Download The Cochrane Collaboration and Evidence for Better Health

The Cochrane Collaboration and
Evidence for Better Health
Dr David Tovey FRCGP
Editor in Chief
The Cochrane Library
Knowledge is important!
“There had been reports that Chloe was
not given the anti-viral drug Tamiflu after
her doctor misdiagnosed her illness as
tonsillitis......”
“Between 1999 and 2002 Roche sold
just 5.5 million treatments. Next year
the total sales of oseltamivir are
projected at 150 million. Roche's share
price has soared this year by 60%.1 ”
“There had been reports that Chloe was
not given the anti-viral drug Tamiflu after
her doctor misdiagnosed her illness as
tonsillitis......”
1 BMJ
2005;331:1277 (26 November), doi:10.1136/bmj.331.7527.1277
“Between 1999 and 2002 Roche sold
just 5.5 million treatments. Next year
the total sales of oseltamivir are
projected at 150 million. Roche's share
price has soared this year by 60%.1”
“There had been reports that Chloe was not given the anti-viral
drug Tamiflu after her doctor misdiagnosed her illness as
tonsillitis......”
1 BMJ
2005;331:1277 (26 November), doi:10.1136/bmj.331.7527.1277
BMJ editor Dr. Fiona Godlee, said "claims that
oseltamivir reduces complications have been a key
justification for promoting the drug's widespread
use. Governments around the world have spent
billions of pounds on a drug that the scientific
community has found itself unable to judge.“
Does it matter?
Does it matter?
Archie Cochrane
“It is surely a great criticism of
our profession that we have
not organised a critical
summary, by specialty or
subspecialty, adapted
periodically, of all relevant
randomised controlled trials.”
Mission
• The Cochrane Collaboration is an
international organisation that aims to help
people make well-informed decisions about
health care by preparing, maintaining and
promoting the accessibility of systematic
reviews of the effects of healthcare
interventions.
Cochrane Principles
•
•
•
•
•
Keeping up to date
Striving for relevance
Promoting access
Ensuring quality
Continuity
• Collaboration
• Building on the enthusiasm
of individuals
• Avoiding duplication
• Minimising bias
Cochrane Principles
•
•
•
•
•
Keeping up to date
Striving for relevance
Promoting access
Ensuring quality
Continuity
• Collaboration
• Building on the enthusiasm
of individuals
• Avoiding duplication
• Minimising bias
Cochrane Principles
•
•
•
•
•
Keeping up to date
Striving for relevance
Promoting access
Ensuring quality
Continuity
• Collaboration
• Building on the
enthusiasm of individuals
• Avoiding duplication
• Minimising bias
Cochrane Principles
•
•
•
•
•
Keeping up to date
Striving for relevance
Promoting access
Ensuring quality
Continuity
• Collaboration
• Building on the enthusiasm
of individuals
• Avoiding duplication
• Minimising bias
The Cochrane Collaboration: a success
story........
• 18,000 active volunteers
• 1.2m website hits/month and > 1000 recorded
media hits for a single issue
• >4000 systematic reviews plus access to
summaries of thousands more?
Cochrane geographical spread
Cochrane Review Groups
Acute Respiratory Infections Group
Airways Group
Anaesthesia Group
Back Group Bone, Joint and Muscle Trauma Group
Breast Cancer Group
Childhood Cancer Group
Colorectal Cancer Group
Consumers and Communication Group
Cystic Fibrosis and Genetic Disorders Group
Dementia and Cognitive Improvement Group
Depression, Anxiety and Neurosis Group
Developmental, Psychosocial and Learning Problems Group
Drugs and Alcohol Group
Ear, Nose and Throat Disorders Group
Effective Practice and Organisation of Care Group
Epilepsy Group
Eyes and Vision Group
Fertility Regulation Group
Gynaecological Cancer Group
HIV/AIDS Group
Haematological Malignancies Group
Heart Group
Hepato-Biliary Group
Hypertension Group
Incontinence Group
Infectious Diseases Group
Inflammatory Bowel Disease and Functional Bowel Disorders Group
Injuries Group
Lung Cancer Group
Menstrual Disorders and Subfertility Group
Metabolic and Endocrine Disorders Group
Methodology Review Group
Movement Disorders Group
Multiple Sclerosis Group Musculoskeletal Group
Neonatal Group
Neuromuscular Disease Group
Oral Health Group
Pain, Palliative and Supportive Care Group
Peripheral Vascular Diseases Group
Pregnancy and Childbirth Group
Prostatic Diseases and Urologic Cancers Group
Public Health Group
Renal Group
Schizophrenia Group
Sexually Transmitted Diseases Group
Skin Group
Stroke Group
Tobacco Addiction Group
Upper Gastrointestinal and Pancreatic Diseases Group
Wounds Group
Global reach
Australia
Canada
Denmark
Finland
India
Ireland
Latin America &Caribbean
Low-Income Countries
New Zealand
Norway
South Africa*
Spain
Sweden
United Kingdom
State of Wyoming*
Impact and impact factor
5.182
th
12
Up from 4.654 in 2007
2 seconds
highest General Medical journal
Up from 14th in 2007
Impact and impact factor
5.182
th
12
Up from 4.654 in 2007
3 seconds
highest General Medical journal
Up from 14th in 2007
Impact and impact factor
5.182
th
12
Up from 4.654 in 2007
4 seconds
highest General Medical journal
Up from 14th in 2007
Increasing usage
800,000
700,000
600,000
500,000
2006 Full Text Download
400,000
2007 Full Text Download
2008 Full Text Download
300,000
200,000
100,000
0
UK
UNITED STATES
AUSTRALIA
CANADA
Top 10 Reviews - Worldwide
Review Title
World India Rank
Rank
Interventions for preventing falls in elderly people
1
47
Interventions for preventing obesity in children
2
178
Cranberries for preventing urinary tract infections
3
410
St John's Wort for major depression
4
439
Interventions for enhancing medication adherence
5
351
Nicotine replacement therapy for smoking cessation
6
69
Antioxidant supplements for prevention of mortality in healthy participants and
patients with various diseases
7
61
Water for wound cleansing
8
127
Support surfaces for pressure ulcer prevention
9
700
11
38
Midwife-led versus other models of care for childbearing women
Where are we going?
• Content development
• Delivery of content
Content
Timely
Valid
Relevant
Accessible
Content developments
• Summary of findings tables
• Diagnosis reviews
• Multiple comparison meta-analysis
• Overviews of reviews
Content developments
• Global Health commitment
– Advocacy
– Capacity building
– Work with WHO and other partners
• Complex reviews
• Health Equity Methods Group
GRADE and Summary of Findings table
Delivery: the web programme
• Increasing publication frequency (publish changed data
only)
• Improved search and browse
• Clarification of content
• Web 2.0 / interactivity etc
Delivery: different vehicles
• Cochrane Journal Club
• Cochrane PICO
• Cochrane on handhelds
• Cochrane decision support
New for The Cochrane Library in 2010
Format
Description
Objective
Frequency
Web
programme
Improved web
presentation and
frequency of
publication
Education materials
related to the content
of reviews building on
Journal Club
Responsive review
service to customers
To improve quality and timeliness of
content, and engage users
Monthly!
To improve accessibility of our
reviews and engage with users
Not yet
determined
To improve relevance and increase
use of cochrane reviews in
guidelines
To improve accessibility, to act as a
user friendly spring board into the
evidence
On demand!
Cochrane
Education
Cochrane
Response
Cochrane PICO An concise summary
of evidence from
Cochrane Reviews
aimed at a specific
question
Pilot due
May 2010
How can we
measure
success?
thanks for listening
[email protected]