- Email: [email protected]
The Cochrane Database of Systematic Reviews
714
by Helen H G Handoll DPhil Senior Lecturer in Musculoskeletal Conditions
The Cochrane Database of Systematic Reviews
Tracey E Howe PhD MSc MCSP Professor and Assistant Director (R&D) Rajan Madhok MSc FRCS FFPHM Visiting Professor*
This issue of Physiotherapy includes citations from an increasingly important source of evidence for healthcare interventions: The Cochrane Database of Systematic Reviews. Contained within The Cochrane Library, the Cochrane Database of Systematic Reviews is an electronic rather than a paper publication. Physiotherapists, in common with other health professionals, can no longer ignore the growth and potential usefulness of electronically disseminated information, as shown by the scope and number of recently published systematic reviews that have been conducted within the Cochrane Collaboration and are of relevance to physiotherapists. A selective list of titles after this leading article is followed by four abstracts of recently published reviews. Further selections will be published quarterly. Systematic Reviews As many physiotherapists and readers of Physiotherapy are probably aware, systematic reviews are one of the keystones of evidence-based medicine (Mulrow, 1994). These are based on a clearly defined question, and use systematic and explicit methods to identify, select and critically appraise all relevant research, to collect and analyse data from eligible studies, and to present results and draw conclusions. Where statistical techniques are used to pool the results of included studies, systematic reviews are often called meta-analyses. Many systematic reviews in the Cochrane Database of Systematic Reviews and elsewhere consider evidence only from prospective trials that have employed random methods to allocate patients to the intervention groups under comparison. This is because randomised controlled trials are more likely to provide valid evidence of the relative effectiveness of the interventions under comparison (Sackett and Wennberg, 1997; Sibbald and Roland, 1998). Often Cochrane reviews also include evidence from trials using quasi-randomised methods, such as by date of birth or alternation of treatment allocation. Such methods are less satisfactory because the allocation is predictable and could be subverted. While other study designs are not generally included at present, there is a growing interest in developing guidelines and methodology towards including these in the future. The Cochrane Collaboration and Physiotherapy The Cochrane Database of Systematic Reviews is the biggest and best full text source of systematic reviews world-wide, and is growing steadily in size and coverage: in the fourth issue in 2002 of the Cochrane Library there were 1,519 reviews, of which 63 were entirely new and 28 were substantive updates of Physiotherapy December 2002/vol 88/no 12
existing reviews. In addition, there were 1,136 protocols for future reviews, with 102 appearing for the first time. All these reviews and protocols, which were prepared using a tailored software package (Review Manager), are refereed and appear in a standardised format. The Cochrane Database of Systematic Reviews, which is currently updated on a quarterly basis, is the key product of the Cochrane Collaboration (http://www.cochrane.org), which was established just ten years ago. It is an international not-for-profit organisation that aims to facilitate well-informed decisions by preparing, maintaining and disseminating systematic reviews of the effects of healthcare interventions. The structure and operation of the Cochrane Collaboration and its relevance to physiotherapy has already been described in this Journal (Newham, 1995). This lead article gives only a summary of the pertinent points, together with an update. Preparation and upkeep of systematic reviews for publication in the Cochrane Database of Systematic Reviews is the main activity of 49 international Collaborative Review Groups, which cover most of the important areas of healthcare, including professional practice. The members of these groups – healthcare professionals, researchers, people using the health ser vices (consumers), and others – have come together because they share an interest in generating reliable up-to-date evidence relevant to the prevention, treatment and rehabilitation of particular health problems or groups of problems. Each Collaborative Review Group has an editorial team, which is international in composition, comprising coordinating editor(s), other editors, the review group *All the authors are associated with the School of Health and Social Care, University of Teesside, Middlesbrough TS1 3BA
Lead article
co-ordinator (who organises the day-to-day activities and may hold the only salaried position) and, often, one or two other support persons, including a trial search co-ordinator (usually salaried). Reviews are carried out by individuals or groups of professionals, often in their own time and usually without financial reward. The selection of a topic for review is strongly influenced by their personal interests and expertise in the subject. It is this special interest that helps to maintain a long-term commitment to keeping reviews up to date; one of the key principles of the Cochrane Collaboration. Identification of, so far as possible, all of the relevant controlled trials is fundamental to the production of valid reviews (Egger and Davey Smith, 1998). Many individuals, within Collaborative Review Groups and other Cochrane entities, have contributed to this effort; in particular by systematic hand searches of specialist and mainline journals and conference proceedings. Their output has led to the second key product of the Cochrane Collaboration, the Cochrane Central Register of Controlled Trials – formerly the Cochrane Controlled Trials Register – which appears in the Cochrane Library and, again, is updated quarterly. One Cochrane entity of specific relevance to physiotherapists and related disciplines is the Cochrane Rehabilitation and Related Therapies Field (http://www.fdg.unimaas.nl/epid/cochrane/field. htm). Early discussions on the development of this entity were reported by Newham (1995). So far, this entity has achieved a substantial database of trials, reviews and guidelines, and has provided support in other ways to Collaborative Review Groups and reviewers. The database acted as core material for PEDro, the Physiotherapy Evidence Database: http://ptwww.cchs.usyd.edu.au/pedro. A bonus of PEDro is that the included randomised controlled trials have been systematically rated for methodological quality. For physiotherapists, though, the main development since 1995 has been the increasing numbers of Cochrane reviews covering areas of immediate relevance to physiotherapy. An inspection of reviews and substantive updates published in the four issues of this year's (2002) Cochrane Database of Systematic Reviews confirms this. There are also other, but older, Cochrane reviews of direct relevance but here we present the most recent material. Abstracts of four of the Cochrane reviews listed are also published in this issue. This feature will recur on a quarterly basis, upon publication of subsequent issues of the Cochrane Database of Systematic Reviews. The hyperlinks in the listing will enable rapid access to the other abstracts. The Cochrane Library The Cochrane Librar y can be considered the key resource for information on the effectiveness of
715
healthcare interventions. As well as including the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and full information about the Cochrane Collaboration, it contains five other databases. Three are compiled by the NHS Centre for Reviews and Dissemination (http://www0.york.ac.uk/inst/crd/): the Database of Abstracts of Reviews of Effectiveness, the NHS Economic Evaluation Database, and the Health Technology Assessment database (including material from the International Network of Agencies for Health Technology Assessment). The other two databases focus on review methodology: the Cochrane Database of Methodology Reviews and the Cochrane Methodology Register. Access to The Cochrane Library The Cochrane Library, and thus the Cochrane Database of Systematic Reviews, may be accessed in various ways, predominantly via the Internet. All NHS health professionals in the UK have full and free access through the National electronic Library for Health (NeLH) gateway/site: http://www.nelh.nhs.uk. This is a key website and we recommend it highly. Some countries have bought a licence to allow their populations free use of The Cochrane Librar y. By October 2002 national provision had been bought by Australia, England and Wales, Finland, Ireland and Norway. The abstracts of reviews are available to everyone without charge. While we have provided the specific web page for each review in our list, the abstracts for all the reviews can be accessed via the Cochrane Collaboration website (http://www.cochrane.org) or directly from Update-Software Ltd, the publishers of The Cochrane Librar y (http://www.updatesoftware.com/Cochrane/). Both websites enable users to browse or search the Cochrane Database of Systematic Reviews. We expect that for most people help with accessing and using The Cochrane Library will be available locally. Training courses and materials for librarians and others with local responsibility for facilitating the use of The Cochrane Library are available from the NHS Centre for Reviews and Dissemination, and further help from The Cochrane Library Users Group. For all these resources please see http://www1.york.ac.uk/inst/crd/clibintro.htm Invitation to Contribute Finally, we encourage you to consider actively contributing to the efforts of the Cochrane Collaboration, especially in areas of evidence-based physiotherapy. You can do this by participating in a review, either from the start or helping with an update, covering a well-defined and focused area which you think is interesting and where it is important to get answers. Support is available from Cochrane Review Group editorial teams, although the Physiotherapy December 2002/vol 88/no 12
716
reviews require meticulous attention to detail and take time to carry out. However, they are worth while and instructive, especially in terms of critical appraisal of research methodology. Given the diverse spread of interests and conditions treated by physiotherapists, we suggest that you look at the list of Collaborative Review Groups (http://www.cochrane.org/ cochrane/crgs.htm#CRGLIST) and bring up the contact details of the group that covers the condition in which you are interested. If this is not be apparent, please consider contacting the Rehabilitation and Related Therapies field. Acknowledgements
References Egger, M and Davey Smith, G (1998). ‘Meta-analysis: Bias in location and selection of studies’, BMJ, 316, 61-66. Mulrow, C D (1994). ‘Rationale for systematic reviews’, BMJ, 309, 597-599. Newham, D (1995). ‘The Cochrane Collaboration: What is it, how does it work, and what has it to do with physiotherapy?’ Physiotherapy, 81, 7, 405-407. Sackett, D L and Wennberg, J E (1997). ‘Choosing the best research design for each question’, BMJ, 315, 1636. Sibbald, B and Roland, M (1998). 'Understanding controlled trials: Why are randomised controlled trials important?' BMJ, 316, 201.
We thank Mike Clarke, Rob de Bie and Kate Light for their advice and encouragement. Address for Correspondence Professor Tracey E Howe, School of Health and Social Care, University of Teesside, Middlesbrough TS1 3BA. E-mail: [email protected]
Cochrane Review Citations Conducted within the Cochrane Collaboration, the systematic reviews listed below have been selected for their relevance to physiotherapy. They are all in The Cochrane Library, issue 4, 2002, Oxford, published by Update Software. Abstracts may be accessed without charge through the addresses shown after each entry.
Newly Published Reviews Acupuncture and electro-acupuncture for the treatment of rheumatoid arthritis, Casimiro, L, Brosseau, L, Milne, S, Robinson, V, Wells, G and Tugwell, P. http://www.cochrane.org/cochrane/revabstr/ab003788.htm Acupuncture for lateral elbow pain, Green, S, Buchbinder, R, Barnsley, L, Hall, S, White, M, Smidt, N and Assendelft, W. http://www.cochrane.org/cochrane/revabstr/ab003527.htm Advice to stay active as a single treatment for low back pain and sciatica, Hilde, G, Hagen, K B, Jamtvedt, G and Winnem, M. http://www.cochrane.org/cochrane/revabstr/ab003632.htm Cognitive rehabilitation for spatial neglect following stroke, Bowen, A, Lincoln, N B and Dewey, M. http://www.cochrane.org/cochrane/revabstr/ab003586.htm Deep transverse friction massage for treating tendinitis, Brosseau, L, Casimiro, L, Milne, S, Robinson, V, Shea, B, Tugwell, P and Wells, G. http://www.cochrane.org/cochrane/revabstr/ab003528.htm Different functional treatment strategies for acute lateral ankle ligament injuries in adults, Kerkhoffs, G M M J, Struijs, P A A, Marti, R K, Assendelft, W J J, Blankevoort, L and van Dijk, C N. http://www.cochrane.org/cochrane/revabstr/ab002938.htm
Physiotherapy December 2002/vol 88/no 12
Electrical stimulation for the treatment of rheumatoid arthritis, Pelland, L, Brosseau, L, Casimiro, L, Robinson, V, Tugwell, P and Wells, G. http://www.cochrane.org/cochrane/revabstr/ab003687.htm Electromagnetic fields for the treatment of osteo-arthritis, Hulme, J, Robinson, V, DeBie, R, Wells, G, Judd, M and Tugwell, P. http://www.cochrane.org/cochrane/revabstr/ab003523.htm Exercise for preventing and treating osteoporosis in postmenopausal women, Bonaiuti, D, Shea, B, Iovine, R, Negrini, S, Robinson, V, Kemper, H C, Wells, G, Tugwell, P and Cranney, A. http://www.cochrane.org/cochrane/revabstr/ab000333.htm Exercise for treating fibromyalgia syndrome, Busch, A, Schachter, C L, Peloso, P M and Bombardier, C. http://www.cochrane.org/cochrane/revabstr/ab003786.htm In-hospital care pathways for stroke, Kwan, J and Sandercock, P. http://www.cochrane.org/cochrane/revabstr/ab002924.htm Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults, Kerkhoffs, G M M J, Rowe, B H, Assendelft, W J J, Kelly, K, Struijs, P A A and van Dijk, C N. http://www.cochrane.org/cochrane/revabstr/ab003762.htm Multidisciplinary bio-psycho-social rehabilitation for chronic low back pain, Guzmán, J, Esmail, R, Karjalainen, K, Malmivaara, A, Irvin, E, and Bombardier, C. http://www.cochrane.org/cochrane/revabstr/ab000963.htm Nocturnal non-invasive positive pressure ventilation for stable chronic obstructive pulmonary disease, Wijkstra, P J, Lacasse, Y, Guyatt, G H and Goldstein, R S. http://www.cochrane.org/cochrane/revabstr/ab002878.htm
by Helen H G Handoll DPhil Senior Lecturer in Musculoskeletal Conditions
The Cochrane Database of Systematic Reviews
Tracey E Howe PhD MSc MCSP Professor and Assistant Director (R&D) Rajan Madhok MSc FRCS FFPHM Visiting Professor*
This issue of Physiotherapy includes citations from an increasingly important source of evidence for healthcare interventions: The Cochrane Database of Systematic Reviews. Contained within The Cochrane Library, the Cochrane Database of Systematic Reviews is an electronic rather than a paper publication. Physiotherapists, in common with other health professionals, can no longer ignore the growth and potential usefulness of electronically disseminated information, as shown by the scope and number of recently published systematic reviews that have been conducted within the Cochrane Collaboration and are of relevance to physiotherapists. A selective list of titles after this leading article is followed by four abstracts of recently published reviews. Further selections will be published quarterly. Systematic Reviews As many physiotherapists and readers of Physiotherapy are probably aware, systematic reviews are one of the keystones of evidence-based medicine (Mulrow, 1994). These are based on a clearly defined question, and use systematic and explicit methods to identify, select and critically appraise all relevant research, to collect and analyse data from eligible studies, and to present results and draw conclusions. Where statistical techniques are used to pool the results of included studies, systematic reviews are often called meta-analyses. Many systematic reviews in the Cochrane Database of Systematic Reviews and elsewhere consider evidence only from prospective trials that have employed random methods to allocate patients to the intervention groups under comparison. This is because randomised controlled trials are more likely to provide valid evidence of the relative effectiveness of the interventions under comparison (Sackett and Wennberg, 1997; Sibbald and Roland, 1998). Often Cochrane reviews also include evidence from trials using quasi-randomised methods, such as by date of birth or alternation of treatment allocation. Such methods are less satisfactory because the allocation is predictable and could be subverted. While other study designs are not generally included at present, there is a growing interest in developing guidelines and methodology towards including these in the future. The Cochrane Collaboration and Physiotherapy The Cochrane Database of Systematic Reviews is the biggest and best full text source of systematic reviews world-wide, and is growing steadily in size and coverage: in the fourth issue in 2002 of the Cochrane Library there were 1,519 reviews, of which 63 were entirely new and 28 were substantive updates of Physiotherapy December 2002/vol 88/no 12
existing reviews. In addition, there were 1,136 protocols for future reviews, with 102 appearing for the first time. All these reviews and protocols, which were prepared using a tailored software package (Review Manager), are refereed and appear in a standardised format. The Cochrane Database of Systematic Reviews, which is currently updated on a quarterly basis, is the key product of the Cochrane Collaboration (http://www.cochrane.org), which was established just ten years ago. It is an international not-for-profit organisation that aims to facilitate well-informed decisions by preparing, maintaining and disseminating systematic reviews of the effects of healthcare interventions. The structure and operation of the Cochrane Collaboration and its relevance to physiotherapy has already been described in this Journal (Newham, 1995). This lead article gives only a summary of the pertinent points, together with an update. Preparation and upkeep of systematic reviews for publication in the Cochrane Database of Systematic Reviews is the main activity of 49 international Collaborative Review Groups, which cover most of the important areas of healthcare, including professional practice. The members of these groups – healthcare professionals, researchers, people using the health ser vices (consumers), and others – have come together because they share an interest in generating reliable up-to-date evidence relevant to the prevention, treatment and rehabilitation of particular health problems or groups of problems. Each Collaborative Review Group has an editorial team, which is international in composition, comprising coordinating editor(s), other editors, the review group *All the authors are associated with the School of Health and Social Care, University of Teesside, Middlesbrough TS1 3BA
Lead article
co-ordinator (who organises the day-to-day activities and may hold the only salaried position) and, often, one or two other support persons, including a trial search co-ordinator (usually salaried). Reviews are carried out by individuals or groups of professionals, often in their own time and usually without financial reward. The selection of a topic for review is strongly influenced by their personal interests and expertise in the subject. It is this special interest that helps to maintain a long-term commitment to keeping reviews up to date; one of the key principles of the Cochrane Collaboration. Identification of, so far as possible, all of the relevant controlled trials is fundamental to the production of valid reviews (Egger and Davey Smith, 1998). Many individuals, within Collaborative Review Groups and other Cochrane entities, have contributed to this effort; in particular by systematic hand searches of specialist and mainline journals and conference proceedings. Their output has led to the second key product of the Cochrane Collaboration, the Cochrane Central Register of Controlled Trials – formerly the Cochrane Controlled Trials Register – which appears in the Cochrane Library and, again, is updated quarterly. One Cochrane entity of specific relevance to physiotherapists and related disciplines is the Cochrane Rehabilitation and Related Therapies Field (http://www.fdg.unimaas.nl/epid/cochrane/field. htm). Early discussions on the development of this entity were reported by Newham (1995). So far, this entity has achieved a substantial database of trials, reviews and guidelines, and has provided support in other ways to Collaborative Review Groups and reviewers. The database acted as core material for PEDro, the Physiotherapy Evidence Database: http://ptwww.cchs.usyd.edu.au/pedro. A bonus of PEDro is that the included randomised controlled trials have been systematically rated for methodological quality. For physiotherapists, though, the main development since 1995 has been the increasing numbers of Cochrane reviews covering areas of immediate relevance to physiotherapy. An inspection of reviews and substantive updates published in the four issues of this year's (2002) Cochrane Database of Systematic Reviews confirms this. There are also other, but older, Cochrane reviews of direct relevance but here we present the most recent material. Abstracts of four of the Cochrane reviews listed are also published in this issue. This feature will recur on a quarterly basis, upon publication of subsequent issues of the Cochrane Database of Systematic Reviews. The hyperlinks in the listing will enable rapid access to the other abstracts. The Cochrane Library The Cochrane Librar y can be considered the key resource for information on the effectiveness of
715
healthcare interventions. As well as including the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and full information about the Cochrane Collaboration, it contains five other databases. Three are compiled by the NHS Centre for Reviews and Dissemination (http://www0.york.ac.uk/inst/crd/): the Database of Abstracts of Reviews of Effectiveness, the NHS Economic Evaluation Database, and the Health Technology Assessment database (including material from the International Network of Agencies for Health Technology Assessment). The other two databases focus on review methodology: the Cochrane Database of Methodology Reviews and the Cochrane Methodology Register. Access to The Cochrane Library The Cochrane Library, and thus the Cochrane Database of Systematic Reviews, may be accessed in various ways, predominantly via the Internet. All NHS health professionals in the UK have full and free access through the National electronic Library for Health (NeLH) gateway/site: http://www.nelh.nhs.uk. This is a key website and we recommend it highly. Some countries have bought a licence to allow their populations free use of The Cochrane Librar y. By October 2002 national provision had been bought by Australia, England and Wales, Finland, Ireland and Norway. The abstracts of reviews are available to everyone without charge. While we have provided the specific web page for each review in our list, the abstracts for all the reviews can be accessed via the Cochrane Collaboration website (http://www.cochrane.org) or directly from Update-Software Ltd, the publishers of The Cochrane Librar y (http://www.updatesoftware.com/Cochrane/). Both websites enable users to browse or search the Cochrane Database of Systematic Reviews. We expect that for most people help with accessing and using The Cochrane Library will be available locally. Training courses and materials for librarians and others with local responsibility for facilitating the use of The Cochrane Library are available from the NHS Centre for Reviews and Dissemination, and further help from The Cochrane Library Users Group. For all these resources please see http://www1.york.ac.uk/inst/crd/clibintro.htm Invitation to Contribute Finally, we encourage you to consider actively contributing to the efforts of the Cochrane Collaboration, especially in areas of evidence-based physiotherapy. You can do this by participating in a review, either from the start or helping with an update, covering a well-defined and focused area which you think is interesting and where it is important to get answers. Support is available from Cochrane Review Group editorial teams, although the Physiotherapy December 2002/vol 88/no 12
716
reviews require meticulous attention to detail and take time to carry out. However, they are worth while and instructive, especially in terms of critical appraisal of research methodology. Given the diverse spread of interests and conditions treated by physiotherapists, we suggest that you look at the list of Collaborative Review Groups (http://www.cochrane.org/ cochrane/crgs.htm#CRGLIST) and bring up the contact details of the group that covers the condition in which you are interested. If this is not be apparent, please consider contacting the Rehabilitation and Related Therapies field. Acknowledgements
References Egger, M and Davey Smith, G (1998). ‘Meta-analysis: Bias in location and selection of studies’, BMJ, 316, 61-66. Mulrow, C D (1994). ‘Rationale for systematic reviews’, BMJ, 309, 597-599. Newham, D (1995). ‘The Cochrane Collaboration: What is it, how does it work, and what has it to do with physiotherapy?’ Physiotherapy, 81, 7, 405-407. Sackett, D L and Wennberg, J E (1997). ‘Choosing the best research design for each question’, BMJ, 315, 1636. Sibbald, B and Roland, M (1998). 'Understanding controlled trials: Why are randomised controlled trials important?' BMJ, 316, 201.
We thank Mike Clarke, Rob de Bie and Kate Light for their advice and encouragement. Address for Correspondence Professor Tracey E Howe, School of Health and Social Care, University of Teesside, Middlesbrough TS1 3BA. E-mail: [email protected]
Cochrane Review Citations Conducted within the Cochrane Collaboration, the systematic reviews listed below have been selected for their relevance to physiotherapy. They are all in The Cochrane Library, issue 4, 2002, Oxford, published by Update Software. Abstracts may be accessed without charge through the addresses shown after each entry.
Newly Published Reviews Acupuncture and electro-acupuncture for the treatment of rheumatoid arthritis, Casimiro, L, Brosseau, L, Milne, S, Robinson, V, Wells, G and Tugwell, P. http://www.cochrane.org/cochrane/revabstr/ab003788.htm Acupuncture for lateral elbow pain, Green, S, Buchbinder, R, Barnsley, L, Hall, S, White, M, Smidt, N and Assendelft, W. http://www.cochrane.org/cochrane/revabstr/ab003527.htm Advice to stay active as a single treatment for low back pain and sciatica, Hilde, G, Hagen, K B, Jamtvedt, G and Winnem, M. http://www.cochrane.org/cochrane/revabstr/ab003632.htm Cognitive rehabilitation for spatial neglect following stroke, Bowen, A, Lincoln, N B and Dewey, M. http://www.cochrane.org/cochrane/revabstr/ab003586.htm Deep transverse friction massage for treating tendinitis, Brosseau, L, Casimiro, L, Milne, S, Robinson, V, Shea, B, Tugwell, P and Wells, G. http://www.cochrane.org/cochrane/revabstr/ab003528.htm Different functional treatment strategies for acute lateral ankle ligament injuries in adults, Kerkhoffs, G M M J, Struijs, P A A, Marti, R K, Assendelft, W J J, Blankevoort, L and van Dijk, C N. http://www.cochrane.org/cochrane/revabstr/ab002938.htm
Physiotherapy December 2002/vol 88/no 12
Electrical stimulation for the treatment of rheumatoid arthritis, Pelland, L, Brosseau, L, Casimiro, L, Robinson, V, Tugwell, P and Wells, G. http://www.cochrane.org/cochrane/revabstr/ab003687.htm Electromagnetic fields for the treatment of osteo-arthritis, Hulme, J, Robinson, V, DeBie, R, Wells, G, Judd, M and Tugwell, P. http://www.cochrane.org/cochrane/revabstr/ab003523.htm Exercise for preventing and treating osteoporosis in postmenopausal women, Bonaiuti, D, Shea, B, Iovine, R, Negrini, S, Robinson, V, Kemper, H C, Wells, G, Tugwell, P and Cranney, A. http://www.cochrane.org/cochrane/revabstr/ab000333.htm Exercise for treating fibromyalgia syndrome, Busch, A, Schachter, C L, Peloso, P M and Bombardier, C. http://www.cochrane.org/cochrane/revabstr/ab003786.htm In-hospital care pathways for stroke, Kwan, J and Sandercock, P. http://www.cochrane.org/cochrane/revabstr/ab002924.htm Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults, Kerkhoffs, G M M J, Rowe, B H, Assendelft, W J J, Kelly, K, Struijs, P A A and van Dijk, C N. http://www.cochrane.org/cochrane/revabstr/ab003762.htm Multidisciplinary bio-psycho-social rehabilitation for chronic low back pain, Guzmán, J, Esmail, R, Karjalainen, K, Malmivaara, A, Irvin, E, and Bombardier, C. http://www.cochrane.org/cochrane/revabstr/ab000963.htm Nocturnal non-invasive positive pressure ventilation for stable chronic obstructive pulmonary disease, Wijkstra, P J, Lacasse, Y, Guyatt, G H and Goldstein, R S. http://www.cochrane.org/cochrane/revabstr/ab002878.htm