What are the best strategies to implement World Health Organization (WHO) recommendations to prevent, detect, and treat postpartum hemorrhage? Key messages Multicomponent implementation strategies may improve adherence to World Health Organization (WHO) postpartum hemorrhage (PPH) prevention recommendations and probably do not make a difference to intensive care unit (ICU) admissions, need for additional surgeries, or death of the mother. We do not know if multicomponent implementation strategies affect blood loss or blood transfusion. We do not know if single-component implementation...

Effectiveness of SARS-CoV-2 testing strategies This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of different SARS-CoV-2 testing strategies in reducing COVID-19 cases, hospitalisations, and deaths among suspected cases and asymptomatic individuals. This is a protocol....

What are the benefits and harms of non-vitamin K antagonist oral anticoagulants (NOACs), the next-generation blood thinners, after transcatheter aortic valve replacement (TAVR)? Key messages • In people who do not have a medical reason to take blood thinners, non-vitamin K antagonist oral anticoagulants (NOACs), specifically rivaroxaban and apixaban, may increase the risk of death for any reason when compared with antiplatelet drugs, while edoxaban appears to have little or no effect. Any differences between rivaroxaban, apixaban, or edoxaban, and antiplatelet therapy in death caused by...

Acupuncture for babies with neonatal abstinence syndrome after exposure to drugs while in the womb Key messages • Due to a lack of evidence, we are unable to draw any conclusions about the benefits and risks of acupuncture for babies with neonatal abstinence syndrome caused by being exposed to drugs while in the womb. • Large studies that are well-designed and reported are needed to find out more about the benefits and risks of acupuncture, including studies that make comparisons of acupuncture techniques, sites, timing and application. What is neonatal abstinence syndrome? Neonatal...

What are the benefits and risks of tumor necrosis factor inhibitors for juvenile idiopathic arthritis? Key messages • When compared to placebo, tumor necrosis factor inhibitors (TNFi) may make young people with juvenile idiopathic arthritis (JIA) feel better overall, but the effects of the medicines on joint function, pain, disease control, and harm are uncertain. • We are uncertain about the benefits and harms of TNFi when compared to another medicine called methotrexate. • More high-quality studies are needed to understand the benefits and harms of TNFi in JIA. What is juvenile idiopathic...

Does cardiovascular training relieve cancer-related fatigue before, during, or after anticancer therapy? Key messages Cardiovascular training during anticancer therapy probably reduces cancer-related fatigue slightly for up to 12 weeks. The longer-term effects of cardiovascular training on cancer-related fatigue and quality of life are uncertain and there is no evidence about the effects of cardiovascular training before anticancer therapy. We found nearly 50 studies of cardiovascular training before, during, and after cancer treatment that are underway and these will add to the evidence...

How accurate is carbon dioxide detection in establishing if a tube inserted through the nose or mouth has been accidentally placed in the airway instead of the stomach in children? Key message • There is not enough evidence to suggest that carbon dioxide (CO₂) testing should be added to current checking procedures. • More studies are needed to determine if CO₂ testing is beneficial for children undergoing insertion of an enterogastric tube. Why is it important to know if the tube is accidentally placed in the airway? The insertion of a thin, flexible plastic tube through the nose or mouth...

What are the effects of angioplasty or stenting in people with deep vein thrombosis? Key messages ⦁ The effects of angioplasty or stenting for people with deep vein thrombosis (DVT) are unclear. ⦁ Further larger studies are needed to determine whether angioplasty and stenting are safe and effective treatments for people with DVT. What is deep vein thrombosis (DVT)? DVT is a blood clot that forms in a deep vein, usually in the leg. It can cause pain, swelling, and redness in the affected leg. DVT can also lead to serious complications, such as post-thrombotic syndrome (PTS) (a chronic...

Can breastfeeding support interventions that target depression prevent the development of depression after childbirth? Key messages - Psychosocial breastfeeding support interventions may prevent some cases of postpartum (postnatal) depression in mothers one to three months after the support has been received and increase the duration of breastfeeding seven to 12 months after the support has been received. The evidence is very uncertain about the effect on other mental health and breastfeeding outcomes. - The evidence is very uncertain about the impact of alternative breastfeeding...

Does treatment with GLP-1 receptor agonists prevent complications for people with chronic kidney disease and diabetes? Key messages • For people with chronic kidney disease (CKD) (a long-term condition where the kidneys do not work effectively) also having diabetes (a lifelong condition that causes a person's blood sugar level to become too high) increases the chances of early death, heart attack, stroke and reduces a person's quality of life. • Glucagon-like peptide 1 receptor agonists (GLP-1) (medicines used to lower blood glucose) probably reduce the risk of death due to any cause but may...

Oral nicotine pouches for cessation or reduction of use of other tobacco or nicotine products This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objectives To evaluate the benefits and harms of oral nicotine pouches when used to help people transition away from combustible tobacco use (smoking) To evaluate the impact of oral nicotine products on the prevalence of combustible tobacco use Secondary objectives To evaluate the benefits and harms of oral nicotine pouches when used to help people transition away from other non-combustible...

What are the benefits and harms of TNF inhibitors for people with psoriatic arthritis? Key messages Tumour necrosis factor inhibitors (TNFi), a group of medicines that help reduce inflammation are probably more effective than placebo (an inactive or 'dummy' medicine) in treating people with psoriatic arthritis who did not benefit from treatment with first-line immunosuppressants (medicines that prevent the activity of the immune system, such as methotrexate). High-quality studies comparing TNF inhibitors with second-line immunosuppressants, and studies that evaluate the effects of TNFi in...

Interventions to slow the progression of short-sightedness in children Key messages Medicines, such as atropine, given as eye drops, can slow the progression of short- or near-sightedness (myopia) in children, and also reduce elongation of the eyeball due to myopia. Higher doses of atropine are most effective. We are uncertain about the effects of lower doses of atropine. Several treatments, including special types of lenses in eyeglasses, contact lenses, and a new therapy using low intensity red light, may slow the progression of short-sightedness, but their effect is still uncertain. There...

Microsurgical versus complex physical decongestive therapy for chronic breast cancer-related lymphoedema This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of microsurgery versus complex physical decongestive therapy in people with chronic breast cancer-related lymphoedema. This is a protocol....

Graded activity for chronic low back pain This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of graded activity compared to placebo, sham, or no treatment for pain and function in adults with chronic non-specific low back pain. This is a protocol....

Acupuncture for the prevention of episodic migraine This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To investigate whether acupuncture is more effective than 'sham' (placebo) acupuncture, no preventative treatment or routine care only, or other interventions, in reducing headache frequency in people with episodic migraine. This is a protocol....

How effective are different physical rehabilitation approaches in the recovery of function, balance, and walking after stroke? Key messages For people who have had a stroke: - Physical rehabilitation may improve daily activities, moving legs, balance, and walking, when compared to no physical rehabilitation. There may be greater benefits when more than 2.5 hours/week of physical rehabilitation is delivered. - Extra physical rehabilitation, given in addition to 'usual' physical rehabilitation, may also improve outcomes. The greater the amount of extra physical rehabilitation, the greater the...

Is ‘prophylactic transarterial embolization’ (blocking blood vessels as a precaution) effective to prevent a peptic (stomach) ulcer bleeding again following earlier successful endoscopic treatment (with a tube through the mouth into the stomach)? Key messages - Prophylactic transarterial embolization (blocking blood supply to the ulcer as a precaution) may make little to no difference in reducing rebleeding, need for reoperation, or death for people whose bleeding peptic ulcer had been successfully treated with endoscopy (a tube through the mouth into the stomach), but length of stay in...

Does giving chemotherapy before surgery improve survival or quality of life in women with advanced epithelial ovarian cancer? Key messages There is little difference in how long women with advanced epithelial ovarian cancer (EOC) survive, whether they have chemotherapy or surgery first. There is probably little difference in how long it takes for EOC to return after treatment. Giving chemotherapy prior to surgery (neoadjuvant chemotherapy (NACT) and interval cytoreductive surgery (ICRS)) probably reduces some of the risks of surgery; probably halves the risk of needing the bowel removed...

Can self-management programs improve the quality of life in adults with low vision? Key messages Self-management programs (types of education or training that help people learn how to manage their own health) may not improve health-related or vision-related quality of life measures in adults with low vision. The evidence is uncertain, and more research is needed to confirm these findings. What is visual impairment? Visual impairment refers to a condition where a person's eyesight is reduced and cannot be corrected using eye glasses, contact lenses, or surgery. This leads to difficulties in...