Healthy Skepticism Library item: 7080

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Publication type: Journal Article

Tostad M.
Cochrane reviews v industry supported meta-analyses: has Cochrane really achieved its goals?
BMJ 2006 Oct 28; 333:(7574):916
http://www.bmj.com/cgi/content/full/333/7574/916-a

Abstract:

EDITOR-I am amazed that the BMJ chose to publish this review, given its small sample size yet broad conclusions.1 I believe that if the results had been in the other direction it would be less likely to have been published.

It is true that Cochrane reviews report specific items more thoroughly than journal based reviews. However, much of this is due to the insistence of addressing methodological issues which are specious at times and the fact that Cochrane reviews are not limited by page length. For example, the issue of reporting allocation concealment, although it makes sense, does not mean that if not reported it was not done,2 nor does it even consistently demonstrate that it is an important methodological issue to report.3

It is disappointing that the Cochrane Library has become an ivory tower, given that many of the reviews are out of date and methodologically weak. The Cochrane Library was established to be a clinically useful resource, but is that really true? There are many Cochrane reviews that would not be published in a paper journal, as they contain zero or just a few trials. There are far too many Cochrane reviews stating that, although upwards of 10 trials were found, the reporting is poor and therefore more research is required before a clinical recommendation can be made. Do you really think it is useful to say that several trials do not permit an inference on effectiveness?

The pharmaceutical industry is an obvious target for attack, and this amounts to little more than bullying. Pharma has an obvious conflict in wanting to publish favourable results. Why does the Cochrane group not go after the agencies claiming to promote health for the goodness of all, but mismanaging money and misusing evidence, such as the World Bank or World Health Organization4 5-not targets that are so uniformly accepting of criticism.

Keywords:
Drug Industry* Goals Meta-Analysis Pharmaceutical Preparations* Review Literature*