Month: October 2011

-The Cochrane Collaboration is the best institution of evidence-based medicine to help make decision-making more effective, efficient and safe for the patient

– “ all treatments that have proven to be effective, must be free ”, so says Dr. Xavier Bonfill, director of the Iberoamerican Cochrane Centre and Chairman of the Executive Committee of the nineteenth Colloquium Cochrane

Madrid, 2011-October “ doctors carry out interventions that or do not work or even cause damage and, therefore, should not take place. Thus, 25% of patients do not receive effective treatments and that same percentage of patients do not receive treatments that have been effective ”, says Dr. Jonathan Craig, co-Chair of the Cochrane Collaboration in the framework of the nineteenth Colloquium Cochrane held in Madrid.

why is this happening? Because in part, says doctor Craig, by the excessive volume of clinical information. “ There are between 700,000 and one million of clinical trials in the world and it is not possible that a medium clinical process this information. our goal is to find all the trials of a medical practice, evaluate them, summarize them and spread them all over the world to make it accessible to clinicians, political and patients ”.

Dr. Xavier Bonfill, director of the Iberoamerican Cochrane Centre ensures, for its part, following the ideology of the mentor of this organization, the British doctor Archie Cochrane, “ all treatments that have proven to be effective, must be free ”. “ Apparently not learned from history nor good ideas made many years ago –-continuous doctor Bonfill — because we are now at a time in which we continue discussing if we claim that all treatments must be free or only those that have proven effective … we would like to ensure that the second option is better but we have not developed neither a culture, or the mechanisms to make this discrimination between those who are effective for those who are not … and in the work of explanation, we are ”.

Dr. Jeremy Grimshaw, co-Chair of the Cochrane Collaboration, considers that assess quality in health care initiatives must be “ first to determine whether the activities carried out are beneficial or harmful, and second, because sometimes you have to repeat studies which invests money thinking that serve to improve the quality of care and are then failed and not show an effective ”.

Gordon Guyatt, Professor of clinical epidemiology and Biostatistics of McMaster University in Hamilton, Ontario and father of evidence-based medicine has pointed out that “ it is important that although we have little evidence on a particular type of clinical performance, these tests are of quality not to waste resources ”. Hence the importance of systematize an appropriate methodology for assessing the degree of confidence and quality of health actions. In this task, continues Dr. Guyatt, “ have developed the method GRADE, an initiative that has revolutionized the world of guidelines for clinical practice and, in general, of the formulation of recommendations on health ”.

Mirta Roses, Director General of the Pan American Health Organization (PAHO) stated outright so “ there is no health without research and is important that in situations of economic crisis, as the current crisis is an opportunity for improvement and not a repetition of past mistakes ”.

“ In the same way – says Mirta Roses – in the area of the Americas there is a huge gap between some countries and others depending on the degree of development and improving people’s health is our priority ”.

We must regain the credibility of the population to health care through the scientific evidence and that is why, says the Director General of PAHO, “ is essential translation and transmission of scientific knowledge and make it reach the population, the researcherspoliticians and the media. The ethical and regulatory framework is also fundamental and that is where the Cochrane Collaboration has put emphasis in helping the formation of professional volunteers ”

in the plenary session devoted to patients and citizens the challenges of the security and quality health care, the new model of patient active has become apparent in the field of health; the need to include the participationdoes the patient in the decision-making of health systems and the importance of the network of training citizens to advance in the improvement of the quality of care.

Involving patients in the prioritization of health research is one of the fundamental objectives of the Cochrane Collaboration. In United Kingdom there is a very suggestive initiatives such as the one made in collaboration with the James Lind Alliance. According to his Manager, Sally Crowe, “ have the need for patients to be involved in the review of the health research because they contribute with their taxes to fund this research. In United Kingdom there are large imbalances between what is researched and that patients require you to look into. It is important to bring together in a same group of researchers, clinicians, and patients to know better to influence decisions affecting people’s health ”.

Silvana Simi, representative of the Cochrane Group of patients with multiple sclerosis in Italy says that “ patients should not be silent. They are not exploited source to analyze how health services and its voice must take into account because it, everyone wins ”.