Cochrane Collaboration in Health Care of Elderly People

摘要

In 1972, Archie Cochrane proposed that health care should be provided equitably if it had been shown to be effective in properly designed evaluations-in particular those using randomized controlled trials. It has taken over twenty years for this simple idea to be taken up in organized fashion and in the interim there has been a general failure to base health care decisions and policies on what is known. One of the best known examples is the treatment of acute myocardial infarction. Cumulative meta-analysis showed that it would have been possible to demonstrate that thrombolysis was effective in reducing mortality from acute myocardial infarction more than a decade before this therapy was widely recommended. Recently published systematic reviews on aspects of the health care of elderly people such as assessment and stroke care have shown how such a synthesis of knowledge might be undertaken and what it might contribute. The Cochrane Collaboration, an international network of individuals and institutions, is now evolving to make good some of the deficiencies in organizing research evidence to assist the development of evidence-based practice. This Commentary describes a new initiative within the Cochrane Collaboration-the establishment of a Field in the health care of elderly people. To put this into context, we first describe the purpose, activities, components, and organization of the Cochrane Collaboration. We then indicate the planned activities of the field and how colleagues might wish to consider participating in them. Finally, we report on how an application to register this field with the Collaboration was prepared.