Unintended consequences of measures implemented in the school setting to contain the COVID-19 pandemic: a scoping review.

Background: Throughout the COVID-19 pandemic, schools were a key setting for intervening with public health and social measures (PHSM) to reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Consequently, there is a need to assess the varied unintended consequences associated with PHSM implemented in the school setting, for students, teachers, and school staff, as well as for families and the wider community. This is an update of a Cochrane scoping review first published in 2022.

Liver fibrosis stage based on the four factors (FIB-4) score or Forns index in adults with chronic hepatitis C.

Background: The presence and severity of liver fibrosis are important prognostic variables when evaluating people with chronic hepatitis C (CHC). Although liver biopsy remains the reference standard, non-invasive serological markers, such as the four factors (FIB-4) score and the Forns index, can also be used to stage liver fibrosis.

Objectives: To determine the diagnostic accuracy of the FIB-4 score and Forns index in staging liver fibrosis in people with chronic hepatitis C (CHC) virus, using liver biopsy as the reference standard (primary objective).

Anticholinergic deprescribing interventions for reducing risk of cognitive decline or dementia in older adults with and without prior cognitive impairment.

Background: Anticholinergics are medications that block the action of acetylcholine in the central or peripheral nervous system. Medications with anticholinergic properties are commonly prescribed to older adults. The cumulative anticholinergic effect of all the medications a person takes is referred to as the anticholinergic burden.

Rapid reviews methods series: Guidance on team considerations, study selection, data extraction and risk of bias assessment.

This paper is part of a series of methodological guidance from the Cochrane Rapid Reviews Methods Group (RRMG). Rapid reviews (RRs) use modified systematic review (SR) methods to accelerate the review process while maintaining systematic, transparent and reproducible methods to ensure integrity. This paper addresses considerations around the acceleration of study selection, data extraction and risk of bias (RoB) assessment in RRs.

Anticholinergic burden for prediction of cognitive decline or neuropsychiatric symptoms in older adults with mild cognitive impairment or dementia.

Background: Medications with anticholinergic properties are commonly prescribed to older adults with a pre-existing diagnosis of dementia or cognitive impairment. The cumulative anticholinergic effect of all the medications a person takes is referred to as the anticholinergic burden because of its potential to cause adverse effects. It is possible that a high anticholinergic burden may be a risk factor for further cognitive decline or neuropsychiatric disturbances in people with dementia.

Clinical judgement by primary care physicians for the diagnosis of all-cause dementia or cognitive impairment in symptomatic people.

Background: In primary care, general practitioners (GPs) unavoidably reach a clinical judgement about a patient as part of their encounter with patients, and so clinical judgement can be an important part of the diagnostic evaluation. Typically clinical decision making about what to do next for a patient incorporates clinical judgement about the diagnosis with severity of symptoms and patient factors, such as their ideas and expectations for treatment. When evaluating patients for dementia, many GPs report using their own judgement to evaluate cognition, using information that is immediately available at the point of care, to decide whether someone has or does not have dementia, rather than more formal tests.

Crowdsourcing the identification of studies for COVID-19-related Cochrane Rapid Reviews.

Background: Utilisation of crowdsourcing within evidence synthesis has increased over the last decade. Crowdsourcing platform Cochrane Crowd has engaged a global community of 22,000 people from 170 countries. The COVID-19 pandemic presented an opportunity to engage the community and keep up with the exponential output of COVID-19 research.

The People's Trial: supporting the public's understanding of randomised trials.

Background: Randomised trials are considered the gold standard in providing robust evidence on the effectiveness of interventions. However, there are relatively few initiatives to help increase public understanding of what randomised trials are and why they are important. This limits the overall acceptance of and public participation in clinical trials.

Machine learning reduced workload for the Cochrane COVID-19 Study Register: development and evaluation of the Cochrane COVID-19 Study Classifier.

Background: This study developed, calibrated and evaluated a machine learning (ML) classifier designed to reduce study identification workload in maintaining the Cochrane COVID-19 Study Register (CCSR), a continuously updated register of COVID-19 research studies.

Methods: A ML classifier for retrieving COVID-19 research studies (the 'Cochrane COVID-19 Study Classifier') was developed using a data set of title-abstract records 'included' in, or 'excluded' from, the CCSR up to 18th October 2020, manually labelled by information and data curation specialists or the Cochrane Crowd. The classifier was then calibrated using a second data set of similar records 'included' in, or 'excluded' from, the CCSR between October 19 and December 2, 2020, aiming for 99% recall.

Does reading a book in bed make a difference to sleep in comparison to not reading a book in bed? The People's Trial-an online, pragmatic, randomised trial.

Background: The best way of comparing healthcare treatments is through a randomised trial. In a randomised trial, we compare something (a treatment or intervention) to something else, often another treatment. Who gets what is decided at random, meaning everyone has an equal chance of getting any of the treatments.

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the detection of dementia within a general practice (primary care) setting.

Background: The IQCODE (Informant Questionnaire for Cognitive Decline in the Elderly) is a commonly used questionnaire based tool that uses collateral information to assess for cognitive decline and dementia. Brief tools that can be used for dementia "screening" or "triage" may have particular utility in primary care / general practice healthcare settings but only if they have suitable test accuracy. A synthesis of the available data regarding IQCODE accuracy in a primary care setting should help inform cognitive assessment strategies for clinical practice; research and policy.

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the detection of dementia within community dwelling populations.

Background: Various tools exist for initial assessment of possible dementia with no consensus on the optimal assessment method. Instruments that use collateral sources to assess change in cognitive function over time may have particular utility. The most commonly used informant dementia assessment is the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE).

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the detection of dementia within a secondary care setting.

Background: The diagnosis of dementia relies on the presence of new-onset cognitive impairment affecting an individual's functioning and activities of daily living. The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) is a questionnaire instrument, completed by a suitable 'informant' who knows the patient well, designed to assess change in functional performance secondary to cognitive change; it is used as a tool for identifying those who may have dementia. In secondary care there are two specific instances where patients may be assessed for the presence of dementia.

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the early detection of dementia across a variety of healthcare settings.

Background: The Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) is a structured interview based on informant responses that is used to assess for possible dementia. IQCODE has been used for retrospective or contemporaneous assessment of cognitive decline. There is considerable interest in tests that may identify those at future risk of developing dementia.

Mini-Cog for the detection of dementia within a secondary care setting.

Background: The diagnosis of Alzheimer's disease dementia and other dementias relies on clinical assessment. There is a high prevalence of cognitive disorders, including undiagnosed dementia in secondary care settings. Short cognitive tests can be helpful in identifying those who require further specialist diagnostic assessment; however, there is a lack of consensus around the optimal tools to use in clinical practice.

Mini-Cog for the detection of dementia within a community setting.

Background: Alzheimer's disease and related forms of dementia are becoming increasingly prevalent with the aging of many populations. The diagnosis of Alzheimer's disease relies on tests to evaluate cognition and discriminate between individuals with dementia and those without dementia. The Mini-Cog is a brief, cognitive screening test that is frequently used to evaluate cognition in older adults in various settings.

Montreal Cognitive Assessment for the detection of dementia.

Background: Dementia is a progressive syndrome of global cognitive impairment with significant health and social care costs. Global prevalence is projected to increase, particularly in resource-limited settings. Recent policy changes in Western countries to increase detection mandates a careful examination of the diagnostic accuracy of neuropsychological tests for dementia.

Anticholinergic burden (prognostic factor) for prediction of dementia or cognitive decline in older adults with no known cognitive syndrome.

Background: Medications with anticholinergic properties are commonly prescribed to older adults. The cumulative anticholinergic effect of all the medications a person takes is referred to as the 'anticholinergic burden' because of its potential to cause adverse effects. It is possible that high anticholinergic burden may be a risk factor for development of cognitive decline or dementia.

Crowdsourcing citation-screening in a mixed-studies systematic review: a feasibility study.

Background: Crowdsourcing engages the help of large numbers of people in tasks, activities or projects, usually via the internet. One application of crowdsourcing is the screening of citations for inclusion in a systematic review. There is evidence that a 'Crowd' of non-specialists can reliably identify quantitative studies, such as randomized controlled trials, through the assessment of study titles and abstracts.

Plasma and cerebrospinal fluid ABeta42 for the differential diagnosis of Alzheimer's disease dementia in participants diagnosed with any dementia subtype in a specialist care setting.

Background: Dementia is a syndrome that comprises many differing pathologies, including Alzheimer's disease dementia (ADD), vascular dementia (VaD) and frontotemporal dementia (FTD). People may benefit from knowing the type of dementia they live with, as this could inform prognosis and may allow for tailored treatment. Beta-amyloid (1-42) (ABeta42) is a protein which decreases in both the plasma and cerebrospinal fluid (CSF) of people living with ADD, when compared to people with no dementia.

An evaluation of Cochrane Crowd found that crowdsourcing produced accurate results in identifying randomized trials.

Background And Objectives: Filtering the deluge of new research to facilitate evidence synthesis has proven to be unmanageable using current paradigms of search and retrieval. Crowdsourcing, a way of harnessing the collective effort of a "crowd" of people, has the potential to support evidence synthesis by addressing this information overload created by the exponential growth in primary research outputs. Cochrane Crowd, Cochrane's citizen science platform, offers a range of tasks aimed at identifying studies related to health care.

State of the evidence: a survey of global disparities in clinical trials.

Introduction: Ideally, health conditions causing the greatest global disease burden should attract increased research attention. We conducted a comprehensive global study investigating the number of randomised controlled trials (RCTs) published on different health conditions, and how this compares with the global disease burden that they impose.

Methods: We use machine learning to monitor PubMed daily, and find and analyse RCT reports.

Machine learning reduced workload with minimal risk of missing studies: development and evaluation of a randomized controlled trial classifier for Cochrane Reviews.

Objectives: This study developed, calibrated, and evaluated a machine learning classifier designed to reduce study identification workload in Cochrane for producing systematic reviews.

Methods: A machine learning classifier for retrieving randomized controlled trials (RCTs) was developed (the "Cochrane RCT Classifier"), with the algorithm trained using a data set of title-abstract records from Embase, manually labeled by the Cochrane Crowd. The classifier was then calibrated using a further data set of similar records manually labeled by the Clinical Hedges team, aiming for 99% recall.

Citation screening using crowdsourcing and machine learning produced accurate results: Evaluation of Cochrane's modified Screen4Me service.

Objectives: To assess the feasibility of a modified workflow that uses machine learning and crowdsourcing to identify studies for potential inclusion in a systematic review.

Study Design And Setting: This was a substudy to a larger randomized study; the main study sought to assess the performance of single screening search results versus dual screening. This substudy assessed the performance in identifying relevant randomized controlled trials (RCTs) for a published Cochrane review of a modified version of Cochrane's Screen4Me workflow which uses crowdsourcing and machine learning.

Trialstreamer: A living, automatically updated database of clinical trial reports.

Objective: Randomized controlled trials (RCTs) are the gold standard method for evaluating whether a treatment works in health care but can be difficult to find and make use of. We describe the development and evaluation of a system to automatically find and categorize all new RCT reports.

Materials And Methods: Trialstreamer continuously monitors PubMed and the World Health Organization International Clinical Trials Registry Platform, looking for new RCTs in humans using a validated classifier.