The Cochrane Library 1996 (CD-ROM)
CMAJ 1997;156:1199
Issue 3. BMJ Publishing Group, London. 1996. Distributed in Canada by the Canadian Medical Association, Ottawa. $270.95 ($214.95 CMA members). For network prices, call Member service Centre tel.: 800 663-7336 ext. 2307, fax: 613 731-9102, email: cmamsc@cma.ca.
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| Overall rating: |
Excellent |
| Strengths: |
Comprehensive source of information about evidence to inform health care decision-making; updated regularly |
| Weaknesses: |
Free-text searches identify too many references; evidence often insufficient because conclusive trials are unavailable |
| Audience: |
Those who believe in the scientific basis for health care services
|
| System requirements: |
IBM-compatible computer with 386 MHz processor or higher or Macintosh, 4 MB RAM, hard disk with at least 15 MB free space, CD-ROM drive |
The tremendous amount of information emerging about new treatments and other health care interventions makes it extremely difficult to stay current. The Cochrane Library CD-ROM is an ambitious attempt to overcome this problem. It is a powerful tool that sifts through the published literature and identifies the best available information. It provides quick access to systematic reviews about the effectiveness of health care interventions and identifies references to studies that meet stringent review criteria. The library is assembled by the Cochrane Collaboration, an international group of expert researchers and reviewers.
The CD-ROM comprises 4 main databases. The Cochrane Database of Systematic Reviews contains 358 systematic reviews of research on the effects of health care. The Database of Abstracts of Reviews of Effectiveness is a collection of 1626 structured abstracts and bibliographic references for reports of systematic reviews of the effects of health care. The Cochrane Controlled Trials Register provides a register of 112 308 controlled trials in given topic areas, including references to published articles and summaries, if available. The Cochrane Review Methodology Database provides a biblio-graphy of 398 books, special journal issues and articles on the methods of preparing systematic reviews.
The CD-ROM is easy to load and use. There are 3 windows: "search," "index" and "document." When the user types a term in the search window, the index window identifies the number of "hits" in each of the 4 databases; the user then double-clicks on the title of interest, and the document window displays the related document. The document can be read on screen, printed or saved in a file. There is also a "help" function. The CD-ROM also contains a 600-page handbook, an extensive glossary of terms and a list of useful sites on the World Wide Web. The CD-ROM is updated 4 times annually, and multiple-user subscriptions are available. There are telephone numbers for technical support in the US, the UK and Australia. A cut-and-paste feature will be included in the next release. The current CD-ROM can conduct free-text searches (the entire record is searched for the term), but these can sometimes produce too many results. A list of medical subject headings (MeSH), to be included in the next release, will allow more accurate searching.
It is difficult to identify weaknesses in this CD-ROM. Thoughtful readers will wonder about those interventions that are not found in the library. There is an emphasis on randomized controlled trials despite the fact that several health care interventions do not lend themselves to this type of evaluation. Summaries of research reports often end with the familiar expressions "insufficient evidence" and "more research needed." These last 2 points are not criticisms of the CD-ROM itself, though.
The Cochrane Library is absolutely essential for anyone who believes in the scientific basis for health care services. The Cochrane Collaboration has made a commitment to developing and improving the CD-ROM. My only complaint is that I cannot listen to music on my CD-ROM drive and use the Cochrane Library at the same time!
Duncan J.W. Hunter, PhD
Director
Health Information Partnership
Eastern Ontario Region
Assistant Professor of Community Health
and Epidemiology
Queen's University
Assistant Professor of Epidemiology
and Community Health
University of Ottawa
Kingston, Ont.
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