Making the resources of the Cochrane Collaboration 'of, by and for the people': a developing country perspective

Article type
Authors
Mathew J, Singh M
Abstract
Background: The Cochrane Collaboration is currently one of the best resources for the practice of Evidence Based Medicine (EBM). However, there are several hurdles that obstruct optimal usage of these resources by people in developing countries; many of these are related to the external source and applicability of information contained therein.

Objective: To examine how the resources of the Cochrane Collaboration can be put to best and maximum use in developing countries.

Methods: Using a questionnaire inviting structured and non-structured responses, the investigators interviewed persons representing the medical profession (clinicians in academic institutions, clinicians involved in research, clinicians in private practice, nurses and paramedical professional); postgraduate students and research fellows; and consumers (patients and caretakers). The interview covered several aspects including perception of EBM, awareness, accessibility, availability, acceptability and affordability of Cochrane Collaboration resources, its relevance and applicability to clinical situations in India and the scope of contributing to it. The responses were analyzed and findings summarized.

Results: In each group of persons interviewed, only a minority was aware of the role and resources of the Cochrane Collaboration. Among these individuals, perceptions on different aspects were variable. However, there was general consensus that the content of the Cochrane Library should contain many more reviews on subjects relevant to local problems, identify mechanisms of incorporating local literature, incorporate the evidence on alternate systems of medicine especially ayurveda and homoeopathic schools, develop a hierarchy of therapeutic options based not only on evidence, but also local applicability, affordability and feasibility, diagnostic reviews and economic evaluation. The detailed findings are presented in the paper.

Conclusion: In India, the awareness and usage of Cochrane Collaboration resources is currently limited by several factors; this situation can be rectified by actively considering the perceptions of the people in the country. This will also serve as a model for other developing countries.