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Cochrane (organisation)

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Cochrane is a British non-profit, non-governmental organization formed to organize medical research findings so as to facilitate evidence-based choices about health interventions faced by health professionals, patients, and policy makers.[4][5] It counts with 52 review groups that are based at research institutions worldwide, each focused on a specific topic of health research. These groups support Cochrane’s primary organizational function of preparing and maintaining systematic reviews. They are all independently run and financed. Cochrane has more than 37,000 volunteers in more than 130 countries.[3]

Cochrane
Cochrane logo stacked.svg
Motto Trusted evidence. Informed decisions. Better health.
Formation 1993; 24 years ago (1993) (as Cochrane Collaboration)
Type International NPO
Purpose Independent research into data about health care
Headquarters London, England, U.K.[1]
Region served
Worldwide
Official language
English
Steering Group Co-Chairs
Lisa Bero,
Cindy Farquhar[2]
Volunteers
Over 37,000 (2015) [3]
Website www.cochrane.org

The group conducts systematic reviews of randomized controlled trials of health-care interventions and diagnostic tests and publishes them in The Cochrane Library.[6][7] A few reviews, in occupational health for example, incorporate results from non-randomized, observational studies[8] as well as controlled before–after (CBA) studies and interrupted time-series studies.[9]

Contents

HistoryEdit

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 randomized controlled trials of health care.[10][11][12]

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,[13] 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.[14][15]

In 2000, the organization began awarding a prize named in honor of Kenneth S. Warren to a person "who is a national living in a developing country of a published Cochrane review which is judged to be both of high methodological quality and relevant to health problems in developing countries"; the winner gets a $1000 and their expenses paid to an annual Cochrane conference where they receive the award.[16]

In 2013 the organization published an editorial describing its efforts to train people in the developing world how to do Cochrane reviews.[17] A 2017 editorial briefly discussed the history of Cochrane methodological approaches, such as including studies that use methodologies in lieu of randomized control trials and the challenge of having evidence adopted in practice.[9]

Edit

 
A blobbogram of seven studies of giving corticosteroids to women about to give birth too early; a similar blobbogram of the same data is shown, stylized, in part of the Cochrane logo.

The Cochrane logo represents a meta-analysis of data from seven randomized 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,[18][19] most obstetricians had not realized that the treatment was so effective and therefore many premature babies probably suffered or died unnecessarily.[20]

ReceptionEdit

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.[21]

Studies comparing the quality of Cochrane meta-analyses in the fields of infertility,[22] physiotherapy[22][23] and orthodontics,[24] 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.[25] Compared to non-Cochrane reviews, those from Cochrane are less likely to reach a positive conclusion about the utility of medical interventions.[26] 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[27] or trial[28] inclusion, insufficiently frequent updating of reviews, an excessively high percentage of inconclusive reviews,[29] and a high incidence of ghostwriting and honorary authorship.[30][31] 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.[32]

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.[33]

PartnershipsEdit

WikipediaEdit

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.[34] 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.[35]

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.[36][37]

World Health OrganizationEdit

Cochrane has been in official relations with the World Health Organization since 2011.[38] 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.[39] Participation in that assembly allows Cochrane to make expository statements on WHO health resolutions.[39]

Similar organizationsEdit

ReferencesEdit

  1. ^ "Contacting us | Cochrane". www.cochrane.org. Retrieved 15 September 2015. 
  2. ^ The Cochrane Steering Group & Subgroups. Retrieved 14 February 2014.
  3. ^ a b "About us | Cochrane". www.cochrane.org. Retrieved 14 September 2015. 
  4. ^ "Our principles". Cochrane Community. Cochrane.org. 2017. Retrieved 19 October 2017. 
  5. ^ Hill GB (December 2000). "Archie Cochrane and his legacy. An internal challenge to physicians' autonomy?". J Clin Epidemiol. 53 (12): 1189–92. PMID 11146263. doi:10.1016/S0895-4356(00)00253-5. 
  6. ^ Scholten RJ, Clarke M, Hetherington J (August 2005). "The Cochrane Collaboration". Eur J Clin Nutr. 59 (Suppl 1): S147–9; discussion S195–6. PMID 16052183. doi:10.1038/sj.ejcn.1602188. 
  7. ^ Ben Goldacre (2012), Bad Pharma, Fourth Estate, p. 14ff.
  8. ^ Kongsted, Hans; Konnerup, Merete (2012). "Are more observational studies being included in Cochrane reviews?". BMC Research Notes. 5 (1): 570. doi:10.1186/1756-0500-5-570.   
  9. ^ a b Ruotsalainen, Jani; Sauni, Riitta; Verbeek, Jos (2017-10-01). "Cochrane Work—championing facts since 2003". Occupational Medicine. 67 (7): 504–506. ISSN 0962-7480. doi:10.1093/occmed/kqx073. 
  10. ^ Chalmers, I; Dickersin, K; Chalmers, TC (1992). "Getting to grips with Archie Cochrane's agenda". BMJ. 305 (6857): 786–788. PMC 1883470 . PMID 1422354. doi:10.1136/bmj.305.6857.786. 
  11. ^ Cochrane AL (1972). Effectiveness and Efficiency. Random Reflections on Health Services. London: Nuffield Provincial Hospitals Trust. ISBN 0-900574-17-8. 
  12. ^ Winkelstein Jr., W (September 2009). "The Remarkable Archie: Origins of the Cochrane Collaboration". Epidemiology. 20 (5): 779. doi:10.1097/EDE.0b013e3181aff391. 
  13. ^ Peckham M (August 1991). "Research and development for the National Health Service". Lancet. 338 (8763): 367–71. PMID 1677710. doi:10.1016/0140-6736(91)90494-A. 
  14. ^ "Cochrane History and Chronology". Cochrane.org. Retrieved 5 October 2015. 
  15. ^ Dickersin K, Manheimer E (1998). "The Cochrane Collaboration: evaluation of health care and services using systematic reviews of the results of randomized controlled trials". Clinical Obstetrics & Gynecology. 41 (2): 315–331. PMID 9646964. doi:10.1097/00003081-199806000-00012. 
  16. ^ "The Kenneth Warren Prize". The Global Evidence Summit. Retrieved 26 July 2017. 
  17. ^ Young T, Garner P, Kredo T, Mbuagbaw L, Tharyan P, Volmink J (2013). "Cochrane and capacity building in low- and middle-income countries: where are we at? [editorial]". Cochrane Database of Systematic Reviews. 11: ED000072. doi:10.1002/14651858.ED000072. 
  18. ^ Crowley, P; Chalmers, I; Keirse, MJ (January 1990). "The effects of corticosteroid administration before preterm delivery: an overview of the evidence from controlled trials.". British journal of obstetrics and gynaecology. 97 (1): 11–25. PMID 2137711. doi:10.1111/j.1471-0528.1990.tb01711.x. 
  19. ^ "Our logo | Cochrane". www.cochrane.org. Retrieved 25 September 2016. 
  20. ^ "Explanation of the Cochrane logo". Cochrane.org. Retrieved 5 October 2015. 
  21. ^ Grimshaw J (September 2004). "So what has the Cochrane Collaboration ever done for us? A report card on the first 10 years". CMAJ. 171 (7): 747–9. PMC 517860 . PMID 15451837. doi:10.1503/cmaj.1041255. 
  22. ^ a b Windsor B, Popovich I, Jordan V, Showell M, Shea B, Farquhar C (December 2012). "Methodological quality of systematic reviews in subfertility: a comparison of Cochrane and non-Cochrane systematic reviews in assisted reproductive technologies". Hum. Reprod. 27 (12): 3460–6. PMID 23034152. doi:10.1093/humrep/des342. 
  23. ^ Moseley, Anne M.; Elkins, Mark R.; Herbert, Robert D.; Maher, Christopher G.; Sherrington, Catherine (October 2009). "Cochrane reviews used more rigorous methods than non-Cochrane reviews: survey of systematic reviews in physiotherapy". Journal of Clinical Epidemiology. 62 (10): 1021–1030. PMID 19282144. doi:10.1016/j.jclinepi.2008.09.018. 
  24. ^ Fleming PS, Seehra J, Polychronopoulou A, Fedorowicz Z, Pandis N (April 2013). "Cochrane and non-Cochrane systematic reviews in leading orthodontic journals: a quality paradigm?". Eur J Orthod. 35 (2): 244–8. PMID 22510325. doi:10.1093/ejo/cjs016. 
  25. ^ Olsen O, Middleton P, Ezzo J, et al. (October 2001). "Quality of Cochrane reviews: assessment of sample from 1998". BMJ. 323 (7317): 829–32. PMC 57800 . PMID 11597965. doi:10.1136/bmj.323.7317.829. 
  26. ^ Tricco AC, Tetzlaff J, Pham B, Brehaut J, Moher D (April 2009). "Non-Cochrane vs. Cochrane reviews were twice as likely to have positive conclusion statements: cross-sectional study". J Clin Epidemiol. 62 (4): 380–386.e1. PMID 19128940. doi:10.1016/j.jclinepi.2008.08.008. 
  27. ^ Tendal B, Nüesch E, Higgins JP, Jüni P, Gøtzsche PC (2011). "Multiplicity of data in trial reports and the reliability of meta-analyses: empirical study". BMJ. 343: d4829. PMC 3171064 . PMID 21878462. doi:10.1136/bmj.d4829. 
  28. ^ Hutton P, Morrison AP, Yung AR, Taylor PJ, French P, Dunn G (July 2012). "Effects of drop-out on efficacy estimates in five Cochrane reviews of popular antipsychotics for schizophrenia". Acta Psychiatr Scand. 126 (1): 1–11. PMID 22486554. doi:10.1111/j.1600-0447.2012.01858.x. 
  29. ^ Green-Hennessy S (January 2013). "Cochrane systematic reviews for the mental health field: is the gold standard tarnished?". Psychiatr Serv. 64 (1): 65–70. PMID 23117176. doi:10.1176/appi.ps.001682012. 
  30. ^ Mowatt, G; Shirran, L; Grimshaw, JM; Rennie, D; Flanagin, A; Yank, V; MacLennan, G; Gøtzsche, PC; Bero, LA (5 June 2002). "Prevalence of honorary and ghost authorship in Cochrane reviews.". JAMA. 287 (21): 2769–71. PMID 12038907. 
  31. ^ Tisdale JE (November 2009). "Integrity in authorship and publication". Can J Hosp Pharm. 62 (6): 441–7. PMC 2827013 . PMID 22478931. doi:10.4212/cjhp.v62i6.840. 
  32. ^ "www.radcliffehealth.com" (PDF). Archived from the original (PDF) on 5 September 2014. 
  33. ^ Page MJ, McKenzie JE, Green SE, Forbes AB (2013). "An empirical investigation of the potential impact of selective inclusion of results in systematic reviews of interventions: study protocol". Syst Rev. 2: 21. PMC 3626625 . PMID 23575367. doi:10.1186/2046-4053-2-21. 
  34. ^ Mathew, Manu; Joseph, Anna; Heilman, James; Tharyan, Prathap (2013). "Cochrane and Wikipedia: the collaborative potential for a quantum leap in the dissemination and uptake of trusted evidence[editorial]". Cochrane Database of Systematic Reviews. 10 (10): ED000069. PMID 24475488. doi:10.1002/14651858.ED000069. Retrieved 15 September 2015. 
  35. ^ Orlowitz, Jake (5 May 2014). "Cochrane Collaboration Recruits Talented Wikipedian In Residence". Wikimedia Foundation Global Blog. Wikimedia Foundation. Retrieved 15 September 2015.  Cross-posted on Cochrane Official Blog, 13 May 2014.
  36. ^ Chatterjee, Anwesh; Cooke, Robin M.T.; Furst, Ian; Heilman, James (23 June 2014). "Is Wikipedia’s medical content really 90% wrong?". Cochrane Community. www.cochrane.org. Archived from the original on 5 October 2015. Retrieved 15 September 2015. 
  37. ^ 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. PMID 24778001. doi:10.7556/jaoa.2014.035. 
  38. ^ "Non-State actors in official relations with WHO". World Health Organization. Retrieved 26 July 2017. 
  39. ^ a b "World Health Organization | Cochrane". www.cochrane.org. Retrieved 17 October 2015. 

External linksEdit