Cochrane has a commitment to producing and sharing high quality health evidence to as broad an audience as possible. Cochrane partnered in 2014 with Wikipedia, with the joint goal of improving the quality and reliability of human health-related articles that people are accessing online.

Jennifer Dawson, PhD, is a Wikipedia Consultant for Cochrane . Her role includes maintaining and building further relations with Wikipedia, connecting new editors to the Wikipedia community, and supporting requests for engagement in Wikipedia work from the Cochrane community. We interviewed Jennifer to learn more about the Cochrane-Wikipedia partnership:

Why should we care about Wikipedia?
Millions of people around the world access health-related information on Wikipedia each day. Medical-related articles are available in over 286 languages on Wikipedia and often come up early on an internet search. The readership base varies broadly and includes members of the public, medical students, medical professionals, journalists, and policy makers (More info here). Given that so many people are consulting Wikipedia on a daily basis, we feel that Cochrane’s commitment to producing and sharing high quality health evidence includes sharing that evidence where people are accessing it.

How can I get involved?
Nearly half of all Cochrane Reviews are already shared on Wikipedia! Cochrane is presently the most frequently cited peer-reviewed medical journal on Wikipedia (More info here).  English Wikipedia includes over 36,000 health-related articles and there are over 3000 Cochrane reviews that are not yet shared on Wikipedia. There are two main ways you can get involved:

1.    Add new Cochrane Evidence to Wikipedia - Every three months, a new list of Cochrane Reviews to consider for Wikipedia is generated. Reviews to consider for Wikipedia are organized by Cochrane Review Group and can be access here:  Cochrane Review List (English).

2.    Ensure that the evidence already shared on Wikipedia is accurate, unbiased, and up to date. - Volunteers are needed to review what is presently shared in Wikipedia. Wikipedia articles that include out dated versions of Cochrane Reviews need to be updated. Cochrane maintains a list of Reviews that need updating. This list is refreshed monthly to include recently updated Cochrane Reviews: Cochrane-Wikipedia Update Project.

How can I edit Wikipedia in languages other than English?
Cochrane has active projects in many different languages including Spanish, French, and Dutch. Please visit the “Projects” tab project page to learn more about specific projects: Cochrane-Wikipedia Projects.

How can I learn how to edit Wikipedia?
Cochrane has developed and collated numerous training resources. Our newest resource, the Wikipedian in Training Resource, is the best place to begin. This resource shares suggested first steps, ideas for how to practice editing, and an example of the general workflow of editing Wikipedia and sharing Cochrane evidence.

Jennifer can be found on Wikipedia at: JenOttawa and by email at jdawson@cochrane.org. Please visit the Cochrane-Wikipedia Project Page for more information.

Readable, clinically-focused, actionable answers to inform point-of-care decision-making for health professionals. 

Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically-focused entry point to rigorous research from Cochrane Reviews. They are designed to be actionable and to inform point-of-care decision-making. Each CCA contains a clinical question, a short answer, and data for the outcomes from the Cochrane Review deemed most relevant to practicing healthcare professionals. The evidence is displayed in a user-friendly tabulated format that includes narratives, data, and links to graphics.

Read the CCAs for the following Special Collections:

• Evidence relevant to clinical rehabilitation
• Support for wellbeing in the healthcare workforce
• Remote care through telehealth
• Effective options for quitting smoking during the pandemic
• Infection control and prevention measures
• Evidence relevant to acute and critical care
• Regional anaesthesia to reduce drug use in anaesthesia and avoid aerosol generation
• Optimizing health in the home workspace

The Following CCAs are free as part of the Special Collection on support for evidence relevant to clinical rehabilitation.

• What are the effects of interventions used to prevent critical illness polyneuropathy or myopathy in patients in intensive care units?
• Does neuromuscular electrical stimulation improve outcomes in adults with advanced disease who have muscle weakness?
• What are the effects of present‐centered therapy for adults with post‐traumatic stress disorder (PTSD)?
• How do internet‐based cognitive and behavioral therapies compare with usual care for adults with post‐traumatic stress disorder (PTSD)?
• What are the benefits of cognitive behavioral therapy (with a therapist's support) when delivered over the Internet?
• What are the benefits and harms of psychological therapies for children in low‐ and middle‐income countries affected by humanitarian crises?
• What are the benefits and harms of psychological therapies for adults in low‐ and middle‐income countries affected by humanitarian crises?
• For people recovering from admission to an intensive care unit (ICU), what are the benefits of patient diaries?
• For critically ill people, do cough augmentation techniques help extubation or weaning from mechanical ventilation?
• For people with neuromuscular disease, what are the effects of respiratory muscle training?

The following CCAs are free as part of the Special Collection on support for wellbeing in the healthcare workforce.

•  How do proactive and request‐based ethical case interventions compare with usual care for adults in intensive care units?
•  Is there randomized controlled trial evidence to support the use of interventions for preventing occupational irritant hand dermatitis?
• Do additional work breaks improve musculoskeletal symptoms and work performance?
• Do psychological interventions help foster resilience among healthcare students?
• What intervention, organizational and individual characteristics impact the implementation of interventions to support frontline health and social care professionals during and after a disease outbreak, epidemic, or pandemic?
  
• For shift workers, what are the effects of person‐directed, non‐pharmacological interventions for preventing sleepiness at work and sleep disturbances?
• Does human resource management training for supervisors improve the health and well‐being of employees?
• For employees, how do computer‐based stress management programs compare with in‐person programs?
• What are the effects of mindfulness‐based psychological interventions for medical students and junior doctors?

The following CCAs are free as part of our Special Collection on the remote care through telehealth.

• What are health workers' perceptions and experiences of using mHealth technologies to deliver primary healthcare services?
• What are the perceptions and experiences of targeted digital communication via mobile devices for reproductive, maternal, child, and adolescent health?
• In people with diabetes, what are the effects of interactive telemedicine?
• In people with heart failure, what are the effects of interactive telemedicine?
• What are the benefits and harms of home telemonitoring and remote feedback between clinic visits in people with asthma?
• How do remote check‐ups compare with face‐to‐face check‐ups in people with asthma?
• For people with asthma, how does shared decision‐making affect outcomes?
• Does mobile phone text messaging improve medication adherence for secondary prevention of cardiovascular disease (CVD)?
• What are the effects of mobile phone–based interventions for primary prevention of cardiovascular disease (CVD)?
• What are the benefits and harms of structured telephone support or non‐invasive telemonitoring in patients with heart failure?
• Can remotely delivered cognitive‐behavioral therapy (CBT) help children and adolescents manage chronic pain?
• How do personalized digital interventions to reduce hazardous and harmful alcohol consumption compare with no/minimal intervention in community‐dwelling populations?
• For women seeking induced abortion, how does self‐administered abortion compare with provider‐administered abortion?
• What is the accuracy of teledermatology using photographic images for detection of invasive melanoma or atypical intraepidermal melanocytic variants?
• May telemedicine provide support to parents of high‐risk newborn infants?
• For adults with type 2 diabetes mellitus, what are the effects of computer‐based diabetes self‐management interventions?
• How do face‐to‐face interventions compare with remote interventions for promoting physical activity in older adults?
• For people with stroke, how does telerehabilitation compare with usual care?
• Do mobile phone–based interventions improve the use of contraception?
• What are the effects of specialist home‐based nursing services for children with acute and chronic illness?
•  What are the effects of telephone counseling for informal carers of people with dementia?
• What are the effects of telephone interventions for providing education and support to informal caregivers of ill adults?
• For pregnant and postpartum women, does targeted client communication improve maternal and neonatal health?
• For adults with suspicious skin lesions, can smartphone applications (apps) accurately rule out cutaneous invasive melanoma and atypical intraepidermal melanocytic variants? 
• For adults, does targeted client communication (TCC) via mobile devices help improve sexual and reproductive health?
• For adolescents, does targeted client communication (TCC) via mobile devices help improve sexual and reproductive health?
• For people with neuromuscular disease, what are the effects of respiratory muscle training?
• Do automated telephone communication systems (ATCSs) improve immunization rates?
• Do automated telephone communication systems (ATCSs) improve cancer screening rates?
• What are the effects of telephone support for women during pregnancy and the first six weeks postpartum?

The following CCAs are free as part of our Special Collection on the effective options for quitting smoking during the pandemic

• How do single over‐the‐counter nicotine replacement therapy (NRT) agents compare with placebo/no NRT agents for smoking cessation?
• How does combination nicotine replacement therapy (NRT) compare with monotherapy for people trying to quit smoking?
• How do tailored and non‐tailored internet‐based interventions for smoking cessation in adults compare with active and inactive controls and with each other?
• Is randomized controlled trial evidence available to support the use of mobile phone–based interventions for smoking cessation?
• What are the effects of telephone counseling for smoking cessation?
• How do different smoking reduction interventions compare in terms of long‐term (≥ 6 months) smoking cessation?
• How do tailored and non‐tailored self‐help interventions compare with no self‐help or each other for smoking cessation?

The following CCAs are free as part of our Special Collection on infection control and prevention measures

• What are the organizational, environmental, and individual barriers and facilitators affecting healthcare workers' adherence to infection prevention and control (IPC) guidelines for respiratory infectious diseases?
• Which type of personal protective equipment (PPE), and which interventions to increase PPE use by healthcare workers, help reduce the spread of highly infectious diseases?
• What are the effects of multimodal campaigns to improve hand hygiene of healthcare workers?
• What are the effects of performance feedback, education, and olfactory/visual cues on hand hygiene of healthcare workers?
• Do gloves, gowns, and masks reduce transmission of MRSA in the hospital setting?
• What are the effects of chlorhexidine bathing for preventing hospital‐acquired infection in people admitted to intensive care units (ICUs)?
• What are the organizational, environmental, and individual barriers and facilitators affecting healthcare workers' adherence to infection prevention and control (IPC) guidelines for respiratory infectious diseases?

• During epidemics, how effective are digital contact tracing technologies for identifying secondary cases and close contacts?

• What are the effects of quarantine for close contacts of people with confirmed COVID‐19?

• What are the effects of quarantine for individuals traveling from a country with a declared COVID‐19 outbreak?

• What are the effects of quarantine plus other measures for controlling the spread of COVID‐19?

• What is the accuracy of symptom screening and elicitation of information about travel history and exposure to a known infected person for diagnosing severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection?

• How do antimicrobial coolants compare with one another or with placebo for reducing contaminated aerosols during dental procedures?

• How does high‐volume evacuation (HVE) compare with no HVE or alternative dental suction for reducing contaminated aerosols during dental procedures?

• Does an education intervention in nursing homes help prevent the transmission of methicillin‐resistant Staphylococcus aureus (MRSA)?
• Does gowning by attendants and visitors in newborn nurseries help prevent neonatal morbidity and mortality?
• Do educational interventions improve respiratory protective equipment (RPE) use in the workplace?
  
• What is the accuracy of immunoglobulin G (IgG) and IgM antibody tests for detection of SARS‐CoV‐2 infection?
• Does healthcare worker education improve adherence to standard precautions for controlling health care‐associated infections?
• What evidence is available on measures implemented in school settings to reopen schools and/or keep schools open during the COVID‐19 pandemic?
• What is the accuracy of World Health Organization (WHO)‐specified and related COVID‐19 symptoms for diagnosis of COVID‐19?
• What is the accuracy of rapid, point‐of‐care antigen and molecular‐based tests for the diagnosis of SARS‐CoV‐2 infection?
• What are the effects of international travel restrictions on the spread of COVID‐19?
• What are the effects of quarantining travelers crossing international borders (with or without screening) on the spread of COVID‐19?
• What are the effects of entry and/or exit screening at international borders on the spread of COVID‐19?
• What are healthcare workers' (HCWs’) perceptions and experiences in communicating with older adults (≥ 50 years) about vaccination?
• What are the effects of COVID‐19 entry regulation measures in long‐term care facilities (LTCFs)?
• What are the effects of contact regulation and transmission‐reducing measures on COVID‐19 in long‐term care facilities (LTCFs)?
• What are the effects of COVID‐19 outbreak control measures in long‐term care facilities (LTCFs)?
• What are the effects of COVID‐19 surveillance measures in long‐term care facilities (LTCFs)?
• Do measures implemented in the school setting help contain the COVID‐19 pandemic?
• How do cuffed endotracheal tubes compare with uncuffed endotracheal tubes for neonates and young infants requiring mechanical ventilation?

The following CCAs are free as part of our Special Collection on  evidence relevant to acute and critical care

• For people with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation, how do conservative and liberal oxygen targets compare?
• What is the accuracy of airway physical examination tests for detection of difficult laryngoscopy in adults?
• What is the accuracy of the modified Mallampati test for detection of difficult intubation in adults?       
• What is the accuracy of airway physical examination tests for detection of difficult face mask ventilation in adults?
• For children with sepsis or septic shock, how does liberal fluid therapy compare with conservative fluid therapy?
• How do colloids compare with crystalloids for fluid resuscitation in critically ill people?
• How do buffered solutions compare with 0.9% saline for critically ill people requiring intravenous fluid therapy?
• How does norepinephrine compare with other vasopressors in people with hypotensive shock?
• How does a high‐flow nasal cannula compare with low‐flow oxygen for adults in intensive care requiring respiratory support?
• What are the effects of recruitment maneuvers for adults with acute respiratory distress syndrome receiving mechanical ventilation?
• How does a semi‐recumbent position compare with a supine position in adults requiring mechanical ventilation?
• How do pressure and volume‐controlled ventilation compare in people with acute respiratory failure or distress syndrome?
• How does interruption of daily sedation compare with no interruption for critically ill adults requiring invasive mechanical ventilation?
• How does protocolized compare with non‐protocolized weaning off mechanical ventilation for critically ill adults?
• For adults admitted to the intensive care unit (ICU), how do different oxygenation levels compare?
• How does prone positioning compare with supine positioning for ventilation in adults with severe acute respiratory failure?
• What are the effects of pharmacological agents for adults with acute respiratory distress syndrome (ARDS)?
• For adults with influenza admitted to hospital, what are the effects of corticosteroids given to relieve symptoms associated with sever influenza?
• For adults with acute respiratory distress syndrome (ARDS) who are mechanically ventilated, how does immunonutrition compare with standard formula feeding?
• Which regimen is most effective at improving outcomes in critically ill adults with hospital‐acquired pneumonia: short‐course or prolonged‐course antibiotic therapy?
• In children admitted to hospital with community‐acquired pneumonia, how do different antibiotics compare with each other? And In children with community‐acquired pneumonia in the ambulatory setting, what are the effects of oral antibiotics?
• In hospitalized adults with community‐acquired pneumonia, is there randomized controlled trial evidence to support the use of empiric atypical antibiotic coverage over typical antibiotic coverage?
• How does haloperidol compare with placebo for preventing delirium in critically ill adults in intensive care?
• How does enteral nutrition compare with parenteral nutrition (with or without enteral nutrition) for adults admitted to the intensive care unit (ICU)?
• What are the benefits and harms of Chinese herbs combined with Western medicine for people with severe acute respiratory syndrome (SARS)?
• What are the effects of convalescent plasma for people with COVID‐19?
• What factors affect the use of mechanical ventilation weaning protocols for critically ill people?
• What are the effects of extracorporeal membrane oxygenation for critically ill adults with acute respiratory distress syndrome (ARDS)?
• For adults with chronic obstructive pulmonary disease (COPD) and respiratory failure, how do noninvasive and invasive positive‐pressure ventilation (PPV) weaning strategies compare?
• How does a protective ventilation strategy compare with conventional ventilation for critically ill adults with acute respiratory distress syndrome?
• What are the effects of prophylactic anticoagulation for people with COVID‐19 who need respiratory support?
• What is the accuracy of immunoglobulin G (IgG) and IgM antibody tests for detection of SARS‐CoV‐2 infection?
• What is the accuracy of changes in white blood cell (WBC) count for diagnosing COVID‐19?
• How do high and low positive end‐expiratory pressure (PEEP) levels compare for mechanically ventilated adults with acute lung injury and acute respiratory distress syndrome?
• What evidence is available on care bundles for improving outcomes in people with COVID‐19 in the intensive care unit (ICU)?
• For adults with coronavirus disease 2019 (COVID‐19), what are the benefits and harms of hydroxychloroquine?
• What is the accuracy of chest computed tomography (CT) and chest X‐ray for the diagnosis of COVID‐19?
• What are the cardiovascular effects of COVID‐19?
• For adults with COVID‐19, what are the effects of the interleukin‐6 blocking agents tocilizumab and sarilumab?
• How do high and low positive end‐expiratory pressure (PEEP) levels compare for mechanically ventilated adults with acute lung injury and acute respiratory distress syndrome?
• For adults in intensive care requiring respiratory support, how does a high‐flow nasal cannula compare with standard oxygen therapy and non‐invasive (positive‐pressure) ventilation (NI[PP]V)?
• What are the effects of convalescent plasma for people with moderate to severe COVID‐19?
• For people with moderate to severe COVID‐19, what are the benefits and harms of vitamin D supplementation?
• For adults with mild or moderate symptomatic COVID‐19, what are the effects of ivermectin?
• What are the effects of remdesivir for the treatment of COVID‐19?
• Does administering post‐exposure ivermectin prevent COVID‐19 infection in asymptomatic close household contacts?
• For adults hospitalized with acute or suspected COVID‐19, what are the benefits and harms of systemic corticosteroids?
• For people with COVID‐19 and terminal disease, what are the effects of pharmacological interventions for palliative symptom control?
• What are the effects of colchicine for treatment of moderate to severe COVID‐19?
• What are the effects of colchicine for treatment of asymptomatic or mild COVID‐19?
• For adults with asymptomatic or mild COVID‐19, what are the effects of azithromycin?
• For adults hospitalized with moderate to severe COVID‐19, what are the effects of azithromycin?
• For people with moderate, severe or critical COVID‐19 illness, what are the effects of interleukin 1 (IL‐1) blocking agents (anakinra or canakinumab)?
• For people with mild COVID‐19, what are the effects of inhaled corticosteroids?
• How do higher‐dose anticoagulants compare with lower‐dose for people with moderate to severe COVID‐19?

The following CCAs are free as part of our Special Collection on regional anaesthesia to reduce drug use in anaesthesia and avoid aerosol generation

• How does neuraxial blockade compare with general anesthesia and systemic analgesia when used postoperatively?
• How does local and regional anesthesia compare with conventional analgesia for women with persistent pain after breast cancer surgery?
• How do lidocaine and bupivacaine compare with each other and with alternative local anesthetics for adults undergoing spinal anesthesia?
• How does air compare with saline in the loss of resistance technique for identification of the epidural space?
• What are the effects of different injection techniques during non-ultrasound guided axillary brachial plexus block for adults undergoing distal arm surgery?
• Can adding perineural or intravenous dexamethasone to peripheral nerve blocks improve outcomes for adults undergoing surgery?
• How does perineural dexamethasone compare with intravenous dexamethasone when used as an adjunct to peripheral nerve block in adolescents and adults undergoing surgery?
• How do peripheral nerve blocks compare with no peripheral nerve block for adults undergoing hip replacement surgery?
• How does a neuraxial block compare with general anesthesia in adults undergoing hip fracture surgery?
• How does adductor canal block compare with sham treatment or femoral nerve block for adults undergoing knee surgery?
• How does epidural pain relief compare with systemic opioid-based pain relief in people undergoing abdominal aortic surgery?
• How does epidural local anesthetics compare with opioid-based analgesia for improving outcomes in adults undergoing abdominal surgery?
• For adults with pain following intra-abdominal surgery, how does epidural analgesia compare with intravenous patient-controlled analgesia (IV PCA)?
• How does perioperative epidural analgesia compare with systemic analgesia for adults undergoing cardiac surgery?
• How does a paravertebral block compare with a thoracic epidural in people undergoing thoracotomy?
• For women undergoing cesarean section, how does hyperbaric bupivacaine compare with isobaric bupivacaine for spinal anesthesia?
• Following major shoulder surgery, how does continuous interscalene brachial plexus block compare with parenteral analgesia for pain relief?
• What are the effects of regional analgesia for improving long‐term functional outcomes after elective total knee replacement?
• How does liposomal bupivacaine peripheral nerve block compare with no nerve block or an alternative nerve block for management of postoperative pain?
• For people undergoing upper or lower limb block, how does ultrasound guidance, with or without nerve stimulation, compare with an alternative guidance technique?
• How does lidocaine alone compare with lidocaine plus epinephrine for digital nerve blocks?
•  For people post knee replacement surgery, how does femoral nerve block (FNB) compare with opioids, epidural, or local infiltration analgesia?

The following CCAs are free as part of our Special Collection on optimizing health in the home workspace

• Do additional work breaks improve musculoskeletal symptoms and work performance
• Do workplace interventions to increase standing and/or walking improve musculoskeletal symptoms among sedentary office workers
• Compared with traditional sit desks, do sit‐stand desks reduce time spent sitting at work? and For office employees, what are the effects of counseling in the workplace on time spent sitting
• What is the impact of changing workplace lighting on alertness and mood of daytime workers
• For computer users, how do progressive computer glasses to correct refractive error compare with monofocal computer glasses for people with presbyopia
• What are the effects of ergonomic equipment for prevention of musculoskeletal disorders of the upper limb and neck among office workers? and What are the effects of ergonomic training on musculoskeletal disorders of the upper limb and neck among office workers?

Get involved: The clinical answer is written either by a practicing clinician or by a CCA Editor, with the answer being peer-reviewed by a practicing clinician. If you would like to join the Clinical Answers authoring team, please contact the team at clinicalanswers@cochrane.org. We are specifically looking for clinicians in the following areas: respiratory medicine; care of the elderly; cardiovascular medicine; pregnancy and childbirth; neurology - especially epilepsy; infectious disease; paediatrics; rheumatology; ENT; and urology.

Learn more about Cochrane Clinical Answers and how they are created

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March is Endometriosis Awareness Month. Endometriosis is an inflammatory condition where endometrial tissue (tissue similar to the lining of the uterus) grows outside of the uterus. It is estimated that 1 in 10 women have endometriosis (Zondervan 2020). Endometriosis frequently presents with the symptom of pain including dysmenorrhoea (painful periods), dyspareunia (pain during sexual intercourse), and chronic pelvic or abdominal pain. Endometriosis can cause infertility and for women with subfertility the prevalence rate ranges from 25% to 40% (Ozkan 2008).

Cochrane Gynaecology and Fertility group has published over 20 intervention reviews and protocols investigating the effectiveness and safety of treatments for the management of endometriosis. In addition, they have published five diagnostic test accuracy reviews assessing the effectiveness of various tests in the diagnosis of endometriosis. They are joining #EndometriosisAwarenessMonth by sharing an updated collection of their reviews on endometriosis that focus on pain-related outcomes and fertility outcomes. The treatments include pharmacological interventions (hormonal therapy, immune-modulators, anti‐inflammatory drugs), surgery, and alternative medicine. Throughout Endometriosis Awareness Month, they will be also sharing blogs that include relevant Cochrane evidence and other information to help inform women’s decisions about endometriosis diagnosis and treatment. 

• Collection of Cochrane Reviews on endometriosis
• Cochrane Gynecology and Fertility website

Cochrane Library releases updated Special Collection on diagnosing tuberculosis

 World Tuberculosis Day is marked annually on 24 March as it commemorates the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis.

This Special Collection, curated by Cochrane contributors, includes Cochrane Reviews from the Cochrane Infectious Diseases Group and other systematic reviews from other international teams. It highlights how Cochrane evidence contributes within a wider landscape of tuberculosis evidence and guidelines. The Collection also describes key WHO guidelines on tuberculosis diagnostics, and their underpinning systematic reviews, some which are published within the WHO Guideline itself.

• View the Special Collection: Diagnosing Tuberculosis

A systematic review attempts to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a specific research question. Researchers conducting systematic reviews use explicit, systematic methods that are selected with a view aimed at minimizing bias, to produce more reliable findings to inform decision making. 

Here is a video from Cochrane Consumers and Communication that explains what a systematic review is clearly and simply for people who may not be familiar with the concepts and terminology of systematic reviews: what they are, how researchers prepare them, and why they’re an important part of making informed decisions about health - for everyone. 

Cochrane evidence provides a powerful tool to enhance your healthcare knowledge and decision making. This video from Cochrane Sweden explains a bit about how we create health evidence, including systematic reviews, and other activities of Cochrane. 

• What is the difference between a Cochrane systematic review of interventions and a Cochrane diagnostic test accuracy review?
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Updated Cochrane research concludes that there is insufficient evidence for the use of Omega-3 fatty acid supplements in treating major depressive disorder.

Omega-3 fatty acids are widely thought to be essential for good health and are naturally found in fatty fish such as mackerel; other seafood; and some nuts and seeds.

Omega-3 fatty acids have been widely promoted globally for a variety of health concerns, and are readily available as an over-the-counter supplement. These supplements have hugely increased in popularity over the last decade, together with a range of other supplements including ginseng, garlic, green tea, vitamins, minerals, and herbal products.

There have been various studies that have suggested a role for Omega-3 fatty acid supplementation in treating major depressive disorder. Adults with major depressive disorders are characterized by depressed mood or a lack of pleasure in previously enjoyed activities for at least two weeks, in the absence of any physical cause, that impact on everyday life.

Figures published in 2018 estimated prevalence rates for major depressive disorders of 163 million cases in 2017, and global incidence rates of 242 million cases, resulting in 33 million years lived with disability globally, an increase of 12.6% since 2007.

This updated Cochrane Review, published recently in the Cochrane Library, gathered together data from 28 randomized trials involving a total of 1944 participants. The trials investigated the impact of giving an Omega-3 fatty acid supplement in a capsule form and compared it to a dummy pill. In one study, involving 40 participants, researchers also investigated the impact of the same supplementation compared to an anti-depressant treatment.

The Cochrane authors found that, whilst people who were given Omega-3 fatty acids reported lower symptom scores than people with the dummy pill, the effect was small and there were important limitations that undermined their confidence in the results. Their analyses showed that although similar numbers of people experienced side effects, more data would be required to understand the risks of taking Omega-3 fatty acids.

Lead author Katherine Appleton from Bournemouth University said, “This is an update of an existing Cochrane Review, using the same methods as we previously used, with some refinements. The update includes 8 randomised controlled trials published since 2015, in addition to the 20 trials included in the previous review.

Our conclusions however remain unchanged. We found a small-to-modest positive effect of Omega-3 fatty acids compared to placebo for depressive symptomology, but the size of this effect is unlikely to be meaningful to people with depression, and we considered the evidence on which this conclusion was based to be of low or very low quality. All studies contributing to our analyses were of direct relevance to our research question, but most of these studies are small and of low quality. We also found insufficient evidence to clearly determine the effects of omega-3 oils on negative side effects or when compared with anti-depressants.”

She added, “At present, we just don’t have enough high-quality evidence to determine the effects of Omega-3 fatty acids as a treatment for major depressive disorder. It’s important that people who suffer from depression are aware of this, so that they can make more informed choices about treatment.”

• View the full update review
• View the Cochrane Common Mental Disorders Group page
• Read the press release for previous version in Spanish and Russian