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. 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.
The group conducts systematic reviews of randomized controlled trials of health-care interventions, which it publishes in The Cochrane Library. 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.
Historyspan>
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.
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, 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.
In October 1995 the Collaboration formed the Cochrane Consumer Network 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.
The Cochrane Collaboration is currently concentrating on capacity building in health research is individuals, groups, and institutions in low- and middle-income countries (LMIC)s.
Logo
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 â€" 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 30â€"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.
Reception
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.
Studies comparing the quality of Cochrane Collaboration 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 the Cochrane collaboration are less likely to reach a positive conclusion about the utility of medical interventions. 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 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 the Collaboration's internal structure may make it difficult to publish studies that run against the pre-conceived opinions of internal subject matter experts.
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.
Cochrane Centres
The Cochrane Collaboration is split into smaller divisions (Centres, Review Groups, Methods Groups and Fields) based on a number of factors, two of which are geographical location and linguistic responsibility. Cochrane Centres, of which there are 14, are responsible for the Review Groups, Methods Groups and Fields in their respective regions, also working on training and promoting evidence based healthcare and access to the region(s) of the world for which they are responsible.
United Kingdom Cochrane Centre
The United Kingdom Cochrane Centre (UKCC) 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.
The UKCC activities include: The Learn + Teach Programme, The Engagement Programme,Students for Best Evidence and The Guidelines Project.
South Asian Cochrane Network and Centre
The South Asian Cochrane Network & Centre (SASIANCC) 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, the South Asian Toxicology Network, the Cochrane Student Journal Club and the South Asian Database of Controlled Clinical Trials.
United States Cochrane Center
The United States Cochrane Center (USCC) was established in December 2002 and operates out of three offices. 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.
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
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
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.
Cochrane Acute Respiratory Infections Group
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
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. The group prepares systematic reviews of all the interventions used to prevent or treat eye diseases and/or visual impairment. Additionally, the group considers the evidence for interventions that aim to help people adjust to visual impairment or blindness.
Cochrane Musculoskeletal Group
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. The group prepares up-to-date reviews for the treatment, prevention or rehabilitation of musculoskeletal disorders. Additionally, also provides secondary products to make the evidence more friendly for those involved in treatments for musculoskeletal diseases.
Cochrane Occupational Safety and Health Review Group
The Occupational Health and Safety (OSH) Review Group 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. The group belongs to the top tier of Cochrane Review Groups and the impact factor of the reviews it produced was 6.4 in 2014.
Cochrane Peripheral Vascular Diseases Review Group
The Cochrane Peripheral Vascular Diseases (PVD) Review Group has been registered with the Cochrane Collaboration since 1995 and is based within the University of Edinburgh, Scotland. The PVD Group has a world-wide membership composed of medical and surgical specialists, hospital administrators, policy makers, statisticians and healthcare consumers who help produce systematic reviews encompassing all surgical and medical interventions for the prevention or treatment of arterial and venous diseases.
Cochrane Methods Groups
All in all there are 16 Cochrane Methods Groups within Cochrane, covering different aspects of methods used in Cochrane Reviews. The contributors to these groups include researchers, methodologists and statisticians to name but a few.
Cochrane Adverse Effects Methods Group
The Cochrane Adverse Effects Methods Group (AEMG) was Cochrane Collaboration registered June 14th 2007. Their aim is to develop high quality systematic review methods and to contribute to the validity and precision of systematic reviews by advising the Cochrane Collaboration in regards to the same.
The focus of the Cochrane Adverse Effects Methods Group is to:
- to raise awareness and promote adverse effects inclusions within interventions, and to promote inclusion of all adverse effects data in Cochrane reviews
- supply education for reviewers and users to promote understanding of assessment of adverse effects
- to offer methodological guidance for adverse effects evaluation
- develop a toolbox for the assessment of adverse effects and identify methodological uncertainties around adverse effects
Cochrane Agenda and Priority Setting Methods Group
The Agenda and Priority Setting Methods Group is a method group of The Cochrane Collaboration and was formed officially in 2011 to develop and advise methodologies to set research agenda or research priorities. It is currently based in Plymouth University, UK. This group shares ways to improve the validity and precision of systematic reviews can be improved. In addition to informing Cochrane entities about available empirical evidence for setting up research agendas and the establishment of top research priorities. The group also serves as a discussion forum connecting individuals or groups with an interest in methods to set research agendas or priorities.
Cochrane Applicability and Recommendations Methods Group
The Cochrane Applicability and Recommendations Methods Group(ARMG) endeavors to provide guidance for reviewers when they are faced with finding answers for who is the population the systematic review results will apply to and the implications of the review for patients and policy?" This guidance is useful as using only inclusion/exclusion criteria of trials can be insufficient ad it limits the basis for generalisation to a larger population. Procedural clarity is optimal for application of getting the evidence into practice and to provide a straightforward path for the activity of policy making. The group members have developed a brief guide for reviewers regarding optimal applicability and help with methods.
Cochrane Bias Methods Group
Campbell & Cochrane Economics Methods Group
Campbell & Cochrane Equity Methods Group
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. 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.
Cochrane Comparing Multiple Interventions Methods Group
Cochrane Individual Patient Data Meta-Analysis Methods Group
Cochrane Information Retrieval Methods Group
Cochrane Non-Randomised Studies Methods Group
Cochrane Patient Reported Outcomes Methods Group
Cochrane Prognosis Methods Group
Cochrane Qualitative and Implementation Methods Group
Cochrane Screening and Diagnostic Tests Methods Group
Cochrane Statistical Methods Group
Cochrane Fields/Networks
There are presently eleven Cochrane Fields/Networks within Cochrane, which are responsible for dissemination of Cochrane Reviews. The contributors to these groups are varied and include consumers,students, authors,academics, clinicians and researchers.
- Cochrane Child Health Field
- Cochrane Complementary Medicine Field
- Cochrane Consumer Network
- Cochrane Health Care of Older People Field
- Cochrane Justice Health Field
- Cochrane Neurological Field
- Cochrane Nursing Care Field
- Cochrane Pre-Hospital and Emergency Care Field
- Cochrane Primary Health Care Field
- Cochrane Rehabilitation and Related Therapies Field
- Cochrane Vaccines Field
Wikipedia's relationship with the Cochrane Collaboration
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. 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.
In 2014 the Cochrane Collaboration blog hosted a rebuttal 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.
See also
- Evidence-based medicine
- Cochrane Library
- Systematic review
- Meta-Research Innovation Center at Stanford
References
External links
- The Cochrane Collaboration web site
- The South Asian Cochrane Network & Centre , India
- The United States Cochrane Center
- Cochrane Infectious Disease Group
- Cochrane Acute Respiratory Group
- Cochrane Epilepsy Group
- Cochrane Musculoskeletal Group
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