Evidence-Based Cancer Nursing: Cancer Nursing and the Cochrane Collaboration
Chan, Raymond Javan PhD(c), MAppSc (Research), BN, RN, FRCNA
Author Affiliation: Cancer Care Services, Royal Brisbane and Women’s Hospital; School of Nursing and Midwifery, University of Queensland, Brisbane; and Research Centre for Clinical Practice Innovation, Griffith University, Nathan, Queensland, Australia.
The author has no funding or conflicts of interest to disclose.
Correspondence: Raymond Javan Chan, PhD(c), MAppSc (Research), BN, RN, FRCNA, Cancer Care Services, Royal Brisbane and Women’s Hospital, Herston Q4029, Australia (email@example.com).
Accepted for publication March 18, 2012.
Anumber of Cochrane systematic review summaries have been published in Cancer Nursing since 2010.1–4 These summaries are the outcomes of the Evidence Transfer Program (Review Summaries), which is an initiative between the Cochrane Nursing Care Field and Cancer Nursing. The participation of Cancer Nursing in this program has demonstrated its commitment to promote evidence-based practice among cancer nurses internationally.
But why the Cochrane Collaboration? The Cochrane Collaboration is a not-for-profit organization established in 1993, following a British medical researcher’s call for systematic, up-to-date reviews of all relevant randomized controlled trials.5,6 To date, over 4600 systematic reviews have been published online in The Cochrane Library.6 Systematic reviews are the highest level of evidence and have been increasingly used as the standard approach in summarizing health research and influencing healthcare decisions.7 Standards of these systematic reviews include having clearly stated objectives with predefined eligibility criteria for studies; an explicit reproducible methodology; a systematic search that attempts to identify all studies that would meet the eligibility criteria; an assessment of the validity of the findings of the included studies, for example, through the assessment of risk of bias; and a systematic presentation and synthesis of the characteristics of findings of the included study.5 While the quality of non–Cochrane systematic reviews varies,8,9 the Cochrane Collaboration has the credibility that its reviews adhere to the above standards very consistently.5
The Cochrane Collaboration has 52 review groups composed of individuals around the world who share an interest in developing and maintaining systematic reviews relevant to a particular health area.10 These reviews group are disease-specific (eg, Gynecological Cancer Group, Childhood Cancer Group, Breast Cancer Group), rather than discipline-specific. Although none of the review groups is nursing-specific, there is a strong nursing involvement in contributing to the high-quality systematic reviews.11
The published summaries in Cancer Nursing thus far have confirmed the relevancy of Cochrane reviews for informing cancer nursing practice. As cancer nurses, we need to further examine our practice and ensure that it is evidence based. Numerous clinical issues require further attention and good evidence from cancer nurses. For example, as cancer nurses, we are challenged to provide the right amount of right information at the right time to cancer patients. In examining the evidence in this area, a Cochrane review was conducted to aid decision making of information giving at the beginning of a patient’s journey.12 In contrast, when a Cochrane review13 reports that a practice is not supported by any evidence, we need to question using such practices.14 Cochrane reviews have direct implications for decision making among cancer nurses and policy makers.
I used to think that I could only make a difference in the individuals that I cared for (patients or caregivers/families) and that I would not be able to contribute to cancer care at a higher level. However, conducting and disseminating Cochrane reviews have been extremely fulfilling for me as a cancer/palliative care nurse, because I know that my work can truly impact the quality of cancer care at an international level. I am encouraged to see that Cancer Nursing is facilitating research utilization among cancer nurses by providing highly accessible and relevant summaries of Cochrane reviews. I hope that an increasing number of cancer nurses will contribute to evidence-based cancer nursing practice by conducting Cochrane reviews. We will together continue to support and advance the conduct, dissemination, and utilization of high-quality systematic reviews in the future.
1. Chan R. Cochrane review summary for cancer nursing: influenza vaccination in children having chemotherapy for cancer. Cancer Nurs. 2010; 33 (4): 327–328.
2. Chan R. Cochrane review summary for cancer nursing: drug therapy for the management of cancer-related fatigue. Cancer Nurs. 2011; 34 (3): 250–251.
3. Konno R. Cochrane review summary for cancer nursing: acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cancer Nurs. 2010; 33 (6): 479–480.
4. Ye X, Chu J. Cochrane review summary for cancer nursing: nonhormonal interventions for hot flushes in women with a history of breast cancer. Cancer Nurs. 2011; 34 (5): 423–424.
5. Higgins J, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions. Chichester, England: John Wiley & Sons Ltd; 2008.
7. Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet. 1993; 342 (8883): 1317–1322.
8. Choi PT, Halpern SH, Malik N, Jadad AR, Tramer MR, Walder B. Examining the evidence in anesthesia literature: a critical appraisal of systematic reviews. Anesth Analg. 2001; 92 (3): 700–709.
9. Hoving JL, Gross AR, Gasner D, et al.. A critical appraisal of review articles on the effectiveness of conservative treatment for neck pain. Spine. 2001; 26 (2): 196–205.
11. Davison CM, Sochan A, Pretorius R. Are Cochrane Collaboration systematic reviews relevant resources for evidence-based nursing internationally? Int J Nurs Stud. 2010; 47 (7): 795–797.
12. Chan RJ, Webster J, Marquart L. Information interventions for orienting patients and their carers to cancer care facilities. Cochrane Database Syst Rev. 2011; 12: CD008273.
13. Chan R, Webster J. End-of-life care pathways for improving outcomes in caring for the dying. Cochrane Database Syst Rev. 2010; (1): CD008006.
14. Chan R, Webster J. A national rollout of an insufficiently evaluated practice: how evidence based are our end-of-life care policies? J Palliat Med. 2011; 14 (7): 802; author reply 803.
© 2013 Lippincott Williams & Wilkins, Inc.
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