Background: Resources to promote evidence-based health care (EBHC) are always limited. Effective sharing and co-operation between institutions and individuals is essential when producing evidence-based information to assist decisions by clinicians and policy makers. Crossing the language barrier from English to other mother tongues is an additional challenge.
Objectives: To describe the co-operation between Cochrane entities, national health technology assessment office (HTA) and national Current Care guidelines (CC) in sharing methodology, topics, and implementation in a country of 5.2 million inhabitants.
Methods: Description of the EBHC networking in Finland based on annual reports and information from entity directors.
Results: There are two Cochrane entities, an HTA agency, and a national guideline organisation in Finland. All receive most of their funding through Ministry of Health (MOH). Workers within each entity often have part-time posts or tasks in the other entities as well. The Finnish Branch of the Nordic Cochrane Centre is hosted in the Finnish Office for Health Technology Assessment (Finohta); this is to our knowledge the only example of HTA and Cochrane under the same roof. The Finnish Branch initiated the establishment of another Cochrane-entity in Finland, the Cochrane Occupational Health Field (COHF) located in the Finnish Institute of Occupational Health. The entities still share the work contribution of one expert who also initiated the production of special guidelines for occupational health professionals. Topics proposed by policy makers or clinicians are often discussed between the entities and sometimes proposals are transferred from one organisation to another to achieve a more appropriate scope or time schedule. Cochrane reviewers and HTA experts can also participate in CC guideline projects. The national guidelines make effective use of Cochrane reviews in guideline production, linking Cochrane evidence summaries to existing guidelines. Translations of information to the Finnish language and environment done by one entity are useful material for others. Finohta undertakes economic analyses based on selected CC guidelines that have major national cost-effectiveness implications. Cochrane reviewers, for their part, can participate in technology assessments or collaborate in methodological and original research projects relevant for both Cochrane and HTA. Occasionally an expert has a clear preference or dislike for the deep-and-narrow Cochrane work, another may prefer the more policy-oriented approach used in technology assessments. New recruits can be jointly trained and eventually directed to the type of work they prefer. The yearly budgets and the number of staff of the various entities are quite different. Nine of the currently 30 staff members of the largest unit, Finohta, are active or have participated in either guideline work or Cochrane reviews. Data on transferring proposed topics between the entities and on staff, budgets, and types of products in the last years will be shown. The MOH has channelled extra money for EBHC activities through these entities as part of national evidence-based policy building and finds the variety of products useful.
Conclusions: This country case report illustrates benefits from co-operation between national units producing Cochrane reviews, HTAs and guidelines.