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The Cochrane Library and Evidence Based MedicineLast update: 14 September 2009, Below are some notes which I hope may be helpful to you in gaining an understanding of evidence-based medicine and the contribution of the Cochrane Collaboration. You will find additional resources on my public health page. The Cochrane Collaboration was the first evidence based collaboration, but there are now two additional and complementary resources - The Joanna Briggs Institute for Evidence Based Nursing, and The Campbell Collaboration Library. Archie Cochrane and the Cochrane LibraryArchie Cochrane, a physician and humanitarian (1909-1988), strongly advocated producing systematic reviews of the medical literature as a way of creating "evidence based medicine." He believed it was not humanly possible for a clinician to keep abreast of the volumes of information that were being generated and summarized this concern in his famous statement, "It is surely a great criticism of our profession that we have not organized a critical summary, by specialty or subspecialty, adapted periodically, of all relevant randomized controlled trials." He envisioned an organization which existed for the sole purpose of conducting these systematic reviews in every aspect of medicine. A systematic review is a systematic assembly of the results of studies which use methods that minimize bias and random error. In 1993, Archie Cochrane's dream came true with the establishment of the the Cochrane Collaboration . The Cochrane Collaboration is comprised of health care providers, consumers, and scientists who volunteer time to compile up-to-date systematic reviews of evidence. These reviews are published quarterly in the Cochrane library, The purpose of the Cochrane Collaboration is to prepare, maintain and disseminate systematic reviews of randomised controlled trials (RCTs). Prior to its establishment the vast amount of clinically important information gathered through RCTs often failed to influence clinical practice. This was because of the enormity of the undertaking for any individual to collate research findings dispersed through the world literature in a number of languages and covering several decades. For additional information click here The Ten Principles of the Cochrane Collaboration(extracted from the Cochrane Collaboration Brochure )The Cochrane Collaboration has evolved rapidly since it was inaugurated at the 1st Colloquium, but its basic objectives and principles have remained the same as they were at its inception. It is an international organization that aims to help people make well informed decisions about health care by preparing, maintaining and ensuring the accessibility of systematic reviews of the effects of health care interventions. The Collaboration is being built on ten principles:
Other Cochrane Collaboration information leaflets can be found here.
The Cochrane Library (and Related Resources)Abstracts of Cochrane Reviews - Browse by Collaborative Review Group The Cochrane Library includes the databases listed below
The Cochrane Database of Systematic Reviews is now indexed for Medline. The definition of evidence-based medicine provided in the Medline thesaurus.The process of systematically finding, appraising, and using contemporaneous research findings as the basis for clinical decisions. Evidence-based medicine asks questions, finds and appraises the relevant data, and harnesses that information for everyday clinical practice. Evidence-based medicine follows four steps: formulate a clear clinical question from a patient's problem; search the literature for relevant clinical articles; evaluate (critically appraise) the evidence for its validity and usefulness; implement useful findings in clinical practice. The term "evidence based medicine" (no hyphen) was coined at McMaster Medical School in Canada in the 1980's to label this clinical learning strategy, which people at the school had been developing for over a decade. (From BMJ 1995; 310:1122)
Systematic ReviewsCochrane Handbook for Systematic Reviews of Interventions Systematic Reviews: CRD's Guidance for Undertaking Reviews in Health Care Randomised Controlled TrialsCentral to the Cochrane methodology and evidence based medicine is the randomised controlled clinical trial. CONSORT (Consolidated Standards of Reporting Trials) comprises a checklist and flow diagram to help improve the quality of reports of randomized controlled trials. It offers a standard way for researchers to report trials. Books on Evidence-Based Medicine held by the LibraryClick here to see a list of books on evidence-based medicine held by the library. The list appears in order by title, but may be resorted by publication date, or by author. Journal Articles of InterestDickersin
K.
, Scherer R., Lefebvre C. Systematic Reviews: Identifying relevant
studies
for systematic reviews. And finally, from the BMJ -Sacred Cows: to the abattoir! Down with EBM! and EBM: Unmasking the ugly truth Yes the promoters of evidence-based methods do have a sense of humour! |
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