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The Cochrane Collaboration

Preparing, maintaining and disseminatingsystematic reviews of the effects of health care

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Archie Cochrane

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Archie Cochrane

• 1941 - 6 months in Salonica as the only medic.

• 20,000 POWs - diets of about 600 cals/day.

• Epidemics of typhoid, diphtheria, sand-fly fever etc. There was jaundice, and everyone had diarrhoea.

• In a ramshackle hospital - only aspirin, antacids and some skin antiseptic.

• He expected hundreds to die of diptheria alone

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Archie Cochrane

• There were only 4 deaths

• 3 due to gunshot wounds.

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“This excellent result had, of course, nothing to do

with the therapy they received or my clinical skills.

It demonstrated, on the other hand, very clearly the

relative unimportance of therapy in comparison

with the recuperative powers of the human body.”

Archie L Cochrane, 1972, p5

‘Effectiveness and Efficiency: Random Reflections on Health Services’

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Archie Cochrane

• Soviet POW who was dying in great pain. He was screaming and Archie had no drugs to help.

• Instinctively, Archie sat on the bed and took the Russian in his arms.

• The effect was almost magical, the Russian quietened at once and died peacefully a little later.

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Archie Cochrane

• Archie C believed his personal

intervention he had improved this

soldier’s quality of life/dying very

dramatically, even though he did not

affect the final outcome.

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“I believe that cure is rare while the need for

care is widespread, and that the pursuit of

cure at all costs may restrict the supply of

care...”

Archie L Cochrane, 1972, p7

‘Effectiveness and Efficiency: Random Reflections on Health Services’

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Archie Cochrane

• He began to Q the effectiveness of the care/treatments he offered. Did they actually worked?

• He became convinced of the importance of RCTs in assessing whether a form of care/treatment worked or not.

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“It is surely a great criticism of our

profession that we have not organised a

critical summary, by speciality and

subspeciality, adapted periodically, of all

relevant randomised controlled trials”

Archie L Cochrane, 1979

‘Medicines for the year 2000’ London. Office for Health Economics. p1-11

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The story of the Cochrane Library

1972 ‘Effectiveness and efficiency: Random

Reflections on Health Sciences’

by Archie Cochrane

Archie awarded the wooden spoon to

obstetricians

1973 Iain Chalmers, an obstetrician, read Archie’s

book and decided to take up the challenge

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Iain Chalmers

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The story of the Cochrane Library

1974 Iain Chalmers began a card file of references of

controlled trials in perinatal medicine

1984 Over 3,000 trials listed and coded

1985 Published ‘Classified bibliography of controlled

trials in perinatal medicine 1940-1984’ (book)1986 Commissioned systematic reviews

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The story of the Cochrane Library

1987 Letters to 42,000 obstetricians in 20 countries seeking unpublished trials1988 Published ‘Oxford database of perinatal trials’ (ODPT) on disc 1989 Published ‘Effective care in pregnancy and childbirth’ (ECPC) and ‘Guide to effective care in pregnancy and childbirth (GECPC)

15 years from beginning to collect the references

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The story of the Cochrane Library

1993 Foundation of the Cochrane Collaboration1993 Publication of the Cochrane Pregnancy & Childbirth database (CCPC)1995 Publication - Cochrane Database of Systematic Reviews (CDSR)1996 Publication of the Cochrane Library (CLIB)

22 years from beginning to collect the references

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The Cochrane LibraryCochrane Database of Systematic Reviews (CDSR)Database of Abstracts of Reviews of Effectiveness

(DARE)Cochrane Central Controlled Trials Register

(CENTRAL)Cochrane Database of Methodology ReviewsCochrane Methodology Register (CMR)About the Cochrane CollaborationHealth Technology Assessment Database (HTA)NHS Economic Evaluation Database (NHS EED)

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The Cochrane Collaboration

About 6000 contributors 49 Collaborative Review Groups (CRGs) 12 Centres throughout the world 9 Fields 11 Methods Groups 1 Consumer Network

Campbell Collaboration

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