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The importance of Cochrane Reviews to evidence based medicine

Last updated on August 24th, 2019 at 11:13 am

Cochrane Collaboration Copyrighted from the Cochrane Collaboration

The Cochrane Collaboration is a critically important source in evidence-based medicine, and a useful tool in providing analytical evidence that can debunk pseudoscientific beliefs. Cochrane’s goal is to organize research data and publications in an logical way that helps physicians and researchers make appropriate decisions about a proposed new therapy, medication or clinical idea. Cochrane Reviews are:

…are systematic reviews of primary research in human health care and health policy, and are internationally recognised as the highest standard in evidence-based health care. They investigate the effects of interventions for prevention, treatment and rehabilitation. They also assess the accuracy of a diagnostic test for a given condition in a specific patient group and setting.

Each systematic review addresses a clearly formulated question; for example: Can antibiotics help in alleviating the symptoms of a sore throat? All the existing primary research on a topic that meets certain criteria is searched for and collated, and then assessed using stringent guidelines, to establish whether or not there is conclusive evidence about a specific treatment. The reviews are updated regularly, ensuring that treatment decisions can be based on the most up-to-date and reliable evidence.

When debunking junk medicine, I always search articles from Cochrane Review regarding the topic. Their review articles combine the results of all the well-done research papers in a particular area, while pointing out weaknesses in experimental design or quality of results in other papers.

This type of review is useful to contradict the standard retort from the pseudoscience pushing crowd, “the evidence isn’t clear.” The evidence usually is very clear. Similar to quote mining, I have found that junk medicine gang will also pick and choose articles that may support their biased point-of-view. If there are 100 articles that say “vaccines don’t cause autism”, but one poorly designed study, published in an obscure journal says “vaccines may cause autism because of X, Y, Z”, Cochrane Reviews does not give much weight to the weaker study.

If you’re looking for pseudoscience-busting articles, a few favorites are below:

  • Cranberries for preventing urinary tract infections .  “There was some evidence to show that cranberries (juice and capsules) can prevent recurrent infections in women. However, the evidence for elderly men and women was less clear, and there is evidence that is not effective in people who need catheterisation. Many people in the trials stopped drinking the juice, suggesting it may not be a popular intervention. In addition it is not clear how long cranberry juice needs to be taken to be effective or what the required dose might be.”
  • Vitamin C for preventing and treating the common cold .  “Regular ingestion of vitamin C had no effect on common cold incidence in the ordinary population. However, it had a modest but consistent effect in reducing the duration and severity of common cold symptoms.”  But a big HOWEVER, “trials of high doses of vitamin C administered therapeutically, starting after the onset of symptoms, showed no consistent effect on either duration or severity of common cold symptoms.”  Treating The Common Cold from Science Based Medicine says Vitamin C doesn’t work.
  • Using the combined vaccine for protection of children against measles, mumps and rubella Updated.  “We could assess no significant association between MMR immunisation and the following conditions: autism, asthma, leukaemia, hay fever, type 1 diabetes, gait disturbance, Crohn’s disease, demyelinating diseases, or bacterial or viral infections. “
  • Statins for the primary prevention of cardiovascular disease.  “All cause mortality. coronary heart disease and stroke events were reduced with the use of statins as was the need for revascularisations. Statin treatment reduced blood cholesterol. Taking statins did not increase the risk of adverse effects such as cancer. and few trials reported on costs or quality of life. This current systematic review highlights the shortcomings in the published trials and we recommend that caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk.”

The best part of the Cochrane Reviews is that they take primary studies, that research that presents initial data that hasn’t been through a round of critiques, and combine them with other primary studies, creating a huge statistical analysis that combines data from several sources. It is an effective way to determine the viability of a whole bunch of studies that may appear to be contradictory or equivocal.

Always make the Cochrane Reviews your first stop in researching medical claims of new ideas.

Michael Simpson

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