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IMPROVING OUTCOMES IN CRISIS SITUATIONS WITH EVIDENCE AID

Annual Report & Financial Statements 2010 /11

Trusted evidence Informed decisions Better health i

COCHRANE COLLABORATION ANNUAL REPORT 2010/11


Our vision is that healthcare decision-making throughout the world will be informed by high-quality, timely research evidence. We will play a pivotal role in the production and dissemination of this evidence across all areas of health care.


CONTENTS

Contents The way we work ....................................................................................... 2 Co-Chairs’ introduction ............................................................................ 4 Board of Trustees ...................................................................................... 6 Making a fast food meal out of a Cochrane Review .............................. 8 Sarah Rosenbaum and Claire Glenton

Report from the Editor in Chief .............................................................. 12 The year at a glance: The Cochrane Library ......................................... 14 The Collaboration enters Official Relations with the World Health Organization................................................................................. 16 What we planned; what we did to achieve our goals ........................... 18 Our plans for 2011–12 ............................................................................. 27 A one-to-one with the Cochrane Training Co-ordinator ...................... 28 Lucie Jones interviews Miranda Cumpston

The Cochrane Colloquium ...................................................................... 30 Cochrane Prizes and Awards 2010 ........................................................ 32 Assessing the Collaboration’s impact: a journalist and a consumer have their say........................................... 34 Lori Tarbett interviews Alan Cassels and Johanna Trimble

Our funding .............................................................................................. 36 A note from the Chief Executive Officer

Improving outcomes in crisis situations with Evidence Aid ................ 40 Mike Clarke, Bonnix Kayabu and Claire Allen

Thanks to our group funders .................................................................. 44 Trustees’ Report and Financial Statements 2010/11 ........................... 46 Acknowledgements ................................................................................. 68

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IMPROVING OUTCOMES IN CRISIS SITUATIONS WITH EVIDENCE AID

The Cochrane Collaboration is an international network of more than 28,000 dedicated people from over 100 countries. We work together to help health care providers, policy-makers, patients, their advocates and carers, make well-informed decisions about health care, based on the best available research evidence, by preparing, updating and promoting the accessibility of Cochrane Reviews – over 4,600 so far, published online in The Cochrane Library. Our work is internationally recognised as the benchmark for high-quality information about the effectiveness of health care.

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THE WAY WE WORK

The way we work Our goals

Our guiding principles

Percentage expenditure against our goals, 2010–11*

We aim to ensure high-quality Cochrane Reviews are available across a broad range of healthcare topics

We believe in ensuring quality by being open and responsive to criticism, applying advances in methodology, and developing systems for quality improvement.

62%

We believe in minimising bias through a variety of approaches such as scientific rigour, ensuring broad participation, and avoiding conflicts of interest. We believe in keeping up-to-date by a commitment to ensure that Cochrane Reviews are maintained through identification and incorporation of new evidence. We aim to promote access to Cochrane Reviews and the other products of The Cochrane Collaboration

We believe in promoting access by wide dissemination of the outputs of the Collaboration, taking advantage of strategic alliances, and by promoting appropriate prices, content and media to meet the needs of users worldwide. We believe in striving for relevance by promoting the assessment of healthcare interventions using outcomes that matter to people making choices in health care.

We aim to ensure an efficient, transparent organisational structure and management system for The Cochrane Collaboration

We believe in collaboration, by internally and externally fostering good communications, open decision-­making and teamwork.

We aim to achieve sustainability of The Cochrane Collaboration

We believe in building on the enthusiasm of individuals by involving and supporting people of different skills and backgrounds.

23%

We believe in avoiding duplication by good management and co-ordination to maximise economy of effort.

15%

We believe in enabling wide participation in the work of the Collaboration by reducing barriers to contributing and by encouraging diversity. *Estimated core expenditure 2010–11 as a percentage of core income (GBP) COCHRANE COLLABORATION ANNUAL REPORT 2010/11

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CO-CHAIRS’ INTRODUCTION

Co-Chairs’ introduction Some years ago, it was suggested that The Cochrane Collaboration is an enterprise that “rivals the Human Genome Project in its potential implications for modern medicine”.1 Whilst the Human Genome Project immediately caught people’s imaginations, meta-analysis and systematic reviews have – understandably – been less eye-catching. Nevertheless, gradually and methodically, we are changing the way people think about health care.

Jonathan Craig

‘Evidence’ is no longer an abstract, distant concept but is becoming an essential part of people’s healthcare decision-making. Clinicians and consumers want to know, “What’s the evidence for this treatment?” Policy-makers are looking at the efficacy of interventions before making funding decision. Journalists are asking, “Do I really believe the results of this new study – what’s the source?” Evidence-based decision-making is profoundly changing the culture of health care at all levels: from a patient assessing the benefits of their own treatment, to a government planning the health care budget for an entire country.

Jeremy Grimshaw

Later on in this report you’ll read an interview with a journalist and a healthcare consumer who offer their thoughts on the impact that the Collaboration is making in their communities, and their suggestions for improvement. We also take a look at a pilot study that turned a full Cochrane Review into a YouTube video, with the aim of making it more digestible to its target audiences. 1

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Naylor CD (1995) Grey zones of clinical practice: some limits to evidence based medicine. Lancet 45:840–842


CO-CHAIRS’ INTRODUCTION

In 2010 we achieved a top-10 ISI Impact Factor for the Cochrane Database of Systematic Reviews (CDSR), an outstanding achievement that reflects the dedication of our 28,000 contributors worldwide and the visionary leadership of the Editor in Chief of The Cochrane Library, David Tovey, who has now been in post for almost three years. The Impact Factor of a journal is a measure of the number of times its articles have been cited by another; in 2010, Cochrane Reviews in the CDSR were cited more than 27,000 times and downloaded almost four million times. In this report you will read about the work we’ve carried out this year to achieve our goals; we’re proud of our achievements, but in true Cochrane style, we know we can do better. Our plans are split into two main threads: improving the ‘Cochrane experience’ for those who so generously donate their time to preparing – and supporting the production of – Cochrane Reviews; and at the other end, improving the Collaboration’s outputs for our end-users. This year we’ve invested significantly in strengthening the central infrastructure that supports our contributors and groups. We’ve appointed a team of co-ordinators to manage our additional core activities: training, methods development and consumer participation. We’re undertaking a review of our marketing and communications strategy, we’ve developed an overarching information services management structure, and we are taking the first steps to facilitating the increase in participation of contributors from low and middle income countries, and for those whose first language is not English. We’ve also invested in innovation by establishing a second trading company through which we can disseminate Cochrane Review spin-off products, and we’re commencing a process to ensure that our future publishing arrangements are optimally aligned to our mission.

In 2011–12 we will continue to prioritise our support for the Editor in Chief and the Cochrane Editorial Unit as they seek to improve the quality and impact of The Cochrane Library, and we will enhance the organisation’s monitoring and management functions, particularly of individuals, groups and platforms that receive core Collaboration funding or use the Cochrane brand. We see our advocacy role, delivered both geographically and thematically by our regional centres, fields and subject-specific groups, as a key part of our mission, convincing the world that health care is better delivered in the context of better knowledge, and we will be taking advantage of our newly established Official Relations with the World Health Organization in achieving this aim. Finally, we couldn’t close without thanking all those who support, contribute to, and use our work: to the 28,000 people throughout the world who are working to achieve the Collaboration’s mission by preparing – or supporting the preparation of – Cochrane Reviews; to the 400 staff at our groups worldwide who make it possible for our contributors to participate, and to the organisations who host and fund these groups; to the 120 people who have volunteered to lead the Collaboration by serving on our management committees; and to the 30 central staff who maintain the central management infrastructure of our organisation. Without you, our work would be impossible.

Jonathan Craig and Jeremy Grimshaw

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THE COCHRANE COLLABORATION STEERING GROUP: BOARD OF TRUSTESS

Board of Trustees The Cochrane Collaboration Steering Group October 2010–11

Jonathan Craig

Donna Gillies

Jeremy Grimshaw

Sonja Henderson

Co-Chair

Author Representative and Treasurer

Co-Chair

Managing Editor Representative

Day job: Co-ordinating Editor, Cochrane Renal Group; Renal specialist, University of Sydney (Australia)

Day job: Senior Research Officer, Sydney West Area Mental Health Service (Australia)

Day job: Co-ordinating Editor, Cochrane Effective Practice and Organisation of Care Group; Director, Clinical Epidemiology Program, Ottawa Health Research Institute (Canada)

Gail Higgins

Julian Higgins

Sophie Hill

Steve McDonald

Trials Search Co-ordinator Representative

Methods Group Representative

Co-ordinating Editor Representative

Centre Representative

Day job: Senior Statistician, MRC Biostatistics Unit, Institute of Public Health (UK)

Day job: Co-ordinating Editor, Cochrane Consumers and Communication Group; Head of Centre for Health Communication and Participation, Australian Institute for Primary Care & Ageing, La Trobe University (Australia)

Day job: Trials Search Co-ordinator, Cochrane Renal Group (Australia)

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Day job: Managing Editor, Cochrane Pregnancy and Childbirth Group, University of Liverpool (UK)

Day job: Co-Director, Australasian Cochrane Centre, Monash University (Australia)


THE COCHRANE COLLABORATION STEERING GROUP: BOARD OF TRUSTESS

Mary Ellen Schaafsma Centre Representative Day job: Executive Director, Canadian Cochrane Centre, University of Ottawa (Canada)

Roger Soll

Liz Whamond

Katrina Williams

Co-ordinating Editor Representative

Consumer Network Representative

Field Representative

Day job: Co-ordinating Editor, Cochrane Neonatal Review Group; Professor of Neonatology, University of Vermont College of Medicine (USA)

Day job: Canadian Cancer Action Network (Canada)

Day job: APEX Australia Chair of Developmental Medicine & Department Head (Australia)

With special thanks to Lorne Becker, Lisa Bero, Zbys Fedorowicz and Rob Scholten, who stepped down from the Steering Group in October 2010.

Hans van der Wouden Cochrane Review Group Representative Day job: Senior Lecturer, Department of General Practice, Erasmus Medical Center, Rotterdam (Netherlands)

Mingming Zhang Consumer Network Representative Day job: Co-ordinator, Chinese Cochrane Centre, West China Hospital, Sichuan University (China)

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“ … we’ve been developing and testing several different ways to transform full-scale Cochrane Reviews into smaller bites of fast food (without compromising nutritional value) for the last four years. This is because we’ve come to realise – through research – that not everyone in our target group has the appetite for a 10-course meal, and many do not have the necessary time or utensils to make it past the appetizer.

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MAKING A FAST FOOD MEAL OUT OF A COCHRANE REVIEW

Making a fast food meal out of a Cochrane Review Sarah Rosenbaum and Claire Glenton

If a researcher sent you an email with two links, one to a copy of his doctoral thesis and the other to a short video on YouTube describing the same work, which one would you be most tempted to click on? This happened to us in late 2010, inspiring an idea that we might be able to lower the threshold of ‘reading’ a systematic review by squeezing key messages into a 10-minute YouTube format. Was this possible? Did a video format lend itself to a reliable presentation of statistics? Could we do it without much of a budget? Would people even bother to watch it? Our curiosity in these issues was not an isolated event – we’ve been developing and testing several different ways to transform full-scale Cochrane Reviews into smaller bites of fast food (without compromising nutritional value) for the last four years. This is because we’ve come to realise – through research – that not everyone in our target group has the appetite for a 10-course meal, and many do not have the necessary time or utensils to make it past the appetizer.

provide some explanation of general concepts which we know from earlier work people tend to struggle with (e.g. “what is a systematic review?”) and to help people familiarise with SoF tables. We wanted to make the video attractive to a wider audience beyond typical Cochrane Review readership and to increase accessibility, also with regard to language. Finally, it shouldn’t cost anything beyond our own working hours, and these should be kept to a minimum.

We decided to test this idea on a recently published Cochrane Review concerning the effects of lay health workers for maternal and child health and tuberculosis. The review was complex with many included studies, outcome measures and sub-groups. But the authors had already created Summary of Findings (SoF) tables for each of the main comparisons, making it easier to identify the key results. A colleague had also published a short SUPPORT Summary of the review specifically targeted at our chosen target group: policy-makers in low- and middle-income countries. Together the SoF tables and the SUPPORT Summary provided critical raw ingredients for our video manuscript.

We convinced our Ugandan colleague Susan MunabiBabigumira that her voice would be perfect for the project, and spent three afternoons taping the 10-minute script to get it right (one take for rough editing, then two takes for final soundtrack). We found free photos on various NGO and governmental websites, and Claire dug up some photos from Nepal, Venezuela, South Africa and Uganda that she and others had taken when visiting lay health worker programmes. We also put together some simple graphics: maps to indicate where studies had taken place and illustrations to help explain the concept of a systematic review. All of this was put together using our copy of Camtasia – a simple user-friendly program originally designed for annotating PowerPoint presentations and transforming them to video format. We didn’t use any video footage, but created movement by zooming and panning the still-photo imagery.

Before we began, we set some goals for the work. We decided not to make one video in isolation, but rather to try to develop a format that could easily be re-used for other reviews with a minimum of resources. In addition to presenting results from one review, we wanted to

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MAKING A FAST FOOD MEAL OUT OF A COCHRANE REVIEW

Making a fast food meal out of a Cochrane Review English captions were created in Camtasia and uploaded to YouTube (where multiple language translation is possible using the “Translate Captions” function based on Google Translate). We made a first version and sent the YouTube link to several health system researchers for feedback. This resulted in a newer improved version, an 11-minute video covering the main results concerning the effect of lay health workers on childhood immunisation, breastfeeding, child deaths and illnesses, and tuberculosis. We didn’t spend any money and in total it took us about 85 hours from start to finish. So far, the video has been seen over 1800 times. It has been circulated on several email lists, generating many responses. These have been largely positive, including appreciation of narration and use of tables, maps and photos. Some feel it’s too long, suggesting that 2–3 minutes is a maximum length for this target group. Another problem is accessibility, despite publishing on YouTube. A researcher from South Africa highlighted the problem with slow internet connections in South Africa and other countries in the continent. Chinese researchers who wanted to translate the captions to Mandarin could not access the video at all on YouTube, owing to national censoring. Iranian colleagues have also been unable to see the video for the same reason.

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We plan to carry out user testing within the next year. This will help us answer questions about presentation, scope and length from the perspective of actual end users. But so far, we’ve discovered that it is possible to create a short video of a Cochrane Review on a shoe-string budget. The content lent itself well to a video format, and the imagery seemed to help put the contextual meat back onto the dry numbers. People bothered to watch. And we had a lot of fun! You can view Sarah and Claire’s YouTube video at: http://www.youtube.com/watch?v=0zHHhpE5Rb0

Sarah Rosenbaum is a designer and researcher for the Norwegian Knowledge Centre for Health Services and a member of the Campbell and Cochrane Equity Methods Group. Claire Glenton also works for the Norwegian Knowledge Centre for Health Services as a senior scientist. She contributes to many Cochrane groups, including as an editor for the Consumers and Communication Group.


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REPORT FROM THE EDITOR IN CHIEF

Report from the Editor in Chief The Annual Report is a good time to reflect on progress, and to look ahead. Cochrane will soon be entering its 20th year. The Collaboration has achieved great things: not only the largest single collection of full-text, updated systematic reviews, but its role as an advocate for evidence-based health care and policy, and its extraordinary, sometimes overlooked contribution to training and education. But it is important that we do not become complacent. There is still a lot to do. The ‘Cochrane’ brand is first and foremost associated with quality. We should be prioritising high-quality, high-impact reviews and supporting researchers in delivering these. We must ensure that our reviews address uncertainties that are important to our stakeholders, whether they are policy-makers, consumers and carers, or health professionals. Furthermore, in 2011, at our mid-year meeting we made a commitment to do better in respect of providing research that is more geographically applicable, and also with engaging and nurturing talented researchers from low and middle income countries (LMICs). At the Cochrane Editorial Unit, working with colleagues from our publishers, we have developed some metrics that we can use to assess the performance of The Cochrane Library. They include usage, citations, impact factor, number of new and updated reviews, percentage of active reviews that are up to date, resolution of complaints, percentage of review authors from LMICs, number of feedback comments, and time taken from completed protocol to review publication. We will soon be able to add to this list measures of review quality assessed against the standards developed during the ongoing work on the Methodological Expectations for Cochrane Intervention Reviews (MECIR) project. This work has brought methodologists and Review Group teams together in a way that has been a true example of ‘building on the enthusiasm of individuals’, one of our core principles. This has been a collaboration in the best sense of the word. We have also identified for some time that the way we delivered and presented Cochrane Reviews did not do justice to the efforts of our research teams and contributors. Over the past six months we have seen the first fruit of our work in rectifying this, with the first raft of changes implemented in the August 2011 issue of The Cochrane Library. These included enabling non-English language content to be displayed, improving links between reviews and from reviews to cited references, showing the articles that have cited each review, and also changes to the ‘look and feel’ of the reviews and the navigation. It is still early days: next we will turn our attention to the search functions, aiming to bring them up to the best contemporary standards utilising the MarkLogic technology.

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REPORT FROM THE EDITOR IN CHIEF

All these innovations are intended to create a web platform that is built around the needs of its users; however, as any Cochrane insider will tell you, it is the content that counts. This is why, in April 2012 at our mid-year meeting in Paris, the subject of the Strategic Session will be ‘Cochrane content’. The preparatory work that we will undertake will ensure that we take on board the perceptions and aspirations of users (and non-users), funders and supporters, as well as the researchers, editors, methodologists, information specialists and others whose work is our primary purpose. These are exciting times for Cochrane, and important times for health care and health systems globally. Trust, it is said, is built on realism, and realism, in a word, is what we are about.

David Tovey Editor in Chief of The Cochrane Library

According to the World Health Organization, the world’s elderly population - people 60 years of age and older was 650 million in 2007. By 2050, it is forecast to reach 2 billion. In 2010, two of the top three most accessed Cochrane Reviews on The Cochrane Library assessed interventions for the care of older people.* *Source: John Wiley & Sons, Ltd. COCHRANE COLLABORATION ANNUAL REPORT 2010/11

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THE YEAR AT A GLANCE: THE COCHRANE LIBRARY

The year at a glance The Cochrane Library We achieved a top 10 Impact Factor ranking for the first time In 2010, the Cochrane Database of Systematic Reviews (CDSR) was awarded an ISI Impact Factor ranking of 6.186, which describes the ratio of the number of reviews published during 2008 and 2009 (1128) to the number of citations these reviews received in 2010 (6978). A review published in the CDSR in 2008 or 2009 was cited, on average, 6.186 times in 2010.

How did we do compared to other journals in the top 10? Rank

Journal title

Total cites

Number of reviews published

1

New England Journal of Medicine

227,674

345

2

Lancet

155,734

271

3

JAMA

117,495

233

5

PLOS Medicine

10,370

99

7

Annual Review of Medicine

4,518

31

10

Cochrane Database of Systematic Reviews

27,366

749

3,957,567 full-text downloads of Cochrane Reviews were made on The Cochrane Library in 2010, a 14% increase compared to 2009 4, 500, 000 4, 000, 000

4%

+1

3, 500, 000 3, 000, 000 2, 500, 000 2, 000, 000 1, 500, 000 1, 000, 000 500, 000 0

0 2005 2006 2007 2008 2009 2010 2011 (to May)

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THE YEAR AT A GLANCE: THE COCHRANE LIBRARY

In 2010, our top 5 most accessed Cochrane Reviews were downloaded by users more than 40,000 times 2010 Rank

Author team

Article

Full Text Access

1

Lesley D Gillespie, M Clare Robertson, William J Gillespie, Sarah E Lamb, Simon Gates, Robert G Cumming, Brian H Rowe

Interventions for preventing falls in older people living in the community (Oct 2010)

11,057

2

Carolyn D Summerbell, Elizabeth Waters, Laurel Edmunds, Sarah AM Kelly, Tamara Brown, Karen J Campbell

Interventions for preventing obesity in children (Jan 2009)

10,557

3

Ian D Cameron, Geoff R Murray, Lesley D Gillespie, M Clare Robertson, Keith D Hill, Robert G Cumming, Ngaire Kerse

Interventions for preventing falls in older people in nursing care facilities and hospitals (Feb 2010)

7,834

4

Hiltje Oude Luttikhuis, Louise Baur, Hanneke Jansen, Vanessa A Shrewsbury, Claire O’Malley, Ronald P Stolk, Carolyn D Summerbell

Interventions for treating obesity in children (Jan 2009)

7,595

5

Elizabeth McInnes, Nicky A Cullum, Sally EM Bell-Syer, Jo C Dumville

Support surfaces for pressure ulcer prevention (May 2010)

6,171

Between April 2010 and March 2011, our contributors prepared 550 new protocols for forthcoming Cochrane Reviews, 389 new Cochrane Reviews and 449 updated Cochrane Reviews (new citation versions) 2011(1–9) 2010 2009 2008 2007 Cochrane Reviews can be withdrawn from the active database when they become out of date or are replaced by new Cochrane Reviews in a similar subject area

2006 2005 2004 2003 2002 2001

0 100 200 300 400 500 600 700

KEY n n

New Cochrane Reviews Updated Cochrane Reviews

n n

Withdrawn Cochrane Reviews (counts began 2004) New Protocols

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THE COLLABORATION ENTERS OFFICIAL RELATIONS WITH THE WORLD HEALTH ORGANIZATION

“ Marie-Paule Kieny, Assistant Director General, Innovation Information Evidence and Research, World Health Organization

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The Cochrane Collaboration provides an international benchmark for the independent assessment and assimilation of scientific evidence.


THE COLLABORATION ENTERS OFFICIAL RELATIONS WITH THE WORLD HEALTH ORGANIZATION

The Collaboration enters Official Relations with the World Health Organization On 24 January, 2011, The Cochrane Collaboration was accepted as a Non-Governmental Organisation in Official Relations with the World Health Organization (WHO), establishing a partnership with formalised communication between our two organisations. This includes a seat for the Collaboration on the World Health Assembly, allowing us to provide input on WHO health resolutions. “The Cochrane Collaboration has been working with the WHO in various capacities for many years and I am delighted to have seen this grow into an official partnership,” said Jeremy Grimshaw at the time. “The WHO and various groups within the Collaboration have embarked on successful evidence-based health projects in the past and I know this will persist as we continue to strengthen this partnership.” One of the significant joint projects the WHO and The Cochrane Collaboration have developed is the WHO Reproductive Health Library. This is an electronic journal covering sexual and reproductive health produced by the WHO’s Department of Reproductive Health and Research using the best available evidence from Cochrane Reviews. This initiative has helped millions of women and babies in developing countries through practice recommendations on newborn health, pregnancy and childbirth, and sexually transmitted infections. One such recommendation is the elimination of the routine use of episiotomies (cutting the skin and muscle surrounding the vagina) during childbirth, which often leads to perineal trauma, infection and painful intercourse. “Formulating an official partnership with an influential institute such as the World Health Organization is an honour. This speaks volumes about the work of Cochrane in evidence-based health care,” added Grimshaw.

“The Cochrane Collaboration provides an international benchmark for the independent assessment and assimilation of scientific evidence. It is a leading producer of high-quality systematic reviews in health care,” said Marie-Paule Kieny, Assistant Director General, Innovation Information Evidence and Research at the WHO. “WHO has been working with The Cochrane Collaboration for several years and is looking forward to formalising what has already been a very productive relationship.” The partnership will allow The Cochrane Collaboration to significantly influence the way research evidence is created and used by the WHO by improving the collection of reliable health information and promoting intersectoral collaboration and high-quality research to produce the necessary evidence to ensure policies in all sectors contribute to improving health and health equity. At its meeting in Madrid in October 2011, the Steering Group will consider how best to commit resources to its partnership with the WHO over the coming months and years in order that we are able to maximise its benefits for our organisation.

With thanks to Lisa Bero from the San Francisco branch of the US Cochrane Center and Davina Ghersi from the WHO for leading our bid to enter Official Relations with the WHO.

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WHAT WE PLANNED; WHAT WE DID

What we planned; what we did To ensure high-quality Cochrane Reviews are available across a broad range of healthcare topics We planned to continue to improve the quality, relevance, usability, and impact of The Cochrane Library

We’re revising the workflows for managing the editorial process for Cochrane Reviews The Review Groups executives, with the support of the Cochrane Editorial Unit (CEU) and Information Management Systems (IMS) Team, have been revising the ‘workflow templates’ for Cochrane Reviews and making other improvements to the workflow system. They are working to develop a comprehensive training and support plan to coincide with and follow the release and uptake. The workflows will enhance the management of Cochrane Reviews through the editorial process and provide benefits to editorial teams and authors.

We’re developing guidance on minimum competencies for Cochrane Review author teams The preparation of Cochrane Reviews is a large and complex task, requiring the contributions of a team of committed people with complementary expertise. To ensure that each review team is suitably prepared, the Managing Editors’ Executive, with support from the Centre Directors, has been developing a set of minimum competencies for review author teams, as a direct response to the recommendation made in the 2009 strategic review of the Collaboration. The idea is that Cochrane groups will use the guidelines in partnership with review author teams to ensure the process of preparing reviews is efficient and the quality of the completed reviews is of the highest level.

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We’ve enhanced our understanding of review updating Together with staff of various Cochrane groups, the CEU completed a UK National Health Service-funded project on updating Cochrane Reviews. The project developed a prioritisation tool and a quantitative tool for predicting the stability of reviews based on number of trials and effects size, and has provided experience of offering focused assistance and interventions to authors to promote the completion of prioritised Cochrane Reviews.

We’re improving the feedback system for Cochrane Reviews The CEU is working with Cochrane groups and our publishing partner, Wiley & Sons, Ltd, to improve and enhance the system that allows users to submit feedback about individual Cochrane Reviews. The changes are being finalised and will be rolled out in 2012.

We’ve audited Cochrane Reviews In 2011 the CEU undertook an audit of abstracts, Plain Language Summaries and Summary of Findings tables in Cochrane Reviews. This has led to a series of proposals for improvement, and another audit will be undertaken once the proposals have been introduced.

We’re undertaking a review of our publishing arrangements We’re at the early stages of a review of our publishing arrangements to ensure that they are optimally aligned to our mission, based on our understanding of the current operating environment and future trends. This review will inform the tender document to be released to bidders for the role as our publishing partner from January 2014, when our current publishing contract expires.


WHAT WE PLANNED; WHAT WE DID

The appointment of a Methods Co-ordinator offers a great opportunity for the Collaboration to benefit maximally from a variety of planned and ongoing initiatives to further improve the methodological quality of our reviews. Julian Higgins, Methods Group representative on the Steering Group

We’ve appointed a Cochrane Library Oversight Committee

We’ve appointed a Methods Co-ordinator

In September 2010 we appointed an independent oversight committee for The Cochrane Library, chaired by Richard Smith, former editor of the BMJ. The role of the committee is to provide independent advice, mediation and performance targets for the Editor in Chief.

In recognition of methods development as a core purpose of the Collaboration, we have drawn together our methods work under the Cochrane Methods banner and appointed a Methods Co-ordinator, Jackie Chandler, in March 2011. The key focus for this position is to provide support to Methods Groups, the Methods Board and Executive, Handbook Editorial Advisory Panel, and the new Methods Application and Review Standards (MARS) Working Group. One of Jackie’s priorities will be to assist with the development and implementation of networks between Cochrane Review Group-based individuals with methodological responsibilities and those providing methods support from the Methods Groups. Jackie is also co-ordinating the administration of a series of methods projects in priority topic areas, supported by core funds.

We’re preparing to launch the Cochrane Register of Studies After more than 18 months’ development, we’re preparing to launch the Cochrane Register of Studies (CRS) in late September 2011, our new, bespoke database and management tool for the Collaboration’s specialised registers of healthcare studies and their reports. The CRS will replace the variety of software packages currently used by Cochrane groups to maintain their specialised registers and will become the source of data for the Cochrane Central Register of Controlled Trials (CENTRAL), a component database of The Cochrane Library. Key to the rationale for developing the CRS is facilitating the improvement of the quality and accessibility of the information in CENTRAL, which represents essential infrastructure of the Collaboration, both for supporting the authors of Cochrane Reviews and as a unique, marketable product.

We planned to support the extension of the methodological work which underpins our reviews, ensuring that any methodological developments can be implemented and will enhance the quality of The Cochrane Library

We’re developing methodological expectations for Cochrane Reviews The Cochrane MECIR project (Methodological Expectations of Cochrane Intervention Reviews), led by the MARS Working Group, the CEU and the Coordinating Editors, has been developing a set of conduct and reporting standards for Cochrane Reviews, to be launched at the Madrid Cochrane Colloquium, with the aim of improving the quality and consistency of Cochrane Reviews. Additionally, with the release of RevMan 5.1 (the Collaboration’s software for preparing and updating Cochrane Reviews) earlier in 2011, the updated ‘risk of bias’ tool will lead to improved assessments of bias during the review preparation process.

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WHAT WE PLANNED; WHAT WE DID

To promote access to Cochrane Reviews and the other products of The Cochrane Collaboration We planned the continued refinement of our partnership strategy and enhancement of our existing partnerships with external stakeholders of the Collaboration and the Library, such as health information providers, policy-makers and funders

organisations to produce the necessary evidence to ensure policies in all sectors contribute to improving health and health equity. Over the coming year we will be implementing a management structure for our relations with the WHO to ensure we take maximum advantage of the opportunities our partnership provides. This will inform the development on an overarching partnership strategy for the Collaboration.

We were awarded Official Relations with the World Health Organization

We’re working with guidelines groups to improve joint working and reduce duplication of effort The CEU has been working with guidelines developers to obtain advance notice of upcoming healthcare guidelines that could benefit from Cochrane input. The outcome has been the establishment of several new collaborations between Cochrane Review Groups and the UK National Institute for Health and Clinical Excellence (NICE), the reinforcement of existing links, and generally increased awareness of the benefit of increased collaboration. The CEU now plans to liaise with other guideline developers to increase collaboration globally.

In January 2011, the Collaboration was accepted as a Non-Governmental Organisation in Official Relations with the World Health Organization (WHO), the public health arm of the United Nations, establishing formalised communication between our two organisations. This partnership includes a seat for the Collaboration on the World Health Assembly, the WHO’s decisionmaking body, allowing us to provide input on WHO health resolutions. It provides the opportunity for the Collaboration to significantly influence the way research evidence is created and used by WHO by improving the collection of reliable health information on which they base their policies. It also promotes intersectoral collaboration and high-quality research between our

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We’ve been preparing and updating reviews in response to external requests The CEU led a WHO-funded project to deliver a suite of reviews on vitamin A supplementation, and this was completed and culminated in their use in the development of WHO guidelines in 2011. The CEU is also providing editorial and project administration to a UK National Institute for Health Research-funded Cochrane Review on neuraminidase inhibitors for influenza, which will be completed in late 2011.


WHAT WE PLANNED; WHAT WE DID

We planned to enhance the relevance and accessibility of the Library to all users, particularly those who belong to low and middle income countries and from communities whose health needs are great

We’re planning to increase global participation in the Collaboration, and the relevance of The Cochrane Library worldwide At the mid-year meetings of our management committees in Split, Croatia, in April 2011, we held a strategic session to develop plans to ensure we better enable global participation in our organisation. We recognised that while a wide range of activities have been undertaken to address this issue, the Collaboration remains dominated by authors from economically developed, English-speaking countries, and has no formal, co-ordinated strategy to address the issues of global participation and topic coverage. Without such a strategy, particular countries or health prioritities may remain under-represented. A key recommendation from the session that we’re looking to implement within the next year is the establishment of a Cochrane Academy; a formal training and mentoring programme to support first time authors – wherever they are in the world – in completing high-quality Cochrane Reviews.

We’ve improved the presentation of Cochrane Reviews In collaboration with our publishing partner, John Wiley & Sons, Ltd (Wiley), we’ve updated the visual presentation of Cochrane Reviews in The Cochrane Library. Reviews are now accessed via a more engaging, user friendly interface, and the text has been amended to a sans-serif font, which is easier for people to read.

We’re developing a consumerfriendly site for Cochrane evidence: summaries.cochrane.org The Consumer Co-ordinator, CEU and Web Team have been working together to develop a new area of cochrane.org aimed at consumers and patients. This new site will focus on ‘search and browse’, with an emphasis on Plain Language Summaries, podcasts and summaries of Cochrane Reviews with full-text links to The Cochrane Library and topic portals. The site will feature the same browse as The Cochrane Library as well as additional browse options, such as by demographic, Archie topic lists and MedlinePlus health topics. In addition, some elements of so-called Web 3.0 are included, such as querying and pulling data from outside sources and publishing of data as RDF, a semantic web mark-up standard aimed at, among many applications, optimising search engine functionality and presentation, as well as enabling efficient linking with external datasets. The site is due to be launched in late September 2011 and will be ‘beta’ for the first six months or so, while additional features are added and developed.

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WHAT WE PLANNED; WHAT WE DID

We planned to improve consumer participation in the Collaboration and increase uptake of our products by consumers

We’ve appointed a Consumer Co-ordinator

We’re developing a review spin-off product In partnership with our publishing partner we’re developing Cochrane Clinical Answers (CCAs), a new product derived from Cochrane Reviews which tailors content to specific clinical queries. CCAs are designed to be accessible to healthcare professionals on the job, so we’re focusing efforts on making them available on devices like smartphones. To date, the template for the CCAs has been developed, author teams trained to prepare the content, and samples drafted and peer reviewed. The development is ongoing and will address the peer review feedback and include designs of the proposed user interface.

We’re using new digital capabilities to increase use of The Cochrane Library content The CEU and Wiley are working together on research of users’ reactions to some ‘re-imaginings’ of Cochrane content as a way of informing digital strategy for The Cochrane Library. This has involved developing directional prototypes for a next-generation Cochrane Library based on three themes (literature focus, medical workflow focus, and topic focus), and running user testing.

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In response to the recommendation from the 2010 Cochrane strategic session in Auckland, New Zealand, the Collaboration appointed Catherine McIlwain as its first Consumer Co-ordinator, in September 2010. In her first year at the Collaboration Catherine has already made a big impact. She has been working with the transitional Consumer Executive to develop comprehensive plans for consumer involvement in the Collaboration, particularly as members of Cochrane Review author teams. She’s collaborated with the Managing Editors’ Executive to develop guidelines for how Review Groups can increase consumer participation and provided an induction pack for when consumers join a group. Catherine is working with the Training Co-ordinator to e nsure that training for new consumers is included as part of the Collaboration’s new comprehensive training programme, Cochrane Training. She’s also looking at consumers’ needs from an end-user perspective – as a key target audience of Cochrane Reviews. The development of summaries. cochrane.org is an essential part of this.


WHAT WE PLANNED; WHAT WE DID

We planned to improve the dissemination and uptake of our reviews, and enhance our brand, through the implementation of a coherent marketing and communication strategy

We’re reviewing our marketing and communications strategy As a response to a recommendation from the 2009 strategic review, we’ve engaged an external marketing and communications firm to undertake a review of our marketing strategies. The aim is to improve the way we communicate with our audiences and contributors in order to ensure that we continue to attract contributors of the highest calibre, guarantee our financial sustainability and increase the impact of our products. Lori Tarbett from the Canadian Cochrane Centre has been seconded to the post of Marketing and Public Relations Officer for the Collaboration to oversee the review. Results and recommendations will be presented to the Steering Group at its October 2011 meeting in Madrid, Spain.

We’re beginning work on our 20th anniversary celebrations 2013 marks 20 years since the establishment of The Cochrane Collaboration, and what a long way we’ve come! To mark the achievement and use the opportunity to advocate the Collaboration to new audiences and supporters, we are planning a series of celebrations, publications and events for 2013.

To ensure an efficient, transparent organisational structure and management system for The Cochrane Collaboration We planned to enhance our monitoring and management functions, particularly of groups and platforms which receive core Collaboration funding and/or use the Cochrane brand

We’re simplifying and strengthening the Collaboration’s management structures The Collaboration is organisationally relatively ‘flat’: we have fewer than 500 people employed on a full or part-time basis at our groups, 30 people employed in our central teams, and around 120 members of our management committees, including the Steering Group. This compares to our more than 28,000 ‘content contributors’, who do the important work of preparing – and supporting the production of – Cochrane Reviews. In order to maximise the efficiency of our organisational management, and provide effective support to our dedicated contributors, we’ve begun a process of simplifying and strengthening our management structures. In 2011 this has included formalising the group executives as advisory committees to the Steering Group, with dedicated budgets, administrative support and faceto-face meeting opportunities. We’ve also established an information services management structure under the oversight of the Editor in Chief, which aims to develop and implement co-ordinated plans to meet our current and predicted information services needs.

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WHAT WE PLANNED; WHAT WE DID

We’ve also …

Appointed a Web Liaison Officer Lorne Becker, previously Steering Group Co-Chair, has been appointed to work with the Web Team to develop web policy and act as a link between the team, the Steering Group and the information services management structure.

Developed our own conference management tool

We’re implementing performance monitoring at group level Cochrane groups are established all over the world within some of the world’s best academic and research organisations. To ensure that they are meeting the high standards the Collaboration expects of them, they are monitored regularly by the Cochrane Monitoring and Registration Committee. Some of the functions of this committee are now being moved to the group executives, with one aim being to improve the implementation of recommendations that result from the monitoring process. As a first task, the group executives are developing sets of key performance indicators to monitor their groups’ performance against their key objectives.

The Web Team has developed and launched a bespoke web application for managing the Collaboration’s meetings and conferences, including its annual Colloquium. The application is being piloted for the management of the 2011 Colloquium in Madrid and is already proving a hit. Attendees are able to sign up to workshops and meetings online, check their schedules and make payments, all via one interface, which is customisable according to the requirements and nature of the event.

Reduced the paperwork In 2011 the IMS Team made two important additions to Archie, the Collaboration’s online repository of documents and contacts details: the addition of electronic monitoring forms, and the introduction of electronic Disclosure of potential conflicts of interest forms and Licence for publication forms. Going online reduces the need for manual data extraction when completing the annual monitoring of the performance of Cochrane groups, and streamlines the review production process.

Commenced a review of our Colloquia The CEO is leading a review of our current Colloquium model with the aim of ensuring that future Colloquia continue to meet our current and predicted organisational needs.

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WHAT WE PLANNED; WHAT WE DID

The appointment of a Training Co-ordinator is a great boost to the Collaboration’s efforts to strengthen training and support for all Cochrane contributors, and will enable several important initiatives to be rolled out over the next two years. Steve McDonald, Co-Director of the Australasian Cochrane Centre with oversight for Cochrane Training

To achieve sustainability of The Cochrane Collaboration We planned to seek to develop alternative funding sources

We’re investing in innovation As part of moves to diversify our funding model, we have provided start-up funding for a new Collaboration Trading Company, Cochrane Innovations. The purpose of Cochrane Innovations is to provide an avenue for the marketing of new Cochrane products – such as Cochrane Clinical Answers – without compromising our principal obligations as a charity.

We planned the enhancement of activities aimed at increasing participation, retaining the energy and commitment of current contributors and staff, and supporting their progression in the Collaboration

We’ve established a Collaboration-wide training initiative Without well-trained contributors preparing Cochrane Reviews, the work of the Collaboration would grind to a rapid halt. In recognition of training as a core purpose of the Collaboration, we have invested core funds in the development of Cochrane Training, a Collaboration-wide initiative designed to bring all training activities under one scheme. The Training Working Group is responsible for overseeing Cochrane Training and the newly appointed Training Co-ordinator, Miranda Cumpston, provides central co-ordination of training and support activities across the Collaboration. Among her tasks

as Training Co-ordinator, Miranda will lead the ongoing development and implementation of standardised author training materials, including in languages other than English, and manage the integration and dissemination of training resources and support mechanisms through the Cochrane Training website.

We’re developing training and mentoring schemes for new group staff As part of the Cochrane Training initiative, the Consumers’, Fields’ and Trials Search Co-ordinators’ Executives are designing and implementing induction and mentoring schemes for new staff of our groups, building on the success of the Managing Editors’ scheme.

We’re supporting the Cochrane community with web technology In August 2011 the Cochrane intranet – designed for Cochrane group staff and contributors – was re-launched as the Cochrane Community site by the Web Team, with the aim of providing a virtual space where Cochrane colleagues throughout the world can access useful resources, read about updates on current Cochrane projects and interact through the discussion forums. The Managing Editors and Fields members are already active on the discussion forums, replacing the need for email discussion lists. The Trials Search Coordinators’ Executive is in the process of developing a portal on the Community site where their constituents can access relevant help and support resources. The Fields’ Executive is planning a shared web space for Fields groups to improve communication between them.

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WHAT WE PLANNED; WHAT WE DID

We’ve welcomed a new director of the UK Cochrane Centre In May 2011 we welcomed Martin Burton as director of the UK Cochrane Centre, who takes over from Mike Clarke. Martin is well known to Collaboration contributors as the Co-ordinating Editor of the Cochrane Ear, Nose and Throat Group. The UK Cochrane Centre is an important strategic and resource support to the Cochrane Review Groups funded by the UK National Institute for Health Research, the Collaboration’s biggest group funder.

We’ve clarified the management guidelines for Centres and Centre-branches In 2011 the Centre Directors’ Executive revised the core functions and accountability mechanisms for Centre-branches. They also developed a generic position description for Centre Directors, with the aim of standardising competencies and skill-sets for those who lead our geographically based groups.

We’ve welcomed a Cochrane Centre in France In June 2010 we welcomed the 14th regional Cochrane Centre, in Paris, France. Under the leadership of Philippe Ravaud and Pierre Durieux from University Paris Descartes, one of the primary aims of the French Centre is to identify and support people in France and in French-speaking countries who wish to be involved in the Collaboration. The French Centre is funded by the L’Ecole des Hautes Etudes en Santé Publique, La Haute Autorité de Santé, L’Assistance Publique - Hôpitaux de Paris, and L’Institut National de la Santé et de la Recherche Médicale.

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This review of our activities 2010–11 is based on the workplans of the Steering Group and its sub-committees, the central teams* and the group executives**, who together form the management structure of The Cochrane Collaboration. * Central teams: The Cochrane Editorial Unit (CEU), London, UK; the Information Management System Team (IMS), Copenhagen, Denmark; the Secretariat, Oxford, UK; the Web Team, Freiburg, Germany; the central co-ordinators: Consumer Co-ordinator, Marketing and PR Officer, Methods Co-ordinator, Training Co-ordinator. With special thanks to Monica Kjeldstrøm, former director of the IMS Team, who left the Collaboration in 2011 after 16 years. **Group executives: Centre Directors, Co-ordinating Editors, Consumers, Fields, Managing Editors, Methods and Trials Search Co-ordinators.


IMPROVING OUTCOMES IN CRISIS SITUATIONS WITH EVIDENCE AID

OUR PLANS FOR 2011–12

Our plans for 2011–12 1. We will continue to prioritise our support for the Editor in Chief and the Cochrane Editorial Unit as they seek to improve the quality, relevance, usability, and impact of The Cochrane Library. 2. We will realign the functions of the Cochrane Operations Unit (Secretariat) to support individuals and groups within the Collaboration better. 3. We will enhance our monitoring and management functions, particularly of individuals, groups and platforms which receive core Collaboration funding and/ or use the Cochrane brand, primarily through the Editorial and Operations Units, working with relevant group executives. 4. We will enhance activities aimed at supporting new contributors and sustain the skills and commitment of current contributors through the implementation of the Cochrane Training initiative. 5. We will strategically support the extension of Cochrane Methods, ensuring that any methodological developments can be implemented and will enhance the quality of The Cochrane Library.

7. We will form an external advisory board, and enhance our partnerships with external stakeholders of the Collaboration and The Cochrane Library, such as health information providers, policy-makers and funders. 8. We will enhance global participation and relevance of The Cochrane Collaboration and Library through the formation of a Cochrane Academy. 9. We will improve the dissemination and uptake of our reviews, and enhance our brand, through the implementation of a marketing and communications strategy. 10. We will appoint a publishing partner for The Cochrane Library for 2014 onwards that maximises the benefit to the Collaboration. 11. We will begin to develop a more author and user friendly and efficient approach to the organisation of topics within The Cochrane Library. 12. We will promote generational change within the organisation, particularly within the leadership, ensuring better global and gender equity.

6. We will seek to develop alternative funding sources.

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A ONE-TO-ONE WITH THE COCHRANE TRAINING CO-ORDINATOR

A one-to-one with the Cochrane Training Co-ordinator Lucie Jones interviews Miranda Cumpston, the Collaboration’s newly appointed co-ordinator of Cochrane Training Lucie: Cochrane Training is a new initiative that covers all aspects of training related to the preparation and production of Cochrane Reviews. Can you explain a little about why it has been developed and what it’s intended to do?

smooth as it can be, that everyone has the information they need to get their job done. Hopefully down the track, the Cochrane Reviews coming out at the other end are also of better quality.

Miranda: The Cochrane Collaboration has always provided training and support for the authors who do the hard work of writing the reviews. That’s been done by lots of different people in lots of different places over time: the different Centres in different countries, different Review Groups providing support for authors. We’ve never really had a co-ordinated strategy to make sure we are covering everything we need to cover, that all the training messages are consistent.

L: What will be your biggest challenges over the coming year?

The Cochrane Training initiative is designed to create a centralised strategic focus for training, make sure that everyone is connected and everyone knows what everyone else is doing, and to provide better support to the trainers, authors, and Cochrane staff. The idea is that everyone gets to learn what they need to learn, the authors are well supported and ultimately we get high-quality reviews in The Cochrane Library. L: That sounds like a big task! M: We are very lucky to have a large group of trainers around the world. We are really building on the expertise and the efforts of all of those people, who will form a new group called the Trainers Network. Network members will have access to central support through the Training Working Group. We are really trying to make sure we have a group of people centrally who are thinking about training strategy at a high level: where we need to go, what gaps we need to fill. We are bringing support to all of the trainers who are on the ground, supporting the authors and supporting other Cochrane staff on a day-to-day basis. L: What do you think the impact of Cochrane Training will be on contributors to The Cochrane Collaboration, now and in five years’ time? M: Well, hopefully the impact will be that there is a really easy pathway to get involved in the Collaboration, and it will be very easy for people to find the information they need to be able to get started. Then, once people do get involved as Cochrane contributors – whether it’s as an author, peer reviewer or editor – they will get access to training wherever they happen to live in the world. That training will provide high-quality information as and when it’s needed, whether that’s face-to-face or whether that’s online. We just want to make sure the process is as

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M: I think one of the challenges will be co-ordinating all the different ideas, but I will have the expertise and assistance of the Cochrane groups in this task. Different groups are taking responsibility for different projects, so the Review Groups are working on mentoring schemes, the UK Cochrane Centre is thinking about peer reviewing, and so on. Keeping track of all of that will be a big challenge. Also, making sure that people are putting things into action, rolling out our central ideas and training resources, making sure that everyone across the Collaboration is aware of what’s happening. So, communication will also be a really big issue, and I’m sure once we start putting things into practice we will learn a lot about how to improve what we are doing. L: Certainly, and I think communication is one of the big issues for the Collaboration as a whole, given we’re so many people in so many countries. M: Absolutely, yes. We will certainly have to consider how to best support all our contributors, particularly in non-English speaking countries and also in low-income countries where people may not have fantastic internet connections all the time. L: Lastly Miranda, why are you proud to be a Cochrane contributor? M: I think it’s very easy to be proud to be a Cochrane contributor. I’ve worked for the Collaboration for a long time now, although I am new to this position. I have never worked for such an organisation of people who aspire to do something good in the world. It is a really inspirational organisation, a really altruistic organisation; there are just so many people, thousands of people, who give up their time, who try to make the world better through improved health care, and I am just really proud to be a part of it.

Miranda Cumpston is based at the Australasian Cochrane Centre in Melbourne. She was interviewed on Skype by Lucie Jones from the Collaboration’s Secretariat, in August 2011.


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THE COCHRANE COLLOQUIUM

Keystone, the famous ski resort in the Rocky Mountains, Colorado, USA, played host to 800 delegates from a wide range of countries, who enjoyed 127 presentations, 101 workshops, 191 posters and 108 official meetings. Six plenary sessions provided a forum for discussing issues such as: civil society and transformational informatics; using evidence to deal with emergent global issues; framing and presenting evidence to influence practitioners and consumers; the global ‘reach’ of evidence-based health and social care; and developing Collaboration leadership for the future. All this activity was set against the background buzz of non-stop networking, as the Collaboration’s contributors and friends came together for our 18th annual conference.

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THE COCHRANE COLLOQUIUM

The Cochrane Colloquium The Cochrane Colloquium is our annual conference, open to everyone, designed to bring people together in one place to discuss, develop and promote our work, and to shape the organisation’s future direction. In 2010 we held the first Joint Colloquium of The Cochrane and Campbell Collaborations. The Campbell Collaboration is a partner organisation of ours, preparing systematic reviews in the fields of education, crime and justice, and social welfare. Acknowledgements On behalf of the Collaboration, the Steering Group would like to thank the following Collaboration contributors for making the Keystone Colloquium such a success: The team of University of Colorado, US Cochrane Skin Group Satellite, and US Cochrane Centre, for hosting the Colloquium, and in particular the Local Organising Committee: Robert Dellavalle; Carolyn DiGuiseppi; Jodi Duke; Vicky Koehler; L. Kendall Krause; Paula Marchionda; and Jen McIntyre. Thanks also to the Campbell Collaboration.

Sponsorship Colloquia are predominantly funded by delegate registration fees, and are also sponsored by generous donations from a number of external organisations and individuals. For their support of the Keystone Colloquium, the Steering Group, on behalf of the Collaboration, would like to thank the following: n The Agency for Healthcare Research and Quality n The Department of Veterans Affairs Eastern

Colorado Health Care System n The University of Colorado School of Medicine n University Physicians Incorporated n John Wiley & Sons, Ltd, and

The Cochrane Library n JAMAevidence & McGraw-Hill n The Jerry Lee Foundation

n n n n n

University of Colorado, Department of Dermatology University Physicians Colorado Injury Control Research Center Pan American Health Organization Kaiser Permanente

All sponsorship and support were in accordance with the Cochrane Colloquium Sponsorship Policy. The sponsors were not involved in the planning and organisation of the Colloquium.

Developing Countries Developing Country and Consumer Stipends support the attendance at Colloquia of contributors to the Collaboration from low and middle income countries, and from consumers and consumer advocates. At the Keystone Colloquium, 19 consumer and 11 developing country stipends were allocated. For their support of the Developing Country and Consumer Stipends, the Steering Group, on behalf of the Collaboration, would like to thank the following: n n n n

BMJ Publishing UK Cochrane Centre Canadian Cochrane Centre Cochrane groups who gave up their sponsored entity place n Singapore Branch of the Australasian Cochrane Centre (proceeds from the Singapore Colloquium, 2009)

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COCHRANE PRIZES AND AWARDS 2010

Cochrane Prizes and Awards 2010 Four prizes are awarded annually to contributors of The Cochrane Collaboration. The Colloquium provides the occasion for the award presentations. The Thomas C Chalmers Award is awarded

The Chris Silagy Prize is awarded at each

at each Cochrane Colloquium for the principal author of the best oral or poster presentation addressing methodological issues related to systematic reviews. In 2005, the panel agreed that the Award should in the future be given for both the best oral and the best poster presentation.

Cochrane Colloquium to an individual who has made “an extraordinary contribution to the work of The Cochrane Collaboration”.

At the 2010 Colloquium, The Thomas C Chalmers Award went to: Lavinia Ferrante di Ruffano, Chris Hyde, Jon Deeks for their work on ‘What do test-treat trials measure?’

The Kenneth Warren Prize is awarded at each Cochrane Colloquium to the principal author of whichever Cochrane Review authored by a national living in a developing country is judged to be both of high methodological quality and relevant to health problems in developing countries. At the 2010 Colloquium, The Kenneth Warren Prize was awarded to:

In 2010 The Chris Silagy Prize was awarded to: Chris Mavergames, Web Operations Manager, based at the German Cochrane Centre. Between 2009 and 2010, Chris led the Web Team in the successful implementation of a new content management system to power the Collaboration’s web presences, replacing the old and outdated infrastructure. Along with the Collaboration’s main website, cochrane.org, more than 70 Cochrane group websites were migrated into the new management system. At the same time, cochrane.org was completely redesigned and relaunched to coincide with the redesign of The Cochrane Library.

The results speak for themselves

Prince RH Christopher of the Cochrane Infectious Diseases Group and Christian Medical College, Vellore, India, for the review: ‘Antibiotic therapy for Shigella dysentery’ 1

Between April and August 2011, cochrane.org was visited by more than 2 million people from over 200 countries. 68% were visiting for the first time. We have over 6,000 followers on Twitter (@cochranecollab) and more than 2,300 members of the Collaboration’s Facebook group.

The Bill Silverman Prize is awarded at each Cochrane Colloquium to acknowledge explicitly the value of criticism of The Cochrane Collaboration, with a view to helping to improve its work, and thus achieve its aim of helping people make well-informed decisions about health care by providing the best possible evidence on the effects of healthcare interventions.

1

At the 2010 Colloquium, The Bill Silverman Prize was presented to: Alexander C Ford, Gordon H Guyatt, Nicholas J Talley and Paul Moayyedi for their article: ‘Errors in the conduct of systematic reviews of pharmacological interventions for irritable bowel syndrome’ 2 32

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2

Christopher PRH, David KV, John SM, Sankarapandian V. Antibiotic therapy for Shigella dysentery. Cochrane Database of Systematic Reviews 2010, Issue 8. Art. No.: CD006784. DOI: 10.1002/14651858.CD006784.pub4

Ford AC, Guyatt GH, Talley NJ, Moayyedi P. Errors in the conduct of systematic reviews of pharmacological interventions for irritable bowel syndrome. Am J Gastroenterol 2010; 105: 280–8; DOI:10.1038/ajg.2009.658.


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COCHRANE PRIZES AND AWARDS 2010

It’s an honour to work for such an amazing organisation with such a grand goal, that of improving health care for everyone. I’m proud to assist in the growth of the Collaboration’s online presences to ensure that our mission is fulfilled. Chris Mavergames, recipient of the Chris Silagy Prize 2010

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ASSESSING THE COLLABORATION’S IMPACT: A JOURNALIST AND A CONSUMER HAVE THEIR SAY

Assessing the Collaboration’s impact: a journalist and a consumer have their say Lori Tarbett interviews a consumer and a journalist, and asks how Cochrane evidence impacts them Lori: Alan, I know that you’ve been interested in the Collaboration for quite some time now, so can you tell us why you think it’s so important?

Alan Cassels

Johanna Trimble

Alan Cassels is a researcher and freelance journalist, and is co-author with Ray Moynihan of Selling Sickness: How the world’s biggest pharmaceutical companies are turning us all into patients (Greystone Books, 2005). Johanna Trimble is a healthcare consumer and member of the Patients for Patient Safety Canada. She first developed an interest in evidence-based health care after becoming concerned at what she considered to be the over-medication of her mother-in-law during a period of inpatient treatment. Both Alan and Johanna live in British Columbia, Canada.

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Alan: I probably became aware of Cochrane in the mid-90s; maybe about ’95 or so, when it was still a fairly young organisation. From my perspective, there has always been a big disconnect between what we know in terms of information from clinical trials and meta-analysis, and what we do. I certainly see this with pharmaceutical companies – and in prescribing – all the time, and it seemed to me that among the groups that were really interested in producing high-quality information, The Cochrane Collaboration had a mission which I’ve always respected. Over the years I’ve been both a user and promoter of Cochrane Reviews. The Cochrane Collaboration isn’t the only group in the world that does systematic reviews, but it has certainly developed a reputation of high standards; and when it comes to really important health decision-making, having a really good quality of evidence is paramount. So, we have a lot to thank Cochrane and Cochrane Reviews for. L : And you Johanna? Johanna: It’s because they do systematic reviews of research. I think any of us who have looked at research realise that you find research that says one thing and then you find something else that contradicts it. Which one are you going to believe? So I think the fact that Cochrane takes the good research, weeds out the [studies] that either don’t have enough people, weren’t conducted long enough, or the protocol wasn’t good. They take the good research and do a systematic review and come up with conclusions. Often the conclusion is there is not enough evidence. Although it may not give you a concrete answer, it gives you a very good idea of what kinds of questions to ask and what kind of discussion to have with health professionals that you’re interacting with. And the fact that Cochrane, of course, is completely independent of any funding from pharmaceutical companies or anyone who might be interested in actually making money from results of reviews – I really admire Cochrane for that.


IMPROVING OUTCOMES IN CRISIS SITUATIONS WITH ASSESSING EVIDENCE THE AID COLLABORATION’S IMPACT: A JOURNALIST AND A CONSUMER HAVE THEIR SAY

L: Alan, how do you think the Collaboration’s work impacts how health care is practised or studied in the world today? A: I think Cochrane’s work around maternity care and obstetric care has been really vital in shaping how babies are delivered in Canada and around the world. There’s huge numbers of Cochrane Reviews around effective practices in childcare that, I think, have really shaped how we do things. Some of the newer groups like the Effective Practice and Organisation of Care Group have influenced health policy-makers when it comes to saying, you know, “What can we do to improve the health system?” The good health policy-makers are going to say, “Well, what does the evidence say about what’s currently being done?” You can find a lot of those reviews about system changes, or ways in which we pay for drugs; I think those reviews will influence future policy. L: Johanna, did you find that the information you found in The Cochrane Library helped you make better informed decisions when it came to health treatments? J: Yes, it did … I think for a lot of people, the Plain Language Summaries are just absolutely invaluable. One of the problems that patients have navigating the whole system is understanding the medical jargon. To have something that gives it to you in plain language is just very, very helpful. L: Alan, as a journalist, how would you say the Collaboration and Cochrane Reviews fare in the media in terms of coverage? A: Ten years ago in the early 2000s I travelled to every single journalism school in Canada and did a presentation around evidence-based reporting. At all the journalism schools that I went to, I have to tell you, I think I only met one person who had ever heard of Cochrane. So, what this told me was that Cochrane really needed to be much more prominent in the eyes of journalists. Lately, I think there has been much more media attention on Cochrane Reviews. A lot of Cochrane Reviews will get published in major medical journals, and those journals will go on to get a lot of media coverage. There are also more and more reviews that are getting press coverage.

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But you know, meta-analysis [is a concept] that for a lot of people is hard to put their head around. Most people – or most journalists anyway – will respond to a new study that says, you know, this week red wine is good for you. That quality of sensationalist journalism doesn’t fit well with what Cochrane produces. I think when it comes to writing reviews and writing the Plain Language Summaries of those reviews, you need the researchers to give good context to why this stuff is important. So there’s always room for improvement. L: Johanna, do you have any suggestions as to what The Cochrane Collaboration can do to meet the needs of health consumers better? J: Well, of course, what I would like is to have the full reviews available to everybody. So, if that little experiment that was done in Canada giving everyone full reviews was continued, that would be wonderful. I think that, certainly the plain language part of it – having patients involved, looking at reviews and making suggestions – and writing up the results in plain language is extremely helpful. I would really like to see The Cochrane Collaboration go to some of the big library conferences. To go to something like the Canadian Library Association – they have a yearly conference – and to do a presentation on Cochrane. I’m sure it would be welcomed. You could do that at the provincial library conferences too, because I think if public librarians were more aware of excellent resources like Cochrane, they’d be more helpful to people when they come in with questions. So, I would really like to see Cochrane involve itself more with the public libraries.

Lori Tarbett is the Marketing and Public Relations Officer for the Collaboration, based at the Canadian Cochrane Centre in Ottawa, Canada.

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OUR FUNDING

Our funding A note from the Chief Executive Officer The Cochrane Collaboration is an amazing network of dedicated volunteers from around the globe. It has never been truer said that the sum of the whole is greater than its parts. The combination of this voluntary effort produces a synergy of intellect, activity and output that, it has been suggested, would take a billion dollars a year to create if it was to be started now using a more traditional organisational model. It has also been calculated that simply to purchase the Collaboration’s outputs from commercial sources would cost in excess of £100 million GBP. The reality is that the central Collaboration and all its constituent groups in financial year 2010/11 spent in the order of £17 million GBP on its full range of activities, demonstrating the leveraging effect of funding the Cochrane network. Put simply, our funding model turns an unaffordable dream into an affordable goal. The role of the Collaboration’s centrally funded infrastructure is to enable the work of our 28,000 contributors in preparing – and supporting the production of – Cochrane Reviews. The income for this, reported in the Financial Statements, comes principally from royalties earned from sales of The Cochrane Library and is known as our ‘core’ income. The proportion of core expenditure spent on different tasks is shown overleaf, both as a proportion of core income, but also – and making a more realistic comparison with other organisations – as a proportion of the overall income earned by all our groups. What is particularly striking about this second graph is that over 90% of income is spent on activities and development; only 2% on central administration. A record to be proud of. I would like to take this opportunity to thank the governments and organisations who fund and host our groups, and to those who continue to place their trust in Cochrane Reviews by purchasing licences to The Cochrane Library. Together, we will fulfil our vision of informing healthcare decision-making throughout the world with high-quality, timely research evidence.

Nick Royle Chief Executive Officer

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COCHRANE COLLABORATION ANNUAL REPORT 2010/11


OUR FUNDING

Core and group income and expenditure 2010/11 25,000,000

INCOME

EXPENDITURE

20,000,000 15,000,000 10,000,000 Group 5,000,000 Core 2011–12

2008–9

2009–10

2007–8

2006–7

2005–6

2004–5

2010–11

2009–10

2008–9

2007–8

2006–7

2005–6

2004–5

GBP 0

Group income is recorded in local currencies and converted to GBP (Sterling) for audit purposes at the end of the financial year. With the fluctuation of the relative value of many of these currencies against the GBP in the financial year 2010/11, group income appears to show a slight decline from 2009/10. However, we are confident that this does not reflect an actual decrease in funds available to groups, who spend in their local currencies.

How our group staff spent their time, 2010/11 (principal activities) Training and presenting at conferences Supporting group staff Producing Cochrane Reviews Developing methods Fundraising Running the group Working on editorial processes Supporting Cochrane Review author teams 0 5% 10% 15% 20% 25% 30% Training and Methods Co-ordinators appointed in 2011/12 financial year

KEY n Cochrane Review Groups (n.53)

n Centres and Branches (n.14)

n Fields (n.11)

n Methods (n.15)

COCHRANE COLLABORATION ANNUAL REPORT 2010/11

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OUR FUNDING

Core expenditure as a proportion of core income 2010/11

Core expenditure as a proporation of core and group income 2010/11

KEY

KEY

n Production and dissemination of Cochrane Reviews 55%

n Group expenditure 87%

n Administration 18%

n Production and dissemination of Cochrane Reviews 7%

n Organisational development 15%

n Organisational development 2%

n Marketing and communication 7%

n Administration 2%

n Governance 4%

n Governance 1%

n Advocacy 0.5%

n Marketing and communication 1%

n Training and capacity building 0.5%

n Advocacy 0.1%

n Methods 0%

n Training and capacity building 0.1%

Training and Methods Co-ordinators appointed in the 2011/12 financial year.

n Methods 0%

Where our group funding came from 2010/11

How our group funding was spent 2010/11

KEY

KEY

n National and trans-national government funding 79%

n Staffing 73%

n National and international charitable body funding 8%

n Host institution overhead 9.4%

n Sales of products and services e.g. training courses 6%

n Travel, conferences and meetings 6.3%

n International organisation funding e.g. WHO 2%

n Other expenditure 11.3%

n Non-pharmaceutical sponsorship funding 1% n Conferences (including Colloquia and symposia) 1% n Host institution in-kind funding 3%

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COCHRANE COLLABORATION ANNUAL REPORT 2010/11

All totals are estimates based on groups’ reports to the Monitoring and Registration Committee, 2010/11.


IMPROVING OUTCOMES IN CRISIS SITUATIONS WITH EVIDENCE AID

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COCHRANE COLLABORATION ANNUAL REPORT 2010/11

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IMPROVING OUTCOMES IN CRISIS SITUATIONS WITH EVIDENCE AID

The humanitarian sector has traditionally been reluctant to collect, systematise and share evidence on what works, what does not and why. There has been a lack of demand for this kind of information, and sometimes an inability to find answers. The sector must increase its efforts to demonstrate impact, and it must use evidence on what works and what does not and why to improve its performance. Humanitarian Emergency Response Review, commissioned by the British Government, led by Lord Paddy Ashdown, published in March 2011: http://www.dfid.gov.uk/emergency-response-review

Lord Ashdown’s comments demonstrate the shift towards using evidence in decision-making for natural disasters and other humanitarian emergencies, and represent a clear signal that those engaged in the production of systematic reviews as a source of evidence for well-informed decisions have a clear role to play in this arena. Evidence Aid is a key initiative in this regard and has taken several important steps in the past year. 40

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IMPROVING OUTCOMES IN CRISIS SITUATIONS WITH EVIDENCE AID

Improving outcomes in crisis situations with Evidence Aid Mike Clarke, Bonnix Kayabu and Claire Allen

Evidence Aid was established by The Cochrane Collaboration following the Indian Ocean tsunami of 26 December 2004. The project grew out of the need to find reliable evidence for the priorities that people in the region affected by the tsunami had identified, and over the next few years it developed a collection of resources which have been called upon periodically, such as in the aftermath of the Haiti earthquake and the Pakistan floods of 2010. During 2010, Evidence Aid began to expand and strengthen in order to achieve its aim of improving access to information for people and organisations confronted by natural disasters and other large scale humanitarian emergencies and crises. This followed an evaluation exercise that highlighted the need to develop better partnerships with organisations and other potential users outside The Cochrane Collaboration. An international Advisory Group is being formed to guide this work and to help focus the efforts on the needs of the users of the evidence. We are working towards this, having secured external funding to add to the seed money provided in the first half of 2010 by the Collaboration and its publishing partner, John Wiley & Sons, Ltd. In December 2010, that funding allowed Bonnix Kayabu to take up the post of Evidence Aid Co-ordinator at the Centre for Global Health in Trinity College Dublin, Ireland. Additional funding allowed the appointment, in August 2011, of Claire Allen as the Evidence Aid Knowledge Manager, based at the Collaboration’s Secretariat in Oxford, England. Furthermore, Mike Clarke’s move from the UK Cochrane Centre to the Centre for Public Health in Queen’s University Belfast, Northern Ireland, in March 2011, has provided an additional academic home for the work of Evidence Aid; and, with the support of the Centre for Public Health, Mike will be able to devote more time to Evidence Aid. Further progress is likely

to flow from the inaugural Evidence Aid Conference in September 2011, organised jointly with the Centre for Evidence-Based Medicine in Oxford, England, and involving senior humanitarian workers from large aid agencies, sections of the United Nations, donors, researchers and publishers. The need for timely, up-to-date, reliable evidence by people engaged in disaster risk reduction, planning and response has become more widely recognised in recent years. Many meetings and conversations with individuals and organisations during 2011 have revealed this clearly. The recognition of this need is accompanied by an increasing desire of agencies and donors to ensure that this evidence is used to inform decisions in disasters and other humanitarian emergencies. This is well illustrated by the British Government’s response to the Humanitarian Emergency Response Review. It has committed itself to develop “a stronger evidence base to direct [the Department of International Development’s] interventions to prevent and mitigate the impact of disasters” and to “use the information collected in responses, from research and from working with other donors, to build up a library of results and costs to improve the evidence base for decision-making.”

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IMPROVING OUTCOMES IN CRISIS SITUATIONS WITH EVIDENCE AID

Improving outcomes in crisis situations with Evidence Aid Within Evidence Aid, we are bringing together information on the priorities for evidence of those involved in the humanitarian response to natural disasters and other crises, their preferences on how the information should be made accessible, and their attitudes towards systematic reviews and other research. To help with this, Evidence Aid launched a needs assessment survey in July 2011, which will be kept open until later this year. The survey provides one means of gathering the opinions of those engaged in humanitarian actions and those who provide funding for these actions. The survey is available in Arabic, English, French and Spanish – with special thanks to the Bahrain Branch of the UK Cochrane Centre and the Iberoamerican Cochrane Centre for their help with the translations – and has already been distributed by colleagues in the World Health Organization (WHO) and the World Association for Disaster and Emergency Medicine (WADEM). Efforts to promote it will continue to ensure that we hear from as many potential users of Evidence Aid as possible. Interim results will be available towards the end of 2011. The existing Evidence Aid resources were also called upon to help in the response to more recent disasters. In March 2011, the Special Collections of Cochrane Reviews on managing injuries and safe water were highlighted, and access to The Cochrane Library was made free throughout Japan within five hours of the earthquake and tsunami. The materials were translated into Japanese by contributors to The Cochrane Collaboration in Kyoto and were shared with the Ministry of Health. The existing resources were also supplemented by a new Special Collection on post-traumatic stress disorder, put together by the Cochrane Editorial Unit and the Cochrane Depression, Anxiety and Neurosis Group.

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COCHRANE COLLABORATION ANNUAL REPORT 2010/11

These efforts have identified a possible need for focused groups to help with specific aspects of the work of Evidence Aid. Several such groups seem likely to form in the coming months, building on the enthusiasm of people and their willingness to collaborate in areas such as maternity care, oral health, mental health, nutrition and shelter. It is also clear that evidence on health care is just one part of the myriad range of knowledge needs for natural disasters. An enhanced Evidence Aid will expand beyond health to provide the knowledge needed to overcome many additional challenges posed by natural disasters and other humanitarian emergencies, including shelter, communication, construction and engineering, education, security and support for displaced people. The core source of evidence within Evidence Aid will continue to be systematic reviews, and these will be supplemented by contextual information that will help decision-makers interpret this knowledge and apply it locally. Looking to the future, achieving the vision for Evidence Aid will require new partnerships, new funding and new ways to deliver its content. It will require full engagement with the users of the resources, to make the resources fit for purpose, and to ensure that they take appropriate account of local needs and values, as well as language and cultural differences. Evidence Aid seeks to provide the information that will help people make well-informed decisions, it does not seek to tell people what to do. It will have succeeded if decision-makers use the resources to ensure that their actions are likely to do more good than harm, and if outcomes for people and communities are improved through the use of these resources.


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COCHRANE COLLABORATION ANNUAL REPORT 2010/11

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THANKS TO OUR GROUP FUNDERS

With special thanks to the funders of our groups, 2010/11: n Argentina, Instituto de Efectividad Clínica y Sanitaria

n Croatia, Split and Dalmatia County

n Arturo Martí-Carvajal

n Denmark, Copenhagen Hospital Corporation

n Australia, Children’s Hospital at Westmead

n Denmark, Danish Government

n Australia, Commonwealth Department of Health

n Denmark, Region Hovedstaden, Copenhagen

and Ageing

n European Society of Anaesthesiology (ESA)

n Australia, Joanna Briggs Institute, Adelaide

n Finland, Finnish Institute of Occupational Health

n Australia, Queensland Health

n Finland, National Institute for Health and Welfare

n Australia, South West Sydney Local Health Network

n France, Ecole des Hautes Etudes en Santé Publique

n Australia, University of Sydney

(EHESP)

n Australia, Victoria Health Promotion Foundation

n France, Haute Autorité de Santé (HAS)

n Austria, Danube University Krems

n France, MAPI Research Trust

n Austria, State Government of Lower Austria

n France, Ministry of Health

n Bahrain, Ministry of Health, Bahrain

n Germany, AOK Baden-Württemberg

n Belgium, Ministry of Health

n Germany, Deutsche Krebshilfe e.V.

n Brazil, EBM Research Centre/Faculties

n Germany, Federal Ministry of Education and Research

n Brazil, Federal Agency for the Support and Evaluation

n Germany, Heinrich-Heine University

of Graduate Education (CAPES) n Brazil, Paulista Association for the Development of

Medicine (SPDM)

n Germany, Institute for Quality and Efficiency in Health

Care - IQWiG n Germany, Köln Fortune/University of Cologne

n Bruce and Sue Shepherd

n Germany, Ministry of Health

n Canada, Canadian Agency for Drugs and

n Germany, University Hospital of Cologne

Technologies in Health (CADTH) n Canada, Canadian Institutes of Health Research n Canada, Center for Global Health, Institution for

Population Health, Ottawa n Canada, Institute for Work & Health n Canada, McMaster funds n Canada, Ministry of Health n Canada, Ministry of Health-LTC, Ontario

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n European Union

n Australia, Department of Health, Victoria

n Germany, University Medical Center Freiburg n Hong Kong, School of Public Health and Primary

Care (SPHPC) n India, Indian Council for Medical Research n India, Public Health Foundation of India n Ireland, Health Research Board n Italy, Association for Epidemiology Research for

Neurological Disease (AREMAN)

n Canada, Nova Scotia Health Research Foundation

n Italy, Cabrini Institute, Cabrini Hospital

n Canada, Ottawa Hospital Research Institute (OHRI)

n Italy, Fondazione I.R.C.C.S. Istituto Neurologico Besta

n Canadian Chiropractic Associations

n Italy, Hospital Galeazzi, Milan

n Chile, Universidad Católica de Chile

n Italy, Italian Drug Agency (AIFA)

n Costa Rica, IHCAI Foundation

n Italy, Italian Multiple Sclerosis Federation (FISM)

n Croatia, City of Split

n Italy, Lazio Regional Health Authority

n Croatia, School of Medicine, Split

n Italy, Mario Negri Institute

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IMPROVING OUTCOMES IN CRISIS SITUATIONS WITH EVIDENCE AID

We do not accept commercial or conflicted funding – this is vital for us to generate authoritative and reliable information, produced by people who can work freely, unconstrained by commercial and financial interests. Nick Royle, Chief Executive Officer

n Italy, Ministry of Health

n Spain, Hospital de la Santa Creu i Sant Pau

n Italy, National Institute of Health

n Spain, Ministry of Health (Instituto de Salud Carlos III)

n Italy, Regione Umbria Health Authority

n Switzerland, Lausanne University Hospital (CHUV)

n Italy, Rete Regionale Allergologia

n Thailand, Thailand Research Fund (TRF)

n Italy, University of Milan

n UK, Age-Related Diseases Trust

n Italy, Voluntary Association for Multiple Sclerosis

n UK, Centre of Evidence Based Dermatology

(AVASM) (ONLUS)

n UK, Department for International Development (DFID)

n Korea, Health Industry Development Institute

n UK, Effective Healthcare Research Consortium

n Netherlands, Dutch Academic Departments of

n UK, Friends of Bath Oncology Charity Donation Funds

General Practice, the Dutch College of GPs and the Netherlands Institute for Health Services Research n Netherlands, Dutch Health Insurance Council n Netherlands, Leiden University Medical Center n Netherlands, Ministry of Health n Netherlands, Netherlands Trial Register n Netherlands, Royal Dutch Society for Physical

Therapy (KNGF) n New Zealand, New Zealand Guidelines Group n Nigeria, Federal Ministry of Education/University

of Calabar n Nigeria, University of Calabar Teaching Hospital/

Federal Ministry of Health n Norway, Norwegian Agency for Development

Cooperation (Norad)

n UK, Medical Research Council (MRC) n UK, National Blood Service n UK, National Institute for Health Research (NIHR) n UK, Newcastle University n UK, Oxford University n UK, Scottish Government Health Directorates,

The Scottish Government n UK, Sightsavers International n UK, University of Birmingham n UK, University of East Anglia n UK, Welsh Assembly Government n US, Agency for Healthcare Research and Quality

(AHRQ) n US, Blue Cross Blue Shield California

n Norway, Norwegian Government

n US Department of Justice

n Norway, Norwegian Knowledge Center for Health

n US National Center for Complementary and

Services n People’s Republic of China, West China Hospital n PEARLS publication n Singapore, Duke-NUS Graduate Medical School n Singapore, National Medical Research Council n South Africa, Medical Research Council n Spain, Agencies for Health Technology Assessment

Alternative Medicine (NCCAM) n US, National Institute of Diabetes and Digestive and

Kidney Diseases (NIDDK) n US, National Library of Medicine n US, Neuroscience Education Institute (NEI) n US, University of California, San Francisco n World Health Organization (WHO)

(CAHIAQ, Catalunya - AETSA, Andalucía) and Guidelines Development n Spain, Fundación Sanitas

COCHRANE COLLABORATION ANNUAL REPORT 2010/11

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TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 2010/11

Trustees’ Report and Financial Statements For the year ended 31 March 2011 The Cochrane Collaboration (a company limited by guarantee) Company Number 3044323 Charity Number 1045921

The Trustees of The Cochrane Collaboration, who are also directors for the purpose of company law, present their report and financial statements for the year ended 31 March 2011.

Reference and Administration Charity name:

The Cochrane Collaboration

Registered and Correspondence Address:

Summertown Pavilion 18–24 Middle Way Oxford OX2 7LG UK

Advisors

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Auditors:

Mazars LLP Chartered Accountants and Registered Auditors The Pinnacle 160 Midsummer Boulevard Milton Keynes MK9 1FF UK

Bankers:

National Westminster Bank PLC Oxford North Branch 249 Banbury Road Summertown Oxford OX2 7HR UK

Legal advisers:

Manches LLP Solicitors 9400 Garsington Road Oxford Business Park Oxford OX4 2HN UK

COCHRANE COLLABORATION ANNUAL REPORT 2010/11


TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 2010/11

Trustees The governing body of The Cochrane Collaboration is known as the Cochrane Collaboration Steering Group (CCSG). The following trustees, who are also the directors for the purposes of company law, have held office on the CCSG during the year: n n n n n n n n n n n n n n n n n n

Prof L Becker (Co-Chair; resigned 20 October 2010) Dr S Hill Prof L Bero (resigned 20 October 2010) Dr S McDonald Prof J Craig (Co-Chair) Ms ME Schaafsma Dr Z Fedorowicz (resigned 20 October 2010) Prof R Scholten (resigned 20 October 2010) Dr D Gillies (Treasurer) Dr R Soll Prof J Grimshaw (Co-Chair; appointed 20 October 2010) Mrs E Whamond Mrs SL Henderson Prof K Williams Ms GY Higgins Dr H van der Wouden Dr JPT Higgins Mrs M Zhang

Senior Staff The senior staff of the charity during the year comprised Mr N Royle, Chief Executive Officer, Ms VM Hetherington, Company Secretary and Administrator, and Dr D Tovey, Editor in Chief, The Cochrane Library.

Narrative Report 1. Structure, Governance and Management Nature of Governing Document The governing documents of The Cochrane Collaboration are the Memorandum and Articles of Association, as amended on 3 October 2004. Trustee Appointment Trustees serve as CCSG members for a three-year period, and may be re-elected for a second consecutive term. After a three-year break, they may be elected again when an appropriate vacancy occurs. Trustees are elected by The Cochrane Collaboration’s members to specific posts, representative of their membership group. Organisational Structure The Charity is organised as follows: An elected Steering Group (CCSG) governs The Cochrane Collaboration on behalf of its members. The Cochrane Collaboration Secretariat (based in Oxford, UK) A small staff co-ordinates the business, financial and organisational functions of The Cochrane Collaboration, consisting of the Chief Executive Officer, Company Secretary and Administrator, Deputy Administrator, Project Support and Business Communications Officer, and Team P.A. During the year they were joined by the Consumer Co-ordinator, a new role designed to assimilate and support the work of healthcare consumers and their representatives better within the Collaboration.

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TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 2010/11

The Cochrane Editorial Unit (based in London, UK) The Editor in Chief is supported by the Senior Editors, Editor, Programme Development Manager, Information Specialist and P.A. During the year they were joined by the Methods Co-ordinator, a new role designed to support and co-ordinate the work of methodologists better within the Collaboration. Working closely with the editorial teams of Cochrane Review Groups, the Editor in Chief is responsible for: n developing, implementing, and directing the editorial policies and vision of The Cochrane Library

in relation to the vision and objectives of the Collaboration; n improving the quality in the editing process and product with respect to scientific content; n providing a strong and visionary lead for conceptualising and developing new products derived

from Cochrane Reviews; and n acting as the main focus for this work, and for applying ethical and scientific standards

consistent with the goals of the Collaboration. Cochrane Entities (known as Cochrane groups) Fourteen geographical Centres (the fourteenth Centre, the French Cochrane Centre, was registered in June 2010) have oversight for the devolved activities of the Cochrane Entities (individual operating units of The Cochrane Collaboration) geographically or linguistically linked to their remit, such as: n Cochrane Review Groups (CRGs, which facilitate the preparation, by volunteers, of Cochrane

Reviews, the Charity’s main output – see section 2, ‘Objectives and Activities’). n Fields (which represent issues relevant to more than one CRG, including healthcare consumers). n Methods Groups (whose members develop appropriate methodologies for Cochrane

Review preparation). Each Cochrane Entity has a devolved management team appropriate to its function. For CRGs this normally consists of a Co-ordinating Editor (commonly a senior healthcare professional such as a Professor or Senior Consultant with extensive knowledge of the healthcare area concerned), a Managing Editor, a Trials Search Co-ordinator, and administrative support. These people are in turn supported by a team of editors, review authors, journal handsearchers (who collate reports of relevant controlled trials), and specialist support is provided by statisticians, other methodologists, healthcare consumers and healthcare experts.

Risk Management The board of trustees has considered the principal risks to which The Cochrane Collaboration is exposed. It uses a risk management matrix to set out and evaluate the major risks, their likely impact, and the steps taken to mitigate risk, and further action that could be taken. This matrix was updated on 25 May 2011. The key risks are considered to be: n The catastrophic loss of core publishing income, which funds the Collaboration’s core activities. n The risk of publishing a Cochrane Review containing significant errors that might affect public safety.

Contingency plans have been developed to manage both of these events.

Induction and Training of Trustees The Secretariat inducts new trustees into their responsibilities as members of the Board by sending them an extensive collection of materials in advance of their joining the Board. These materials include such documents as the Memorandum and Articles of Association, the most recent approved Report and Financial Statements, descriptions of the Steering Group’s sub- and advisory committees (some of which they will join), an organisational chart, minutes of several previous trustees’ meetings, the charity’s strategic plan and key policies, the table of risk assessment, information on and a claim form for expense reimbursement, etc.

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TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 2010/11

2. Objectives and Activities

Legal Objects The legal objects of the charity, as defined in the Memorandum and Articles of Association, are: “The protection and preservation of public health through the preparation, maintenance and dissemination of systematic reviews of the effects of health care, for the public benefit.” Significant Activities The charity has undertaken the following major activities in the year: n Preparation of Cochrane Reviews. n Dr David Tovey, Editor in Chief, has primary responsibility for the publication of Cochrane

Reviews and related products, and for their continuing high-quality. n The following were published during the past year:

– 550 new protocols for forthcoming Cochrane Reviews

– 389 new Cochrane Reviews – 449 updated Cochrane Reviews (new citation versions) n Dissemination of output: Providing free at the point of use one-click access to more of the

world’s population remains one of our goals. Around half the world’s population now has free at the point of use one-click access to our output through various provisions. Considerable progress has been made in developing new ways in which people can access Cochrane outputs, and new products are expected to be launched in 2012. n International conferences: The Cochrane Collaboration’s annual conference - the ‘Colloquium’ -

was held in Keystone, Colorado, USA, in October 2010 and was attended by 835 people from 53 countries. n New methodological development: Development has continued to improve the presentation

of Cochrane Reviews; a Methods Co-ordinator has been appointed to co-ordinate these activities better. Contribution of volunteers The charity makes extensive use of volunteers, with more than 28,000 people from 116 countries currently volunteering their time. Amongst their many contributions, volunteers were involved in the following activities: n Developing the knowledge base and tools for facilitating preparation of The Cochrane

Collaboration’s outputs. n Preparation of The Cochrane Collaboration’s outputs through handsearching of scientific

journals, authorship of Cochrane Reviews and editorials, editorial activities such as peer review and refereeing, and other related activities. n Dissemination of The Cochrane Collaboration’s ethos and outputs through conference

presentations, symposia, scientific papers, and related activities. n Engagement of healthcare consumers in The Cochrane Collaboration’s activities.

It is impossible to calculate the monetary value of volunteers’ contributions, but if the work they perform were to be done at commercial rates their contributions would cost tens of millions of pounds per year.

Aims of the Charity The aims of the charity are as follows: The Cochrane Collaboration is an international organisation that aims to help people make well-informed decisions about healthcare by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of healthcare interventions. The Cochrane Collaboration’s vision is that healthcare decision-making throughout the world will be informed by high-quality, timely research evidence. The Cochrane Collaboration will play a pivotal role in the production and dissemination of this evidence across all areas of health care.

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TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 2010/11

Main objectives for the year The main objectives for the year were: n To ensure high-quality Cochrane Reviews are available across a broad range of healthcare topics. n To promote access to Cochrane Reviews and the other products of The Cochrane Collaboration. n To ensure an efficient, transparent organisational structure and management system for The

Cochrane Collaboration. n To achieve sustainability of The Cochrane Collaboration PLEASE REFER TO MAIN BODY OF ANNUAL REPORT FOR ASSESSMENT OF ACHIEVEMENTS AGAINST GOALS

3. Achievements and Performance

Review of Activities in the year PLEASE REFER TO MAIN BODY OF ANNUAL REPORT FOR REVIEW OF ACTIVITIES

Fundraising performance The Cochrane Collaboration’s core income is derived principally from publication royalties from its main output, The Cochrane Library, published on its behalf by John Wiley & Sons, Ltd. During 2010–11 the income from this source remained steady compared to 2009–10, reflecting or perhaps exceeding expectations based on global economic conditions.

4. Financial Review

Reserves Policy The aim of the reserves policy is to accumulate sufficient funds to enable us to achieve our longterm strategic aims, and then to allocate these funds to projects of Collaboration-wide impact over single- or multi-year projects as required. We have a strategic plan of work going forward that is managed through our cash flow forecast, which details known and expected annual expenditure over the next decade. In addition to the known and expected items of expenditure there are a number of expected projects that have not yet been costed, such as new product development, increased support to resource-poor settings, and expanding our training provision, which are expected to entail considerable outlay. Taking these into account, it is judged that there are sufficient resources to allow us to achieve our strategic aims over the next few years, whilst still being able to react flexibly to and take advantage of opportunities as they arise. It is also the policy of the trustees to have a contingency plan for maintaining the Collaboration’s basic functions for twelve months in the event of the loss of core income from publishing. The resources necessary to enact the contingency plan are reviewed on an annual basis. For the year 2010–11, the level of the contingency fund was set at £748,000. Agreed payments for the projects funded by the fourth and final round of the Collaboration’s Opportunities Fund began in the year 2010–11, with all invoices for older projects settled as final reports were received. The Steering Group had agreed at its meeting in Auckland, New Zealand, in March 2010 to discontinue the Opportunities Fund on completion of the fourth round, considering that it was not contributing sufficiently to achieving the Collaboration’s strategic goals. Instead, core funds will be directed at programmes considered of key strategic importance, including Cochrane Training and Cochrane Methods. These initiatives will include budgets allocated by application to groups conducting research, development, training and advocacy projects in relevant subject areas. Discretionary Fund A Fund to the value of £15,000 per year was designed to facilitate small projects of general benefit to a majority of the Collaboration’s entities. Three projects received funding this year: n Costs of a meeting in Milan, Italy, to address the handling of comparison of multiple

interventions in Cochrane Reviews. n Costs of a workshop in Ottawa, Canada, on including non-randomized studies in Cochrane Reviews. n Development of a guide for authors on involving consumers in Cochrane Reviews.

Other designated funds are set out in the notes to these financial statements.

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TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 2010/11

Funds in deficit There were no funds in deficit in the year.

Investment policy The Cochrane Collaboration has no investments other than deposit accounts. The charity’s current policy regarding investment is to put all surplus income into interest-bearing savings accounts. The funds for items of expenditure need to be readily available, in keeping with the ten-day notice periods on these accounts. Commitments have been continued to sponsor registration fees (one per entity) for the Colloquium, to develop and maintain The Cochrane Collaboration website, and for the substantial development of The Cochrane Collaboration’s Information Management System, including maintaining a small team of people to support the editorial bases of Cochrane Review Groups in implementing the system (the IMS Support team).

Principal funding sources Funding model Core income referred to in this report comes from publishing income, as described above (‘Fundraising performance’). The groups (‘entities’) who contribute towards the work of The Cochrane Collaboration are principally based within other organisations such as universities and hospitals, and as such are responsible for their own funding. Their funding model is described below. Most of The Cochrane Collaboration’s funding for Cochrane Review preparation and related activities comes from government and institutional sources, and from the in-kind contributions of health professionals, researchers and their employers. Funding derived from subscriptions to and sales of The Cochrane Library are used to invest in core activities such as software development (in partnership with other funders such as the Nordic Cochrane Centre, for which the Collaboration is deeply grateful) and in projects of Collaboration-wide application. This allows national funders to fund activities in their own country, and international activities benefiting many countries to be funded through international income. The main sources of income for individual entities, as reported to the Monitoring and Registration Committee, are as follows: n National and trans-national government funding (including EU), typically from health and related

ministries (79%); n National and international charitable body funding (8%); n Sale of products (including The Cochrane Library, derivatives, books, etc.) (6%); n International organisation funding, e.g. WHO (2%); n Non-pharmaceutical sponsorship funding (<1%); n Conferences (including colloquia and symposia) (1%); and n Host institution in-kind funding (3%).

Funds are currently available for the day-to-day operations of most of The Cochrane Collaboration’s Review Groups and Centres. However, a number of these face severe financial pressures such as meeting the cost of salary increases arising from linked third-party pay awards (e.g. NHS pay awards in the UK), and others are struggling to maintain all or part of their funding.

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TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 2010/11

Policy on commercial sponsorship After a period of extensive consultation during 2004, there was overwhelming consensus that The Cochrane Collaboration should maintain a clear barrier between the production of Cochrane Reviews and any funding from commercial sources with financial interests in the conclusions of the reviews. Thus, sponsorship of a Cochrane Review by any commercial source or sources is prohibited. A Foundation Fund was established in 2005 to accept donations from conflicted sources. (A ‘commercial source’ is any for-profit manufacturer or provider of health care, or any other for-profit source with a real or potential vested interest in the findings of a specific review.) Whilst government departments, not-for-profit medical insurance companies and health management organisations may find the conclusions of Cochrane Reviews carry financial consequences for them, these are not included in this definition. Also not included are for-profit companies that do not have real or potential vested interests in Cochrane Reviews (e.g. banks). Other sponsorship is allowed, but a sponsor should not be allowed to delay or prevent publication of a Cochrane Review, or to interfere with the independence of the authors of reviews in regard to the conduct of their reviews, and the protocol for a Cochrane Review should specifically mention that a sponsor cannot prevent certain outcome measures being assessed in the review.

5. Plans for the future PLEASE REFER TO MAIN BODY OF ANNUAL REPORT FOR PLANS FOR FUTURE

Public benefit statement This public benefit statement has been drawn up in accordance with the Charity Commission’s January 2008 guidance on public benefit and its reporting. To deliver high-quality healthcare services, medical and allied health professionals depend on highquality information about the effects and effectiveness of the healthcare interventions available to meet population or individual healthcare needs. Healthcare consumers and healthcare providers need to be able to make valid choices between the various options open to them, in order to facilitate dialogue between patient and provider. Huge amounts of information are available; hundreds of thousands of scientific articles are published every year. Nobody can assimilate this mass of information. The primary public benefit provided by The Cochrane Collaboration therefore relates to the advancement of health and the saving of lives, by assimilating, on behalf of the world’s population, the results of multiple clinical trials relating to individual treatments, and then presenting these results in a single scientific paper (a ‘Cochrane Review’), formulated to be accessible to both healthcare consumer and practitioner. The secondary public benefit relates to the advancement of education. Producing hundreds of Cochrane Reviews each year requires the assistance of thousands of volunteers. In fact, around 28,000 people now contribute their time to this task, principally health professionals, patients and their representatives, and academics. These volunteers need to be trained in the advanced techniques necessary for the work, and so international educational initiatives train upwards of 3,500 people each year in Cochrane techniques.

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Statement of Trustees’ responsibilities Company law requires the trustees to prepare the financial statements for each financial year, which give a true and fair view of the state of affairs of the company and of the surplus or deficit of the company for that period. In preparing those financial statements, the trustees have: n selected suitable accounting policies and applied them consistently; n made judgements and estimates that are reasonable and prudent; n followed applicable accounting standards, subject to any material departures disclosed and

explained in the financial statements; and n prepared the financial statements on the ‘going concern’ basis.

The trustees have maintained adequate accounting records, which disclose with reasonable accuracy at any time the financial position of the company, enabling them to ensure that the financial statements comply with the Companies Act 2006. They have safeguarded the assets of the company and taken reasonable steps for the prevention and detection of fraud and other irregularities.

Statement of disclosure to auditors (a) As far as the trustees are aware, there is no relevant audit information of which the company’s auditors are unaware, and (b) The trustees have taken all the steps that they ought to have taken in order to make themselves aware of any relevant audit information and to establish that the company’s auditors are aware of that information.

Auditors The auditors, Mazars LLP, have signified their willingness to continue in office. A resolution to reappoint them as auditors will be proposed at the forthcoming Annual General Meeting. The trustees have prepared this report in accordance with the special provisions of Part 15 of the Companies Act 2006 relating to small entities. Approved and signed on behalf of the trustees by

Dr D Gillies Trustee and Treasurer Date: [to be approved at 2011 Annual General Meeting]

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Independent Auditor’s Report to the Members of The Cochrane Collaboration We have audited the financial statements of The Cochrane Collaboration for the year ended 31 March 2011 which comprise the Statement of Financial Activities, the Consolidated Statement of Financial Activities, the Charity and Group Balance Sheet and the related notes. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice). Respective responsibilities of trustees and auditors As explained more fully in the Trustees’ Responsibilities Statement, the trustees (who are also the directors of the charity for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view. Our responsibility is to audit and express an opinion on the financial statements in accordance with applicable law and International Standards on Auditing (UK and Ireland). Those standards require us to comply with the Auditing Practices Board’s (APB’s) Ethical Standards for Auditors. This report is made solely to the charity’s members as a body in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charity’s members those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charity and the charity’s members as a body for our audit work, for this report, or for the opinions we have formed. Scope of the audit of the financial statements A description of the scope of an audit of financial statements is provided on the APB’s web-site at www.frc.org.uk/apb/scope/private.cfm. Opinion on the financial statements In our opinion the financial statements: n give a true and fair view of the state of the charity’s and group’s affairs as at 31 March 2011 and

of its incoming resources and application of resources, including its income and expenditure, for the year then ended; n have been properly prepared in accordance with United Kingdom Generally Accepted

Accounting Practice; and n have been prepared in accordance with the requirements of the Companies Act 2006.

Opinion on the other matter prescribed by the Companies Act 2006 In our opinion the information given in the Trustees’ Report for the financial year for which the financial statements are prepared is consistent with the financial statements. Matters on which we are required to report by exception We have nothing to report in respect of the following matters where the Companies Act 2006 requires us to report to you if, in our opinion: n adequate accounting records have not been kept, or returns adequate for our audit have not

been received from branches not visited by us; or n the financial statements are not in agreement with the accounting records and returns; or n certain disclosures of trustees’ remuneration specified by law are not made; or n we have not received all the information and explanations we require for our audit; or n the trustees were not entitled to prepare the financial statements in accordance with the

small companies regime.

Stephen Brown Senior Statutory Auditor for and on behalf of Mazars LLP Chartered Accountants and Statutory Auditor The Pinnacle 160 Midsummer Boulevard Milton Keynes MK9 1FF UK 54

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IMPROVING OUTCOMES IN CRISIS SITUATIONS WITH EVIDENCE AID

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Statement of Financial Activities For the year ended 31 March 2011 *Charity only (see over for group accounts)

Restricted Designated Unrestricted 2011 2010 NOTE £ £ £ £ £

INCOMING RESOURCES Incoming resources from generated funds Voluntary Income 3 311,364 10,831 85,339 407,534 72,469 Investment Income 4 699 - 2,450,263 2,450,962 2,261,725 Incoming resources from charitable activities 6 - - - - 6,381 TOTAL INCOMING RESOURCES

312,063

10,831 2,535,602 2,858,496 2,340,575

RESOURCES EXPENDED Costs of Generating Funds Charitable Activities Governance Costs

7 - - 194,685 194,685 152,042 8 172,524 102,381 1,441,266 1,716,171 1,200,433 9 - - 256,146 256,146 248,852

TOTAL RESOURCES EXPENDED

172,524 102,381 1,892,097 2,167,002 1,601,327

Net (Outgoing)/Incoming Resources Before Transfers 139,539 (91,550) 643,505 691,494 739,248 Fund Transfers 15 25,000 5,657 (30,657) - Net (Outgoing)/Incoming Resources 164,539 (85,893) 612,848 691,494 739,248 Reconciliation of funds Total funds brought forward at 1 April

100,437

TOTAL FUNDS CARRIED FORWARD AT 31 MARCH

264,976

15,16

140,991

2,584,667

2,826,095

2,086,847

55,098 3,197,515 3,517,589 2,826,095

The statement of financial activities includes all gains and losses recognised in the year. The charity’s incoming resources and expended resources all relate to continuing operations. The funds carried forward at 31 March 2011 of £3,517,589 differ from the consolidated funds of £3,517,066 due to the net reserves retained in the trading subsidiary, Collaboration Trading Company Limited. The Notes to the Financial Statements form part of these accounts.

*Group accounts to do not refer the accounts of the Collaboration’s entities (which are referred to informally as ‘Cochrane groups’) but to the grouped accounts of the Collaboration’s component companies under UK law: the Charity and the Collaboration Trading Company Limited.

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TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 2010/11

Consolidated Statement of Financial Activities For the year ended 31 March 2011 Group Group 31 March 31 March Restricted Designated Unrestricted 2011 2010 NOTE £ £ £ £ £

INCOMING RESOURCES Incoming resources from generated funds Voluntary Income Investment Income Incoming resources from charitable activities

3 4 6

TOTAL INCOMING RESOURCES

311,364 699 -

10,831 85,339 407,534 72,469 - 32,186 32,885 32,554 - 2,454,166 2,454,166 2,427,578

312,063

10,831

2,571,691

2,894,585

2,532,601

RESOURCES EXPENDED Costs of Generating Funds Charitable Activities Governance Costs

7 - - 194,685 194,685 192,223 8 172,524 102,381 1,441,266 1,716,171 1,285,569 9 - - 292,721 292,721 315,561

TOTAL RESOURCES EXPENDED

172,524 102,381 1,928,672 2,203,577 1,793,353

Net Incoming/(Outgoing) Resources Before Transfers 139,539 (91,550) 643,019 691,008 739,248 Funds Transfers

15,16 25,000 5,657 (30,657) - -

Net Incoming/(Outgoing) Resources 164,539 (85,893) 612,362 691,008 739,248 Reconciliation of funds Total funds brought forward at 1 April

100,437

TOTAL FUNDS CARRIED FORWARD AT 31 MARCH

264,976

15,16

140,991

2,584,630

2,826,058

2,086,810

55,098 3,196,992 3,517,066 2,826,058

The statement of financial activities includes all gains and losses recognised in the year. The group’s incoming resources and expended resources all relate to continuing operations. The Notes to the Financial Statements form part of these accounts.

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Balance Sheets As at 31 March 2011 Company Number 3044323 Cochrane Cochrane Collaboration Group Collaboration Group 31 March 31 March 31 March 31 March 2011 2011 2010 2010 NOTE £ £ £ £ FIXED ASSETS Fixtures, Fittings & Equipment Investments

11 14,951 17,807 10,699 15,090 12 1,100 1,000 1,100 1,000

16,051 18,807 11,799 16,090

CURRENT ASSETS Debtors 13 933,175 662,904 1,293,713 680,937 Cash at bank and in hand 2,907,917 3,294,935 1,779,092 2,512,768 3,841,092 3,957,839 3,072,805 3,193,705

CREDITORS – AMOUNTS FALLING DUE WITHIN ONE YEAR

14 (339,554) (459,580) (258,509) (383,737)

3,501,538 3,498,259 2,814,296 2,809,968

TOTAL ASSETS LESS CURRENT LIABILITIES 3,517,589 3,517,066 2,826,095 2,826,058

INCOME FUNDS Restricted funds 15 264,976 264,976 100,437 100,437 Unrestricted funds: Designated 16 55,098 55,098 140,991 140,991 Other unrestricted 3,197,515 3,196,992 2,584,667 2,584,630

17 3,517,589 3,517,066 2,826,095 2,826,058

The Notes to the Financial Statements form part of these accounts. These accounts are prepared in accordance with the special provisions of Part 15 of the Companies Act 2006 relating to small entities. Approved and authorised for issue by the Trustees and signed on their behalf by

Dr D Gillies Trustee and Treasurer Date: [to be approved at 2011 Annual General Meeting]

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TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 2010/11

Notes to the Financial Statements For the year ended 31 March 2011 1. ACCOUNTING POLICIES The financial statements have been prepared in accordance with applicable accounting standards and the Statement of Recommended Practice “Accounting for Charities” issued by the Charity Commission in 2005 with the approval of the Accounting Standards Board.

The charity’s main accounting policies are as follows: a) Accounting Convention The financial statements are prepared under the historical cost convention (i.e. balances are recorded at the original cost and are not subsequently revalued). b) Incoming Resources Donations, legacies and gifts income is recognised on a receipts basis (i.e. when it is virtually certain that the income will be received) under Gift Aid from the subsidiary undertaking, Collaboration Trading Company Limited, and is recognised on a receivable basis (i.e. when the income is earned). Group incoming resources include royalties from the subscriptions to and sales of The Cochrane Library to Collaboration Trading Company Limited, which are recognised on a receivable basis (i.e. when the income is earned). In the consolidated Statement of Financial Activities (SOFA) this income has been included in incoming resources from charitable activities. Investment income, representing amounts received from subsidiary and bank interest earned, is recognised on a receivable basis (i.e. when the income is earned). c) Resources Expended Expenditure shown in the accounts includes accruals for goods and services rendered up to the financial period end. Expended resources are classified between the relevant activity categories of resources expended as relevant to the nature of the expenditure incurred. All expenditure is considered to be directly chargeable to the relevant activity category apart from salary costs for Secretariat staff which are apportioned evenly across activity categories. d) Fixed Assets Tangible fixed assets are stated at cost less depreciation. Depreciation is provided at rates calculated to write off the costs less estimated residual value of each asset over its expected useful life as follows: Plant and machinery Fixtures, fittings and equipment

33% Straight Line Method 25% Straight Line Method

Fixed assets with an initial cost of under £100 are not capitalised. e) Investments Investments in subsidiary undertakings are included at cost. Other investments are included at cost or deemed cost due to the non availability of reliable market values. f) Basis of Consolidation The income and expenditure and assets and liabilities of Collaboration Trading Company Limited are consolidated within the results of The Cochrane Collaboration. All amounts in respect of group balances and transactions have been eliminated in arriving at the group figures. Amounts disclosed in the accounts under the Trading Company column in the Notes to the Accounts are for information purposes only.

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g) Funds Structure The charity holds a number of funds which have been restricted for specific purposes by the donors. These are classified under “restricted funds”. The charity holds funds which have been internally designed for specific purposes. These are classified under “designated funds”. h) Unrestricted Funds Unrestricted funds represent revenue grants and donations and interest receivable etc, which can be applied to the objectives of the charity. Transfers out of unrestricted funds represent new designations made in the period and are detailed in note 16. i) Grant Expenditure Grants payable are recognised in the year in which the offer is accepted by the recipient except in those cases where the offer is conditional, such grants being recognised as expenditure when the conditions attaching are fulfilled. Grants offered subject to conditions which have not been met at the year end are noted as a commitment, but not accrued expenditure. j) Foreign Exchange Transactions denominated in foreign currencies are translated into sterling on the exchange rate ruling on the date of transaction. k) Operating leases Rentals payable under operating leases are charged on a straight line basis over the term of the lease. l) Financial Commitments Approved grants are recognised as liabilities once approved by the trustees and communicated to the beneficiary. m) Liabilities When an obligation exists that will probably lead to expended resources after the year end, a liability is recognised. n) Governance Costs Expended resources are recognised as governance costs where they relate to the oversight of the charity.

2. SURPLUS FOR THE FINANCIAL YEAR Cochrane Collaboration Collaboration Trading Co. Group Group 2011 2011 2011 2010 £ £ £ £ The surplus is after charging: Auditors’ remuneration – audit services

3,500

1,500

5,000

5,000

3. VOLUNTARY INCOME Cochrane Collaboration Collaboration Trading Co. Group Group Restricted Designated Unrestricted 2011 2011 2011 2010 £ £ £ £ £ £ £ Donations

311,364 10,831 85,339 407,534

- 407,534 72,469

311,364 10,831 85,339 407,534

- 407,534 72,469

4. INVESTMENT INCOME Cochrane Collaboration Collaboration Trading Co. Group Group 2011 2011 2011 2010 £ £ £ £ Bank interest

27,545 5,340 32,885 32,554

27,545 5,340 32,885 32,554

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5. TAXATION The Cochrane Collaboration is a registered charity, and is therefore not liable to pay corporation tax on its charitable activities. The Collaboration Trading Company is not a charity and is therefore subject to corporation tax on its activities. However, the net profit chargeable to corporation tax on its trading activities is considered for donation on an annual basis. On this basis, no provision has been made for corporation tax.

6. INCOMING RESOURCES FROM CHARITABLE ACTIVITIES

Cochrane Collaboration Collaboration Trading Co. Group Group 2011 2011 2011 2010 £ £ £ £

Unrestricted funds Royalties from subscriptions to and sales of The Cochrane Library and other income Other income

- -

2,454,166 -

-

2,454,166 2,454,166 2,427,578

2,454,166 -

2,421,197 6,381

Donations made from Collaboration Trading Company Limited to The Cochrane Collaboration under Gift Aid are included in the charity’s income as Investment Income and are shown in note 4.

7. COSTS OF GENERATING FUNDS Cochrane Collaboration Collaboration Trading Co. Group Group Restricted Designated Unrestricted 2011 2011 2011 2010 £ £ £ £ £ £ £ Meeting expenses Staff salaries Editorial costs

- - -

- 31,986 31,986 - 90,480 90,480 - 72,219 72,219

- 31,986 179 - 90,480 86,123 - 72,219 105,921

-

- 194,685 194,685

- 194,685 192,223

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8. COSTS OF ACTIVITIES IN FURTHERANCE OF CHARITABLE OBJECTIVES Cochrane Collaboration Collaboration Trading Co. Group Group Restricted Designated Unrestricted 2011 2011 2011 2010 £ £ £ £ £ £ £ Awards, Fellowships & Prizes Chris Silagy Prize Bill Silverman Prize Kenneth Warren Prize Aubrey Sheiham Scholarship Thomas C Chalmers Award Total Awards, Fellowships & Prizes

- 627 8,304 5,438 630

- - - - -

- - - - -

- 627 8,304 5,438 630

- - - - -

- 627 8,304 5,438 630

2,242 2,386 6,089 614

14,999

-

-

14,999

-

14,999

11,331

Consumables - - - EUNetHTA Grant - - - WHO Vitamin A Project 11,578 - - WHO Influenza Project 9,348 - - NHS Updating Project 111,708 - - Evidence Aid 24,891 - - Office running costs - - 46,671 Designated grants (note 16) - 102,381 - Grants - - 635,787 IMS Support team - - 86,176 Legal fees - 1,418 Meeting expenses 22,394 Staff salaries 520,886 Website and Communications 127,934

172,524

102,381

1,441,266

- - 11,578 9,348 111,708 24,891 46,671 102,381 635,787 86,176 1,418 22,394 520,886 127,934

- - 11,498 - - 3,974 - 11,578 - 9,348 - 111,708 - 24,891 - 46,671 44,795 - 102,381 117,028 - 635,787 496,579 - 86,176 97,847 - 1,418 778 - 22,394 23,030 - 520,886 345,483 - 127,934 133,226

1,716,171

- 1,716,171 1,285,569

Items of negative expenditure, shown in parentheses, represent projects committed and provided in prior years where the actual costs were lower than originally provided. Overprovided amounts have been released to the Statement of Financial Activities in the year.

GRANTS WERE MADE TO THE FOLLOWING PROJECTS:

2011 2010 £ £

IMS Project Grant The Cochrane Library – Complimentary subscriptions La Biblioteca Cochrane Plus translation Diagnostic Test Reviews Support Unit Diagnostic Test Accuracy Register Cochrane Register of Studies Sponsored Entity Registrations 2010 CENTRAL Interim Measures Other amounts individually less than £25,000 Refund for costs of complimentary subscriptions in prior years

330,990 4,554 - 10,239 47,763 195,886 43,079 27,042 31,127 (54,893)

635,787 496,579

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COCHRANE COLLABORATION ANNUAL REPORT 2010/11

234,317 4,978 20,480 36,864 38,089 68,740 38,587 20,322 34,202 -


TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 2010/11

9. GOVERNANCE COSTS

Cochrane Collaboration Collaboration Trading Co. Group Group TOTAL TOTAL 2011 2010 £ £ £ £

Advisory group costs Audit and accountancy Bank interest and charges Insurance Legal and professional Meeting expenses Printing, postage and stationery Office running costs Colloquium – support costs Staff salaries Telephone

19,008 - 19,008 14,626 5,000 12,531 17,531 12,268 1,206 693 1,899 2,473 4,278 - 4,278 2,479 - 5,961 5,961 50 136,174 1,520 137,694 163,717 - 4,537 4,537 4,173 - 10,597 10,597 12,107 - - - 5,275 90,480 - 90,480 86,123 - 736 736 12,270

256,146

36,575 292,721 315,561

All governance expenditure is from unrestricted funds.

10. TOTAL STAFF COSTS £

Cochrane Collaboration Collaboration Trading Co. Group Group TOTAL TOTAL 2011 2010 £ £ £

Wages and salaries Social security costs Pension costs

618,634 61,510 21,702

- 618,634 473,964 - 52,891 43,765 - 30,321 -

701,846

- 701,846 517,729

Staff costs have been apportioned between the headings in the Statement of Financial Activities in accordance with the accounting policy, as follows:

Cochrane Cochrane Collaboration Trading Co. Group Group TOTAL TOTAL 2011 2010 £ £ £ £

Costs of generating funds Costs in Furtherance of the Charity’s objectives Governance costs

90,480 520,886 90,480

- 90,480 - 520,886 - 90,480

701,846

- 701,846

The average number of employees analysed by function was: Management Finance Administration

7 2 2

- - 4 - - 2 - - 2

11

- - 8

2 employees received emoluments in excess of £60,000 during the year (2009–2010: 2) >£80,000<£85,000 1 >£140,000<£145,000 1 Employers pension contributions to defined contribution pensions schemes for employees with emoluments in excess of £60,000 during the year was £12,143 (2009–2010: £nil).

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TRUSTEES’ REMUNERATION AND EXPENSES The trustees received no remuneration during the year, apart from reimbursement for attendance at trustees’ meetings in furtherance of their duties of £43,321 (2009-2010: £147,332). One trustee’s employer was also reimbursed for their work as a member of the IMS Support team (see note 8). Professional indemnity insurance was purchased in the year for £3,318 (2009–2010: £1,860).

11. FIXED ASSETS

COLLABORATION

GROUP

COMPUTER FIXTURES & COMPUTER FIXTURES & EQUIPMENT FITTINGS TOTAL EQUIPMENT FITTINGS TOTAL £ £ £ £ £ £

Cost As at 1 April 2010 Additions Disposals As at 31 March 2011

6,823 6,416 13,239 23,263 18,138 41,401 5,586 2,800 8,386 6,418 3,112 9,530 - - - (396) - (396) 12,409

9,216

21,625

29,285

21,250

50,535

Depreciation As at 1 April 2010 Charge for the year Disposals

1,605 935 2,540 2,360 1,774 4,134 - - -

15,640 10,671 26,311 3,685 2,732 6,417 - - -

As at 31 March 2011

3,965

2,709

6,674

19,325

13,403

32,728

As at 31 March 2011

8,444

6,507

14,951

9,960

7,847

17,807

As at 31 March 2010

5,218

5,481

10,699

7,623

7,467

15,090

Net book value

12. FIXED ASSET INVESTMENTS

Cochrane Cochrane Collaboration Group Collaboration Group 2011 2011 2010 2010 £ £ £ £

Investment in Collaboration Trading Company Limited Other investments

100 - 100 1,000 1,000 1,000 1,000

1,100 1,000 1,100 1,000

The investment represents a 100% shareholding in Collaboration Trading Company Limited (incorporated in England and Wales). All figures have been included in the consolidation. At the year end, after donations to The Cochrane Collaboration under Gift Aid, the net assets of Collaboration Trading Company Limited (the total of Share Capital and accumulated Profit and Loss Account) were £-422, following a loss for the year of £484. Other investments represent the value of the oil painting of the Cochrane logo gifted by Sir Iain Chalmers.

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13. DEBTORS

Cochrane Cochrane Collaboration Group Collaboration Group 2011 2011 2010 2010 £ £ £ £

Prepayments and accrued income Amount due from subsidiary Other debtors Trade debtors

35,897 574,196 19,176 616,340 819,374 - 1,210,950 56,420 64,912 63,587 64,597 21,484 23,796 - -

933,175 662,904 1,293,713 680,937

14. CREDITORS: AMOUNTS FALLING DUE WITHIN ONE YEAR

Cochrane Cochrane Collaboration Group Collaboration Group 2011 2011 2010 2010 £ £ £ £

Trade creditors Social security and other taxation VAT creditors Accruals and deferred income

124,296 136,813 - 21,469 21,469 - 14,159 - 104,654 13,222 2,446 193,789 196,644 245,287 367,132

339,554 459,580 258,509 383,737

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15. RESTRICTED FUNDS

Balance as at Incoming Utilised/ Transfer Balance as at 1 April 2010 Resources Expenditure between funds 31 March 2011 £ £ £ £ £

Kenneth Warren Prize Bill Silverman Prize Wellcome Trust Thomas C Chalmers Award Aubrey Sheiham Scholarship WHO Vitamin A project HTA Influenza project NHS Updating project Evidence Aid Charity and Group

25,862 - (8,304) - 17,558 2,046 - (627) - 1,419 6,247 - - - 6,247 4,414 - (630) - 3,784 61,868 699 (5,438) - 57,129 - 27,000 (11,578) - 15,422 - 11,807 (9,348) - 2,459 - 147,875 (111,708) - 36,167 - 124,682 (24,891) 25,000 124,791 100,437

312,063

(172,524)

25,000

264,976

The Kenneth Warren Prize was formed to fund the annual prize of the same name. The Bill Silverman Prize was formed to fund the annual prize of the same name. The Wellcome Trust funded a short-term project to assess the Collaboration’s need to archive its written and electronic materials. The Thomas C Chalmers Award was formed to fund the annual prize of the same name. The Aubrey Sheiham Scholarship Fund is to provide one three-month scholarship each year, in order that individuals from developing countries can learn to prepare systematic reviews. WHO Vitamin A project – A commission from the World Health Organization to update a number of Cochrane Reviews on Vitamin A Supplementation in specific population groups. HTA Influenza project – A grant awarded by the NIHR as part of the HTA programme to support a review team evaluating the effects of neuraminidase inhibitors in influenza. NHS Updating project – A grant received as part of the NHS Engagement Award; its main focus was to develop and circulate recommendations aimed at improving Cochrane Review Group/Author performance in updating Cochrane Reviews. Evidence Aid – An initiative to improve access to information for people and organisations facing health and healthcare challenges arising in natural disasters and other large-scale health emergencies and crises. A transfer of £25,000 was made from unrestricted funds in the year, to cover specific costs incurred in assessing whether the project was feasible. The bracketed figures represent expenditure which is deducted from the fund balances.

16. DESIGNATED FUNDS Discretionary Fund Prioritisation Fund Opportunities Fund Colloquium Fund

Balance as at Transfers and Utilised/ Balance as at 1 April 2010 new designations Expenditure 31 March 2011 £ £ £ £ 15,000 13,184 95,181 17,626 140,991

5,657 (5,657) 15,000 - - 13,184 - (80,075) 15,106 10,831 (16,649) 11,808 16,488 (102,381)

The charity designates to the Discretionary Fund a maximum of £15,000 of its unrestricted funds annually in support of those Cochrane entities which require funding for their activities which are in line with the charity’s mission. Each successful application is restricted to £5,000 (exclusive of any administration charges). A transfer has been made from the unrestricted reserves to increase the balance back up to £15,000 at the year end following expenditure of £5,657 from the fund in the year. Agreed payments for the projects funded by the fourth and final round of the Collaboration’s Opportunities Fund began in the year 2010–11, with all invoices for older projects settled as final reports were received. The Steering Group had agreed at its meeting in Auckland, New Zealand, in March 2010, to discontinue the Opportunities Fund on completion of the fourth round, considering that it was not contributing sufficiently to achieving the Collaboration’s strategic goals. Instead, core funds will be directed at programmes considered of key strategic importance, including Cochrane Training and Cochrane Methods. These initiatives will include budgets allocated by application to groups conducting research, development, training and advocacy projects in relevant subject areas. The Colloquium Fund has been established for activities associated with the preparation, administration, oversight, management and reporting related to the organisation of Cochrane Colloquia.

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55,098


TRUSTEES’ REPORT AND FINANCIAL STATEMENTS 2010/11

17. ANALYSIS OF GROUP NET ASSETS BETWEEN FUNDS

Restricted Unrestricted Total £ £ £

Charity Fixed assets Current assets Current liabilities

- 16,051 16,051 264,976 3,576,116 3,841,092 - (339,554) (339,554)

264,976 3,252,613 3,517,589

Group Fixed assets Current assets Current liabilities

- 18,807 18,807 264,976 3,692,863 3,957,839 - (459,580) (459,580)

264,976 3,252,090 3,517,066

18. FINANCIAL COMMITMENTS Operating lease commitments At 31 March 2011 the charitable company had annual commitments in respect of premises rental as follows:

Expiry date of premises lease: Between two and five years Over five years Other leases: Between two and five years

Cochrane Cochrane Collaboration Group Collaboration Group 2011 2011 2010 2010 £ £ £ £

- -

- 21,650

- -

21,650 -

1,485

1,485

-

-

The premises are subject to a rent review in 2016. Pension Commitments The charity operates a defined contributions pension scheme. The assets of the scheme are held separately from those of the company in an independently administered fund. The pension cost charge represents contributions payable by the company to the fund and amounted to £30,321 (2009–2010: £nil). Contributions totalling £5,050 (2009–2010: £nil) were payable to the fund at the balance sheet date and are included in creditors.

19. RELATED PARTY TRANSACTIONS The charitable company has taken advantage of the exemption in Financial Reporting Standard Number 8 from the requirements to disclose transactions with group companies in consolidated financial statements.

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ACKNOWLEDGEMENTS

Acknowledgements n Production and editorial team: Lucie Jones, Cochrane Collaboration Secretariat;

Giovanna Ceroni, Cochrane Editorial Unit n Distribution and communications strategy: Lori Tarbett, Canadian Cochrane Centre n Design: Daniel Foster, daniel@bigtop-design.co.uk

With special thanks to John Wiley & Sons, Ltd, for their generous support of the printing and distribution of the 2010/11 Annual Report to The Cochrane Collaboration’s friends and supporters worldwide. In particular, thanks to Deborah Pentesco Gilbert and Rachel Robinson

Special thanks also to: Claire Allen, Sally Bell-Syer, Karen Bennett, Stephen Brown, Alan Cassels, Jackie Chandler, Mike Clarke, Miranda Cumpston, Robert Dellavalle, Bernard Gauthier, Donna Gillies, Claire Glenton, Emma Grose, Sonja Henderson, Jini Hetherington, John Hilton, David Hives, Martin Janczyk, Bonnix Kayabu, Chunjie Li, Harriet MacLehose, Chris Mavergames, Caroline Mavergames, Steve McDonald, Catherine Mcilwain, Rasmus Moustgaard, Nancy Owens, Jacob Riis, Sarah Rosenbaum, Rachel Sayers, Evgenia Slavinova, Gavin Stewart, Denise Thomson, Johanna Trimble, Sarah Wilkins; and the Collaboration Trading Company Directors, the German Cochrane Centre, the Monitoring and Registration Committee. The Co-Chairs would like to thank the Croatian Branch of the Italian Cochrane Centre, who hosted the Cochrane mid-year meetings in April 2011, and in particular, Dalibora Behmen and Dario Sambunjak.

Images: Use of headshots: Alan Cassels, Jackie Chandler, Miranda Cumpston, Chunjie Li, Catherine Mcilwain, Johanna Trimble; and the Cochrane Collaboration Steering Group. Stock images sourced from istock. With the exception of: Improving outcomes in crisis situations with Evidence Aid, copyright UN Photo/WFP/Amjad Jamal; Making a fast food meal out of a Cochrane Review, copyright WHO/P. Virot; Cochrane Colloquium images, copyright Elliott Asbury.

Online version: The online version of this report is available on the Collaboration’s website: www.cochrane.org. A PDF version is available to download here too. With special thanks to the Cochrane Web Team.

Comments: Comments and queries are welcome at: annualreport@cochrane.org.

Want to know more about The Cochrane Collaboration? Visit the Collaboration’s website: www.cochrane.org, or access Cochrane Reviews on The Cochrane Library: www.thecochranelibrary.com The Cochrane Collaboration: working together to provide the best evidence for health care September 2011

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COCHRANE COLLABORATION ANNUAL REPORT 2010/11


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©The Cochrane Collaboration, 2011. All rights reserved. The Cochrane Collaboration is a registered Charity in the United Kingdom Charity No 1045921; Registered in England No 3044323 (UK) Registered Office: The Cochrane Collaboration, Summertown Pavilion, 18–24 Middle Way, Oxford OX2 7LG The Cochrane Library, the principal product of The Cochrane Collaboration, is published online and in DVD format by the Collaboration’s publishing partner, John Wiley & Sons, Ltd


Annual Report & Financial Statements 2010/11