Cochrane (previously known as the Cochrane Collaboration) is a British international charitable organisation formed to organise medical research findings to facilitate
evidence-based
Evidence-based practice (EBP) is the idea that occupational practices ought to be based on scientific evidence. While seemingly obviously desirable, the proposal has been controversial, with some arguing that results may not specialize to indiv ...
choices about
health interventions
A public health intervention is any effort or policy that attempts to improve mental and physical health on a population level. Public health interventions may be run by a variety of organizations, including governmental health departments and n ...
involving health professionals, patients and policy makers.
It 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 review
A systematic review is a Literature review, scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from publ ...
s of health-care interventions and diagnostic tests and publishes them in the
Cochrane Library
The Cochrane Library (named after Archie Cochrane) is a collection of databases in medicine and other healthcare specialties provided by Cochrane and other organizations. At its core is the collection of Cochrane Reviews, a database of system ...
.
[ 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
Occupational safety and health (OSH), also commonly referred to as occupational health and safety (OHS), occupational health, or occupational safety, is a multidisciplinary field concerned with the safety, health, and welfare of people at wor ...
for example, incorporate results from non-randomised observational studies
In fields such as epidemiology, social sciences, psychology and statistics, an observational study draws inferences from a sample to a population where the independent variable is not under the control of the researcher because of ethical concern ...
[ ] as well as controlled before–after (CBA) studies and interrupted time-series studies.
History
Cochrane, previously known as the Cochrane Collaboration, was founded in 1993 under the leadership of Iain Chalmers
Sir Iain Geoffrey Chalmers (born 3 June 1943) is a British health services researcher, one of the founders of the Cochrane Collaboration,[Archie Cochrane
Archibald Leman Cochrane (12 January 1909 – 18 June 1988) was a Scottish doctor noted for his book ''Effectiveness and Efficiency: Random Reflections on Health Services''. This book advocated the use of randomized control trials to make med ...](_blank)
's call for up-to-date, systematic reviews of all relevant randomised controlled trials in the field of healthcare.
In 1998, the Cochrane Economics Methods Group (CEMG) was established to facilitate the basing of decisions on health economics
Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and healthcare. Health economics is important in determining how to improv ...
, evidence-based medicine
Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". The aim of EBM is to integrate the experience of the clinician, the values of t ...
, and systematic review
A systematic review is a Literature review, scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from publ ...
s.
Cochrane's suggestion that methods used to prepare and maintain reviews of controlled trials in pregnancy and childbirth be applied more widely was taken up by the Research and Development Programme, initiated to support the National Health Service
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
. Through the NHS research and development programme, led by Michael Peckham
Michael John Peckham (2 August 1935 – 13 August 2021) was a British oncologist and artist. As a cancer physician he is best known for his contribution to the treatment of testicular cancer. His paintings were first exhibited in 1962 and he sho ...
, 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 healthcare.
In 2004, the Campbell Collaboration joined with the CEMG to form the Campbell & Cochrane Economics Methods Group (CCEMG).
In 2013 the organization published an editorial describing its efforts to train people in developing nations to perform 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.
During its 2018 annual meeting, the Cochrane board expelled Peter C. Gøtzsche
Peter Christian Gøtzsche (born 26 November 1949) is a Danish physician, medical researcher, and former leader of the Nordic Cochrane Center at Rigshospitalet in Copenhagen, Denmark.
He is a co-founder of the Cochrane Collaboration and has writ ...
, 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 remains an outspoken critic of Cochrane's relationship with the pharmaceutical industry. The Cochrane board stated that Gøtzsche was expelled for his behavior, which had been reviewed by an independent counsel hired by Cochrane.[
]
Reception
A 2004 editorial in the ''Canadian Medical Association Journal
The ''Canadian Medical Association Journal'' (French ''Journal de l'Association Médicale Canadienne'') is a peer-reviewed general medical journal published by the Canadian Medical Association (CMA). It publishes original clinical research, anal ...
'' noted that Cochrane reviews appear to be more up to date and of better quality than other reviews, describing them as "the best single resource for methodologic research and for developing the science of meta-epidemiology
Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population.
It is a cornerstone of public health, and shapes policy decisions and evidenc ...
" and crediting them with leading to methodological improvements in the medical literature.
Studies comparing the quality of Cochrane meta-analyses in the fields of infertility
Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). It is the normal state ...
, physiotherapy,[ and ]orthodontics
Orthodontics is a dentistry specialty that addresses the diagnosis, prevention, management, and correction of mal-positioned teeth and jaws, and misaligned bite patterns. It may also address the modification of facial growth, known as dentofacial ...
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
A ghostwriter is hired to write literary or journalistic works, speeches, or other texts that are officially credited to another person as the author. Celebrities, executives, participants in timely news stories, and political leaders often h ...
and honorary authorship. In some cases Cochrane's internal structure may make it difficult to publish studies that run against the preconceived opinions of internal subject matter experts.
Partnerships
World Health Organization
Cochrane maintains an official relationship with the World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
that affords Cochrane the right to appoint nonvoting representatives to WHO meetings, including sessions of the World Health Assembly
The World Health Assembly (WHA) is the forum through which the World Health Organization (WHO) is governed by its 194 member states. It is the world's highest health policy setting body and is composed of health ministers from member states.
Th ...
, and make statements on WHO resolutions.
Wikipedia
In 2014, the Cochrane-Wikipedia partnership was formalised. This supports the inclusion of relevant evidence within all Wikipedia medical articles, as well as processes to help ensure that medical information included in Wikipedia is of the highest quality and accuracy. Wikipedia and Cochrane collaborate to increase the incorporation of Cochrane research into Wikipedia articles and provide Wikipedia editors with resources for interpreting medical data. Cochrane and John Wiley and Sons, publisher of Cochrane reviews, make one hundred free Cochrane accounts available to Wikipedia medical editors—the financial value of which has been estimated by Cochrane at between thirty thousand and eighty thousand US dollars per annum—and pay a nominal stipend and travel expenses to support a Wikipedian in Residence
A Wikipedian in residence or Wikimedian in residence (WiR) is a Wikipedia editor, a Wikipedian (or Wikimedian), who accepts a placement with an institution, typically an art gallery, library, archive, museum, cultural institution, learned so ...
at Cochrane.
In 2014, the Cochrane blog hosted a rebuttal, written by four Wikipedia medical editors, of an article published in the ''Journal of the American Osteopathic Association
''Journal of Osteopathic Medicine'' (JOM) is a monthly peer-reviewed open access medical journal published by the American Osteopathic Association. The journal primarily publishes original research publications and editorial articles. The editor ...
'' that was critical of the accuracy of Wikipedia medical content.
Funding partners
Cochrane receives funding from governments, supranational organizations, non-governmental organization
A non-governmental organization (NGO) or non-governmental organisation (see spelling differences) is an organization that generally is formed independent from government. They are typically nonprofit entities, and many of them are active in h ...
s, academic institutions, hospitals, and foundations, while avoiding funding from corporate interests. Primary government donors include the United Kingdom's National Institute for Health and Care Research
The National Institute for Health and Care Research (NIHR) is the British government’s major funder of clinical, public health, social care and translational research. With a budget of over £1.2 billion in 2020–21, its mission is to "impr ...
(NIHR), the Danish Health Authority, the Federal Ministry of Health (Germany)
The Federal Ministry of Health (german: link=no, Bundesministerium für Gesundheit), abbreviated BMG, is a cabinet-level ministry of the Federal Republic of Germany. It is the highest German federal government department responsible for health. ...
, and the National Institutes of Health
The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
(NIH).
Academic funders include McMaster University
McMaster University (McMaster or Mac) is a public research university in Hamilton, Ontario, Canada. The main McMaster campus is on of land near the residential neighbourhoods of Ainslie Wood and Westdale, adjacent to the Royal Botanical Ga ...
, Amsterdam University
The University of Amsterdam (abbreviated as UvA, nl, Universiteit van Amsterdam) is a public research university located in Amsterdam, Netherlands. The UvA is one of two large, publicly funded research universities in the city, the other b ...
Medical Center, Kazan Federal University
Kazan (Volga region) Federal University (russian: Казанский (Приволжский) федеральный университет, tt-Cyrl, Казан (Идел буе) федераль университеты) is a public research uni ...
, and University of Copenhagen
The University of Copenhagen ( da, Københavns Universitet, KU) is a prestigious public university, public research university in Copenhagen, Copenhagen, Denmark. Founded in 1479, the University of Copenhagen is the second-oldest university in ...
, among others. Funding from foundations includes the National Research Foundation (South Africa)
South Africa’s National Research Foundation (NRF) is the intermediary agency between the policies and strategies of the Government of South Africa and South Africa's research institutions.
It was established on 1 April 1999 as an autonomous ...
and the Gerber Foundation.
Public involvement
Cochrane involves the public via community curation Biocuration is the field of life sciences dedicated to organizing biomedical data, information and knowledge into structured formats, such as spreadsheets, tables and knowledge graphs. The biocuration of biomedical knowledge is made possible by th ...
, to produce systematic reviews and other outputs. Tasks can be organised as 'entry level' or higher. Tasks include:
*Joining a collaborative volunteer effort to help categorise and summarise healthcare evidence
*Data extraction and risk of bias assessment
*translation of reviews into other languages
A recent systematic review of how people were involved in systematic reviews aimed to document the evidence-base relating to stakeholder involvement in systematic reviews and to use this evidence to describe how stakeholders have been involved in systematic reviews. Thirty percent involved patients and/or carers.
While there has been some criticism of how Cochrane prioritises systematic reviews, a recent project involved people in helping identify research priorities to inform future Cochrane Reviews.
The representation of women as editors in Cochrane was found to be better than that of other organizations.
See also
* Campbell Collaboration
*Coalition for Evidence-Based Policy
Evidence-based policy is an idea in public policy proposing that policy decisions should be based on, or informed by, rigorously established objective evidence. The implied contrast is with policymaking based on ideology, 'common sense,' anecdo ...
*Evidence-based practice
Evidence-based practice (EBP) is the idea that occupational practices ought to be based on scientific evidence. While seemingly obviously desirable, the proposal has been controversial, with some arguing that results may not specialize to indiv ...
References
External links
*
Cochrane Tobacco Addiction Group
Cochrane Neonatal Group
{{Authority control
Evidence-based medicine
Evidence-based practices
Health care quality
Health economics
Health in the City of Westminster
International scientific organizations
Medical research institutes in the United Kingdom
Organisations based in the City of Westminster
Systematic review