The Cochrane Collaboration httpwwwcochraneorg

The Cochrane collaboration is a worldwide organization committed to evidence-based medicine and the rigorous evaluation of healthcare interventions [61]. Although a relatively young organization, it has already produced a great many high quality systematic reviews and put in place mechanisms for their widespread dissemination and updating, both to healthcare professionals and to the public. It has also done much to promote lay involvement in the organization and in the development and appraisal of systematic review and meta-analysis methodology.

The collaboration is named after Archie Cochrane who, in 1972 published a now classic monograph [61] suggesting that because healthcare resource would always be limited, it should be used to provide, equitably, treatments which had been shown to be effective by properly designed evaluation. In particular he stressed the importance of using evidence from RCTs as these were likely to provide much more reliable information than other sources of evaluation. He noted that even though the results of trials may have been published, valid evidence about the effects of healthcare was not always readily available to those who needed it. He wrote:

It is surely a great criticism of our profession that we have not organised a critical summary, by specialty and subspecialty, adapted periodically, of all relevant randomized controlled trials [62].

These ideas that treatment should be based on interventions that have been shown to be effective by properly controlled research and that systematic, up-to-date summaries of this information should be widely and easily available, comprise the central philosophy and ultimate goal of the Cochrane Collaboration. Founded upon an ambitious vision to put Cochrane's ideas into practice, and building on the experience of the international collaborative development of the Oxford Perinatal Trials Database, the first Cochrane Centre opened in Oxford in 1992. The Cochrane Collaboration, which was founded in 1993, is a worldwide endeavour, the importance of which has been likened to the Human Genome Project [63]. Internationally, thousands ofhealth professionals, consumers and researchers are working together using the principles of systematic review and evidence-based medicine to address unresolved health problems. The collaboration, which has ten key principles (Box 11.10), aims to prepare, maintain, and promote the accessibility of high quality systematic reviews of all aspects of healthcare, based largely, though not exclusively, on the results of RCTs. However, like the Human Genome Project, this will take time. It has been estimated that up to a million RCTs have been published and it is estimated that it will take about twenty years to reach a stable state, where all existing information has been assessed and summarized, so that new primary research can be

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