The Cochrane rehabilitation portfolio has provided an important and reliable source of contemporary evidence used in many clinical guidelines including NICE, ESC and AHA. Our Cochrane reviews have provided a means to identify key research gaps that we have used to leverage funding of ongoing clinical trials - REACH-HF, ISRCTN86234930 and CADENCE, ISRCTN34701576)
Oxygen therapy for acute myocardial infarction (JB Cabello)
Prior to the original review, published in 2010, a mainstay of acute phase treatment for myocardial infarction was the use of oxygen, and this was reflected in national and international guidelines. This review led to a significant alteration in these guidelines, demonstrating the discord between the actual use of oxygen during acute phase treatment (>98%) and its perceived benefit to patients by cardiologists (48%). Our systematic review and metanalysis of three randomised controlled trials suggested that oxygen might even be associated with worse patient outcome, with a three-fold increase in relative risk of mortality compared to the use of air alone, raising further concerns about patient safety.
The research described here has challenged existing practice at both national and international level, and has led to Policy impact at regional, national and international level. This can be evidenced by revisions to the guidelines issued by the European Society of Cardiology (1)... [read more]
As a resident of the [...] Retirement Community [...], I was asked to give a presentation for other elderly residents at one of their "TED" (Technology, Entertainment, Design) talks. Accordingly, on March 29 I gave a brief account of the role of Cochrane in fostering evidence-based medicine, and commented on RCTs, meta-analyses, and forest plots. I concluded the talk by showing two meta-analyses taken from our review on the effects of digitalis in congestive heart failure. Almost 100 residents attended.