Consulting, Interpreting And Using First Aid Research Evidence

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Consulting, interpreting and usingfirst aid research evidenceDr. Jorien LaermansField coordinator Cochrane First AidCentre for Evidence-Based Practice (CEBaP)Belgian Red CrossElke WeyenberghFocal Point First AidInternational DepartmentBelgian Red Cross

What is Cochrane First Aid? Thematic Field of Cochrane Mission: Forming a global network of people advocating for the development,dissemination and uptake of high-quality evidence on first aid Promoting the use of evidence on first aid Form a liaison between science and practice: Provide overview of the best available scientific evidence Monitoring practitioner’s needsGuidelinedevelopersFirst AidFirst Aidtrainerscurriculum developersLaypeopleperforming &receiving first aid

Overview Part 1: Scientific research for dummies Part 2: Interpreting the results of scientific studies and systematicreviews Part 3: Cochrane First Aid

Overview Part 1: Scientific research for dummies Part 2: Interpreting the results of scientific studies and systematicreviews Part 3: Cochrane First Aid

Scientific research: the processMore information: https://www.youtube.com/watch?v Jd3gFT0-C4s

Scientific research: defining the study question?PICOquestionShould we have been able to deliver the content of thiswebinar as an interactive live session in Calgary, would:- our attendees learn more?- the level of interaction be higher?- the overall experience of the attendees be better?PopulationSurvival 2020 conference attendeesInterventionAttending webinarComparisonAttending interactive live sessionOutcomeLearning outcomes, interaction, overall experience

Scientific research: selecting the right study typeMore rch/https://www.youtube.com/watch?v a-XtVF7Bofg

Scientific research: selecting the right study typeFeatureActiveintervening?Experimental studyObservational studyYesAt least 2 interventionsNoGoal?Compare the effectiveness ofinterventionsInvestigate if Δ in 1 parameter(e.g. received intervention)cause/are associated withΔ in a 2nd parameter (e.g. mortality)Demonstratecausality?YesNot necessarilyOften only association or correlation

Scientific research: experimental and observational study designshttps://www.youtube.com/watch?v Jd3gFT0-C4sGreat YouTube movie that covers themost important observational andexperimental study designs, includingadvantages and disadvantages!

Scientific research: systematic review and atch?v egJlW4vkb1Y

Scientific research: the hierarchy of trolled trials (RCTs)Non-randomized studiesCohort studiesCase-control studiesCross sectional studiesCase series, case reportsExpert opinion, editorials

Additional useful resources Students 4 Best Evidencehttps://s4be.cochrane.org/ Learning resources, Tutorials andfundamentals Topics: Study design and research methods,Statistics YouTube channel of Simple Learning ajTud90Sw Types of Experimental designs Sampling methods Placebo effect, control groups, and the double blind experiment

Overview Part 1: Scientific research for dummies Part 2: Interpreting the results of scientific studies andsystematic reviews Part 3: Cochrane First Aid

How to read a scientific -how-to-read-a-scientific-paper

How to read a scientific -how-to-read-a-scientific-paper

How to read a systematic review? Take a close look at the Methodology section How rigorously was the review performed?Replicability and robustness of findings

Rigour of methodology: aspects to consider Protocol registration Have they planned the review a priori? Did they stick to their plan? 2 independent reviewers Literature search Did the reviewers search enough and relevant databases? Is the string of search terms sensitive (inclusive, broad) enough to answerthe question? Are we sure they didn’t miss studies? Is there enough information to replicate the search? Have they included unpublished studies (e.g. evaluation reports, conferenceabstracts)?

Rigour of methodology: aspects to consider Selection criteria Should cover study designs, Population, Intervention,Comparison and Outcomes Are they clearly described? Do they make sense? Are rationales provided? Limits regarding language, time frame? Quality appraisal Individual studies: Risk of Bias assessment (tools: RoB 2, ROBINS-I) Body of evidence: GRADE Data extraction and analysis Have they explored the possibility to perform meta-analysis? If not, have they used alternative manners to synthesize the data?

Rigour of methodology: Cochrane & PRISMA Cochrane MECIR standards “Methodological Expectations of Cochrane Intervention Reviews” Most rigorous method https://community.cochrane.org/mecir-manual PRISMA checklist “Preferred Reporting Items for Systematic Reviews and Meta-analyses” Minimum set of items for reporting http://www.prisma-statement.org/

Cochrane systematic reviews: fixed formatAbstractPlain language summarySummary of onAuthors conclusionsReferencesCharacteristics of includedstudies Data and analysis Additional Tables

Cochrane systematic reviews: Results Risk of bias – Traffic light plot text Randomization Allocation concealed Blinding (participants, personnel,outcome assessors) Incomplete outcome data Selective reporting Other bias (e.g. Conflicts of Interest)

Cochrane systematic reviews: Results Effect of interventions Per intervention Per outcome Meta-analyses – Forest plots

Cochrane systematic review: keeping the overview

Cochrane systematic review: keeping the overviewGRADEcertainty ofevidenceInterpretationConclusion statementsWe have a lot of confidence that thetrue effect is similar to the estimatedeffectContinuous chest compressions aloneincreases survival to hospital dischargeModerate (B)We believe that the true effect isprobably close to the estimated effectContinuous chest compressions aloneprobably increases survival to hospitaladmissionLow (C)The true effect might be markedlydifferent from the estimated effectX may increase/decrease YVery Low (D)The true effect is probably markedlydifferent from the estimated effectThe evidence is very uncertain aboutthe effect of X on YHigh (A)

Cochrane systematic review: keeping the overview

Additional useful resources Judging the reliability of research https://www.askforevidence.org/help/evidence 6/11/IDontKnowWhatToBelieve.pdf 16/09/peer-review-thenuts-and-bolts.pdf Cochrane Training - https://training.cochrane.org/ Online learning, learning events (webinars, workshops,courses) All aspects of systematic reviews and evidence-based medicine Students 4 Best Evidence - https://s4be.cochrane.org/ Learning resources, Tutorials and fundamentals Topics: Bias, Searching for evidence, Systematic Reviews Catalog of bias - https://catalogofbias.org/ Collaborative project mapping all biases that affect health evidence

Overview Part 1: Scientific research for dummies Part 2: Interpreting the results of scientific studies and systematicreviews Part 3: Cochrane First Aid

Cochrane First Aid so far1. Network building GFARC as collaborating centre2. Building demand Quarterly screening of Cochrane Library https://www.cochranelibrary.com/ Register on first aid-related Cochrane systematic reviewshttps://firstaid.cochrane.org/evidence

Cochrane First Aid so far3. Knowledge translation@Cochrane FA@CochraneFirstAid@cochrane firstaidfirstaid.cochrane.org

How to contribute to knowledgetranslation within Cochrane First Aid?Product generatorsProduct DisseminatorsMaking blogshotsSpreading the workvia social media(Facebook, Twitter, Instagram)and other channelsTranslatorsTranslating blogshotsfrom English toanother language(e.g. own Red Cross Society ne.org

31From evidence to guideline: the Belgian Red Cross3. Contextualized first aid manuals1. Scientific publications2. Evidence summariesExpert panel(field experts andacademic experts)

Other organisations putting the evidence-based in first aid Scientific Advisory Council (SAC) of the American Red Cross dvisory-council International Liaison Committee on Resuscitation (ILCOR) First Aid Task Force https://www.ilcor.org/ and https://costr.ilcor.org/ International Federation of Red Cross and Red Crescent Societies(IFRC) Global First Aid Reference Centre (GFARC) IFRC First Aid guidelines 2021 in the making d-saves-lives/

Additional useful resources From evidence to guidelines using the principles ofEvidence-Based Practice https://www.cebap.org/methodology/ebp-e-learning/

Hope to hear from you soon!@Cochrane FA@CochraneFirstAidfirstaid.cochrane.org@cochrane ebap.org@CEBaP evidenceCEBaP

curriculum developers First Aid trainers Laypeople performing & receiving first aid What is Cochrane First Aid? Thematic Field of Cochrane Mission: Forming a global network of people advocating for the development, dissemination and uptake of high-quality evidence on first aid Promoting the use of evidence on first aid

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