Page 102 - Encyclopedia of Nursing Research

CoCHRAnE REvIEW n 69

understand potential risks and benefits of par- specialty and subspecialty. In 1974, initial
ticipation and any effects on their care should work toward systematically collating evi-
they decide to withdraw at any point in the dence from controlled trials began in peri- C
study. Issues of withholding treatment include natal medicine, which developed into an
increasing subject risk or subject benefit if international collaboration 10 years later. In
there is reasonable evidence of positive effects 1992, the Cochrane Centre opened in oxford,
of the intervention or treatment. Careful mon- United Kingdom, and two Cochrane Review
itoring of the effects of interventions or treat- Groups were registered: the Pregnancy and
ment is necessary to stop the trial if there is Childbirth Group and the Subfertility Group
associated morbidity or mortality and extend- (The Cochrane Collaboration History, 2010).
ing the intervention or treatment to the con- Twelve months later, the international col-
trol group in the event of significantly positive laboration now known as the Cochrane
treatment effects. Collaboration was launched. The work of
Clinical trials remain the principal way the Cochrane Collaboration in preparing
to collect scientific data on the value of inter- and maintaining reviews centers around
ventions and treatment. However, in design- Cochrane Review Groups of which there are
ing and evaluating clinical trials, rigor of now more than 50 representing a broad range
method, including careful evaluation of of health care specialities (Green et al., 2008).
potential biasing factors, is essential. Meta- Publication of Cochrane reviews on
analysis provides a summary of all available, health care evidence has important societal
unbiased evidence on the relative effects of and economical implications. The philoso-
treatment. However, rigor of methods used phy of the Cochrane Collaboration centers
to conduct the meta-analysis also must be on the need for the best quality evidence
evaluated. being readily available in an easily accessible,
comprehensible format to all stakeholders
Dorothy Brooten including policy makers, health care practi-
tioners, patients, their advocates, and carers.
Therefore, Cochrane reviews target society
at large such that they can be accessed free
CoChrane review of charge by all citizens in countries where
a national license has been purchased by
governments to access the Cochrane Library
Cochrane reviews are systematic reviews (Green & McDonald, 2005). Accessibility
that aim to collate all the available evidence involves more than making reviews avail-
that fits predetermined eligibility criteria to able and easy to find; it includes mak-
assess the effectiveness of health care inter- ing reviews easy to interpret by lay health
ventions. The pioneering work of an epidemi- care consumers (Green & McDonald, 2005).
ologist, Archie Cochrane, has influenced the To this end, a lay summary of evidence is
development of Cochrane reviews. Cochrane included in all Cochrane reviews. “Avoiding
was committed to addressing major deficits duplication by good management and co-
within the British health care services. In a ordination to maximise economy of effort”
seminal textbook, Cochrane (1972) stated is a principle underpinning the work of
that “effectiveness” ought to be one of the the Cochrane Collaboration (Green et al.,
pillars underpinning health care interven- 2008, p. 8). According to Clarke, Alderson,
tions, and he pointed to a collective need to and Chalmers (2002), there is a serious risk
question the effects of health care interven- of wasting billions of dollars spent on con-
tions through the systematic review of evi- trolled trials if systematic reviews of the
dence from controlled trials, organized by findings of individual trials are not collated