Founding of the Cochrane Collaboration

Archie Cochrane, whose experience as a doctor with scarce resources in the Second World War shaped his views, spent much of his career arguing that medicine spent money on treatments that had never been properly tested. His 1972 book Effectiveness and Efficiency argued that randomized controlled trials were the way to find out which treatments worked and which did not. In 1979 he wrote that it was a great criticism of the profession that no one had organized a critical summary, by specialty and updated periodically, of all relevant randomized controlled trials.

Iain Chalmers, a British epidemiologist with a long background in perinatal research, took that challenge seriously. He and colleagues built the Oxford Database of Perinatal Trials and a series of systematic reviews published in 1989 as Effective Care in Pregnancy and Childbirth; the database became a regularly updated electronic publication that year. The UK Cochrane Centre opened in 1992 under Chalmers's direction. Its logo, later the Collaboration's, reproduced a meta-analysis of seven randomized trials of antenatal corticosteroids; Chalmers said it was chosen to show that clear evidence had been available for a decade without changing practice. The Cochrane Collaboration was founded the following year, after a meeting of 77 people from nine countries at the first Cochrane Colloquium in Oxford, and review groups formed to cover specific clinical areas.

The Collaboration's core innovation was methodological standardization. Before Cochrane, most reviews were narrative, shaped by the judgment and reading habits of their authors. Cochrane reviews required explicit search strategies, pre-specified inclusion and exclusion criteria, structured data extraction, and, where appropriate, formal meta-analysis with pooled effect estimates. The protocol had to be registered in advance, making it possible to audit the process and update the review as new trials appeared.

By the 2000s the Cochrane Library had become a standard source for guideline developers, and Cochrane now reports that a majority of World Health Organization guidelines draw on evidence from its reviews. Since February 2013 authors have been allowed to post the published version of a review in a repository 12 months after publication, and since September 2016 reviews have been deposited automatically in PubMed Central.

Cochrane had died in 1988, four years before the Centre opened in Oxford. The network named for him has since produced more than 16,000 new and updated reviews, and by 2023 it had 11,000 members and 100,000 supporters in more than 130 countries. Its perinatal database grew into the Cochrane Pregnancy and Childbirth Database in early 1993.