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Cochrane Peer ReviewFrom: Jason Gardosi (jason.gardosi@nottingham.ac.uk)Tue Jun 4 11:44:31 1996
The Cochrane Pregnancy and Childbirth database is being quoted increasingly on this list, as elsewhere, and this is surely a good thing. Any push towards evidence based medicine is to be applauded. The two principal roles I see for Cochrane is as a reference of published and ongoing controlled trials; and for the reviews and meta-analyses. I am feeling increasingly uncomfortable though with the way this latter role has been adopted and reviews are taken at face value without being subject to independent review themselves. I am reading reviews which just do not seem to stand up to scrutiny yet are quoted as Gospel. Some RCTs have been included and heavily weighted even though their methodology is less than adequate. Two good examples are the selection of trials in the sections on Induction of labour and EFM. The element that is sorely missing is a mechanism in which the reviews themselves can be peer-reviewed, or at least alternative views published on the appropriateness of some of the trials which are included. There is a section within the Database which acknowledges that there need to be <snip> .....Procedures and strategies for maintaining and raising the standards of Cochrane Reviews: ... One of the most important of the proposed strategies is to facilitate comments and criticisms, both of electronically published protocols and of 'completed' Cochrane Reviews. As outlined by Chalmers and Haynes (BMJ 1994;309:862-5), it should be possible to establish an iterative process through which the reviewers and editors in Collaborative Review Groups can take into account published comments and criticisms when preparing and maintaining the reviews for which they have accepted responsibility....<snip> Ideally, such comments/criticisms should not have to be first published elsewhere, but allowed for in some sort of correspondence / second opinion section as part of the review in question. This would require active encouragement for a response and to allow space to publish appropriate feedback - critical or otherwise - with the next 6 monthly disk issue, as a section of each review. There seems to be space for this in the new format but this is not utilised. Any further progress on this matter? I am sure Cochrane himself would not have wanted the debate to be stifled. Several years since the database has started to be marketed, this is one publication which is not peer reviewed nor even has a correspondence section. We ought to take this into consideration when we see reference made to this - otherwise potentially most valuable - endeavour. I wonder whether Murray Enkin or any other editors/members of the Cochrane collaboration who might be on this list would share their views? Jason -- Jason Gardosi MD FRCS MRCOG OB/GYN, Queen's Medical Centre Director, PRAM (Perinatal Research, Audit & Monitoring) University of Nottingham, UK Tel +44 115 9709211 Fax +44 115 9709791 jason.gardosi@nottingham.ac.uk
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