In September 2017 the Cochrane Skin Group has been running for 20 years, and we are proud of the 100+ high quality systematic reviews that have been produced over that period. Our expanding portfolio, and the increasing number of non-Cochrane systematic reviews, means that we need to take stock and prioritise Cochrane Skin reviews going forward. We want to ensure that Cochrane Skin reviews are the reviews most needed by our stakeholders. We are particularly interested in reviews that are key to informing guidelines or policy, or that are funded by our stakeholders. We are also particularly interested in doing methodologically challenging systematic reviews that involve techniques such as network meta-analysis, individual patient meta-analysis and diagnostic test accuracy reviews.
With this in mind, we have undertaken a prioritisation exercise, asking for suggestions from a wide range of stakeholders about what reviews or updates they would like us to prioritise over the next two years.
Our Deputy Co-ordinating Editor, Dr Bob Boyle, led the project, which began in January 2017. Our aim was to identify titles which were 1) key to informing guidelines or policy, 2) not already well-covered by a Cochrane systematic review, and 3) of maximum clinical importance and greatest relevance to patients and health care funders.
We consulted a wide range of stakeholders (such as professional societies, guideline development groups, healthcare commissioners, the CSG membership and patient representatives) to ask for title suggestions.
We then reviewed prioritisation exercises undertaken by the James Lind Alliance (JLA) and others and suggestions for further research made by national and international guideline groups. Furthermore, skin disorders identified as carrying a significant global burden in the Global Burden of Disease (GBD) project and their representation in the CSG portfolio were considered and gaps identified.
We were open to suggestions of completely new review questions that had never been registered, as well as updates of existing reviews where there may be important new evidence. We asked that suggestions were about healthcare interventions, i.e. the effectiveness of different approaches to preventing, treating or diagnosing skin disease.
After gathering all title suggestions and incorporating wider dermatological research results, a final shortlist was sent to our international editors, who rated their preferences. The full document can be downloaded here.
Implications of the prioritisation work
The prioritisation process is part of our response at Cochrane Skin to major changes in the way we work being requested by both Cochrane centrally and our funders. We are in the process of reviewing our current portfolio of titles and putting new processes in place in ensure we can support our priority titles effectively. If you are currently working on a legacy title not in the priority list, you will still be able to submit it to the editorial process. However, our aim over time is to only work on titles from among our priorities. The prioritisation process will be undertaken again in 18-24 months’ time and we encourage all our members to contribute to it.
The Global Burden of Disease Project (GBD) with the WHO has identified 13 skin conditions within the scope of the Cochrane Skin Group that will help to guide our efforts. In the order in which they have an effect on DALYs (disability adjusted life years): dermatitis, acne, bacterial and viral skin diseases, urticaria, fungal skin diseases, pruritus, alopecia areata, cellulitis, melanoma, psoriasis, non-melanoma skin cancer and leprosy.
The International League of Dermatology Societies (ILDS) have launched an initiative to address the challenge of achieving global skin health and have identified 9 criteria which should guide progress with NMSC, acne and psoriasis.