Cochrane Collaboration

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The Cochrane Collaboration
Cclogo.svg
Motto Working together to provide the best evidence for health care
Formation 1993 (1993)
Type International NPO
Purpose Independent research into data about health care
Headquarters Oxford, England
Region served Worldwide
Official language English
Steering Group Co-Chairs Jeremy Grimshaw,
Lisa Bero[1]
Volunteers Over 31,000 (2013)[2]
Website www.cochrane.org

The Cochrane Collaboration is an independent, non-profit, non-governmental organization consisting of a group of more than 31,000 volunteers in more than 120 countries.[3] The collaboration was formed to organize medical research information in a systematic way to facilitate the choices that health professionals, patients, policy makers and others face in health interventions according to the principles of evidence-based medicine.[4][5]

The group conducts systematic reviews of randomized controlled trials of health-care interventions, which it publishes in The Cochrane Library.[6][7] A few reviews (in fields such as occupational health) have also studied the results of non-randomized, observational studies.

The collaboration formed an official relationship in January 2011 with the World Health Organization (WHO) as a partner non-governmental organization with a seat on the World Health Assembly to provide input into WHO resolutions.[8][9]

History[edit]

The Cochrane Collaboration was founded in 1993 under the leadership of Iain Chalmers. It was developed in response to Archie Cochrane's call for up-to-date, systematic reviews of all relevant randomized controlled trials of health care.[10][11]

Cochrane's suggestion that the methods used to prepare and maintain reviews of controlled trials in pregnancy and childbirth should be applied more widely was taken up by the Research and Development Programme, initiated to support the United Kingdom's National Health Service. Through the NHS R&D programme, led by the first Director of Research and Development Professor Michael Peckham,[12] funds were provided to establish a "Cochrane Centre", to collaborate with others, in the UK and elsewhere, to facilitate systematic reviews of randomized controlled trials across all areas of health care.[13][14]

In October 1995 the Collaboration formed the Cochrane Consumer Network[15] to incorporate patient perspectives into the review process. Shortly thereafter, new "plain language summaries" provided users with a jargon-free synopsis of each systematic review.[16]

The Cochrane Collaboration is currently concentrating on capacity building in health research is individuals, groups, and institutions in LMICs [17]

[edit]

The logo of the Cochrane Collaboration illustrates a meta analysis of data from seven randomized controlled trials (RCTs), comparing one health care treatment with a placebo in a forest plot. The diagram shows the results of a systematic review and meta analysis on inexpensive course of corticosteroid given to women about to give birth too early – the evidence on effectiveness that would have been revealed had the available RCTs been reviewed systematically a decade earlier. This treatment reduces the odds of the babies of such women dying from the complications of immaturity by 30–50%. Because no systematic review of these trials had been published until 1989, most obstetricians had not realized that the treatment was so effective and therefore many premature babies have probably suffered or died unnecessarily.[18]

Reception[edit]

An editorial in the Canadian Medical Association Journal in 2004 noted that Cochrane reviews appear to be more updated and of better quality than other reviews and due to their standardized methodologies, was "the best single resource for methodologic research and for developing the science of meta-epidemiology." Their work has also led to methodological improvements in the medical literature. However, the editorial also noted areas for improvement remained, including adequately assessing potential harms from medical interventions and providing a more user friendly format as well as promoting international collaboration.[19]

Studies comparing the quality of Cochrane Collaboration meta analyses in the fields of infertility,[20] physiotherapy[21] and orthodontics,[22] to those published by other sources have concluded that Cochrane Reviews incorporate superior methodological rigor. A broader analysis across multiple therapeutic areas reached similar conclusions but was performed by Cochrane authors.[23] Compared to non-Cochrane reviews, those from the Cochrane collaboration are less likely to reach a positive conclusion about the utility of medical interventions.[24] Key criticisms that have been directed at the Collaboration's studies include a failure to include a sufficiently large number of unpublished studies, failure to pre-specify or failure to abide by pre-specified rules for endpoint[25] or trial[26] inclusion, insufficiently frequent updating of reviews, an excessively high percentage of inconclusive reviews,[27] and a high incidence of ghostwriting and honorary authorship.[28][29] In some cases the Collaboration's internal structure may make it difficult to publish studies that run against the pre-conceived opinions of internal subject matter experts.[30]

An ongoing systematic review being performed by Cochrane authors will examine the potential impact of selective inclusion of results in meta analyses, comparing Cochrane to non-Cochrane studies.[31]

Cochrane Centres[edit]

The Cochrane Collaboration is split into smaller divisions based on a number of factors, one of these being geographical location, Cochrane Centres are responsible for the Cochrane Review groups in their respective regions, also working on promoting evidence based healthcare and access to their Reviews.[32]

United Kingdom Cochrane Centre[edit]

The United Kingdom Cochrane Centre (UKCC) [33] is the first Centre of the Cochrane Collaboration. Funded mostly by the National Institute for Health Research (NIHR).

Almost half of all Cochrane Review Groups are based/ or have bases in the United Kingdom; almost 34% of all authors in the Cochrane Collaboration are based in the UK. [34]

The UKCC activities include: The Learn + Teach Programme, The Engagement Programme, and The Guidelines Project. [35]

South Asian Cochrane Network and Centre[edit]

The South Asian Cochrane Network & Centre (SASIANCC)[36] is a part of the global network of Cochrane Collaboration, and is located at the Christian Medical College, Vellore, India. The centre, originally the South Asian Cochrane Centre, was established in January 2004, as a branch of the Australasian Cochrane Centre, with geographical responsibility for South Asia (Afghanistan, Bangladesh, Bhutan, India, Sri Lanka, Pakistan, the Maldives and Nepal). SASIANCC is hosted by the Prof Bhooshanam V Moses Centre for Evidence-Informed Healthcare at the Carman Block at the Christian Medical College (CMC) Campus, Bagayam, Vellore since December 2004 in memory of the late Prof Bhooshanam Vasanthakumar Moses at the suggestion of his MBBS colleagues, who also donated funds towards establishing the Centre with the aim of increasing the uptake of reliable and locally relevant evidence to inform health decisions, and to co-ordinate the activities of the South Asian Cochrane Network. In July 2008 it was re-designated as an independent centre of The Cochrane Collaboration, with a co-ordinating centre at the Christian Medical College, Vellore, in India, and five network sites in India, two in Pakistan, one in Sri Lanka, and one in Bangladesh.

Its projects have included the National Snakebite Survey in India,[37] the South Asian Toxicology Network, the Cochrane Student Journal Club [38] and the South Asian Database of Controlled Clinical Trials.

United States Cochrane Center[edit]

The United States Cochrane Center (USCC) was established in December 2002 and operates out of three offices.[39] The main office is headquartered at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. The USCC is dedicated to promoting awareness of the Cochrane Collaboration and its objectives and access to The Cochrane Library in the United States. The USCC main office in Baltimore is responsible for, among other things, providing training and support for review authors, Trials Search Coordinators, Review Group Coordinators, editors, handsearchers, consumers and others.[40]

A special function of the USCC is to support Consumers United for Evidence-based Healthcare (CUE), a partnership with health and consumer advocacy organizations interested in integrating understanding and interpretation of evidence-based healthcare into their advocacy activities, strengthening the voice of consumers in healthcare research, and providing leadership in these areas. From 1994 to 2005, the USCC coordinated development of the Cochrane Central Register of Controlled Trials (CENTRAL), a source of reports of controlled clinical trials worldwide, a master list of journals being searched, and handsearcher training.

The San Francisco Branch of the United States Cochrane Center operates out of the University of California, San Francisco and develops and evaluates systems for assessing and sustaining the quality of Cochrane reviews.

The Caribbean Branch of the USCC was launched in June 2013 and is the reference center for English-speaking Caribbean territories. The branch is housed at the University of the West Indies in Mona, Jamaica.

Brazilian Cochrane Center[edit]

The Brazilian Cochrane Center was established in 1996 and it is connected to the Federal University of São Paulo (UNIFESP), one of the largest in Brazil, through the Post-Graduation Course in Evidence-Based Healthcare. It is a training center in systematic literature reviews and research methodology and, in addition to the teaching activities, with workshops and online courses, the Brazilian Cochrane Center acts also offering scientific consulting for specific research projects.

The Cochrane Center of Brazil has a scientific production comparable to similar institutions of European countries. It works as a laboratory for primary clinical research and for the production of systematic reviews of the literature, having published more than 200 articles in international journals, with new scientific evidence to assist in decision making about health.

The Brazilian Cochrane Center also performs systematic reviews and other studies commissioned by the Brazilian Ministry of Health to verify the effectiveness and cost-effectiveness of preventive and treatment procedures and technologies to be adopted by public hospitals and primary care centers of the National Health System (SUS). The Brazilian Cochrane Center has offered one-year courses in Evidence Based Medicine and systematic reviews to nearly 10,000 health professionals working for the Ministry of Health in 25 of the 27 Brazilian states who are responsible for evaluating technologies, medicines and medical equipment for the SUS.

Thus, the Cochrane Center of Brazil cooperates with the world Cochrane Collaboration both in the area of education and training and in research.

Cochrane Review Groups[edit]

All in all there are 53 Cochrane Review Groups within the Collaboration, covering different subject areas in healthcare. The contributors to these groups vary from researchers to consumers of healthcare services to healthcare professionals.

Campbell & Cochrane Equity Methods Group[edit]

The Campbell and Cochrane Equity Methods is co-registered with the Cochrane Collaboration and the Campbell Collaboration. It is based at the London School of Hygiene and Tropical Medicine and the University of Ottawa. The group encourages authors of Campbell and Cochrane systematic reviews to consider the effect of the interventions on the disadvantaged or their ability to reduce inequities in health.[41] The group provides guidance to authors who want to incorporate equity into their reviews and has developed tools for planning, conducting, and reporting these systematic reviews.[41]

Cochrane Acute Respiratory Infections Group[edit]

The Cochrane Acute Respiratory Infections group is registered since 1994. Its editorial base is currently located in the Bond University in Australia.The group deals with healthcare interventions aimed at prevention, treatment and rehabilitation aspects of acute respiratory infections including diphtheria,meningitis,measles and chickenpox. About 175 systematic reviews have been conducted under its purview.

Cochrane Eyes and Vision Group[edit]

The Cochrane Eyes and Vision Group has been registered with the Cochrane Collaboration since 1997. Its editorial base is currently located at the London School of Hygiene & Tropical Medicine in London, England, with a satellite group at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.[42] The group prepares systematic reviews of all the interventions used to prevent or treat eye diseases and/or visual impairment.[43][44] Additionally, the group considers the evidence for interventions that aim to help people adjust to visual impairment or blindness.

Cochrane Musculoskeletal Group[edit]

The Cochrane Musculoskeletal Group has been registered with the Cochrane Collaboration since 1993. Its editorial base is currently located at the University of Ottawa in Canada, with satellite groups at Cabrini Institute, Melbourne, Australia, at the University of Alabama at Birmingham, United States, and at the Hôpital Hôtel-Dieu de Paris, Université Paris Descartes, France.[45] The group prepares up-to-date reviews for the treatment, prevention or rehabilitation of musculoskeletal disorders.[46][47] Additionally, also provides secondary products to make the evidence more friendly for those involved in treatments for musculoskeletal diseases.[48]

Cochrane Occupational Health and Safety Review Group[edit]

The Occupational Health and Safety (OSH) Review Group [49] is one of the 53 review groups in the Cochrane Collaboration. The OSH group publishes reviews of the effectiveness of interventions to reduce occupational diseases, injuries and disability. Currently there are 126 review OSH-related topics in the Cochrane Library. The editorial base is located in Kuopio, Finland and funded by the Finnish Institute of Occupational Health.

Wikipedia's relationship with the Cochrane Collaboration[edit]

In October 2013, Wikipedia and the Cochrane Collaboration announced a collaborative venture, the announced goals of which include increasing the incorporation of Cochrane research in Wikipedia articles and providing Wikipedia editors with additional resources and assistance in interpreting medical data.[50] The Cochrane Collaboration and John Wiley and Sons, the publisher of the Cochrane Reviews, provide financial support for the collaboration in the form of 100 free Cochrane Reviews accounts made available to Wikipedia medical editors, the financial value of which has been estimated by the Cochrane Collaboration at $30,000 to $80,000 dollars per annum. Other support includes a nominal stipend and travel expenses for a Wikipedian in Residence at Cochrane.[51]

In 2014 the Cochrane Collaboration blog hosted a rebuttal[52] written by two Wikipedia medical editors in response to an article critical of the accuracy of Wikipedia medical content published in the Journal of the American Osteopathic Association.[53]

See also[edit]

References[edit]

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  47. ^ Ghogomu, EA; Maxwell, LJ; Buchbinder, R; Rader, T; Pardo Pardo, J; Johnston, RV; Christensen, RD; Rutjes, AW; Winzenberg, TM; Singh, JA; Zanoli, G; Wells, GA; Tugwell, P; Editorial Board of the Cochrane Musculoskeletal, Group (Feb 2014). "Updated method guidelines for cochrane musculoskeletal group systematic reviews and metaanalyses.". The Journal of rheumatology 41 (2): 194–205. doi:10.3899/jrheum.121306. PMID 24293581. 
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  50. ^ "Editorial :: Cochrane and Wikipedia: the collaborative potential for a quantum leap in the dissemination and uptake of trusted evidence - The Cochrane Library". 
  51. ^ "Wikipedia:Cochrane/Wikipedian in Residence - Wikipedia, the free encyclopedia". 
  52. ^ "Is Wikipedia’s medical content really 90% wrong? | The Cochrane Collaboration". 
  53. ^ Hasty RT, Garbalosa RC, Barbato VA, et al. (May 2014). "Wikipedia vs peer-reviewed medical literature for information about the 10 most costly medical conditions". J Am Osteopath Assoc 114 (5): 368–73. doi:10.7556/jaoa.2014.035. PMID 24778001. 

External links[edit]