Most Cochrane members will have felt at best uneasy about the recent events in Cochrane. We also felt uncomfortable and wondered what caused our feelings. The biggest problem we felt was the lack of transparency. Who had been doing what? Who makes the decisions in Cochrane? What can I do as a member of a Cochrane Centre or a Review Group? Many questions were also triggered by the statement of the Governing Board that there will be ‘zero tolerance for bad behaviour’. We fear this will easily lead to ‘zero tolerance for different opinions’.
We are all members of Cochrane because we believe that evidence-based health care is an important asset for public health. Evidence that can be trusted is what we all want to create. We believe that the lack of transparency and trust which we experience at the moment is detrimental to Cochrane and we have to do something about it.
There are four major policy issues that we would like to improve.
- Create a culture of open discussion
First of all, we need a culture of open discussion. At the moment, many people don’t dare to speak out because they fear that it will be used against them. We ask the Governing Board and the Cochrane Central Executive Team (CET) to create a forum where interactive discussions can be held. Modern organizations commonly have a freely accessible online discussion platform that can be used by all members.
- Refocus on the heart of Cochrane
Authors, members of methods and review groups put enormous effort in producing Cochrane Reviews without payment. The revenues of these reviews finance a large Cochrane CET. In the past, many good investments have been made such as the Game Changer project. We would like to see an increase in support to the heart of Cochrane by for example financially supporting review production, methods development and stakeholder interaction worldwide. Cochrane CET and Cochrane members in various groups around the world should work together to achieve this.
- Increase the involvement of Cochrane members
We as Cochrane members are very motivated to do our reviews, train our authors, develop methods, assist with difficult analyses or other important tasks for getting our high-quality reviews published. However, our involvement in the governance of the organization is minimal. At the Annual General Meeting only 240 members voted out of a potential 11 250 voters (2%). To support the democratic process in general and to increase ownership in the implementation of new policies in Cochrane, voter participation rates should be increased. The members are the basis of the organization according to the constitution of Cochrane. A good start would be to have a lively debate among members during the coming Governing Board elections and to organize general meetings more effectively.
- Find a better business model for Cochrane
Cochrane reviews are sold to subscribers. The European Union has decided that science funded by public money should be published Open Access, which means that it is freely available for the end-user. Cochrane does not have such an Open Access model. Even though content is freely available to a large part of the world, important new reviews are behind a paywall. Also, content that is older than 12 months is free but this is largely not up-to-date. This is different from our promise to be the most reliable, up-to-date and accessible source of evidence. We conclude that in the long run the current business model is untenable and we must find better solutions.
Signed by the following Cochrane Members:
- Jos Verbeek, Coordinating Editor, Cochrane Work
- Gerd Antes, former Director, Cochrane Germany
- Matteo Bruschettini, Director, Cochrane Sweden
- Jani Ruotsalainen, Managing Editor, Cochrane Work
- Chris Del Mar, Coordinating Editor, Cochrane Acute Respiratory Infections
- Mark Jones, Centre for Research in Evidence-Based Practice (CREBP), Bond University, Australia
- Caroline Struthers, UK EQUATOR Centre, University of Oxford
- Lotty Hooft, Director, Cochrane Netherlands
- Tianjing Li, Co-ordinating Editor, (US Satellite) Eyes and Vision
- Gerald Gartlehner, Director, Cochrane Austria
- Nicole Skoetz, Senior Editor, Cochrane Cancer
- Barbara Nußbaumer-Streit, Associate Director, Cochrane Austria
- Nancy Santesso, Deputy Director, Cochrane Canada
- Philipp Dahm, Coordinating Editor, Cochrane Urology
- Malgorzata Bala, Director, Cochrane Poland
- Joerg Meerpohl, Director, Cochrane Germany
We asked people to sign this petition if they wanted to join us. By the start of voting, when we closed the petition, 620 people had signed it. We think this is great and totally new in Cochrane. Thank you to everyone who signed!
“All effective treatment must be free” — Archibald Cochrane