Updating of systematic reviews is generally more efficient than starting all over again when new evidence emerges, but to date there has been no clear guidance on how to do this. This guidance helps authors of systematic reviews, commissioners, and editors decide when to update a systematic review, and then how to go about updating the review.

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Background Bronchiectasis is a chronic respiratory disease characterised by abnormal dilatation of the bronchi, and presents typically with a chronic productive cough (or chronic wet cough in children) and recurrent infective exacerbations. It significantly impacts daily activities and quality of life, and can lead to recurrent hospitalisations, severe lung function impairment, respiratory failure and even death. Objectives To provide an overview of the efficacy and safety of interventions for adults and children with bronchiectasis from Cochrane reviews. To identify gaps in the evidence base that will inform recommendations for new research and reviews, and to summarise information on reported outcomes and make recommendations for the reporting of standard outcomes in future trials and reviews. Methods We included Cochrane reviews of non-cystic fibrosis (CF) bronchiectasis. We searched the Cochrane Database of Systematic Reviews. The search is current to 11 February 2015. We also identified trials that were potentially eligible for, but not currently included in, published reviews to make recommendations for new Cochrane reviews. We assessed the quality of included reviews using the AMSTAR criteria. We presented an evidence synthesis of data from reviews alongside an evidence map of clinical trials and guideline data. The primary outcomes were exacerbations, lung function and quality of life. Main results We included 21 reviews but extracted data from, and rated the quality of, only nine reviews that reported results for people with bronchiectasis alone. Of the reviews with no usable data, two reviews included studies with mixed clinical populations where data were not reported separately for people with bronchiectasis and 10 reviews did not contain any trials. Of the 40 studies included across the nine reviews, three (number of participants nine to 34) included children. The studies ranged from single session to year-long studies. Each review included from one to 11 trials and 28 (70%) trials in the overview included 40 or fewer participants. The total number of participants included in reviews ranged from 40 to 1040. The age range of adult participants was from 36 to 73 years and children Interventions for bronchiectasis: an overview of Cochrane systematic reviews (Review)

Background Caffeine has a variety of pharmacological effects; it is a weak bronchodilator and it also reduces respiratory muscle fatigue. It is chemically related to the drug theophylline which is used to treat asthma. It has been suggested that caffeine may reduce asthma symptoms and interest has been expressed in its potential role as an asthma treatment. A number of studies have explored the effects of caffeine in asthma; this is the first review to systematically examine and summarise the evidence. Objectives To assess the effects of caffeine on lung function and identify whether there is a need to control for caffeine consumption prior to either lung function or exhaled nitric oxide testing. Search methods We searched the Cochrane Airways Group trials register and the reference lists of articles (August 2011). We also contacted study authors. Selection criteria We included randomised trials (RCTs) of oral caffeine compared to placebo or coffee compared to decaffeinated coffee in adults with asthma. Data collection and analysis Two review authors independently carried out trial selection, quality assessment and data extraction. Main results We included seven trials involving a total of 75 people with mild to moderate asthma. The studies were all of cross-over design. Six trials involving 55 people showed that in comparison with placebo, caffeine, even at a 'low dose' (less than 5 mg/kg body weight), appears to improve lung function for up to two hours after consumption. Forced expiratory volume in one second (FEV1) showed a small improvement up to two hours after caffeine ingestion (standardised mean difference 0.72; 95% confidence interval 0.25 to 1.20),

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Analysis 1.1. Comparison 1 Fluticasone/Salmeterol (FPS) versus Tiotropium (Tio), Outcome 1 Mortality (All-cause). Analysis 1.2. Comparison 1 Fluticasone/Salmeterol (FPS) versus Tiotropium (Tio), Outcome 2 Hospital Admission. Analysis 1.3. Comparison 1 Fluticasone/Salmeterol (FPS) versus Tiotropium (Tio), Outcome 3 Exacerbations (all cause