitimila EI, Cooke RWI. Antibiotic regimens for suspected early neonatal sepsis. Cochrane Databaseof Systematic Reviews 2004, Issue 4. Art. No.: CD004495. DOI: 10.1002/14651858.CD004495.pub2.Editorial group: Cochrane Neonatal Group.Publication status and date: Edited (no change to conclusions), published in Issue 1, 2009.Review content assessed as up-to-date: 15 June 2004.SCORE : LOWTHE OBJECTIVE OF THIS REVIEW:To compare antibiotic monotherapies, monotherapy with combination therapy, andcombination therapies for empirical treatment of suspected early neonatal sepsis (within48 hours after birth), for both effectiveness and adverse effects.THE REVIEW RESULTS ARE NOT CONCLUSIVE BECAUSE LACK OF EVIDENCE“…. There were no differences between the two groups. Both of the studies werepublished in the 1980s and are probably out of date. The authors of this review concludedthat there is no evidence for using a particular kind of antibiotic for early neonatal sepsis.…”
    • 22. Examples of tagged (2) Systematic reviewsAntibiotic regimens for suspected late onset sepsis in newborn infantsGordon A, Jeffery HE. Antibiotic regimens for suspected late onset sepsis in newborn infants. CochraneDatabase of Systematic Reviews 2005, Issue 3. Art. No.: CD004501. DOI: 10.1002/14651858.CD004501.pub2.Review content assessed as up-to-date: 1 March 2005.The authors WROTE “…In developing countries infection is estimated to cause 30 - 40% of neonatal deaths(WHO 1999).SCORE : LOWTHE OBJECTIVE OF THIS REVIEW:To compare the effectiveness and adverse effects of different antibiotic regimens for treatmentof suspected late onset sepsis in newborn infants.THE REVIEW RESULTS ARE NOT CONCLUSIVE BECAUSE LACK OF EVIDENCEAuthors’ conclusions…There is inadequate evidence from randomised trials in favour of any particular antibioticregimen for the treatment of suspected late onset neonatal sepsis. The available evidence is notof high quality. Although suspected sepsis and antibiotic use is common, quality research isrequired to specifically address both narrow and broad-spectrum antibiotic use for late onsetneonatal sepsis. Future research also needs to assess cost effectiveness and the impact ofantibiotics in different settings such as developed or developing countries and lower gestationalage groups.
    • 23. OTHER TAGGED SR ON RELATED TOPICS ANTIBIOTICS AND CHILD AND MATERNAL HEALTH TAGGED SYSTEMATIC REVIEWSREVIEW GROUP EVIDENCE QUALITY AND RELAVANCE FOR LMIC LAST UPDATE POWER FOR MAIN OUTCOMEAntibiotic adjuvant therapy for Cochrane Cystic Fibrosis and LOW MODERATE Published Online: 6 OCT 2010pulmonary infection in cystic fibrosis Genetic Disorders Group Assessed as up-to-date: 8 SEP 2010Antibiotic regimens for the empirical Cochrane Neonatal Group LOW HIGH Published Online: 15 AUG 2012treatment of newborn infants with . Assessed as up-to-date: 18 FEB 2012necrotising enterocolitisAntibiotic prophylaxis for cesarean Cochrane Pregnancy and LOW HIGH Published Online: 20 JAN 2010section Childbirth Group Assessed as up-to-date: 4 MAR 2002Antibiotic prophylaxis for operative Cochrane Pregnancy and Published Online: 21 JAN 2009vaginal delivery Childbirth Group Assessed as up-to-date: 30 AUG 2008Antibiotic prophylaxis for third- and Cochrane Pregnancy and LOW HIGH Published Online: 10 NOV 2010fourth-degree perineal tear during Childbirth Group Assessed as up-to-date: 3 OCT 2010vaginal birthAntibiotic regimens for endometritis Cochrane Pregnancy and HIGH HIGH Published Online: 21 JAN 2009after delivery Childbirth Group Assessed as up-to-date: 22 MAY 2002Antibiotic regimens for management of Cochrane Pregnancy and OUTDATED HIGH Publication status and date: Edited (no changeintraamniotic infection Childbirth Group to conclusions), published in Issue 9, 2011. Review content assessed as up-to-date: 22 May 2002.Antibiotics for meconium-stained Cochrane Pregnancy and OUTDATED HIGH Publication status and date: Edited (no changeamniotic fluid in labour for preventing Childbirth Group to conclusions), published in Issue 9, 2011.maternal and neonatal infections Review content assessed as up-to-date: 22 May 2002Antibiotics for preterm rupture of Cochrane Pregnancy and LOW HIGH Publication status and date: New search formembranas Childbirth Group studies and content updated (conclusions changed), published in Issue 8, 2010. Review content assessed as up-to-date: 6 July 2010.
    • 24. Doing synergy: Stakeholders and alliestagging SR for child and maternal healthTaken from =>
    • 26. MASCOT-F7partners in developing countries… (contd.) SCHOOL OF PUBLIC HEALTH – UNIVERSITY OF GHANA (GHANA) Dr. Patricia Akweongo – HOPITAL FARHAT HACHED DE SOUSSE (TUNISIA) Prof. Hassen Ghannem – UNIVERSIDAD CATOLICA DE LA SANTISIMA CONCEPCION (CHILE) Dr. Patricia Marcela Cortes Jofre – INSTITUTO NACIONAL DE SALUD PUBLICA (MEXICO) Dr. Victor Becerril Montekio –
    • 28. Questions, comments and suggestions
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