The Prioritisation Fund

At a joint meeting of Centre Directors, Co-ordinating Editors and Steering Group members held in Khon Kaen, Thailand, April 2006, a strategic view was taken of the need for The Cochrane Collaboration to improve prioritisation mechanisms for key review topics to better meet the needs of national and international stakeholders, and to meet the Collaboration’s own goals. In response, the Steering Group established the Prioritisation Fund in 2007 as a one-off initiative to fund projects mounted by Cochrane entities to address these aims. 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, Cochrane Bone, Joint and Muscle Trauma Group
• Using practice guidelines to determine review priorities: a pilot project. Led by Kay Dickersin, 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, Cochrane Consumer Network
• Prioritising Cochrane review topics to reduce the know-do gap in low- and middle-income countries. Led by Peter Tugwell, Cochrane Health Equity Field
• Piloting and evaluation of a patient-professional partnership approach to prioritising Cochrane reviews and other research. Led by Adrian Grant, Cochrane Incontinence Group

At this year’s Colloquium in Singapore, a special session was held 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, one of the four Centre representatives on the Steering Group, and David Tovey, Editor in Chief of The Cochrane Library, the session included presentations by representatives (David Tovey, Roberta Scherer, Maria Belizán, Mona Nasser and Brian Buckley) 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?

David Tovey and Lisa Bero watching a presentation at the special session

Following the session, David commented: “What came across most strongly for me was the need for prioritisation 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 review groups. Otherwise the perspective is too narrow.”

Lisa also summarised her views: “I think 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, “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.”

A paper drawing together the issues, with input from the project teams, the Cochrane Editorial Unit and the Steering Group will be published to take forward the results of the projects and the discussions of the special session. The final reports and other resources from the projects will soon be available on cochrane.org, along with reports from other core-funded projects, for which details will be sent to all Cochrane entities.

Lucie Jones
The Cochrane Collaboration Secretariat