Cochrane (organization)
Cochrane is a nonprofit, nongovernmental organization founded in Great Britain in 1993, aimed at improving global health care through the production of systematic reviews that focus on evidence-based practices. Named after Scottish epidemiologist Archie Cochrane, the organization emerged from his advocacy for the rigorous assessment of medical treatments, particularly emphasizing randomized controlled trials (RCTs). Cochrane's systematic reviews synthesize existing research to provide comprehensive, unbiased summaries of treatment efficacy, enabling healthcare providers to make informed decisions based on the best available evidence.
The organization has garnered contributions from over 37,000 reviewers across more than 100 countries, ensuring a diverse and expert-driven approach to medical analysis. Cochrane publishes the findings in its quarterly Cochrane Reviews and maintains the Cochrane Library, which includes a variety of health care databases and resources. The collaborative structure of Cochrane fosters cooperation while minimizing bias, with oversight provided by a governing board and operational management by an executive team. Importantly, Cochrane avoids commercial influence by rejecting funding from pharmaceutical companies, relying instead on donations and sales from its educational products. Through these efforts, Cochrane aims to enhance the quality of health care worldwide.
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Cochrane (organization)
Cochrane (previously known as the Cochrane Collaboration) is a nonprofit, nongovernmental organization founded in Great Britain in 1993. Its purpose is to help improve health care around the world by conducting systematic reviews to determine the best evidence-based practices. By using the information gathered and provided by Cochrane, physicians are able to make better decisions for patient treatment. Cochrane's research is also provided online for access by patients and others with an interest in carefully reviewed and curated evidence-based medical practices.
Background
Cochrane was named after Scottish epidemiologist Archie Cochrane. In addition to his contributions to the establishment of epidemiology—the study of the patterns and causes of both health and disease in specific populations—Cochrane wrote a book titled Effectiveness and Efficiency: Random Reflections on Health Services, which was published in 1972. In it, Cochrane proposed that since the resources to provide health care are not infinite, care should be taken to ensure these resources are used to provide the greatest possible good.
He proposed a greater emphasis on the results of randomized controlled trials (RCTs). This type of clinical study randomly assigns people to receive the treatment being tested, one or more alternate treatments, or no treatment (a placebo). RCTs are considered to be the most reliable type of clinical trial.
Shortly before his death, Cochrane highlighted the results of a study done on best practices for prenatal care and delivery, and he recommended that other medical practices should be subjected to the same type of analysis to determine best practices. This led to the establishment of the Cochrane Center in Oxford, England, in 1992. This was the first center dedicated to conducting systematic reviews of medical research. This led to the establishment of the Cochrane Collaboration a year later. The collaborative was founded by a group led by Iain Chalmers, a British medical researcher.
The hallmark of the collaborative is the systematic review endorsed by Cochrane himself. A systematic review is a type of research analysis that painstakingly gathers all existing research studies and clinical trials on a condition or medical practice, establishes criteria for analyzing it, determines the validity of each individual study or trial and eliminates those that do not meet the predetermined standards, and analyzes the information. The findings are then summarized into a report that documents the available evidence so physicians can use it in their decision-making processes. This evidence-based medicine becomes the standard for treatment. It is more reliable than any single study because it combines the findings of multiple studies and is also carefully screened for any bias or false findings.
Overview
The stated mission of Cochrane is to improve health care by providing high-quality evidence-based reviews of the most up-to-date information and making this information widely available. By collecting the information and conducting research in a collaborative environment, Cochrane aims to improve expertise and enthusiasm for new studies and avoid duplication of efforts by making information accessible and easy to find. By conducting reviews of the most relevant information with the cooperation of a variety of highly qualified experts, the collaborative hopes to minimize the effects of bias and improve the quality of the available information.
As a result of its efforts, Cochrane has been able to produce a large body of very current and scientifically researched information on a variety of medical conditions and treatments. More than thirty-seven thousand reviewers from more than one hundred countries have contributed to the pool of research and analysis completed by the organization. The studies and summaries produced by Cochrane are considered authoritative and impartial.
In addition to the fifty-plus review boards that conduct the systematic reviews and publish them quarterly as the Cochrane Reviews, the organization also maintains the Cochrane Library of these reviews as well as medical studies, clinical reviews, and other health care databases to further assist medical providers. The library includes a number of subsidiary databases, including the Cochrane Central Register of Controlled Trials, the Cochrane Database of Abstracts of Reviews of Effectiveness, and a collection of the protocols and methods used by the collaborative. Other groups under the collaborative include Cochrane Centres, which help support contributors in various areas and also provide a regional point of contact for health care providers in those areas; Cochrane Fields, which focuses on aspects of health care besides diseases, such as health care settings, patient populations, and provider needs; and the Cochrane Methods Groups, which provide support and assistance in applying the results of all the studies and information produced by the collaborative.
The work of the collaborative is overseen by a governing board of thirteen members. The board includes people who contribute to the work of the collaborative and some chosen from the community. The day-to-day operation is under the guidance of a chief executive officer and an executive team.
The collaborative is funded by proceeds from items sold through its library and some products developed by the collaborative to provide income. These products include Cochrane Clinical Answers, a subscription-based database of medical information, and Cochrane Responses, a consultancy product that handles special requests for reviews on commission.
The remainder of its funding comes from a wide variety of sources, including international governments, governmental and nongovernmental organizations, schools, hospitals, private nonprofit foundations, and individual donors. To avoid any possibility of bias or outside influence affecting its research, Cochrane does not accept any funding from pharmaceutical corporations or any other commercial entities.
Bibliography
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"The Cochrane Collaboration." Cochrane United States, us.cochrane.org/cochrane-collaboration. Accessed 14 Nov. 2017.
"The Cochrane Collaboration." Health Knowledge, www.healthknowledge.org.uk/public-health-textbook/research-methods/1a-epidemiology/cochrane-collaboration. Accessed 14 Nov. 2017.
Scholten, R. J. P. M. "The Cochrane Collaboration." European Journal of Clinical Nutrition,28 July 2005, www.nature.com/articles/1602188. Accessed 14 Nov. 2017.
Smith, Richard. "The Cochrane Collaboration at 20." BM J, 18 Dec. 2013, www.bmj.com/content/347/bmj.f7383. Accessed 14 Nov. 2017.
Watts, Geoff. "Profile: Iain Chalmers: Maverick Master of Medical Evidence." Lancet,30 Dec. 2006, www.thelancet.com/pdfs/journals/lancet/PIIS0140673606698796.pdf. Accessed 14 Nov. 2017.
"What Is the Cochrane Collaborative?" U.S. National Library of Medicine, www.nlm.nih.gov/bsd/cochrane.html. Accessed 14 Nov. 2017.