SMF Prognostic Studies

Trusted methods and Support for Cochrane Reviews of Prognostic Studies

Prognostic studies address future outcomes and the prediction of these outcomes in individuals. Prognosis forms the basis for personalized or risk-based medicine. Primary studies on prognostic factors, (bio)markers, tests and models are abundant,  so. systematic reviews are necessary to manage this literature effectively. Available methodological guidance for systematic reviews (SRs) of prognostic studies comes primarlily from Cochrane Members. This funding will allow Cochrane to initiate investment in a sustainable infrastructure for these novel reviews within Cochrane and provide guidance for, and teaching to conduct these review in Cochrane. The proposal will develop and disseminate face to face and online training and guidance tailored to Cochrane authors, editors and methodologists, addressing the necessary skills for SRs of prognostic studies: from framing the review question, design and search strategies to data extraction, critical appraisal,meta-analysis, interpretation and reporting.

Over the last 4-5 years we have taken progressive steps towards the implementation of reviews of prognosis in Cochrane. This new review type covers 4 types of questions: overall prognosis prognostic factors, prognostic models, and treatment selection factors or models. These types of reviews are considered vital as the health sector moves towards personalized and precision medicine. The Prognosis Methods Group (PMG) with funding support (Methods Innovation and Strategic Methods Funds) are tasked with developing the methods, tools and templates, and implementation strategies to enable Cochrane to publish these reviews. An implementation team that includes members of the PMG, a senior network editor, members of EMD and training meet monthly. A key development tool is the publication of exemplar reviews. Currently 11 protocols are live with their reviews in varying stages towards publication. There are an additional seven registered titles. Two reviews “Protease activity as a prognostic factor for wound healing in venous leg ulcers” (now published) and  “Development of type 2 diabetes mellitus in people with intermediate hyperglycaemia” (near publication), not originally planned as part of the exemplar programme are the first to be published.  

A title registration form and protocol template are now available with a review template to follow. MECIR type standards are in development and expected towards the end of the year or early 2019. Further information on available tools for data extraction, critical appraisal and reporting and application of GRADE are on the PMG website . The PMG will publish an editorial and conduct a webinar during September before the Colloquium to update the community on progress. PMG typically provide five workshops at Colloquia and in addition this year will conduct a pre- colloquium half day workshop, which is over booked with 60+particpants. These workshops cover general introduction, to data extraction, risk of bias assessment, meta-analysis and interpretation, both using aggregate and individual participant data, and grading of review evidence. Further advanced distance learning training is available from the PMG website.

Led by Carl Moons, Co-convenor of the Prognosis Methods Group of the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht.