The past, the present and the future

The last day of the Cochrane Colloquium kicked off with the first annual Cochrane lecture, delivered by Sir Iain Chalmers via videoconference. He showed a film he recently made with Mark Starr demonstrating the Oxford Database of Perinatal Trials (ODPT – 1988-1993) and The Cochrane Collaboration Pregnancy and Childbirth Database (CCPC – 1993-1995), both of which were developed to provide the means for keeping systematic reviews up to date, and which the vast majority of people involved in The Cochrane Collaboration will never have heard of. These two publications were the predecessors of the Cochrane Database of Systematic Reviews. This short flim gave us some insight into the origins of the Cochrane Library and was really interesting.

During his discussion Sir Chalmers also emphasized the need to meet the continuing challenge of keeping reviews up to date. Currently, about 75 trials and 11 systematic reviews are being published on a daily basis! Not only does this pose a challenge to anyone who wants to keep abreast of the newest developments in health care, but also to the Cochrane Collaboration and the various editorial groups that are attempting to keep systematic reviews up to date.

By referring to a recent article published in PLoS Medicine (Bastian H et al. 2010: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000326), Sir Chalmers made the following suggestions for overcoming this challenge:

1. We need to reduce avoidable waste. This includes putting new RCT’s in the context of existing systematic reviews, therefore only conducting new trials if additional evidence is necessary. The same applies to systematic reviews.

2. We need to prioritise the questions that need to be addressed by considering the needs of policy makers, clinicians and patients, and by identifying the gaps in clinical guidelines.

3. We need streamlining and innovative methods to increase efficiency without comprimising the quality of the reviews. Some advances towards the standardisation of rapid reviews and the automation of systematic reviews have been made in this regard – although it is imperative to note that humans are the essential ingredient of systematic reviews and that cutting corners has the potential to introduce bias.

4. We need international collaboration among research funders. This could result in better use of available resources, as well as avoid duplication (=waste) of efforts.

5. We need systematic reviews to be available to clinicians, patients and policy-makers. This means having access to these on an open-access platform, so that they have the information they need to make important healthcare decisions.

After five days of interesting presentations, workshops, conversations and sharing of innovative ideas, it is evident that the future of the Cochrane Collaboration is filled with exciting opportunities, fascinating developments and enthusiastic contributors.

Here is to the next 20 years!

Chateau Frontenac

Chateau Frontenac

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About Centre for Evidence-based Health Care

Evidence-based health care is the use of best evidence to inform healthcare decision-making to improve patient care. The Centre for Evidence-based Health Care develops, teaches and promotes evidence-based health care (EBHC) at undergraduate and postgraduate levels of all healthcare professionals; provides EBHC support and resources to healthcare professionals to help maintain the highest standards of healthcare practice; and enhances the use of best evidence by government, non-governmental organizations and the private sector in healthcare policy and practices. The Centre works in collaboration with a number of local and international institutions. The key principles are to encourage dialogue, enhance EBHC activities and to avoid duplication.
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