Cochrane for Dummies: by Anna Joseph, a laywoman-turned-Cochrane enthusiast

Anna Joseph is the recently-appointed Communications Officer of the South Asian Cochrane Network and Centre, based in India. Anna, who holds a post-graduate degree in Mass Communication, has editorial experience in print and electronic media. As a face of the Cochrane Collaboration, she is trying to be more Communicator than the Consumer she is by default, essentially more of a Plain Language Summary Person than an Abstract Person, and if she had to go through an Abstract, more likely to look at the Risk Ratios than the Odds Ratios.

Cross-posted from the Cochrane Consumer Blog.

The South Asian Cochrane Network and Centre, which I joined in March, kicked off its training workshops for the year 2012 with one on ‘Understanding and Using Systematic Reviews and Meta-Analyses in Informing Health Decisions’.

That’s quite a few unpalatable words for a laywoman and under previous circumstances, this would have been one workshop that I would have avoided, especially if I knew it had anything to do with medicine. I’m married to a doc and I live in a medical community. So I get more than my fair share of ‘medicated talk.’

But as their newly appointed communications officer, I wanted to have a clear idea of what exactly it is that I am trying to disseminate and so, sat in. I couldn’t make sense of it all but here’s what I did make sense of.

But before that… though this was supposed to be the report on the workshop, it has now turned into this blog-like article. How did it go from drab, professional to involved, personal?
Because after the workshop, it suddenly struck me that this place, one of the 13 world-wide centres of the international, non-profit organisation known as the Cochrane Collaboration, actually has something to offer.

But don’t just take it from me. Allow me to help you find out for yourself.

Let me start with something that really piqued my interest, for the simple reason that it is a woman-centric topic.

Did you know that hormone replacement therapy actually does more harm than good?

How about - that Tamiflu, into which millions are being pumped, is really not the wonder-drug that it’s supposed to be?

Or that electric or powered toothbrushes are not better than manual toothbrushes?

Or that administering oxygen to a person who was having a heart attack might actually harm him?!

These are claims made by The Cochrane Collaboration and the reason they can be believed is because these guys chase after the truth like a shark that has caught the scent of blood.

Time for some shark trivia from the amazing HowStuffWorks.com:
Sharks are able to respond to one part blood for every one million parts of water; this is like being able to smell one teaspoon of something in a swimming pool. What's more, sharks can smell these small amounts from hundreds of meters away.

The shark metaphor, which came to mind more as an after-thought, is actually a great one for the work of the Collaboration. Because that’s what their authors, the ones who write for their on-line Cochrane Library, do - go through a million parts of matter on a chosen topic and sift out that one part of matter that is The Truth (or as close to it as it gets). And their million actually covers not just the swimming pool, but all the water-bodies in the world.

In other words, why the stuff that comes out on The Cochrane Library can be trusted is because a conclusion is reached only after two or more people go through everything written about a particular topic. And that includes non-English data, and even stuff that has not been published.

These studies are then run through extremely stringent and scientific methods of assessment to get to the truth of the matter.

Technically, that final review that shines the light on The Truth (or as close to it as it gets!) is what is called the ‘systematic review’. And in the medical community, a Cochrane systematic review is the gold standard for a systematic review.

For the curious layperson, for the scribe looking for facts to back up an interesting lead, for the anxious parent or for the patient who wants to know what his/her best treatment options are, the information that Cochrane Reviews offer is simply the best out there. And they have it all plain and simple in what is called their plain language summaries. No wonder then that the Collaboration, begun in 1993, now spans over 100 countries and boasts more than 28,000 enthusiastic volunteers, which include people from all walks of life.

Now, to wind up, let me finish the job I left incomplete – what the workshop was about! I think I already dealt with the bit on understanding and using systematic reviews. The second half talks about meta-analyses and about informing health decisions.

Assuming you really want to know, a meta-analysis synthesises the analyses of various studies and informing health decisions means using the findings pro-actively to influence policy making in health care.

So that’s what the workshop was about.

Ciao!

Comments

Re: Cochrane for Dummies: by Anna Joseph, a ...

Hi Anna

Please consider posting a REAL "Cochrane for Dummies" - a step-by-step "How to use this site" for laymen.

Eg:

You're interested in

- (cancer treatment); ( a certain drug); (a surgical procedure)

You go to:

- Section of Cochrane they should access;

You use it like this:

- Where's the summary? How to approach medical people with your new-found knowledge;

etc.

Thanks a lot

P

Re: Cochrane for Dummies: by Anna Joseph, a ...

Dear Pete,

Thank you for your thought-provoking suggestion. So far, in my work, I'd only thought of how to promote Cochrane evidence, in general, or specific reviews  - not of the actual road blocks that people who would like to use our evidence may have while trying to do so.

I'll defintely take this into consideration.

Trying to answer a question like, 'How to approach medical people with your new-found knowledge' -  very important for the layperson -  would be pretty challenging though!  

Regards,

Anna.

Re: Cochrane for Dummies: by Anna Joseph, a ...

Anna, I really enjoyed your summary of your interpretation of what the Cochrane Group is about. I just joined the group and know this is a place I will seek more info. I am currently writing a book, LISTENING TO THE PATIENT and your writing style engaged me and I thought: she writes like I do! Your metaphor regarding sharks was interesting to me. First, the study of homeopathy has a parallel to this relationship. Second, I like the fact you expressed the "accepted and selected as evidence based medicine" examples of drugs that don't work or are harmful...Tamiflu, HRT and I have one biggy to add: Statin drugs...they do what they say as in lowering cholesterol...but...they are potentially very harmful and they were to me. If you read Ben Goldacre's newly released book "Bad Pharma" you will understand just how difficult it is to believe anything that is considered "evidence based medicine."  Unfortuantely none of the docs I ever saw and some that followed me regularly ever recognized my side effects were from these drugs. I write extensievly in my book about this problem and I have ascientist from M.I.T. who is doing a chapter on these drugs for me from an unbiased point of view! I am not a  PhD. but have  medical background through nursing and I might like to write for this group when I have more time. So should you! We need writiers who can separate the wheat from the chaf and you are one that can. 

As I get to read more about this group I may write myself that is, if there is a place for my topics. If you are on Linkedin...please join me!

Elizabeth

Re: Cochrane for Dummies: by Anna Joseph, a ...

Dear Elizabeth,

Sorry for this late response and thank you very much.

Could you send me your e-mail id so I can write you?

Anna

 

Re: Cochrane for Dummies: by Anna Joseph, a ...

I also enjoyed reading your blog!

teresa 

Re: Cochrane for Dummies: by Anna Joseph, a ...

Dear Teresa,

It's great to hear that. Thank you!

Hope to see you at the Colloquium!

Anna

 

Re: Cochrane for Dummies: by Anna Joseph, a ...

Great poste, Anna!

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Updated on: May 15, 2012, 17:37

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