COCHRANE COLLABORATIVE REVIEW GROUP ON HIV INFECTION AND AIDS
poster presentation at February, 1999 California University-wide AIDS Research Project Meeting (UARP) Investigator's Meeting, San Diego, CA.
George W. Rutherford, M.D., Gail E. Kennedy, M.P.H.
AIDS Research Institute, University of California, San Francisco
EVIDENCE-BASED MEDICINE, EVIDENCE-BASED PUBLIC HEALTH AND SYSTEMATIC REVIEWS
Evidence-based medicine is defined as "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". This model of medical practice has also be extended to public health practice (e.g., as has been done by the United States Preventive Services Task Force's Guide to Clinical Preventive Services). What the best evidence is varies. In many clinical situations, the best evidence is provided by properly conducted randomized controlled trials. In other situations, and many of the population-level interventions conducted by public health agencies are among these, the most reliable evidence may come from other types of controlled studies. However, no matter what the best evidence is, the overwhelming volume of the relevant medical literature makes keeping fully abreast of the best evidence in generalist, as well as in specialist, fields an almost impossible task. Systematic reviews combine detailed searching for all relevant published and unpublished studies, predetermined research questions and methodologies, qualitative reviews of the quality of the data from relevant studies and, where appropriate, quantitative estimates of the effects of the same or similar interventions for the same conditions (meta-analysis).
THE COCHRANE COLLABORATION
Systematic reviews can be used by individual clinicians to answer specific questions about the management of specific patients, by expert panels as a basis for the formulation of clinical practice guidelines, by public health practitioners as a guide to best public health practices, by policy makers to prioritize limited resources for interventions to those that provide the greatest proven value and by consumers to inform their search for the most effective treatment. The need to provide these types of reviews has led to the formation of the Cochrane Collaboration, a now large international and interdisciplinary network of over 4,000 investigators, clinicians and consumers. The mission of the Cochrane Collaboration is to help physicians, public health practitioners, policy makers and consumers make informed decisions about health care through the preparation, dissemination and continuous updating of systematic reviews of randomized controlled trials and other methodologically sound studies of health care and public health interventions.
THE COCHRANE LIBRARY
The main work of the Collaboration is done by 46 collaborative review groups (Table 1) within which the systematic reviews are prepared and maintained, including the Collaborative Review Group on HIV infection and AIDS. Each review group has an editorial base, consisting of a coordinating editor, an administrative coordinator, the infrastructure necessary to manage the review group and an international and interdisciplinary editorial team that oversees the production and maintenance of the systematic reviews. Each review group conducts reviews on the prevention, treatment and rehabilitation of diseases and other conditions under its purview. The reviews are published in The Cochrane Library, an electronic database, published quarterly and distributed on CD-ROM and via the Internet to subscribers. The Cochrane Library consists of:
THE COCHRANE COLLABORATIVE REVIEW GROUP ON HIV INFECTION AND AIDS
Responsible for commissioning and overseeing the preparation, updating and dissemination of systematic reviews on the prevention and treatment of HIV infection and AIDS and on the organization and delivery of health services for patients with HIV infection and AIDS
Serves as nidus for investigators and groups who have conducted or are conducting systematic reviews, meta-analyses and bibliographic database projects on HIV infection and AIDS
The products of the review group, published in The Cochrane Library, are:
Systematic Reviews (Table 2)
ORGANIZATION AND MANAGEMENT OF COLLABORATIVE REVIEW GROUP ON HIV INFECTION AND AIDS
GETTING INVOLVED IN THE COLLABORATIVE REVIEW GROUP ON HIV INFECTION AND AIDS
The Cochrane Collaborative Review Group on HIV Infection and AIDS is supported by generous grants from the Henry J. Kaiser Family Foundation of Menlo Park, California, the California HealthCare Foundation of Oakland, California, and the National Association of People with AIDS of Washington, D.C.
REGISTERED AND PROBABLE COCHRANE COLLABORATIVE REVIEW GROUPS, 1999
Registered Review Groups
Probable Review Groups