Cochrane Response
Developed by Lorne Becker with significant input from Rob Scholten, David Tovey, and David Moher
June 17, 2011
This paper outlines a new project being developed by the Collaboration’s new trading company Cochrane Innovations Limited. We are holding a meeting at 7:30 am on Friday Oct 21st to discuss the project in more detail. Centre Directors are invited to attend or to designate someone from their Centre to attend this meeting and to interact with the project team following the Colloquium. We are looking for individuals who are willing to put in some work on this project - to further develop the model, to identify potential clients for the service, and to participate in responding to requests for reviews as they come in.
Background
CCSG approval of this as a one of several new Trading Company projects
At its Keystone (October 2010) meeting, the Steering Group adopted a proposal that the Cochrane Trading Company expand the scope of its activities, to act as a vehicle for new projects and income generation. Two key goals for this new activity were outlined
1 To generate additional revenue for the Collaboration through new lines of work undertaken on a commercial basis.
2 To act as a vehicle for new projects, to ensure that the Collaboration does not lose its focus on its primary product – Cochrane Systematic Reviews in The Cochrane Library.
At its Split Meeting (March 2011), the Steering Group reviewed and approved business plans for several proposed Trading Company projects including Cochrane Response.
Why Cochrane Response is needed?
Over the years, the suggestion has often been made that the Collaboration should develop a mechanism for producing Cochrane Reviews on a specific topic when there is a perceived need or on request from guideline groups, government agencies or other key organizations. Because of the organization and structure of the Collaboration (with volunteer authors and frequently overstretched Review Groups), it has never seemed feasible to produce “commissioned reviews” of this sort using the standard Cochrane process. However, a number of organizations or groups have used Cochrane-like methods to produce systematic reviews on a commissioned basis. Some of these groups are within the Cochrane Collaboration (e.g. some Centres perform these activities), while others are not official Cochrane groups but may involve Cochrane authors or editors in the production of these commissioned reviews. While some of these reviews have made it into The Cochrane Library, most have not.
Since January 2009, the Cochrane Editorial Unit (CEU) has been commissioned to co-ordinate three such projects: one review prepared by the Cochrane Wounds Group; three reviews prepared by the Cochrane Acute Respiratory Infections (ARI) Group; and a suite of reviews of vitamin A supplementation prepared by several Cochrane Review Groups. The first and third projects were commissioned by the World Health Organization (WHO) and the second project by the UK National Institute for Health Research (NIHR). David Tovey has summarized this experience and made a series of recommendations for ongoing activity in a restricted paper presented to the CCSG in Keystone.
Proposed structure and organization
The business plan approved in Split proposed that the Cochrane Trading Company would set up a program, labeled “Cochrane Response,” with the following goals:
· To provide a mechanism by which the Collaboration can respond to requests for commissioned reviews.
· To involve the various Cochrane groups or individuals who are currently undertaking such activities in a consortium model that would:
o Build a successful business
o Provide an income stream to the review teams and also to the Collaboration
o Improve engagement and strengthen partnerships with review commissioning bodies
o Utilise the expertise within the Collaboration
o Allow sharing of techniques strategies and expertise
o Facilitate methods development e.g. novel review types, rapid reviews
o Facilitate the engagement of Cochrane Review Groups and increase the probability that commissioned reviews result in publication in CDSR.
We are now looking for entities within the Collaboration who are interested in helping to further develop these plan and participating in the production of commissioned reviews.
The plan is that Cochrane groups that wish to participate in this new endeavour will be invited to become members of a Cochrane Response Consortium and will agree to share expertise, ideas, requests for commissioned reviews, and the work involved in producing those reviews. In addition, a central project coordination team will be formed, to be located within the CEU.
Each time a commissioned review is considered, a number of tasks will need to be undertaken. These include:
• Meet with the commissioner to refine the study question and translate it into a form that can be approached by a Cochrane review
• Conduct a scoping search so tat an estimate of the workload can be made
• Contact the pertinent CRG to determine the degree to which they wish to participate in the review
• Prepare budget
• Negotiate with commissioner and sign a contract.
• Select a review team with the required methodology and content expertise
• Prepare a protocol
• Perform a full search
• Perform the review, including additional tasks such as creating summary of findings tables as appropriate.
• Monitor time lines and review processes
• Charge the commissioner for the completed review
Depending on the circumstances of the review, these tasks may be divided in a variety of ways among members of the consortium. The CEU team will provide general oversight and ensure that an adequate plan is in place to address each step and could support individual projects in a variety of ways - by initiating contact with the commissioning body, liaising with CRGs, the TC Directors and review authors teams as appropriate, scoping the reviews, ensuring that there is a concrete understanding between commissioner and review team, and performing additional editorial, information specialist or author support tasks as agreed..
The product
The primary aim of Cochrane Response will be to produce high quality systematic reviews that use Cochrane methods to address the focused questions of interest to the commissioner. A secondary aim will be to have some of these reviews published in CDSR. Whether or not this secondary aim is achieved will be a decision made by the relevant Cochrane Review Group. Early in the development process for each Cochrane Response review, all potentially relevant CRG(s) will be contacted and invited to participate to the extent they feel able to do so. Depending on their priorities, interest and resources CRGs would be able to choose any one of the following options.
· Publish the Cochrane Response as a Cochrane review concurrently with its release to the commissioner if it meets their criteria for doing so. This option may only rarely be chosen, since the time frame required for a Cochrane Response will rarely allow time for the full CRG editorial process.
· Identify an author team (possibly including some or all of the team involved in the Cochrane Response) to perform a Cochrane review on the same topic after the commissioned review has been completed. If this option is chosen, results of the searches, data extraction, risk of bias assessments etc from the Cochrane Response would be made available to the CRG to facilitate the process.
· Make no effort to include the review in CDSR and allow the authors of the Cochrane Response to pursue publication elsewhere if they wish.
In cases for which existing CRG workload and competing priorities preclude any participation, the Cochrane Response will be produced by other consortium members and the TC will ensure that the CRG is kept fully informed of progress
Funding
The Steering Group has allocated initial funding to the Trading Company to cover start up costs of this and other projects. Thus we anticipate that funds will be available for activities such as marketing, establishing contact with potential commissioners, drawing up agreements, scoping and costing of individual projects, etc. In negotiating contracts for individual reviews, the aim would be for the fees charged to be set at a high enough rate to cover expenses and generate a profit, which would then be shared between consortium members & the Trading Company in proportion to the work provided on each project. The Trading Company portion of these profits would be used to cover initial costs of subsequent projects as well as to provide for any ongoing infrastructure costs involved in continuing the program. The aim would thus be to have sufficient activities to cover all trading company costs and begin returning a profit to the Collaboration within 18 months.
Opportunities and challenges:
The program would bring a number of potential opportunities for the Collaboration, including:
· building closer relationships with key partners
· producing additional high priority reviews for CDSR.
There are also a number of risks that will need to be addressed, including
· the possibility of losing money if our cost projections are inaccurate
· threatening the reputation of the Collaboration by not delivering on time and on budget or by producing reviews that are not felt to meet the Cochrane standards for high quality
Next steps
All of the ideas above are preliminary thoughts and open for further discussion and development by individual Cochrane entities who are interested in joining this consortium. Please direct any comments or ideas to or to our new Project Officer for Cochrane Innovations Juliane Ried ().