The Cochrane Collaboration

1.  The Cochrane Collaboration Preparing, maintaining and disseminating systematic reviews of the effects of health care

2. Archie Cochrane

3. 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 Archie Cochrane

4. There were only 4 deaths 3 due to gunshot wounds. Archie Cochrane

5. “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’

6. 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. Archie Cochrane

7. 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. Archie Cochrane

8. “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’

9. 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. Archie Cochrane

10. “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

11. 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

12. Iain Chalmers

13. 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 The story of the Cochrane Library

14. 1987 Letters to 42,000 obstetricians in 20 countries seeking unpublished trials 1988 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 The story of the Cochrane Library

15. 1993 Foundation of the Cochrane Collaboration 1993 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 The story of the Cochrane Library

16. Cochrane Database of Systematic Reviews (CDSR) Database of Abstracts of Reviews of Effectiveness (DARE) Cochrane Central Controlled Trials Register (CENTRAL) Cochrane Database of Methodology Reviews Cochrane Methodology Register (CMR) About the Cochrane Collaboration Health Technology Assessment Database (HTA) NHS Economic Evaluation Database (NHS EED) The Cochrane Library

17. About 6000 contributors 49 Collaborative Review Groups (CRGs) 12 Centres throughout the world 9 Fields 11 Methods Groups 1 Consumer Network Campbell Collaboration The Cochrane Collaboration