Transcript The Cochrane Collaboration

Finola Delamere,
Managing Editor
Cochrane Skin Group
Centre of Evidence Based
Dermatology (CEBD)
Nottingham, UK
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An introduction to the
Cochrane Collaboration & the
Cochrane Skin Group
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Rationale for Cochrane Collaboration

Collective ignorance about effects of healthcare
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Overwhelming amount of clinical information

A systematic approach needed to organising
and evaluating clinical trial data

The Cochrane systematic review
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What is the Cochrane
Collaboration?
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An international organisation
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It prepares and maintains the Cochrane Library
which is published online

The principle source of up-to-date high quality
evidence on the effects of healthcare interventions
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Cochrane Centres
Canadian
Nordic
German
UK
Dutch
French
Iberoamerican
Italian
Chinese
US
South Asian
Brazilian
South
African
Australasian
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Cochrane Collaboration - structure
Collaborative
Review
Groups
Fields
Centres
Steering
Group
Methods
Groups
The
Consumer
Network
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Why the ‘Cochrane’ Collaboration?

Archie Cochrane, a British epidemiologist, pointed out the
deficiencies of current reviews of the medical literature in
Cochrane AL (1972). 'Effectiveness and Efficiency: random
reflections on health services'.

Iain Chalmers -an obstetrician in Cardiff,UK. The first
‘Cochrane Centre’ opened in Oxford 1992.
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What makes a Cochrane review?
 Structured
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process involving several steps
Well formulated question
Team effort
Comprehensive data search
Unbiased selection and abstraction process
Critical appraisal of data
Synthesis of data
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Why is a Cochrane review different
from any other review?
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Rigorous, open, published research methods
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More exhaustive search for trials than a conventional
review
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Two stages - protocol and full review - both peer
reviewed
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Highlights both implications for practice and for
research
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Only systematic review to be updated regularly.
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Stages of a Cochrane Review
 Submit
 Write
 Write
a title-the idea
the protocol-the plan
the review-the product
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Cochrane Skin Group
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Currently we have published 48 reviews-which we
aim to update every 2 years
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Currently we have published 40 protocols- which
are under development to reviews
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Currently 20 registered titles under development
to published protocols
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Cochrane Skin Group
Some of the reviews & updated reviews we have
published in The Cochrane Library in 2010
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Interventions for vitiligo (updated review) by Whitton ME,
Pinart M, Batchelor J, Lushey C, Leonardi-Bee J, González U
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Interventions for bullous pemphigoid (updated review) by
Kirtschig G, Middleton P, Bennett C, Murrell DF, Wojnarowska
F, Khumalo NP
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Interventions for melasma (new review) by Rajaratnam R,
Halpern J, Salim A, Emmett C
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Interventions for cellulitis and erysipelas (new review) by
Kilburn SA, Featherstone P, Higgins B, Brindle R
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Cochrane Skin Group
Some of the protocols we have published in
The Cochrane Library in 2010

Specific allergen immunotherapy for the treatment of atopic
eczema by Calderon MA, Boyle RJ, Nankervis H, García
Núñez I, Williams HC, Durham S
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Interventions for preventing and managing radiation-induced
skin reactions in cancer patients by Chan R, Webster J,
Battistutta D, Chung B, Brooks L
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Topical interventions for genital lichen sclerosus by Chi C-C,
Baldo M, Kirtschig G, Brackenbury F, Lewis F, Wojnarowska F
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Cochrane Skin Group
Some of the reviews currently in the editorial process
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Interventions for ingrowing toenails (U)
 Interventions for impetigo (U)
 Interventions for nail psoriasis (R)
 Interventions for infantile haemangiomas (R)
 Venom immunotherapy for preventing allergic reactions to
insect stings (P)
 Balneophototherapy for chronic plaque type psoriasis (P)
 Interferon alpha for the adjuvant treatment of cutaneous
melanoma (P)
 Interventions for mycosis fungoides (P)
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Impact of Skin Group reviews
About half of our reviews make recommendations to help
clinical practice by for example being used in guidelines:
Interventions for vitiligo –Clinical Knowledge Summary
Topical treatments for chronic plaque psoriasis – the subject
of a publication to help clinicians put evidence into practice
Interventions for American cutaneous and mucocutaneous
leishmaniasis- 1st prize from Pan American Health
Organisation for its relevance to a neglected disease in the
Americas
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Other skin reviews highlight research gaps:
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Interventions for basal cell carcinoma – SINS trial
(Surgery vs Imiquimod for Nodular & Superficial BCC)
RCT of excisional surgery vs imiquimod 5% cream for nodular and
superficial basal cell carcinoma (SINS)
Patient 3 year follow up has been completed, analysis due to start on
primary outcomes
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Interventions for bullous pemphigoid – BLISTER trial
(The Bullous Pemphigoid Steroids and Tetracyclines Study)
RCT to compare the safety & effectiveness of doxycycline (200 mg/day) with
prednisolone (0.5 mg/kg/day) for the initial treatment of bullous pemphigoid.
64 of 256 bullous pemphigoid participants currently recruited
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Cochrane Skin Group
www.skin.cochrane.org
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How you can get involved
 Read
our reviews
 Comment
on published reviews via the
feedback facility on the Cochrane Library
 Be
a peer referee for us
 Become
a Skin Group review author!
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The Cochrane Library
www.thecochranelibrary.org
 Electronic
publication published online
 Issued monthly
 Database called ‘Cochrane Reviews’
 Database called ‘Clinical Trials’
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Rationale for Cochrane Collaboration

Collective ignorance about effects of healthcare

Overwhelming amount of clinical information

A systematic approach needed to organising
and evaluating clinical trial data

The Cochrane systematic review
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