Archie Cochrane

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Archibald Cochrane
Professor Archibald Leman Cochrane (Dr. Archie Cochrane).gif
Archibald Cochrane
Born Archibald Leman Cochrane
(1909-01-12)January 12, 1909
Galashiels, Scotland
Died June 18, 1988(1988-06-18) (aged 79)
Nationality Scottish
Occupation Physician

Archibald Leman Cochrane[1] (1909–1988)[2] was a Scottish doctor and pioneer of evidence based medicine.

Contents

Biography [edit]

Cochrane was born in Kirklands, Galashiels, Scotland. He qualified in 1938 at University College Hospital, London, at University College London and joined the Medical Research Council's Pneumoconiosis Unit at Llandough Hospital, a part of Welsh National School of Medicine, now Cardiff University School of Medicine in 1948. Here he began a series of studies on the health of the population of Rhondda Fach — studies which pioneered the use of randomised controlled trials (RCTs).

Cochrane’s experiences during the Spanish Civil War, where he served as a member of a British Ambulance Unit within the International Brigades, and during World War II as a captured Medical Officer at Salonika (Greece)[3] and Hildburghausen, Elsterhorst and Wittenberg an der Elbe (Germany) prisoner of war camps, led him to believe that much of medicine did not have sufficient evidence to justify its use.[1][4]

He said, "I knew that there was no real evidence that anything we had to offer had any effect on tuberculosis, and I was afraid that I shortened the lives of some of my friends by unnecessary intervention." As a result, he spent his career urging the medical community to adopt the scientific method.[1]

Academic life [edit]

In 1960 he was appointed David Davies Professor of Tuberculosis and Chest Diseases at the Welsh National School of Medicine, now Cardiff University School of Medicine and nine years later became Director of the new Medical Research Council’s Epidemiology Research Unit at 4 Richmond Road, Cardiff. His groundbreaking paper on validation of medical screening procedures, published jointly with fellow epidemiologist Walter Holland in 1971, became a classic in the field.[5]

His 1971 Rock Carling Fellowship monograph Effectiveness and Efficiency: Random Reflections on Health Services, first published in 1972,[6] was very influential. To quote Cochrane himself from the book's summary : "An investigation into the workings of the clinical sector of the NHS strongly suggests that the simplest explanation of the findings is that this sector is subject to severe inflation with the output rising much less than would be expected from the input". According to a review in the British Medical Journal, "the hero of the book is the randomized control trial, and the villains are the clinicians in the "care" part of the National Health Service (NHS) who either fail to carry out such trials or succeed in ignoring the results if they do not fit in with their own preconceived ideas".[7] Maintaining this challenge to the medical care system as he saw it, in 1978, with colleagues, he published a study of 18 developed countries in which he made the following observations: "the indices of health care are not negatively associated with mortality, and there is a marked positive association between the prevalence of doctors and mortality in the younger age groups. No explanation of this doctor anomaly has so far been found. Gross national product per head is the principal variable which shows a consistently strong negative association with mortality."[8] This work was selected for inclusion in a compendium of influential papers, from historically important epidemiologists, published by the Pan American Health Organization (PAHO/WHO) in 1988.[9]

His advocacy of randomized controlled trials eventually led to the development of the Cochrane Library database of systematic reviews, the establishment of the UK Cochrane Centre in Oxford and the international Cochrane Collaboration.

Honours [edit]

For his 'gallant and distinguished' services in prisoner of war camps he was awarded an MBE by the British Government; for his contributions to epidemiology as a science he was later awarded the CBE.

Autobiography and archive [edit]

One Man's Medicine: An Autobiography of Professor Archie Cochrane was published in 1989 and co-authored by Professor Max Blythe. The book was out of print for a number of years but a paperback edition was published by Cardiff University in April 2009 to celebrate the centenary of Cochrane's birth.[10]

The Cochrane Archive[11] is held at Llandough Hospital, Penarth.

References [edit]

  1. ^ a b c Who was Archie Cochrane? AAAS Member Central, August 15, 2011, Aria Nouri, MD
  2. ^ Cochrane, Archibald L; Blythe, Max (1989), One Man's Medicine: An autobiography of Professor Archie Cochrane, London: British Medical Journal, ISBN 0-7279-0277-6 
  3. ^ Cochrane, A L (1984), "Sickness in Salonica: my first, worst, and most successful clinical trial", Br Med J (Clin Res Ed) 289 (6460): 1726–1727, doi:10.1136/bmj.289.6460.1726 
  4. ^ Archie Cochrane (1984). "Sickness in Salonica: my first, worst, and most successful clinical trial (extract)" (pdf). 
  5. ^ Cochrane AL, Holland WW, Validation of Screening Procedures. Br Med Bull 1971; 27:3-8.
  6. ^ Cochrane, A L (1972), Effectiveness and Efficiency: Random Reflections on Health Services (2nd ed.), London: Nuffield Provincial Hospitals Trust (published 1989), ISBN 0-7279-0282-2 
  7. ^ Dollery CT, Constructive Attack. Effectiveness and Efficiency. Random Reflections on Health Services (AL Cochrane) Book Reviews. Br Med J 1972: 56
  8. ^ Cochrane AL, St Leger AS, Moore F. Health service "input" and mortality "output" in developed countries. J Epidemiol and Community Health. 1978; 32:200-205.
  9. ^ Buck C, Llopis A, Najera, Terris M (eds). The Challenge of Epidemiology: issues and selected readings. Scientific Publication No. 505. Pan American Health Organization. Washington DC. 1988.
  10. ^ The Cochrane Collaboration http://www.cochrane.org/docs/archieco.htm#ByAC
  11. ^ Archie Cochrane Archive

External links [edit]

See also [edit]

Authority control
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