Thursday, November 21, 2013

Cochrane Review -What They Have to Offer Addiction Medicine -Robert Ali

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The Cochrane Reviews were developed to review scientific research asking the question when do we have enough science to make a right decision.  Do we have enough information or do we need more.
They help the busy clinician understand scientifically what works. Theres also information about prevention.
IMG 1790
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Brief Interventions have been studied and shown beneficial. There are major studies to date reviewing existing research in vital areas of drug and alcohol treatment.
CDAG Authors - european centric area - however there are 11% asia - concern for Cochrane Reviews is the generalizability so we're looking forward to
more reviews and studies outside of America.
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Categorization of Interventions - this methodology is especially helpful for busy clinicians
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40% Opiate effectiveness
16% Likely beneficial
When a Cochrane Review has been done there's a duty of the Cochrane Reviews to return a few years later and see what has changed.
Cochrane provides standardized systematic way to review evidence, points to what works, also identifies what doesn't work, importantly point to areas where further work is required.
(These are my rough notes and I apologize for any mistakes, they're just an overview. )
I had read a couple of Cochrane Reviews and frankly didn't know what their overall significance was . That brought me to this course, as one of four symposium occurring at this time.  I'd noted they were very good reviews. Indeed I referred to one as evidence  in a major court case, justifying the treatment which I'd been using, but had been called upon to explain by a colleague for the opposing side. Naturally I appreciated the Cochrane Reviews that day. This presentation helped me understand the Reviews better. Now I'm planning to consider them a first source.  When there was less overall information out there, when I began practice a quarter century ago, as a clinician I loved the 'Review" section best in the NEJM and CMAJ and other major medical journals.  I tend only to look at the original research when something doesn't fit with what I'm seeing clinically. Now that I've gone mostly to the internet for information I've missed these 'review' articles and can see that the Cochrane Reviews are the obvious replacement of that previous helpful read in the paper journals. - W. Hay

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