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. 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. The group conducts systematic reviews of randomized controlled trials of health-care interventions and diagnostic tests and publishes them in The Cochrane Library. Ben Goldacre (2012), Bad Pharma, Fourth Estate, p. 14ff. A few reviews, in occupational health for example, incorporate results from non-randomized, observational studies as well as controlled before–after (CBA) studies and interrupted time-series studies.
HistoryCochrane, 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. 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 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. 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 randomized control trials and the challenge of having evidence adopted in practice.
Logoto 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, Cochrane|url=http://www.cochrane.org/about-us/our-logo|website=www.cochrane.org|accessdate=25 September 2016}} most obstetricians had not realized that the treatment was so effective and therefore many premature babies probably suffered or died unnecessarily.
ReceptionAn 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 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. 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.
WikipediaIn 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. Cross-posted on Cochrane Official Blog, 13 May 2014. 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.
World Health OrganizationCochrane 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. Cochrane|url = http://www.cochrane.org/about-us/our-partners-and-funders/world-health-organization|website = www.cochrane.org|accessdate = 17 October 2015}} Participation in that assembly allows Cochrane to make expository statements on WHO health resolutions.
- Campbell Collaboration
- Coalition for Evidence-Based Policy
- Laura and John Arnold Foundation
- What Works Clearinghouse