Jonathan Craig, Australasian Cochrane Symposium

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The Cochrane Collaboration: people and product for improving policy and practice …

The Cochrane Collaboration: people and product for improving policy and practice
(Presentation by Jonathan Craig, Co-Chair of the Cochrane Collaboration, at the Australasian Cochran Symposium, 1 July 2011)

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  • The gap between what we know and what we do. Eg A famous study by Antman in the early 90s charted the delays from the results of cardiovascular trials and recommendations in textbooks Given rise to the new discipline of knowledge translation

Transcript

  • 1.  
  • 2. The Cochrane Collaboration: people and product for improving policy and practice Jonathan Craig Co-Chair, Cochrane Collaboration Coordinating Editor, Cochrane Renal Group + Australasian Contributors
  • 3. Modern healthcare
    • Is full of (intervention) questions
    • Is expensive
      • A$150 billion
    • Is a commercial enterprise
    • Is informed by a massive amount of poor quality and inaccessible data (...and some valid data)
    • Is often unhealthy
  • 4. PBS expenditure
  • 5. Research-practice gap Schuster, McGlynn, Brook (1998). Milbank Memorial Quarterly Use Don’t use More good than harm ☺ + (30-40%) More harm than good + (20-25%) ☺
  • 6.
    • ‘ There is a gap between today’s scientific advances and their application: between what we know and what is actually being done. Health work teaches us with great rigour that action without knowledge is wasted effort, just as knowledge without action is wasted resource’.
    • LEE Jong-wook, past WHO Director General
  • 7. Use of IL2a in kidney transplants
  • 8.  
  • 9.  
  • 10.  
  • 11.  
  • 12.  
  • 13. Most cited neonatal reviews: almost all have an Australia author
  • 14. Cooling asphyxiated term infants prevents severe disability and death
    • Jacobs SE, Hunt R, Tarnow-Mordi WO, Inder TE, Davis PG. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database of Systematic Reviews 2007, Issue 4.
    • Therapeutic hypothermia resulted in a statistically significant and clinically important reduction in the combined outcome of mortality or major neuro-developmental disability to 18 months of age [RR 0.76, 95% CI 0.65, 0.89, RD -0.15, 95% CI -0.24, -0.07, NNT 7 (95% CI 4, 14)].
  • 15. Philippa Middleton
  • 16.  
  • 17. The Cochrane Collaboration Where are we now?
    • Globally
    • Currently over 28,000 contributors from 109 countries
    • Nearly 90 groups
      • Collaborative review groups
      • Methods groups
      • Fields
      • Centres
  • 18. Global coverage of Cochrane Library – ½ worlds population now free one-click access Green – national license, Red – free access, Blue – old wide, Yellow – new wide
  • 19. Our vision and work-plan: a pipeline connecting authors with users
    • Develop Cochrane reviews which are more relevant to users, more up to date, higher quality, better organised, and easier to read and access
    • Develop a more comprehensive suite of reviews (diagnostic, multiple comparisons)
    • A more rapid and consistent editorial process
  • 20. Our vision and workplan: a pipeline connecting authors with users
    • Ensure Cochrane reviews are consumer focussed
    • Ensure Cochrane reviews are relevant globally
      • Cochrane Academy
      • Cochrane Satellites
    • Diversify and strengthen our funding streams
    • Develop stronger partnerships with relevant organisations (WHO, NHMRC, DOHA)
  • 21. We care about health We care about improved health We care about evidence-informed decision making