10 studies (N=686 participants) included.

1. Catch 22: Is the future of systematic reviewing only for the experienced? Mahesh Jayaram1, Kai Koch2, Kamel Mansi3, Euan Haynes3, Clive E Adams3, Vivek A Furtado4 1University of Melbourne , 2 School of Medicine, University of Nottingham, UK3Cochrane Schizophrenia Group, University of Nottingham, Nottingham, UK4Forensic Psychiatry, Rampton Hospital, Retford, UK Introduction Results of the review • 10 studies (N=686 participants) included. • Clinical improvement in clinical global state at short term (< 3months) and medium term (3 -6 months)(evidence quality - low) • Fewer people receiving trifluoperazine left studies early due to relapse or worsening at medium term (2 RCTs, n=381, RR 0.34 CI 0.23 to 0.49, very low quality evidence). • No difference between trifluoperazine and placebo for outcome of leaving the study early any reason/due to severe adverse effects (medium term). • For economic outcomes, we valued outcomes for relapse and hospital discharge and presented them in additional tables (Grade C level of economic data from trials reporting limited information). • Increasingly, calls are made for those undertaking systematic reviews to have highly specialist knowledge in the field. • Some Cochrane groups prefer authors with previous experience of conducting reviews or statistical background. • ….so, experience cannot be gained except by those with experience. • The existing cohort of reviewers are getting older, there is lots of work to be done and we need young energetic reviewers! Outcome: Global state - Clinical improvement (as defined by each study) Aims • To investigate whether motivated but inexperienced people, with a bit of support and training, follow a structured template and produce a high quality Cochrane review. Materials Economic outcomes: Sensitivity analysis* Free online training* Enthusiastic Medical Student, Research assistant & a school leaver Cochrane Schizophrenia Group Straightforward review topic Published in Cochrane Library Trifluoperazine vs Placebo for Schizophrenia 153.4 days, 216 days, 3£338, 4£299, 5£376*Unlike the effectiveness data of this review, the included economic studies have not been weighted according to sample size; hence risk ratios (RR) of cost of relapse for the study population (if calculated) may not be equal to the RR as calculated by RevMan.**Cost attributed to each individual participant within each arm of the trial, irrespective of whether they relapsed or not. Discussion * For free online training visit: https://sites.google.com/site/revmantutorial1/ • Lots of high quality reviews can be conducted by those with interest, who may not have a lot of experience but gain it in the process. • These can be done relatively quickly. • A supportive environment is necessary but is available within the Collaboration. • Results of the review show that trifluoperazine is an effective drug compared to placebo for treating schizophrenia. • The unit cost of relapse is a novel way of calculating economic costs. Results of the project • The students need some help in understanding the process, data extraction, clinical application and write up. This took approximately 8 hours of one experienced reviewers time (CEA). • The review was completed in 1 month (excluding editing time) • Medical student (KK) now in final year of medical school. School student (EH) gained entry into medical school and KM gained lectureship in a leading UK university. • VF provided economic analysis and MJ edited the review. • The review process was helpful to the students. References 1. Heller J. Catch-22 / Joseph Heller. London: Corgi; 1974. 2. Koch K, Mansi K, Haynes E, Adams CE, Furtado V. Trifluoperazine versus placebo for schizophrenia. Cochrane Database Systematic Reviews 2013 (in press)