Cochrane for Clinicians

These are summaries of reviews from the Cochrane Library.

Jan 1, 2020 Issue
Intrapartum Omega-3 Fatty Acid Intake and Length of Gestation
Omega-3 fatty acids, whether taken as supplements or consumed as part of the diet, reduce the risk of preterm birth (number needed to treat = 68) and early preterm birth (number needed to treat = 55).

Jan 1, 2020 Issue
Positional Therapy for Obstructive Sleep Apnea
Positional therapy for OSA reduces scores on the apnea-hypopnea index (AHI) and Epworth Sleepiness Scale compared with no treatment. Although continuous positive airway pressure (CPAP) improves AHI scores more than positional therapy, patients seem to better tolerate positional therapy and, therefore, have improved adherence vs. those treated with CPAP.

Dec 1, 2019 Issue
Combined Hormonal Contraceptives for Heavy Menstrual Bleeding
Combined oral contraceptives decrease the number of women reporting menorrhagia over six months compared with placebo (absolute risk reduction = 36.7%; number needed to treat = 2.7).

Dec 1, 2019 Issue
General Health Checks in Adults for Reducing Disease-Related Morbidity and Mortality
General health check visits have no benefit on cardiovascular morbidity or on total, cardiovascular, or cancer-related mortality. There is also no evidence that they cause patient harm.

Nov 1, 2019 Issue
Renin-Angiotensin System Inhibitors vs. Other Antihypertensive Drug Classes for Hypertension
RAS inhibitors, which include angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, and renin inhibitors, should not be used as first-line agents.

Nov 1, 2019 Issue
Oral H1 Antihistamines as Add-on Therapy to Topical Treatment for Eczema
In children with eczema, there is no evidence to support the addition of oral H1 antihistamines to standard treatment regimens. In adults, the use of fexofenadine (Allegra), 120 mg per day, improves patient-assessed eczema symptoms compared with placebo (number needed to treat = 11; 95% CI, 5.5 to 255).

Oct 1, 2019 Issue
Effectiveness and Safety of Factor Xa Inhibitors in Patients with Atrial Fibrillation
Treatment of AFib with a factor Xa inhibitor results in a decrease in the combined end point of stroke and embolic events (odds ratio [OR] = 0.89; 95% CI, 0.82 to 0.97), as well as a decrease in intracranial hemorrhage (OR = 0.50; 95% CI, 0.42 to 0.59) and all-cause mortality (OR = 0.89; 95% CI, 0.83 to 0.95) compared with warfarin (Coumadin) therapy.

Oct 1, 2019 Issue
Antihypertensive Drug Therapy for Mild to Moderate Hypertension During Pregnancy
Compared with placebo, antihypertensive drug therapy for mild to moderate hypertension (defined by the authors as a blood pressure of 140 to 169 mm Hg systolic or 90 to 109 mm Hg diastolic) caused by chronic hypertension, gestational hypertension, or preeclampsia during pregnancy does not affect any pregnancy outcomes.

Sep 1, 2019 Issue
Treatment of Threatened Miscarriage with Progestogens
Progestogens reduce the risk of miscarriage when compared with placebo in patients with threatened miscarriage (number needed to treat [NNT] = 10.) Use of progestogens poses no significant risks to mother or baby.

Sep 1, 2019 Issue
Use of Amphetamines for Attention Deficit/Hyperactivity Disorder in Adults
Amphetamines provide a clinician-rated 30% or greater reduction in ADHD symptoms when compared with placebo (number needed to treat = 5).

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