Objective:

The impact of the CDSIR in terms of whether it influences appropriate change in clinical practice has still to be measured. Encouragement to change practice has been shown to be more effective if product championing and academic detailing are employed. This project will investigate and evaluate the effectiveness, efficiency and acceptability of the output of the Cochrane Collaboration, to determine both the level of uptake of evidence based advice and whether specific barriers exist to the adoption of change recommended by current evidence.

Methods:

This is an intervention study with measurements of effectiveness taken before and after in a uniform manner in three comparator regions in the UK. It will investigate, specific topics published in successive editions of the CDSIR, Each topic will be investigated in three stages:


1. A survey and validation of the existing practice focusing on areas where it is known that Cochrane systematic reviews will be produced.
2. Measurement of exposure to the output of the Collaboration will be monitored. Information will be sought on the awareness, accessibility and use of the CDSR and factors constraining use.
3. Survey and validation of changes in practice.

Results:

The analysis will identify areas of practice where the extent of change is related to the exposure. Validation of reported changes will be by case note review and structured interview. Examination of the areas where the evidence (systematic review) did appear to change practice or had no influence on practice may help to determine the reasons why the output from the Cochrane Collaboration is successful in changing (or fails to change) clinical practice. Areas where improvements in methods of dissemination, uptake of information etc. will be highlighted and strategies to assist evidence-based change in clinical practice will be suggested.

Discussion:

We clearly must assess the impact of our efforts. Now is the time to decide how to do it.