Cochrane Collaboration in Ireland: Facilitating Evidence-Based Practice
11 February 2005

Dr Dónal O'Mathúna

When a doctor, nurse or patient wants to know which drug has better evidence to support its use, where can they turn? Over 120 health care professionals from many disciplines and librarians gathered at the DCU School of Nursing on February 3 to learn about one approach called the Cochrane Collaboration.

The Director of the UK Cochrane Centre, Professor Mike Clarke, presented his vision: "I look forward to a system where everyone making a decision about their own, or someone else's, health care in any part of the world will, in 15 minutes, be able to obtain up-to-date, reliable evidence of the effects of interventions they might choose, based on all relevant research from anywhere in the world." The Cochrane Collaboration is an international organisation that aims to help people make well-informed decisions about healthcare. They do this by carefully reviewing and summarising the results of research carried out around the world. The need for such `systematic reviews' has arisen because no one can keep up with the over 2 million articles being published annually in over 20,000 biomedical journals.

These systematic reviews are made available as the Cochrane Library. Cara McCaffrey, Science & Health Sciences Librarian at the University of Limerick demonstrated how to access this information. Three years ago the island of Ireland became the first region in the world where every computer with Internet access can connect to the Cochrane Library for free (www.thecochranelibrary.com). This program is funded jointly through the Health Research Board (HRB) in Dublin and the Research & Development Office in Northern Ireland. Such region-wide free access has since expanded and is currently available to all countries directly impacted by the Asian tsunami to help health care decision-making there.

Other innovative aspects of Ireland's role with Cochrane were revealed at the DCU School of Nursing conference. The HRB makes available a number of fellowships every year. These fund health care professionals and researchers so they can dedicate two days a week to conduct a systematic review relevant to their area of practice. Declan Devane, Lecturer in Midwifery at Trinity College Dublin explained this process to delegates. He used the example of his on-going review into whether foetal monitoring provides any benefit for women with low-risk pregnancies.v

Dr Dónal O'Mathúna, Lecture in Health Care Ethics at the DCU School of Nursing described his experience conducting a Cochrane review. His review found no evidence to support the use of a complementary therapy called Therapeutic Touch for wound healing. This study demonstrated how systematic reviewing can reveal mistakes and other problems that can creep into health care literature. Professor Clarke presented results from a review that showed how the drug tamoxifen reduces women's deaths from breast cancer. Several individual studies had revealed no clear evidence on this, but combining the data in a systematic review showed clear benefit.

Dr Teresa Maguire, Head of Research and Development for Health at the HRB closed the conference reminding people of the importance of good quality evidence in health care decisions. Ireland will continue to play an important role in Cochrane by hosting the next World Cochrane Colloquium in October 2006. Over 1,000 participants will gather in Dublin from around the world.

The delegates left DCU after an informative day, with several commenting on how they were excited to become involved in providing the sort of evidence that will help Irish patients make the best possible health care decisions. For further details contact: Dónal O'Mathúna, 01-700-7808, donal.omathuna@dcu.ie