Cochrane reviews in neonatology: Past, present and future

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Summary

The Neonatal Review Group of the Cochrane Collaboration is dedicated to improving outcomes of newborn infants through the collection and synthesis of the highest quality evidence. Much has been achieved with limited resources. Future challenges for the group are to maintain and extend current reviews of therapeutic interventions, to develop bridging reviews to assist clinicians in applying current evidence more easily, to expand the scope of the Cochrane Library to include diagnostic tests, and to utilize techniques such as prospective meta-analysis to answer remaining questions in the field. In future, the Neonatal Review Group needs to assist reviewers in developing countries to prepare reviews relevant to their settings that will reduce the global burden of neonatal mortality and morbidity.

Section snippets

Archibald Cochrane (1909–1988)

Best known as an epidemiologist, Archie Cochrane had several careers preceding the publication of his landmark book Effectiveness and EfficiencyRandom Reflections on Health Services. He served in the Royal Army Medical Corps in World War II and was a POW Medical Officer in Greece and Germany. Undermanned and with little equipment or drugs, he was surprised at the low mortality rate in the camps from severe epidemics of typhoid and diphtheria. He realized that the natural defences of the

The present

‘Look not mournfully into the past. It comes not back again. Wisely improve the present. It is thine. Go forth to meet the shadowy future, without fear.’ Henry Wadsworth Longfellow.

The Cochrane Collaboration was founded in 1993, and the Neonatal Review Group was registered in the same year. The founding editors Jack Sinclair, Michael Bracken, Roger Soll and Jeffrey Horbar are supported by the review group coordinator, Diane Haughton. Four regional coordinators have been added to the review

The future

When you make a mistake, don't look back at it long. Take the reason of the thing into your mind and then look forward. Mistakes are lessons of wisdom. The past cannot be changed. The future is yet in your power. Hugh White (US politician, 1773–1840)

The field of neonatology is comparatively young but one in which important ‘mistakes’ have been made. Response to these mistakes drives the neonatal review group. The mistakes are of two types: first, that exemplified by the oxygen toxicity story

Conclusions

The science of systematic reviews and meta-analysis is young and still rapidly evolving. It is likely that when this period of the Cochrane Library's history is reviewed from a vantage point decades in the future, the methods used now will seem primitive, clumsy, and perhaps in some cases wrong. However, in a relatively short time much has been accomplished in collating and disseminating high-quality evidence relevant to the care of newborn infants. Silverman frequently used the term

Acknowledgements

I thank Jack Sinclair, Diane Haughton and David Henderson-Smart for their helpful reviews of this chapter. Diane Haughton provided the figure and table used.

References (24)

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