An intitiative to improve prioritisation mechanisms for Cochrane Reviews

...Prioritisation [needs] to be a process that involves different groups of people working together, whether they are outside the Collaboration - as with patient groups or guidelines groups - or inside, as with Fields and Cochrane Review groups. Otherwise the perspective is too narrow."

David Tovey, Editor in Chief of The Cochrane Library

In 2007, the Collaboration's Steering Group established the Prioritisation Fund as a one-off initiative to fund projects by Cochrane groups which addressed the Collaboration's need to improve prioritisation mechanisms for key review topics and to better meet the needs of national and international stakeholders. A total of 100,000 GBP was made available and, from that, five projects were funded:

• Delivering on priorities: developing and implementing effective collaboration between a Cochrane Review Group and a Cochrane Field, led by Rajan Madhok and Helen Handoll of the Cochrane Bone, Joint and Muscle Trauma Group
• Using practice guidelines to determine review priorities: a pilot project, led by Kay Dickersin of the United States Cochrane Center
• Prioritisation of Cochrane Reviews for consumers and the public in low and high-income countries as a way of promoting evidence-based health care, led by Janet Wale of the Cochrane Consumer Network
• Prioritising Cochrane Review topics to reduce the know-do gap in low and middle income countries, led by Peter Tugwell of the Cochrane Health Equity Field
• Piloting and evaluation of a patient-professional partnership approach to prioritising Cochrane Reviews and other research, led by Adrian Grant of the Cochrane Incontinence Group

At the Collaboration's 2009 Colloquium in Singapore, a special session was conducted to examine the success of these projects in the context of the strategic objectives of the Fund, and to explore the lessons to be learned for guiding future prioritisation efforts across the Collaboration. Chaired by Lisa Bero from the San Francisco branch of the US Cochrane Center, and David Tovey, Editor in Chief of The Cochrane Library, the session included presentations by representatives from each of the projects and was themed around the issues identified in Khon Kaen: whose priorities should Cochrane Reviews address? What are the risks and benefits of prioritisation? Should we be using a ‘top-down’ or ‘bottom-up’ approach to prioritising reviews?

Lisa summarised the outcomes of the session: “We have learned that it would be difficult for The Cochrane Collaboration to have a single, top-down prioritisation scheme.

The projects showed us that different approaches can be used to identify priorities for different groups of people.  Although some of the approaches worked more smoothly than others, they were all relatively successful in identifying topics for high priority reviews. However, the question of “whose priorities?” remains. 

So, I think we have to encourage different prioritisation approaches and for the Collaboration as a whole to become more responsive in producing priority reviews for specific groups. The development of the special relationship between the Collaboration and the World Health Organization is a good example of how this can be achieved."

Lisa went on to say that: “One of the interesting new questions to come from the prioritisation session was whether reviews that have been produced as a result of a prioritisation process have more impact than non-prioritised reviews. We assume that priority reviews will be read, cited and will influence practice and policy, but we haven't actually measured that yet.”

To take forward the results of the projects and the discussions of the special session an article series is currently in development, with input from the project teams, Cochrane Editorial Unit and Steering Group.

Image: David Tovey and Lisa Bero watching the special session in Singapore. Courtesy of Uncle Thien.