What is Cochrane all about?

What is the Cochrane Library and how can it be used? The Cochrane Collaboration is a loose knit organisation of people located throughout the world who are dedicated to providing the work necessary to produce the Cochrane Library. The library is an attempt to present research findings in a way that can be easily accessed by clinicians. It is named after Archie Cochrane, a British epidemiolo-gist who highlighted the great gap between research being undertaken, published and stored carefully in libraries, and the actual clinical decisions made by clinicians. 1 The gap seems to be ever widening: more and more information is discovered about diseases and their best management, but doctors seemed to ignore this information when making clinical decisions. Treatments are being used that are ineffective (or even harmful), and effective treatments are not used. Iain Chalmers, an obstetrician practising in Oxford, attempted to redress this in the area of obstetrics. He developed the Oxford Database of Perinatal Trials, which was followed by a series of systematic reviews, Effective Care in Pregnancy and Childbirth. 4 From this kernel came the worldwide collaboration , extending beyond perinatal care. There are now 50 Collaborative Review Groups acting as editorial bases to coordinate the systematic review of the literature searching for answers about different treatments. The engine of the Cochrane Collaboration is the systematic review. This is a piece of research that attempts to answer a question of effectiveness for a clinical treatment. The subject matter is the literature itself. 'Reviewers' (as the authors of this research are called, rather confusingly) systematically search the literature for any research that answers the treatment question. Reviews are presented as a document that looks like a research paper, ie. there is an abstract, methods, results and conclusions. Sometimes the data from the reviewed research can be combined, in which case the systematic review is called a 'meta-analysis' (meta meaning after). The process for completing Cochrane Reviews is complicated: potential reviewers submit a question to answer (called a Title at this stage). When accepted, this discourages others working on the same question (to reduce duplication of effort). The reviewers are then asked to submit a full Protocol, which is the methods intended to conduct the review. This is subject to peer review, and after any necessary amendments are made, the reviewers are invited to actually complete the review. When this is submitted to the Collaborative Review …