1. Promoting Evidence-based Health Care: the role of the Cochrane Collaboration? Jimmy Volmink Faculty of Health Sciences, Stellenbosch University SA Cochrane Centre, Medical Research Council
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3. What is evidence-based health care? “ the conscientious, explicit and judicious use of the current best evidence in making (health care) decisions.” Sackett DL, et al. 1997 “ The notion that right-minded people will naturally make decisions on the basis of the best available scientific evidence is a misleading and dangerous idea.” Erve Chambers, 1985
9. The Cochrane Collaboration is an international organisation that aims to help people make well-informed decisions about healthcare by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of healthcare interventions
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11. Canadian US UK Nordic Dutch German Italian IberoAmerican Chinese Australasian South African Brazilian Bahrain Branch Thai Network South Asian Centre and Network New Zealand Branch ch San-Francisco Branch Cochrane Centres and Branches Hong-Kong Russian Branch Japanese Branch Nigerian Branch
Getting the evidence straight Getting the evidence used
Dependent largely upon volunteer efforts, Cochrane has grown from its original 77 founding individuals led by epidemiologist Iain Chalmers and others to a global network of nearly 12,000 people from more than 90 nations, including over 1,000 individuals from developing countries. The work of these individuals is supported by 84 Cochrane entities, composed of 51 Collaborative Review Groups (CRGs), each responsible for reviews within a particular area of health; 9 Fields with broad areas of interest and expertise spanning the scope of many CRGs; 10 Methods Groups, providing underpinning knowledge and expertise in relevant areas of methodology; a Consumer Network helping to promote the interests and involvement of users of healthcare; and 12 regional Cochrane Centres and their auxiliary branches whose role is to support these Groups. Each of these constituencies is represented on the Collaboration’s elected Steering Group.
The regional Cochrane Centres include the Australasian, Brazilian, Canadian, Chinese, Dutch, German, Iberoamerican, Italian, Nordic, South African, UK and US Centres as well as the South Asian and South East Asian Cochrane Networks, branches in Finland, Hong Kong and Russia, and a branch in Bahrain. These centres and Branches in particular as well as individuals in the various other Cochrane entities are active in engaging practitioners, researchers, and policy makers throughout the world in this vital effort to improve global health. While the Cochrane Collaboration Steering Group remains unsatisfied with the overall balance of representation within this international organisation, substantial progress has been made. For instance, the launch of the Bahrain Branch of the UK Cochrane Centre represents a significant step forward that will perhaps one day lead to the establishment of a full Cochrane Centre for Arabic-speaking peoples. The Cochrane Collaboration is an international notforprofit organisation registered in the UK as a charity for tax purposes. We exploit the power of the Internet to link our diverse global community of practitioners and researchers into a powerful force for improving healthcare worldwide.
Summaries may take different forms synopses, CATS, guideline recommendations. The key is linking summaries tightly to evidence
Available cost effective interventions, however still ill health and premature deaths from preventable causes especially developing countries However, despite available evidence, gaps exist between evidence, policy and real world practice. These gaps between what we know and what we do are common and can be explained by various reasons - for example: resource constraints, patient and societal preferences, acceptability and political issues. Identifying gaps not the issue -- Need systematic approaches to address the gap – to promote the use of best evidence and strategic research Millendium development goals – 2015, 8 goals, 18 targets, 348 indicators
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