|Motto||Trusted evidence. Informed decisions. Better health.|
|Formation||1993(as Cochrane Collaboration)|
|Type||Charity in UK|
|Purpose||Independent research into data about health care|
|Leader||Martin Burton and Margerite Koster|
|Over 37,000 (2015) |
Cochrane is a British charity formed to organise medical research findings so as to facilitate evidence-based choices about health interventions faced by health professionals, patients, and policy makers. Cochrane includes 53 review groups that are based at research institutions worldwide. Cochrane has approximately 30,000 volunteer experts from around the world.
The group conducts systematic reviews of health-care interventions and diagnostic tests and publishes them in the Cochrane Library. According to the Library articles are available via one-click access but some require paid subscription or registration before reading. A few reviews, in occupational health for example, incorporate results from non-randomised observational studies, as well as controlled before–after (CBA) studies and interrupted time-series studies.
Cochrane, previously known as 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 randomised controlled trials of health care.
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,[when?] funds were provided to establish a "Cochrane Centre", to collaborate with others, in the UK and elsewhere, to facilitate systematic reviews of randomised controlled trials across all areas of health care.[when?]
In 2013 the organization published an editorial describing its efforts to train people in the developing world how to do Cochrane reviews. A 2017 editorial briefly discussed the history of Cochrane methodological approaches, such as including studies that use methodologies in lieu of randomised control trials and the challenge of having evidence adopted in practice.
In 2018, during its annual meeting, the Cochrane board expelled Peter Gøtzsche, a board member and director of Cochrane's Nordic center, from the organization, telling Nature that it had received “numerous complaints” about Gøtzsche after he co-authored an article in BMJ Evidence-Based Medicine alleging bias in Cochrane's May 2018 review of HPV vaccines. Gøtzsche's expulsion led four elected board members to resign in protest, which in turn led the board to cut two appointed members in order to comply with the ratio of elected to appointed members required by the organization's charter. Gøtzsche announced that this had happened via an open letter, in which he said there is a “growing top-down authoritarian culture and an increasingly commercial business model” taking root at Cochrane that “threaten the scientific, moral and social objectives of the organization”. Gøtzsche has also been an outspoken critic of Cochrane’s relationship with the pharmaceutical industry. Cochrane's board said that Gøtzsche was expelled due to his behavior, which had been reviewed by an independent counsel hired by Cochrane.
The Cochrane logo represents a meta-analysis of data from seven randomised controlled trials (RCTs), comparing one health care treatment with a placebo in a blobbogram or 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 around 1982. 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 was published until 1990, most obstetricians had not realised that the treatment was so effective and therefore many premature babies probably suffered or died unnecessarily.
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 standardised 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.
Studies comparing the quality of Cochrane meta-analyses in the fields of infertility, physiotherapy and orthodontics, 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. Compared to non-Cochrane reviews, those from Cochrane are less likely to reach a positive conclusion about the utility of medical interventions. Key criticisms that have been directed at Cochrane'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 or trial inclusion, insufficiently frequent updating of reviews, an excessively high percentage of inconclusive reviews, and a high incidence of ghostwriting and honorary authorship. In some cases Cochrane's internal structure may make it difficult to publish studies that run against the pre-conceived opinions of internal subject matter experts.
World Health Organization
Cochrane has been in official relations with the World Health Organization since 2011. This collaboration includes the right to appoint a representative to participate, without vote, in WHO's meetings, including at the World Health Assembly, the WHO's decision-making body. Participation in that assembly allows Cochrane to make statements on WHO health resolutions.
In October 2013, Wikipedia and Cochrane 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. Cochrane and John Wiley and Sons, the publisher of the Cochrane reviews, provide financial support for the collaboration in the form of 100 free Cochrane accounts made available to Wikipedia medical editors, the financial value of which has been estimated by Cochrane 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.
In 2014 the Cochrane blog hosted a rebuttal written by four 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.
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