Management and training of linguistic volunteers: a case study of translation at Cochrane Germany

Cochrane is a global, non-profit organisation that synthesizes health-related research evidence. It established a translation strategy in 2014 to increase the significance of its information beyond the English-speaking world. Under the strategy, translation at Cochrane is achieved mostly through the efforts of linguistic volunteers. Translation in crisis settings, too, relies on the work of volunteers; however, appropriate ways to manage and train these volunteers are unclear. We carried out a study of the case of translation at one part of Cochrane, Cochrane Germany, to learn about the management and training of linguistic volunteers there and in Cochrane more broadly. Thematic analysis of data gathered by the researcher during a two-month secondment to the offices of Cochrane Germany– including data from formal interviews, informal meetings, field notes, a reflective journal, and a large corpus of grey literature – generated three main themes. The themes relate to appropriate conceptualisations of linguistic volunteers, project management in the assurance of quality volunteer work, and feedback as a form of volunteer training. Recommendations are made to apply these lessons learned to future work on crisis translation and for possible improvements to linguistic volunteer management and training at Cochrane

A proposal for the retrospective identification and categorization of older people with functional impairments in scientific studies : recommendations of the Medication and Quality of Life in Frail Older Persons (MedQoL) research group

When treating older adults, a main factor to consider is physical frailty. Because specific assessments in clinical trials are frequently lacking, critical appraisal of treatment evidence with respect to functional status is challenging. Our aim was to identify and categorize assessments for functional status given in clinical trials in older adults to allow for a retrospective characterization and indirect comparison of treatment evidence from these cohorts. We conducted 4 separate systematic reviews of randomized and nonrandomized controlled clinical trials in older people with hypertension, diabetes, depression, and dementia. All assessments identified that reflected functional status were analyzed. Assessments were categorized across 4 different functional status levels. These levels span from functionally not impaired, slightly impaired, significantly impaired, to severely impaired/disabled. If available from the literature, cut-offs for these 4 functioning levels were extracted. If not, or if the existing cut-offs did not match the predefined functional levels, cut-off points were defined by an expert group composed of geriatricians, pharmacists, pharmacologists, neurologists, psychiatrists, and epidemiologists using a patient-centered approach. We identified 51 instruments that included measures of functional status. Although some of the assessments had clearly defined cut-offs across our predefined categories, many others did not. In most cases, no cut-offs existed for slightly impaired or severely impaired older adults. Missing cut-offs or values to adjust were determined by the expert group and are presented as described. The functional status assessments that were identified and operationalized across 4 functional levels could now be used for a retrospective characterization of functional status in randomized controlled trials and observational studies. Allocated categories only serve as approximations and should be validated head-to-head in future studies. Moreover, as general standard, upcoming studies involving older adults should include and explicitly report functional impairment as a baseline characteristic of all participants enrolled

Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach

Q2Q1Artículo de investigación1-10Background: There are diverse opinions and confusion about defining and including patient values and preferences (i.e. the importance people place on the health outcomes) in the guideline development processes. This article aims to provide an overview of a process for systematically incorporating values and preferences in guideline development. Methods: In 2013 and 2014, we followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to adopt, adapt and develop 226 recommendations in 22 guidelines for the Ministry of Health of the Kingdom of Saudi Arabia. To collect context-specific values and preferences for each recommendation, we performed systematic reviews, asked clinical experts to provide feedback according to their clinical experience, and consulted patient representatives. Results: We found several types of studies addressing the importance of outcomes, including those reporting utilities, non-utility measures of health states based on structured questionnaires or scales, and qualitative studies. Guideline panels used the relative importance of outcomes based on values and preferences to weigh the balance of desirable and undesirable consequences of alternative intervention options. However, we found few studies addressing local values and preferences. Conclusions: Currently there are different but no firmly established processes for integrating patient values and preferences in healthcare decision-making of practice guideline development. With GRADE Evidence-to-Decision (EtD) frameworks, we provide an empirical strategy to find and incorporate values and preferences in guidelines by performing systematic reviews and eliciting information from guideline panel members and patient representatives. However, more research and practical guidance are needed on how to search for relevant studies and grey literature, assess the certainty of this evidence, and best summarize and present the findings

Research response to coronavirus disease 2019 needed better coordination and collaboration: a living mapping of registered trials

Objectives: Researchers worldwide are actively engaging in research activities to search for preventive and therapeutic interventions against coronavirus disease 2019 (COVID-19). Our aim was to describe the planning of randomized controlled trials (RCTs) in terms of timing related to the course of the COVID-19 epidemic and research question evaluated. Study Design and Setting: We performed a living mapping of RCTs registered in the WHO International Clinical Trials Registry Platform. We systematically search the platform every week for all RCTs evaluating preventive interventions and treatments for COVID-19 and created a publicly available interactive mapping tool at https://covid-nma.com to visualize all trials registered. Results: By August 12, 2020, 1,568 trials for COVID-19 were registered worldwide. Overall, the median ([Q1–Q3]; range) delay between the first case recorded in each country and the first RCT registered was 47 days ([33–67]; 15–163). For the 9 countries with the highest number of trials registered, most trials were registered after the peak of the epidemic (from 100% trials in Italy to 38% in the United States). Most trials evaluated treatments (1,333 trials; 85%); only 223 (14%) evaluated preventive strategies and 12 postacute period intervention. A total of 254 trials were planned to assess different regimens of hydroxychloroquine with an expected sample size of 110,883 patients. Conclusion: This living mapping analysis showed that COVID-19 trials have relatively small sample size with certain redundancy in research questions. Most trials were registered when the first peak of the pandemic has passed

Management and training of linguistic volunteers: a case study of translation at Cochrane Germany

Cochrane is a global, non-profit organisation that synthesizes health-related research evidence. It established a translation strategy in 2014 to increase the significance of its information beyond the English-speaking world. Under the strategy, translation at Cochrane is achieved mostly through the efforts of linguistic volunteers. Translation in crisis settings, too, relies on the work of volunteers; however, appropriate ways to manage and train these volunteers are unclear. We carried out a study of the case of translation at one part of Cochrane, Cochrane Germany, to learn about the management and training of linguistic volunteers there and in Cochrane more broadly. Thematic analysis of data gathered by the researcher during a two-month secondment to the offices of Cochrane Germany– including data from formal interviews, informal meetings, field notes, a reflective journal, and a large corpus of grey literature – generated three main themes. The themes relate to appropriate conceptualisations of linguistic volunteers, project management in the assurance of quality volunteer work, and feedback as a form of volunteer training. Recommendations are made to apply these lessons learned to future work on crisis translation and for possible improvements to linguistic volunteer management and training at Cochrane

School Entry Proceedings as Organisational Practices. Ethnographic perspectives on the interferences between governmental and situated regulations

Kelle H. School Entry Proceedings as Organisational Practices. Ethnographic perspectives on the interferences between governmental and situated regulations. In: Bollig S, Honig M-S, Neumann S, Seele C, eds. MultiPluriTrans. Approaching the Multimodality, Plurality and Translocality of Educational Realities . Bielefeld : transcript ; 2015: 175-193

Evidence gap on antihyperglycemic pharmacotherapy in frail older adults : A systematic review.

BACKGROUND Although antihyperglycemic pharmacotherapy in frail older adults with type 2 diabetes mellitus (T2DM) is challenging, recommendations from international guidelines are mainly based on indirect evidence from trials not including frail participants. OBJECTIVE This systematic review investigated the effectiveness and safety of pharmacotherapy in frail older adults with T2DM. MATERIAL AND METHODS Randomized (RCT) and non-randomized prospective clinical trials (non-RCT) were searched in three electronic databases (Medline, Embase, Central) up to October 2018. Trials in older adults with T2DM who were assessed as significantly or severely impaired by defined cut-off scores of assessment instruments on frailty, activities of daily living or physical functional impairment were included. RESULTS Two reviewers independently screened 17,391 references for inclusion and assessed risk of bias with ROBINS‑I. Five non-RCTs and no RCT were identified. Treatment of T2DM without insulin compared to insulin could be associated with increased improvement in cardiac functions in patients with cardiac resynchronization therapy and with decreased falls in frail older women. While better glycemic control with low variability and low HbA1c (hemoglobin A1c) values (<7%) was associated with better maintenance of physical function in community-dwelling older persons, higher HbA1c values (8-8.9%) were associated with a reduction in the composite outcome of death or functional decline in community-dwelling diabetic older adults with need for skilled assistance. Due to serious risk of bias in all studies, results should be considered with caution. CONCLUSION Well-designed, large-scale RCTs including this important group of patients are required to assess the effectiveness and safety of pharmacotherapy and HbA1c targets