Marian Showell

and 3 more

Objective The aim of this project was to identify gaps and research waste in the dissemination of Cochrane gynaecology evidence in the Cochrane database of systematic reviews (CDSR). Design A research article Setting The Cochrane Gynaecology and Fertility (CGF) Group’s specialised register of random controlled trials (RCTs). Sample Trials looking at benign gynaecological conditions, contained in the CGF specialised register, published between the years 2010-2011. Methods Gynaecology trials from the CGF specialised register were matched, by the specific gynaecological issue and treatment, to existing Cochrane reviews. Unmatched trials were categorised to develop and prioritise new review topics. Main outcome measures Proportions Results 740 trials, published from 2010 to 2011, were exported from the specialised register, after removing duplicates and out of scope trials, 185 of these trials were found to be already included in Cochrane reviews. 422 trials were found to be unused, however 192 (26%) of these could be included in an existing CGF SR if it were updated. 230 trials (32%) were not matched to any review title and from these 21 new review titles were developed. The topic with the largest number of associated ‘unused’ trials, was ‘Plant and herbal extracts for symptoms of menopause’. Conclusions This project was used to consider unused trials, prioritise new review topics and identify those reviews that need to be updated, thereby identifying the gaps in evidence for women with gynaecological problems.

Marian Showell

and 3 more

Objective The aim of this project was to identify gaps and research waste in the dissemination of fertility evidence in the Cochrane database of systematic reviews (CDSR). Design A research article. Setting The Cochrane Gynaecology and Fertility (CGF) Group’s specialised register of random controlled trials (RCTs). Sample Infertility trials contained in the CGF specialised register, published between the years 2010-2011. Methods Infertility trials from the CGF specialised register were matched, by the specific fertility issue and treatment, to existing Cochrane reviews. Unmatched trials were categorised to develop and prioritise new review topics. Main outcome measures Proportions Results 564 trials, published from 2010 to 2011, were exported from the specialised register and after removing duplicates, 318 trials were found to be already included in a Cochrane review. 187 (37%) of trials were found to be unused, however 115 (23%) of these could be included in an existing CGF SR, if it were updated. 72 trials (14%) were not matched to any review topic and from these, eight new Cochrane review titles were developed. The topic with the largest number of associated ‘unused’ trials, was ‘Traditional Chinese Medicine for women undergoing assisted reproductive techniques’. Conclusions This project was used to consider unused trials, prioritise new review topics and identify those reviews that need to be updated, thereby identifying the gaps in evidence for couples with fertility problems. Keywords research waste, gaps, fertility, infertility, randomized controlled trials, systematic reviews, prioritisation.

James Duffy

and 4 more

Sir, We would like to thank Sharma and colleagues for their interest in our recent study evaluating the effectiveness and safety of surgical interventions for Bartholin’s cyst or abscess.1Their response highlights the unique opportunity offered by randomised trials, and their syntheses into meta‐analyses, to assess patient reported outcomes. We would strongly encourage researchers to select, collect and report patient reported outcomes in future research evaluating interventions for Bartholin’s cyst or abscess.2The primary outcome should be the outcome of greatest therapeutic importance to the study’s prospective hypothesis. There is currently no consensus regarding the selection of outcomes and methods of definition or measurement for randomized trials evaluating interventions for Bartholin’s cyst or abscess.3 In the absence of a standardized approach, researchers have made arbitrary decisions when choosing among several important outcomes.4 It would be useful for healthcare professionals, researchers, and women with lived experience of Bartholin’s cyst or abscess to engage in a formal consensus development process to agree appropriate primary and secondary outcomes.3We agree the use of adjuvant antibiotics is an important consideration. They were not reported by any of the included trials.5We have no experience of marsupialization performed under local anaesthetic. In our opinion, this approach would need to be evaluated within a research setting. The recent COVID-19 pandemic would provide additional impetus to undertake this much needed research.James M. N. Duffy 1,2, Emma Kirk 3, BJG Illingworth 4, K Stocking 5,Marian Showell 61 Institute for Women’s Health, University College London, London, United Kingdom.2 King’s Fertility, Fetal Medicine Research Foundation, London, United Kingdom.3 Department of Obstetrics and Gynaecology, Royal Free London NHS Trust, London, United Kingdom.4 North West Anglia NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK5 Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK6 Cochrane Gynaecology and Fertility Group, University of Auckland, Auckland, New Zealand.