Medicine and Society 250
International activity in The Cochrane
Collaboration with particular reference to India
Claire Allen, Mike Clarke,
Prathap Tharyan
ABSTRACT
The Cochrane Collaboration is the world’s
largest organization dedicated to preparing, maintaining and
promoting the accessibility of systematic reviews of the
effects of healthcare interventions. It is an international
organization with participants in more than 100 countries.
Since the year 2000, a periodic audit has been done to count
the number of active members in Cochrane Review Groups,
categorized by the countries in which these people are based.
At the beginning of 2007, there were more than 15 800 people
involved, an increase from about 5500 in 2000. The South Asian
Cochrane Network was formed in 2005 to raise awareness about
the Cochrane Collaboration and evidence-based practice in
South Asia, support review authors and contributors from
countries within the region, promote access to The Cochrane
Library and advocate high quality research in South Asia.
The growth of activity in India has been dramatic,
particularly authors of Cochrane reviews and protocols—from
just 19 (with 11 authors) in 2000 to 126 (with 78 authors) in
2007. Increasing the uptake of relevant and reliable evidence
in healthcare decisions in India and the South Asian region
forms the core of the network’s strategic plan. The continued
growth of contributors from India and South Asia will help
ensure that decisions regarding healthcare in the region are
informed by reliable and relevant evidence.
Natl Med J India 2007;20:250–5
BACKGROUND
The Cochrane Collaboration (www.cochrane.org) is an
international, independent and non-profit organization
established in 1993 that has become internationally renowned
for striving to improve healthcare for the world’s population.
It does this by preparing, maintaining and promoting the
accessibility of systematic reviews of the effects of
healthcare interventions. Systematic reviews are a key
component in the evidence base for healthcare and are vital to
making the vast amount of healthcare research manageable and
available for decision-makers. During the past 14 years, more than 3200 full
Cochrane reviews have been prepared, protocols are available
for 1700 more, and many hundreds more are at earlier stages of
development.
This paper describes a periodic audit of
the number of active members in Cochrane Review Groups, which
are responsible for these Cochrane reviews, with a particular
emphasis on activity in India. We show how The Cochrane
Collaboration grew from about 5500 people in 64 countries in
the year 2000 to more than 15 000 people in over 100 countries
by 2007; and how the number of participants in India rose from
19 to 126 over the same period. (Additional information for
other countries is available at http://www.cochrane.org/docs/contributorsbycountry.htm.)
We also detail the activities of the South Asian Cochrane
Network (SACN) and its role in improving healthcare in India
and the South Asian region.
International activity and growth
Since the year 2000, we have conducted a
periodic audit of international activity within Cochrane
Review Groups using information published in The Cochrane
Library.1 This was done most
recently with Issue 1 (January), 2007, using data taken from
the ‘Editorial information’ section in each Cochrane Review
Group’s module. The published information includes the names
and country locations of active members of Cochrane Review
Groups. These members include people involved in the editorial
process for Cochrane reviews, as well as the authors, referees
and others, without whom the enormous collaborative,
international, multidisciplinary effort would not be possible.
One of the authors (CA) extracted data from the modules.
In January 2007, a total of 51 Cochrane
Review Groups were registered with The Cochrane Collaboration
and 15 804 contributors from over 100 countries were listed in
the Cochrane Review Group modules. This represents almost
three times the number of active members since the year 2000,
when there were 5437 contributors in 64 countries. There has
been a steady annual increase of around 20% in the number of
contributors over the past 6 years.
The
majority of the contributors to the work of Cochrane Review
Groups are authors of Cochrane reviews. In 2007, 9457 (60%) of
all contributors were listed as review authors, compared with
2840 (52%) in 2000. During this period, The Cochrane
Collaboration has paid particular attention to increasing
involvement by people in low and middle income countries. In
2006, 1676 (11.2%) people were based in low, lower–middle, and
upper–middle income countries (as classified by the World Bank
http://www.worldbank.org/data/countryclass/classgroups.htm).
This is a more than 5-fold increase in the number of people
since 2000 (307; 5.6%). The growth in these countries is much
larger than the average level worldwide.
|
What is a systematic
review?
To
help identify which forms of healthcare work, which do not and which are
harmful, results from similar studies need to be brought together.
Potentially eligible studies need to be assessed and those that are good
enough can be combined to produce both a more statistically reliable result
and one that can be more easily applied in a variety of settings. This
combination of trials needs to be done in as reliable a way as possible. It
needs to be systematic. A systematic review uses a predefined, explicit
methodology. The methods used include steps to minimize bias in all parts of
the process: identifying relevant studies, selecting them for inclusion, and
collecting and combining their data. Studies should be sought regardless of
their results. The method of statistically pooling data from different
studies is called a meta-analysis. Not all systematic reviews contain a
meta-analysis.
Cochrane reviews are a special type of systematic review, focusing on the
effects of healthcare interventions. They are preceded by a published
protocol, setting out what the authors of the review intend to do, and are
all peer reviewed by at least 2 experts before publication. The authors of
Cochrane reviews have also agreed to keep their reviews up-to-date, so as to
take account of new evidence as it accumulates. |
Cochrane
Collaboration activity in India
The SACN was established in
January 2005 as a branch of the Australasian
Cochrane Centre, with geographical responsibility
for South Asia (India, Sri Lanka, Pakistan,
Bangladesh, Bhutan, the Maldives and Nepal, and more
recently, Afghanistan). There are 3 other branches
of Cochrane Centres (Thailand, Nigeria and
Singapore) and 3 Cochrane Centres (Brazil, China and
South Africa) in low and middle income countries.
The SACN (http://www.cochrane-sacn.org)
consists of a central coordinating base at the
Christian Medical College (CMC), Vellore, Tamil Nadu,
India and a devolved network of sites across the
South Asian region, each contributing to and
supporting the activities of SACN. The site
representatives make up the steering group of SACN.
At present, SACN comprises 6 sites in India, 2 in
Pakistan, 1 in Sri Lanka and 1 in Bangladesh. The
SACN hopes to expand its activities to Afghanistan,
Bhutan, Nepal and the Maldives in the near future.
(Further details of the sites, site coordinators and
activities, and of the members of the international
advisory board can be accessed from http://www.cochrane-sacn.org.)
The goals
of SACN
The goals enumerated in the strategic plan of SACN at its
inception were to: raise awareness about
T ABLE
I. Strategic
plan of the South Asian Cochrane Network (SACN) for
2007–2009
|
Goal |
Themes* |
To increase awareness of The
Cochrane Collaboration, The
Cochrane Library and evidence-
based healthcare in South Asia |
- To increase awareness about Cochrane
systematic reviews and evidence-based practice
- To increase access to and usage of The
Cochrane Library
- To disseminate the results of Cochrane
systematic reviews and evaluate their
usefulness for clinicians, policy-makers and
consumers
|
II. To train and support
contributors
to The Cochrane Collaboration in
South Asia
|
- To develop standard training resources and
a pool of trained trainers
- To conduct a series of workshops and
mentoring activities for review authors
throughout the region
- To train information specialists on the
use of The Cochrane Library and other
evidence-based resources
- To train and organize hand-searching
activities
- To involve and train consumers of
healthcare
|
|
III. To increase the use of
reliable evidence in healthcare decisions |
- To increase capacity among policy-makers
to access, appraise and use evidence from
systematic reviews in formulating healthcare
policy
- To increase capacity among clinicians to
access, appraise and implement evidence
- To identify and prioritize locally
relevant areas for research
|
|
IV. To represent and
advocate for high quality research in South Asia |
- To encourage the prospective registration
of clinical trials in the region
- To improve the design, conduct, quality
and reporting of clinical trials from the
region
- To develop and maintain a register of
published and unpublished clinical trials
conducted in the region
- To identity health research priorities in
the region
- To develop capacity for methodological
research in evaluating healthcare
interventions
|
V. To ensure a sustainable
structure for SACN and contribute substantially
to the Cochrane Collaboration |
- To enhance the capacity of SACN to support
the activities of the Cochrane Collaboration
- To integrate training and support
activities within all countries in South Asia
- To contribute substantially to the
Cochrane Collaboration’s activities
|
*A detailed list of
proposed activities under each theme can be
downloaded with the strategic plan from http/www.cochrane-sacn.org
the Cochrane Collaboration and
evidence-based practice in South Asia; train and
support contributors to the Cochrane Collaboration
in South Asia; promote access to The Cochrane
Library for South Asia; ensure a sustainable
structure for SACN and represent and advocate for
high quality research in South Asia. The activities
and achievements to date are detailed below. The
revised strategic plan for 2007–2009 extends these
goals and adds themes for activities that are
summarized in Table I.
Training and mentoring review authors
Since 2004, SACN has promoted Cochrane activities
in India with help from the Australasian Cochrane
Centre at Melbourne (http://www.cochrane.org.au/)
and others in the Collaboration, particularly from
the UK. Annual 3-day workshops on developing
protocols for Cochrane systematic reviews have been
held for potential review authors at the
coordinating centre at Vellore and have been
followed by annual review completion workshops. In
2007 the Indian Council of Medical Research (ICMR)
funded a protocol development workshop at CMC,
Vellore attended by over 40 members of the ICMR and
ICMR-funded institutions, which led to many
registered titles for systematic reviews authored
T ABLE
II. Number
of contributors from India to Cochrane Reviews
Groups, by type and year
|
Type of contributor |
2000 |
2002 |
2003 |
2004 |
2005 |
2006 |
2007 |
|
Advisors |
2(2) |
2(2) |
2(2) |
1(1) |
1(1) |
1(1) |
1(1) |
|
Authors |
11 (0.5) |
15(0.5) |
20(0.5) |
31 (0.5) |
42 (1) |
80 (1) |
78 (1) |
|
Consumers |
0 |
1(0.5) |
1(0.5) |
3(1) |
3(1) |
3(1) |
3(1) |
|
Editorial team
members |
0 |
1(0.5) |
1(0.5) |
1(0.5) |
0 |
0 |
0 |
|
Editors |
2(1) |
1 (0.5) |
2(1) |
5 (1) |
5 (1) |
5 (1) |
5 (1) |
|
Hand-searchers |
1 (0.5) |
2 (1) |
3 (1) |
3 (1) |
1 (0.5) |
1 (1) |
1 (0.3) |
|
Peer reviewers
|
3 (0.5) |
6 (0.5) |
8 (0.5) |
17 (1) |
21 (1) |
26 (1) |
35 (1) |
|
Translators
|
0 |
3(2) |
3(1) |
3(1) |
3(1) |
3(1) |
3(1) |
|
Trials search
coordinators |
0 |
0 |
0 |
0 |
0 |
1(2) |
0 |
|
Total |
19 (0.3) |
31 (0.4) |
40 (0.4) |
64 (0.5) |
76 (0.6) |
120 (0.8) |
126 (0.8) |
Note: Figures in
parentheses are the proportion of the relevant
global figure
by policy-makers. In 2006, a
5-day workshop on basic and advanced statistics for
meta-analysis was held at Vellore, India and was
repeated in August 2007 in Karachi, Pakistan and
Chandigarh, India. Shorter workshops to assist
review authors have also been held at other network
sites in India, Bangladesh, Pakistan and Sri Lanka.
The editorial base of the Cochrane Schizophrenia
Review Group in the UK (http://szg.cochrane.org/en/index.html)
helped establish a satellite centre at Vellore in
India in January 2006 that now helps in searching
for and coding trials of interventions for people
with schizophrenia for the Cochrane Schizophrenia
Group’s Specialized Register (that holds more than
10 000 reports of randomized controlled trials). The
SACN coordinating centre at Vellore also runs a
mentorship programme for authors of reviews
addressing some of the Millennium Development Goals
through its involvement in the Effective Health Care
Research Programme Consortium (http://www.liv.ac.uk/evidence/)
coordinated by the editorial base of the Cochrane
Infectious Diseases Review Group at the Liverpool
School of Tropical Medicine, UK. The coordinating
centre of SACN is now funded by a 5-year grant as an
ICMR Advanced Centre for Research and Training in
Evidence-Based Healthcare.
The activities of SACN are likely to have been
influential in increasing the number of contributors
to the work of Cochrane Review Groups in India––from
19 in the year 2000 to 126 in 2007. Particularly
dramatic has been the increase in authors from 11 in
the year 2000 and 31 in 2004 (before the formation
of SACN) to 78 in January 2007 (Table II).
TABLE
III. Cochrane
Review Groups in which people based in India are
listed
|
Group |
Group |
Acute respiratory infections
Airways
Anaesthesia
Breast cancer
Childhood cancer
Colorectal cancer
Cystic fibrosis and genetic disorders
Dementia and cognitive improvement
Ear, nose and throat
Epilepsy
Fertility regulation
Heart
Hepato-biliary
HIV/AIDS |
Infectious diseases
Injuries
Movement disorders
Multiple sclerosis
Musculoskeletal
Neonatal
Neuromuscular diseases
Oral health
Pregnancy and childbirth
Renal
Schizophrenia
Skin
Stroke
Wounds |
By Issue 1, 2007 of The
Cochrane Library, there were 23 reviews and 27
protocols with a contact author based in India, and
contact or co-authors were listed in the modules of
28 (55%) out of the current 51 Cochrane Review
Groups (Table III). This increase in participation
in the activities of the Cochrane Collaboration from
South Asia is, however, far less dramatic than that
seen in China; from 15 in 2000 to 454 in 2007,
making China the seventh largest contributor in the
Collaboration.1
The majority of reviews published from China cover
Chinese herbal medicines and traditional Chinese
remedies. Many people in the Indian subcontinent use
remedies from within the ancient systems of Ayurveda,
Siddha and Unani for their ailments and yoga is also
widely used as an intervention in healthcare. The
SACN hopes to undertake systematic reviews on the
efficacy and safety of the more promising of these
interventions so that their continued use is based
on reliable evidence.
Promoting access to The Cochrane Library
The abstracts of Cochrane
systematic reviews are freely available to anyone in
the world, but access to the full resources of
The Cochrane Library requires a subscription.
All countries in Latin and Central America and the
Caribbean, and several other developing countries in
many parts of Africa and Asia (including
Afghanistan, Bangladesh, Bhutan and Nepal) get free
access through internationally funded initiatives.
India was ineligible for free access via these
sponsored initiatives, hence the need to consider
other means for universal access.
In January 2007, an agreement was
reached between the ICMR and the publishing partner
of The Cochrane Collaboration, John Wiley and Sons
Limited, to ensure provision of The Cochrane
Library to all residents of India with internet
access, free at the point of use. One concern
expressed was that this national provision would not
be widely used. This fear was belied by data
provided by the publishers that reveals a 350%
increase in downloads of full texts of Cochrane
reviews from The Cochrane Library by users in
India in the first 6 months of 2007 over the last 7
months of 2006 (3999 downloads with 2848 instances
where access was denied in 2006 versus 24 090
downloads and no instances where access was denied
in 2007). India is the first low income country to
purchase national access to this evidence-based
information resource for its entire people. This
initiative of the ICMR has the potential to help
shape the future of healthcare in India.
If this investment is to prove worthwhile, then
dissemination of this information needs to be
coupled with more workshops on the role of systematic reviews in
informing healthcare decision-making and on using
The Cochrane Library, for clinicians, students,
policy-makers and members of the public.
Disseminating evidence from Cochrane systematic
reviews
It is also important to
disseminate the evidence from systematic reviews in
the form of summaries that are easily understood by
busy clinicians. One such initiative is Evidence
Update (www.liv.ac.uk/evidence/evidenceupdate/home.htm),
2-page summaries of Cochrane Reviews of
healthcare interventions relevant to people in low
income and middle income countries. Each Evidence
Update is prepared by a member of the Effective
Health Care Research Programme Consortium (a
partnership of researchers from the UK, Africa,
China, India, Russia and the Philippines,
coordinated by the Cochrane Infectious Diseases
Group from Liverpool, UK) in collaboration with the
Australasian Cochrane Centre, and is updated every
time a review update is published in the Cochrane
Database of Systematic Reviews. The SACN
coordinating site is helping to disseminate and
evaluate Evidence Update. Currently, over 45
such summaries are free to download, print, include
in news bulletins, journals and continuing education
programmes.
Another initiative to disseminate
evidence from Cochrane reviews is the ‘Evidence Aid
Project: Resources for natural disasters and other
healthcare emergencies’ (www.cochrane.org/evidenceid/project.htm).
This is a project initiated by the Collaboration in
2005 in the aftermath of the Asian tsunami in
December 2004.2 Where
possible, a structured summary (Evidence Update)
or another summary has been prepared, based on one
or more Cochrane reviews of interventions relevant
to healthcare emergencies. A link is given to the
review in The Cochrane Library, if a summary
is not available but a relevant Cochrane review
exists. If a suitable Cochrane review is not
available, there are links to other sources of
evidence, in particular to topics in the BMJ’s
Clinical Evidence. It is hoped that
Evidence Aid will help government and
non-government agencies, other organizations and
individuals in planning and making decisions about
healthcare in the aftermath of disasters or
healthcare emergencies. The site also contains a
list of topics for which no Cochrane review is
currently available; this list could inform
potential review authors who seek a suitable topic
to review.
Using evidence to change policy
Cochrane systematic reviews have been influential
in changing policy and practice, and are
systematically incorporated into many practice
guidelines worldwide (for more details, see
http://www.cochrane.org/reviews/impact/index.htm).
In India, the results of Cochrane reviews were used
to guide the content of counsellor training and the
official response to the psychological trauma
wreaked by the Asian tsunami.2
More recently, the results of a Cochrane review,
with authors from the region,3
were
|
What is The Cochrane
Library?
The Cochrane Library is
an electronic publication, available on the
internet. It contains high quality, independent
evidence to inform healthcare decision-making.
It includes reliable evidence from Cochrane and
other systematic reviews, a register of
published and unpublished clinical trials, and
more. Cochrane reviews bring you the combined
results of the world’s best medical research
studies, and provide the knowledge needed to
underpin many decisions for evidence-based
healthcare. |
influential in changing the
Malaria Drug Policy 2007 in India (http://www.nvbdcp.gov.in/Doc/Revised%20drug%20policy.pdf)
on dosing regimens for primaquine in preventing
relapses of malaria due to Plasmodium vivax.
Health is a state subject in
India. If healthcare at the state level is to be
based on reliable evidence, progress in engaging
policy-makers within the ICMR and ICMR-supported
institutions needs to be followed up with engaging
policy-makers within health ministries in every
state in India.
Ensuring a sustainable structure for SACN
In April 2008, the coordinating
centre of SACN at Vellore, India, will host the
mid-year meetings of the Cochrane Collaboration
Steering Group (which is the internationally elected
group of people who make policy decisions on behalf
of The Cochrane Collaboration), the Cochrane Centre
Directors and Editorial Board of the Coordinating
Editors of the Review Groups. This will hopefully
raise the profile of both SACN and the Collaboration
through a series of associated meetings, including a
South Asian Regional Seminar on Evidence Based
Healthcare. The SACN also hopes to succeed in its
bid to become an independent South Asian Cochrane
Network and Centre in the interim.
Limitations of the evidence in the Cochrane
Library
The overall quality of systematic
reviews produced by The Cochrane Collaboration has
been judged to be of greater methodological rigour
than systematic reviews published in printed
journals indexed in MEDLINE.4However, the Cochrane
Database of Systematic Reviews does not provide
definitive answers to all questions raised about the
efficacy and safety of interventions. Roughly 50% of
reviews for some healthcare conditions have
uncertain results and a third of the interventions,
from the ones that do have conclusive results, may
not be applicable in developing country settings.Less than 10% of the trials in
many Cochrane reviews were conducted in countries
with similar healthcare problems or delivery systems
to those in India and the South Asian region, adding
further to the difficulties in generalizing the
results of these reviews to policy and care in
India.5
The responsibility for rectifying these limitations
undoubtedly rests with the Collaboration, but since
the Collaboration largely exists because of the
enthusiasm, involvement and generosity of
individuals, it would be fair to lay a large part of
this responsibility with all those in the South
Asian region interested in using reliable evidence
to inform healthcare decisions.
Advocating for high quality research in the
region
Cochrane reviews often exclude
randomized trials of poor methodological quality and
those that are not randomized, in order to provide
reliable answers to review questions. The full
benefits of the national provision to The
Cochrane Library are therefore unlikely to be
realized unless more randomized trials that
adequately report methods that minimize bias,
confounding and the effects of chance are conducted
and published from the region, so that their
inclusion in systematic reviews could provide
evidence that is relevant to the region. This
requires the coordinated efforts of medical journal
editors, peer reviewers, institutional review boards
and trialists, and conformity with international
standards in prospectively registering these trials
and in reporting results. If more people from India
and the region undertake systematic reviews, then
the review questions themselves are also more likely
to be framed to reflect the healthcare conditions
and interventions used in the region.
|
Getting involved with The
Cochrane Collaboration
There are many ways in
which you can get involved with the activities
of The Cochrane Collaboration:
As a review author
Resources: The Cochrane
Collaboration’s web-page has useful resources
for learning more about how to do systematic
reviews (http://cochrane.org/index_authors_researchers.htm)
that include the Collaboration’s handbook and
links to download RevMan, the Collaboration’s
software to prepare and maintain systematic
reviews; online training through the open
learning materials that complement the
Collaboration’s handbook can be accessed at
http://www.cochrane-net.org/openlearning/
Face to face training
workshops: Schedules for training
workshops worldwide can be accessed at
http://www.cochrane.org/news/workshops.htm
and for workshops in the South Asian Region at
http://www.cochrane-sacn.org
You can also contact
Cochrane Review Groups to enquire about local
workshops and about review topics at
http://www.cochrane.org/contact/entities.htm
As a hand-searcher
You can hand-search
healthcare journals from the region that are
not indexed in international databases and
contribute trials from the region to the
Cochrane Central Register of Controlled
Clinical Trials (CENTRAL). Databases and
procedural documents, training resources
including an online training course and other
resources are available at http://cochrane.org/resources/hsearch.htm
As a consumer of healthcare
You can help by providing
consumer input into developing Cochrane
systematic reviews of best evidence in
healthcare and in utilizing this evidence. The
Cochrane Consumer Network homepage with
resources and information on how you can
contribute can be accessed at http://www.cochrane.org/consumers/homepage.htm.
You may also contact cochrane@cmcvellore.ac.in
for guidance.
As a methodologist
If you are a statistician
or have expertise in other methodological
aspects of systematic reviews, you can
contribute through one of the 12 Cochrane
Methods Groups (http://www.cochrane.org/contact/entities.htm#MGLIST).
As a translator
Many reports of trials are
in languages other than English. If your
language skills extend beyond English or
Indian languages, and you are willing to
contribute your time and skill free of cost,
please contact the SACN coordinating centre (http://www.cochrane-sacn.org).
We also need help in translating evidence
summaries into Indian languages.
As a member of a Cochrane field
Cochrane fields focus on
dimensions of healthcare other than
interventions such as the setting of care
(e.g. primary care), the type of consumer
(e.g. older people), the type of provider
(e.g. nurses) or the type of intervention
(e.g. physical therapies). For more
information on ways to get involved, contact
one of the relevant fields (http://www.cochrane.org/contact/entities.htm#FIELDLIST).
As a funder
The work of the
Collaboration is based on voluntary commitment
of individuals and organizations. If you or
your organization wishes to fund the
activities of the Cochrane Collaboration, you
may contact the relevant review group, field
or network or the Collaboration’s secretariat
(secretariat @cochrane.org). If
you wish to support the work of SACN, please
contact cochrane@cmcvellore.ac.in.
|
Evidence-based healthcare in South
Asia
There will always be tension between the
disciplines of evidence-based medicine and the
experiences of people in the developing world
pertaining to what the evidence indicates and what
people actually do. Healthcare in the region is
largely driven by profit (profit-based medicine) and
people have largely sought traditional remedies and
magical–religious treatments (fate or faith-based
medicine). However, evidence-based medicine attempts
to integrate the best research evidence with
clinical expertise and
the values and preferences of people. These tensions
are
therefore inevitable and do not detract from the
need to continue to assemble, synthesize, maintain
and disseminate the evidence, and even to attempt to
produce good quality, real-world evidence, when
indicated by the results of systematic reviews.5,6
The greater participation from people in India and
the region in this collaborative endeavour is the
best way to ensure that healthcare in the region is
based on reliable and relevant evidence.
Conclusions
Through international
cooperation, the 51 Cochrane Review Groups with
editorial bases around the world have produced 3000
full Cochrane reviews and are working on thousands
more. However, it has been estimated that at least
10 000 or more separate systematic reviews would be
needed to cover all healthcare interventions
investigated in randomized trials published before
2001,7 and maintaining these
reviews would require that at least 5000 would have
to be updated every year in accordance with The
Cochrane Collaboration’s current policy of updating
reviews every 2 years. This will require continuing
global cooperation and collaboration.
India has one of the largest
populations in the world and, therefore, can be
thought to have one of the greatest potentials to be
a country with the most active contributors to The
Cochrane Collaboration. It has shown a rapid growth
in the number of participants between 2000 and 2007.
Given that one of the objectives of SACN is to
identify and support people in the South Asian
region who wish to prepare and maintain Cochrane
reviews, it is to be expected that the number of
authors based in those countries will continue to
rise, as will the number of their reviews in The
Cochrane Library. This is likely to bring fresh
challenges for cooperation between these authors,
the SACN and Cochrane Review Groups. However,
without such cooperation the growth will not be
sustained and the potential enormous value of
Cochrane reviews for well-informed decision-making
in India may be lost. As with many other aspects in
the growth of The Cochrane Collaboration during its
first 14 years, we look forward to these challenges
being met.
Acknowledgements
We are grateful to Liz Fisher,
Jini Hetherington, Louise Kitchener, Kim Pollard and
Diana Wyatt, who helped with the audits in earlier
years and to Youping Li for her suggestion to report
this work. The SACN is grateful for the support from
the Australasian Cochrane Centre (Sally Green and
Steve McDonald in particular), Clive Adams and the
editorial base of the Cochrane Schizophrenia Group,
Paul Garner and the International Health Group at
the Liverpool School of Tropical Medicine, Sir Iain
Chalmers, from the James Lind Initiative, and Mike
Clarke from the UK Cochrane Centre, Jini
Hetherington at the Collaboration Secretariat and
others from the Cochrane Collaboration too numerous
to name.
More information about The
Cochrane Collaboration is available from
http://www.cochrane.org, including 5
introductory leaflets (http://www.cochrane.org/resources/leaflet.htm).
The SACN invites subscribers to its mailing list
that can be accessed via:
south-asian-subscribers@cochrane.de
The views expressed in this paper
are those of the authors and not necessarily those
of The Cochrane Collaboration. A part of this
article has been published previously.1
DECLARATION OF INTEREST
The authors are members of the
Cochrane Collaboration. Dr Tharyan has received
funds for travel and hospitality from the WHO
International Clinical Trials Registry Platform, the
ICMR, the Cochrane Collaboration and John Wiley and
Sons, the publishers of The Cochrane Library.
REFERENCES
-
Allen C, Clarke M,
International activity in Cochrane Review Groups
with particular reference to China. Chin J Evid
Based Med 2006;6:541–5.
-
Tharyan P, Clarke M, Green S.
How the Cochrane collaboration is responding to
the Asian tsunami. PLoS Med 2005;2:e169.
-
Galappaththy GN, Omari AA,
Tharyan P. Primaquine for preventing relapses in
people with Plasmodium vivax malaria.
Cochrane Database Syst Rev 2007;(1): CD004389.
DOI: 10.1002/14651858.CD004389.pub2
-
Jadad AR, Cook DJ, Jones A,
Klassen TP, Tugwell P, Moher M, et al.
Methodology and reports of systematic reviews and
meta-analyses: A comparison of Cochrane reviews
with articles published in paper-based journals.
JAMA 1998;280:278–80.
-
Tharyan P. The Cochrane
Schizophrenia Group: Preparing, maintaining and
disseminating the evidence for interventions used
for people with schizophrenia. Int Rev
Psychiatry 2005;17:115–21.
-
Raveendran NS, Tharyan P,
Alexander J, Adams CE. Rapid tranquillisation in
psychiatric emergency settings in India: Pragmatic
randomised controlled trial of intramuscular
olanzapine versus intramuscular haloperidol plus
promethazine. BMJ 2007;335:865.
-
Mallett S, Clarke M. How many
Cochrane reviews are needed to cover existing
evidence on the effects of health care
interventions? Evid Based Med 2003;8:100–1.
|
