Cardiovascular disease is the single greatest threat to global health. Could fixed-dose combinations (FDCs) of drugs play a larger role in primary and secondary prevention of cardiovascular events? Advocates of the ‘polypill’ have proposed that FDCs might be prescribed to everyone over the age of 55, and a cheap FDC might be particularly useful for secondary prevention of cardiovascular events in low- and middle-income countries. A new Cochrane Review looks at the evidence for cardiovascular FDCs, finding that they do improve cardiovascular outcomes, but not as much as was hoped. Questions remain about the dosing, combination with other therapies, incentives for manufacturers, and the willingness and ability of health systems to support FDC therapy.
Preclinical evidence, like clinical evidence, is used to inform decisions about the safety and efficacy of treatments for participants in clinical trials. Unlike clinical studies, most preclinical animal studies are not systematically reviewed. Systematic reviews of preclinical animal studies can however contribute significantly to creating more transparency regarding the possible translation from preclinical animal studies to clinical trials. A small but growing international community of researchers is conducting systematic reviews of preclinical animal studies.
Many couples experiencing infertility will seek treatment in the form of in vitro fertilisation (IVF) or another type of assisted reproductive technology (ART). These treatments are complex and costly, and the stakes are high, so each step should be supported by good evidence from well-designed studies. A recent overview of Cochrane Reviews of ART summarises the evidence from 54 systematic reviews on ART procedures and treatment options. As the number of published systematic reviews increases, overviews are increasingly important to facilitate decision-making for patients and doctors, as well as for guideline panels, policy-makers, and caregivers. The ART overview is by far the largest overview to date and can be used to guide clinical practice, helping to improve live birth rates and reduce adverse events such as multiple pregnancy, cycle cancellation, and ovarian hyperstimulation syndrome.
The Cochrane Collaboration's risk of bias tool has been used in hundreds of systematic reviews over the last five years. There is debate about whether to include funding source as a standard item in the tool. In this editorial, Lisa Bero puts the case for including funding source in the Cochrane risk of bias tool.
The Cochrane Collaboration's risk of bias tool has been used in hundreds of systematic reviews over the last five years. There is debate about whether to include funding source as a standard item in the tool. In this editorial, Jonathan Sterne presents the arguments against including funding source in the Cochrane risk of bias tool.