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Abstract
Objective: The relationship between humans and technology has been the subject of theoretical discussions in social sciences for a long time. Approaches which lean towards society start with the assumption that technology and its resulting consequences are planned by social actors. Approaches leaning towards technology assume that technology develops according to its own internal necessity and out of dynamics beyond human control. Characteristic for both models is a clear distinction between society on one side and technology on the other. The discussion focuses on the question: `which is leading which. The actor-network theory of B. Latour and M. Callon offers a new perspective on the relationship between humans and technology. The theorys aim is to describe a society of humans and non-humans as equal actors tied together into networks built and maintained in order to achieve a particular goal. Since the beginning of its existence the Cochrane Collaboration has been challenged to collect, synthesize and distribute evidence. Information technology able to provide evidence has become crucial to assist practitioners, patients and policy makers in their decision making processes. Drawing on the actor-network perspective we will explore the dynamic struggle of the Cochrane Collaboration to reach their goals.
Method: The theoretical discourse will concentrate on the introduction of the meaning of the central concepts in the actor-network theory. We will highlight the role of information technology in an `evidence-based oriented health care system. Relevant insights of the actor-network theory will be used to explore the dynamic relationships in the Cochrane Collaboration.
Results: Information technology is embedded in relations to other tools, practices, groups, professionals and patients and it is throughout their location in these heterogeneous networks that treatment or any other action is possible in health care. The Cochrane Collaboration is one of the more important networks that provide access to relevant information for practitioners, patients and policy makers. The actor-network theory forces us into looking at: (1) the development of the Cochrane Collaboration (2) the different actors that are part of its network a. Who brought them into circulation? b. Where and when did they appear? c. What do they do in the network? d. How are they translated and put into further circulation?
Conclusion: Gaining insight in the complex network of the Cochrane Collaboration might lead to a new dialogue between disciplines, bringing social sensitivity to problems that are felt to be relevant by practitioners, patients and designers of information systems: (1) why systematic reviews are not used (enough) in clinical decision making, (2) how information technology could truly support practitioners and patients and (3) why implementing Evidence-Based Medicine is about more than collecting, synthesizing and distributing evidence or creating the necessary technical infrastructure.
Method: The theoretical discourse will concentrate on the introduction of the meaning of the central concepts in the actor-network theory. We will highlight the role of information technology in an `evidence-based oriented health care system. Relevant insights of the actor-network theory will be used to explore the dynamic relationships in the Cochrane Collaboration.
Results: Information technology is embedded in relations to other tools, practices, groups, professionals and patients and it is throughout their location in these heterogeneous networks that treatment or any other action is possible in health care. The Cochrane Collaboration is one of the more important networks that provide access to relevant information for practitioners, patients and policy makers. The actor-network theory forces us into looking at: (1) the development of the Cochrane Collaboration (2) the different actors that are part of its network a. Who brought them into circulation? b. Where and when did they appear? c. What do they do in the network? d. How are they translated and put into further circulation?
Conclusion: Gaining insight in the complex network of the Cochrane Collaboration might lead to a new dialogue between disciplines, bringing social sensitivity to problems that are felt to be relevant by practitioners, patients and designers of information systems: (1) why systematic reviews are not used (enough) in clinical decision making, (2) how information technology could truly support practitioners and patients and (3) why implementing Evidence-Based Medicine is about more than collecting, synthesizing and distributing evidence or creating the necessary technical infrastructure.