Established in 1993 Thousands of collaborators worldwide Organized in entities Dedicated to ensuring that accurate, current information is available about the effects of healthcare interventions
Members (usually volunteers) prepare a structured review of a specific health intervention and pledge to maintain that review regularly.
In 2004: > 11,500 contributors 91 countries ~ half working on reviews
Collaborative Review Groups Focus on particular area of health Groups of interest to EMS Airways Bone, joint, and muscle trauma Heart Infectious diseases Injuries Stroke
Fields Emerge around areas of interest which extend across a number of health problems Example Fields Behavioral medicine Cancer network Child health Neurological network Prehospital and emergency health Vaccines
Cochrane Centres Geographic entities Example Centres Australoasian Canadian German UK US
Central functions funded by royalties from the sales of subscriptions to the Cochrane Library. Individual entities (Centres, etc) funded by government, institutional, & private sources. Funds from corporate sponsors are quite limited by policy.
Published electronically at Updated every 3 months Some countries have national subscriptions, e.g. Australia, allowing anyone in the country free access. The USA does not have such a subscription.
Initiated by Frank Archer, a physician in Melbourne, Australia in 2003 at Cochrane Colloquium in that city. Formally constituted at Cochrane Colloquium in Ottawa in Funded in part by the Australian government Has more than 3,000 members worldwide
Frank Archer (Convenor) Melbourne, Australia Erin Smith (Coordinator) Melbourne, Australia Rhona Macdonald (Trials Search Coordinator) Melbourne, Australia Mal Boyle Melbourne, Australia Frederick "Skip" Burkle Jr. Baltimore, Maryland, United States Mark E. Cooke London, United Kingdom Matthew Cooke Coventry, United Kingdom Marica Ferri Rome, Italy Cameron Glass British Columbia, Canada Hugh Grantham Adelaide, Australia Ian Jacobs Perth, Australia Steve McDonald Melbourne, Australia Andrew Marsden Edinburgh, Scotland Brian Rowe Edmonton, Canada Omer Sakaf Dubai, United Arab Emirates Arturo Salazar Costa-Rica Michael Sayre Columbus, Ohio, United States Ayan Sen Manchester, United Kingdom
Reflects references located within the Cochrane CENTRAL register of Controlled Trials, Randomized Controlled Trials, Protocols and Reviews, that are relevant to Prehospital Health
Formalized a search strategy to identify prehospital clinical trials Found >900 clinical trials relevant to prehospital emergency medicine Beginning development of a disaster medicine search strategy
Smith E. Ann Emerg Med 2007; 49:
Annals of Emergency Medicine (10.7%) Resuscitation (8.8%) JAMA (5%) Prehospital Emergency Care (4%) New Engl J Med (3.5%) Circulation (3.3%) American Journal Emergency Medicine (3%) Prehospital and Disaster Medicine (2.7%) Journal of Trauma, Injury, Infection and Crit Care (2.2%) Smith E. Ann Emerg Med 2007; 49:
Developing EMS professionals skilled in performing evidence-based medicine reviews. Course at Monash University in Australia Proposal for online version of course Two awards annually of AU$5,000 each to fund reviewers, one of which is prioritized to a EMS professional
Cochrane reviews: Comprehensive Rigorous Well accepted But… “Absence of evidence is NOT evidence of absence.” – Carl Sagan
Sethi, D. Kwan, I. Kelly, AM. Roberts, I. Bunn, F. Advanced trauma life support training for ambulance crews. [Systematic Review] Cochrane Injuries Group Cochrane Database of Systematic Reviews. 3, Lecky, Fiona. Bryden, Daniele. Little, Rod. Tong, Nam. Moulton, Chris. Emergency intubation for acutely ill and injured patients. [Systematic Review] Cochrane Injuries Group Cochrane Database of Systematic Reviews. 3, Kwan, I. Bunn, F. Roberts, I. Timing and volume of fluid administration for patients with bleeding. [Systematic Review] Cochrane Injuries Group Cochrane Database of Systematic Reviews. 3, 2008.
Cochrane Collaboration is the International Standard for evidence-based practice reviews. The Prehospital and Emergency Health Field is active and willing to help support additional development of evidence-based practice for EMS.
Michael R. Sayre, MD Emergency Medicine The Ohio State University