Cochrane Collaboration

Relatively few data exist concerning the relative benefits of UFH, LMWH, and heparinoids in acute stroke treatment. In 2005, the Cochrane Collaboration reviewed trials comparing LMWHs or heparinoids with UFH in acute ischemic... 

The Cochrane Collaboration. Anticoagulants for acute ischemic stroke 2006 [Review]. 

Sandercock P, Counsell C, Stobbs SL. Low-molecular-weight heparins or Heparinoids versus standard Unfractionated heparin for acute ischemic stroke (Review). The Cochrane Collaboration 2006. 

Cochrane Library. The Cochrane Library [44] includes The Cochrane Database of Systematic Reviews, a collection of regularly updated, systematic reviews of the effects of health care. It is maintained by contributors to the Cochrane Collaboration. Cochrane reviews are reviews mainly of randomized controlled trials. To minimize bias, evidence is included or excluded on the basis of explicit quality criteria. Data are often combined statistically, with meta-analysis, to increase the power of the findings of numerous studies, each too small to produce reliable results individually. Database of Abstracts of Reviews of Effectiveness is also included. It consists of critical assessments and structured abstracts of good systematic reviews published elsewhere. The Cochrane Controlled Trials Register with bibliographic information on controlled trials and other sources of information on the science of reviewing research and evidence-based health care are part of the Cochrane Library. It is commercially available on CD-ROM or the Internet. 

From http //www.cochrane.org/docs/newcomersguide.htm by permission of the Cochrane Collaboration. 

The Cochrane Collaboration prepares Cochrane Reviews and aims to update them regularly with the latest scientific evidence. Members of the organisation (mostly volunteers) work together to provide evidence to help people make decisions about health care. Some people read the healthcare literature to find reports of randomised controlled trials others find such reports by searching electronic databases others prepare and update Cochrane Reviews based on the evidence found in these trials others work to improve the methods used in Cochrane Reviews others provide a vitally important consumer perspective and others support the people doing these tasks. The Cochrane Collaboration website provides information on a variety of ways of registering interest or becoming directly involved www.cochrane.org/docs/involve.htm involve. 

Data from The Cochrane Library in 2004 show that there are more than 11,500 people working within The Cochrane Collaboration in 91 countries, half of whom are authors of Cochrane Reviews. The number of people has increased by about 20% every year for the last five years. The increase in the number of contributors from low, lower-middle and upper-middle income countries has been even greater, to more than 1000 (9.3%) in 2004 - up by 42% since 2003, and by 248% since 2000. See Reference Centres by country (www.cochrane.org/contact/country.htm) and a world map showing the locations of the Cochrane Centres (www.cochrane.org//contact/entities.htm centres). 

The members of The Cochrane Collaboration are organised into groups, known as entities , of which there are five different types (www.cochrane.org/ contact/entities. htm) ... 

Cochrane Centres (some of which have additional branches) support people in their geographic and linguistic area (www.cochrane.org/contact/ entities.htm centres). Newcomers are encouraged to contact their local Cochrane Centre for information about The Cochrane Collaboration this can save a lot of time and effort. 

The Cochrane Manual (www.cochrane.org/admin/ manual.htm) contains detailed descriptions of the responsibilities of each of these groups of people ( entities ). Cochrane entities receive their funding from different sources, but agree to follow the policies and practices of The Cochrane Collaboration (also contained in The Cochrane Manual). 

The development and implementation of policy affecting The Cochrane Collaboration are the responsibility of the Cochrane Collaboration Steering Group (CCSG), after Collaboration-wide consultation ... 

The Secretariat is the administrative office of The Cochrane Collaboration, and supports the work of the Steering Group and its sub-committees, manages the central finances of the organisation, and facilitates communication (www.cochrane.org/contact/ entities.htm secretariat). It is based in Oxford, England, and has four full-time members of staff the Chief Executive Officer, Secretariat Administrator, Deputy Administrator and Administrative Assistant. 

The Cochrane Collaboration s central functions are funded by royalties from its publishers, John Wiley and Sons Limited, which come from sales of subscriptions to The Cochrane Library. The individual entities of The Cochrane Collaboration are funded by a large variety of governmental, institutional and private funding sources, and are bound by organisation-wide policy limiting uses of funds from corporate sponsors (www.cochrane.org/news/ articles/2004.04.06.htm). There is a Funders Forum to help facilitate discussions between The Cochrane Collaboration and funders (www.cochranefunders. 

Cochrane Reviews are systematic assessments of evidence of the effects of healthcare interventions, intended to help people to make informed decisions about health care, their own or someone else s. Cochrane Reviews are needed to help ensure that healthcare decisions throughout the world can be informed by high quality, timely research evidence. This is described in Systematic reviews and The Cochrane Collaboration (www.cochrane. org/docs/whycc.htm). Cochrane Reviews are published in full in The Cochrane Database of Systematic Reviews, one of several databases in The Cochrane Library (www.thecochranelibrary.com). 

The main output of The Cochrane Collaboration, the Cochrane Reviews, has had a real and significant impact on practice, policy decisions and research around the world. Many examples are given in The Dissemination of Cochrane Evidence (www.cochrane.org/reviews/impact). 

The Cochrane Collaboration has special software for processing Cochrane Reviews called RevMan (Review Manager), managed by the Information Management System (IMS) team at the Nordic Cochrane Centre (www.cc-ims.net/IMSG). 

Information on how to prepare a Cochrane Review is contained in the Cochrane Reviewers Handbook (www.cochrane.org/resources/handbook). Preparing a Cochrane Review requires skills that may be new to the author. The Cochrane Collaboration s Open Learning Material (www.cochrane.org/resources/ openlearning), together with the Cochrane Reviewers Handbook, helps people to prepare a Cochrane Review, and the Cochrane Centres and some Collaborative Review Groups provide or facilitate training through workshops (www.cochrane.org/news/ workshops.htm). 

For editorial teams of Collaborative Review Groups (www.cochrane.org/crgprocedures). This password-protected material contains many procedural resources, including examples of checklists, forms, etc. In addition, the Cochrane Style Guide (www.liv.ac.uk/lstm/ehcap/CSR/home. html) provides guidance to enable people to copy edit Cochrane Reviews and other documents produced within The Cochrane Collaboration in a consistent manner. 

For consumers, the Consumer Network CCNet has a website providing information on the role of health consumers, patients and the general public in the work of The Cochrane Collaboration (www.cochrane.org/consumers). 

Newcomers are enthusiastically welcomed at The Cochrane Collaboration s annual conferences, the Cochrane Colloquia, which take place around the world. Colloquia were held in Barcelona, Spain, in 2003, and in Ottawa, Canada, in 2004. Future Colloquia are scheduled to take place in Melbourne, Australia (2005) in Dublin, Ireland (2006) and in Sao Paulo, Brasil (2007). Further information on these, and all previous Colloquia, is on the website (www.cochrane.org/colloquia), with the abstracts of presentations. 

This material was prepared by Jini Hetherington (Cochrane Collaboration Secretariat), with advice from Jordi Pardo (Iberoamerican Cochrane Centre) and Greg Saunders (German Cochrane Centre). Earlier drafts were sent to many people for comment, and grateful thanks are due in particular to Phil Alderson, Claire Allen, Dave Booker, Mike Clarke, Denis Gregory, Lisa Horwill, Philippa Middleton and Rob Scholten for their helpful feedback. 

Reports and guidelines from drug regulatory authorities, health authorities or other independent institutions, like the Cochrane Collaboration, are valuable in many aspects. Drug regulatory authorities have, in the process of drug... 

The Cochrane Collaboration reviewed interventions for delirium in patients with chronic cognitive impairment and concluded Delirium, though a frequent problem in the hospitalised elderly patient, is still managed empirically and there is no conclusive evidence in the literature to change practice at this time . 

At the time of writing over 190 systematic reviews concerning the use of antimicrobial agents and generated by various review groups, were available in the Cochrane database (www.theCochraneLibrary. com). Of course space does not permit to refer to all these particular reviews individually. However, the indications given and the treatments which are recommended rely as far as possible on evidence-based data as covered by these Cochrane Collaboration Reviews. 

Leontiadis GI, Sharma VK, Howden CW. Systematic review and meta-analysis proton pump inhibitor treatment for ulcer bleeding reduces transfusion requirements and hospital stay-results from the Cochrane Collaboration. Aliment Pharmacol Ther 2005 22 169-74. 

The technique can provide a quantification of the current state of knowledge regarding a particular treatment both in terms of safety and efficacy. The Cochrane Collaboration uses the methodology extensively to provide systematic overviews of treatments in particular therapeutic areas and to answer general health questions. 

Two recent reviews have assessed the efficacy of echinacea for this primary indication. A review by the Cochrane Collaboration involved 16 randomized trials with 22 comparisons. Trials were included if they involved monopreparations of echinacea for cold treatment or prevention. Prevention trials involving rhinovirus inoculation versus natural cold development were excluded. Overall, the review concluded that there was some evidence of efficacy for the aerial (above ground) parts of E purpurea plants in the early treatment of colds but that efficacy for prevention and for other species of echinacea was not clearly shown. Among the placebo-controlled comparisons for cold treatment, echinacea was superior in nine trials, showed a positive trend in one trial, and was insignificant in six trials. 

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