Tony Cenicola/The New York Times

Cochrane systematic reviews have provided further support in the benefits and safety of fortifying wheat with folic acid.

August 24, 2022

Cornell and Partners Host Evidence Synthesis and Systematic Reviews in Nutrition for Global Policy Making

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From July 4 to July 25, the University’s Division of Nutritional Sciences collaborated with the World Health Organization and Cochrane to host the eighth annual Summer Institute for Systematic Reviews in Nutrition for Global Policy Making.  

Cochrane is a global network of medical practitioners, scientific researchers, public health professionals and others in the healthcare field. These contributors produce accessible, unbiased health information.  

As a WHO Collaborating Center on Nutrition Research for Health and a Cochrane Center for Nutrition affiliate, the division partners with WHO to develop systematic reviews and inform clinical and public health guidelines.  

The three week long summer institute allowed 27 scientists and practitioners from the Americas, Africa, Europe and South-East Asia to apply scientific evidence in policy making for nutrition guidelines and programs. 

The Summer Institute brings together people from academia, government and non-governmental organizations, including program director Dr. Pat Cassano, faculty Drs. Julia L. Finkelstein and Saurabh Mehta, in addition to nutritional sciences doctoral candidate and teaching fellow Elizabeth Centeno Tablante.  

“The Summer Institute aims to improve and develop technical skills and knowledge in the development of systematic reviews of nutritional interventions using a hands-on approach in a small group setting,” Dr. Cassano said. 

“In addition, participants in the institute gain an understanding of the process of global policy making in nutrition and the role of evidence synthesis,” she added.

Evidence synthesis is heavily emphasized within the Cochrane framework. 

“Cochrane reviews are the cornerstone for guidelines and policies used and implemented in medicine and public health. The Cochrane network also is continuously developing methods to conduct systematic reviews,” Dr. Finkelstein, associate professor of epidemiology and nutrition, said. 

Systematic reviews help address a specific question using predefined and transparent methods to help understand data and evidence from scientific research. Patients, policy makers, program implementers and researchers use these reviews to make informed decisions such as breastfeeding in the context of COVID-19 or folic acid flour fortification programs for prevention of anemia and neural tube defects.

For example, a Cochrane systematic review on the benefits and safety of fortifying wheat or maize flour with folic acid and population health outcomes, led by Centeno Tablante and Dr. Finkelstein, found that fortification with folic acid–the synthetic form of folate–may improve folate status and reduce the occurrence of neural tube defects. 

“We review, evaluate and summarize the data and information from research to address a specific question using standardized methods. In this way, a systematic review offers a summary of all the available evidence on a specific topic or research question,” Tabalnte said. 

This year’s summer institute followed a virtual format and included both synchronous and asynchronous sessions. The first week involved the completion of self-paced training modules on Cochrane methods for systematic reviews. During their second week, participants took part in live sessions such as seminars, hands-on workshops and group discussions led by experts from WHO, Cochrane and the University. 

“During the live and interactive sessions, the participants gain valuable insights into the evidence synthesis process and how it fits in the development of health guidelines,” Dr. Finkelstein said. 

Some of the featured faculty panelists were Dr. Juan Pablo Peña-Rosas, human ecology, and Dr. Hector Pardo-Hernandez from the WHO, who talked about the WHO guideline development process and innovations underway for the guidelines for the prevention and treatment of obesity currently under development. 

Other faculty members included Dr. Lee Hopper, editor for the Cochrane Heart Group; Dr. Jordi Pardo-Pardo, managing editor for the Cochrane Musculoskeletal Group; and Damian Francis, former Co-Director of Cochrane Caribbean. 

They discussed the current methods for evaluating risk of bias—with the Cochrane Risk of Bias Tool 2.0—the certainty of evidence gathered for systematic reviews, the use of software developed for systematic reviews, and Logic Models as an important component to contextualize evidence in a systematic review. 

This year marked the eighth anniversary of this Summer Institute. As part of this Summer Institute for Systematic Reviews in Nutrition for Global Policy Making in collaboration with the WHO, Cochrane and the University, there have been over 11 Cochrane systematic reviews and 15 published protocols. Systematic reviews developed during the summer institutes have also contributed to more than 12 health and nutrition guidelines from WHO and other international agencies.