1. The Bahrain Branch of the UK Cochrane Centre In Collaboration with Reyada Training & Management Consultancy, Dubai-UAE Cochrane Collaboration and Systematic Review Workshop, 20-21 February 2007, Dubai - UAE Dr. Zbys Fedorowicz, Dr. Dunia Al Hashimi, Dr. Ahmed Al Asfoor http://bahrain.cochrane.org/en/index. html http://www.rt.ae W01

2. What is the Cochrane Collaboration an international organisation that aims to help people make well-informed decisions about healthcare

3. How? by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of healthcare interventions

5. “It is surely a great criticism of our profession that we have not organized a critical summary, by specialty or subspecialty, adapted periodically, of all relevant randomized controlled trials.” Archie Cochrane

6. Iain Chalmers Founding Director

7. The Cochrane Collaboration Formed in 1993 15,000+ people in 80+ countries 50 Collaborative Review Groups 12 Centres, Fields, Method Groups and Cochrane Consumer Network Cochrane Secretariat Oxford UK

8. Our structure

9. The Cochrane Collaboration Collaborative Review Groups Fields The Consumer Network Centres Methods Groups Steering Group

10. All the Cochrane Collaboration working groups are supported by a secretariat based in Oxford UK. The Secretariat

11. Established at the end of 1992 by the NHS Research and Development Programme Responsible for supporting contributors to The Cochrane Collaboration in the United Kingdom & Ireland and since March 2005 a branch in Bahrain. UK Cochrane Centre (UKCC)

12. Where are we?

13. Represented in 2000, 2002 & 2003 Represented in 2002 & 2003 Represented in 2003 COUNTRIES IN WHICH INDIVIDUALS ARE CONTRIBUTING TO THE COCHRANE COLLABORATION

15. Bahrain Branch of the UK Cochrane Center The first Cochrane Collaboration entity in the Middle East established 17th March 2005

16. What do we do?

17. Role of the Bahrain Branch To act as a focal point for people in the region To co-ordinate the provision of training and support to Cochrane review authors in these countries To develop a resource for hand searching non-English healthcare journals and identify relevant studies to the wider Collaboration. To co-ordinate the translation of training and support documents to ensure they can be accessed by target audiences.

18. Why do we need The Cochrane Collaboration?

19. Evidence is important. Why? “In 10yrs 50% of what you have been taught will have been shown to be wrong…………….. only problem is which 50%?” Burwell Dean of Harvard Medical School 1950

20. Evidence Clinical ClinicalJudgment Patients Choice EBM TRIAD

21. Graph showing publication of Cochrane Protocols and Reviews in the Cochrane Database of Systematic Reviews from Issue 1, 1995 to present

22. Where will you find our evidence?

23. The Cochrane Library is the single most reliable source for evidence on the effects of health care. THE COCHRANE LIBRARY

24. The Cochrane Library is designed to provide information and evidence to support decisions taken in health care and to inform those receiving care.

25. Which topics do we cover?

26. Acute Respiratory Infection Airways Anaesthesia Back Breast Cancer Colorectal Cancer Consumers and Communication Cystic Fibrosis and Genetic Disorders Dementia and Cognitive Impairment Depression, Anxiety and Neurosis Developmental, Psychosocial & Learning Problems Drugs and Alcohol

27. Ear, Nose and Throat Disorders Effective Practice and Organization of Care Epilepsy Eyes and Vision Fertility Regulation Gynaecological Cancer Haematological Malignancy Heart Hepato-Biliary HIV/AIDS Hypertension Incontinence

28. Oral Health Pain, Palliative and Supportive Care Peripheral Vascular Diseases Pregnancy and Childbirth Group Prostatic Diseases and Urological Cancers Renal Schizophrenia Sexually Transmitted Diseases Skin Stroke Tobacco Addiction Upper Gastrointestinal and Pancreatic Diseases Wounds

29. Cochrane Fields Cancer Child Health Complementary medicine Health care of older people Health promotion and public health Neurology Primary Health Care Rehabilitation and related therapies Vaccines

30. How do we do what we do?

31. RCT SYSTEMATIC REVIEW “STRONGER” EVIDENCE Meta-analysis

32. Where are we going? Thousands of Cochrane reviews underway, and results already available from more than 2000 of these, there is still a large amount of work to be done. At least 10,000 Cochrane reviews are needed to cover all healthcare interventions. Need to encourage more authors from the region. Implement evidence based decision-making in our regional healthcare and medical education.

34. British Invention?

35. First Cochrane Colloquium 1993 Cochrane Collaboration founded by 77 people from 9 countries In 2006 10,000+ in 90+ countries International organisation

36. Represented in 2000, 2002 & 2003 Represented in 2002 & 2003 Represented in 2003 COUNTRIES IN WHICH INDIVIDUALS ARE CONTRIBUTING TO THE COCHRANE COLLABORATION

38. Best single v single best Other sources

39. Randomised controlled trials

40. Only therapy/interventions? Diagnostic tests and screening COMING SOON TO A LIBRARY NEAR YOU

41. Clinical recommendations Evidence (strength, direction) Implications for practice/research X √

42. Bias in systematic reviews Yes systematic biases as in RCTs

43. Is it the ‘last word’? Current best evidence

44. ﺸﻛﺮﺍ Thank you