Michael R. Sayre, MDEmergency MedicineThe Ohio State University

Philips Medical: Consulting, 2004 – present.

Zoll/Revivant: Research funding, 2004 – 2006.

Medtronic Emergency Response Systems: Travel reimbursement, 2004, 2006

National Highway Traffic Safety Administration: Research funding, 1999 – 2007

Medivance: Research funding, 2004 – 2007

Established in 1993 Thousands of

collaborators worldwide Organized in entities Dedicated to ensuring

that accurate, current information is available about the effects of healthcare interventions

Members (usually volunteers) prepare a structured review of a specific health intervention and pledge to maintain that review regularly.

In 2004: > 11,500

contributors 91 countries ~ half working

on reviews

Collaborative Review Groups Focus on

particular area of health

Groups of interest to EMS Airways Bone, joint, and

muscle trauma Heart Infectious

diseases Injuries Stroke

Fields Emerge around

areas of interest which extend across a number of health problems

Example Fields Behavioral

medicine Cancer network Child health Neurological

network Prehospital and

emergency health

Vaccines

Cochrane Centres Geographic

entities

Example Centres Australoasian Canadian German UK US

Central functions funded by royalties from the sales of subscriptions to the Cochrane Library.

Individual entities (Centres, etc) funded by government, institutional, & private sources.

Funds from corporate sponsors are quite limited by policy.

Published electronically at www.TheCochraneLibrary.com

Updated every 3 months Some countries have national

subscriptions, e.g. Australia, allowing anyone in the country free access. The USA does not have such a subscription.

Initiated by Frank Archer, a physician in Melbourne, Australia in 2003 at Cochrane Colloquium in that city.

Formally constituted at Cochrane Colloquium in Ottawa in 2004.

Funded in part by the Australian government

Has more than 3,000 members worldwide

Frank Archer (Convenor) Melbourne, Australia

Erin Smith (Coordinator) Melbourne, Australia

Rhona Macdonald (Trials Search Coordinator) Melbourne, Australia

Mal Boyle Melbourne, Australia

Frederick "Skip" Burkle Jr. Baltimore, Maryland, United States

Mark E. Cooke London, United Kingdom

Matthew Cooke Coventry, United Kingdom

Marica Ferri Rome, Italy

Cameron Glass British Columbia, Canada

Hugh Grantham Adelaide, Australia

Ian Jacobs Perth, Australia

Steve McDonald Melbourne, Australia

Andrew Marsden Edinburgh, Scotland

Brian Rowe Edmonton, Canada

Omer Sakaf Dubai, United Arab Emirates

Arturo Salazar Costa-Rica

Michael SayreColumbus, Ohio, United States

Ayan Sen Manchester, United Kingdom

Reflects references located within the Cochrane CENTRAL register of Controlled Trials, Randomized Controlled Trials, Protocols and Reviews, that are relevant to Prehospital Health

Formalized a search strategy to identify prehospital clinical trials

Found >900 clinical trials relevant to prehospital emergency medicine

Beginning development of a disaster medicine search strategy

Smith E. Ann Emerg Med 2007; 49:344-350.

Smith E. Ann Emerg Med 2007; 49:344-350.

Annals of Emergency Medicine (10.7%) Resuscitation (8.8%) JAMA (5%) Prehospital Emergency Care (4%) New Engl J Med (3.5%) Circulation (3.3%) American Journal Emergency Medicine (3%) Prehospital and Disaster Medicine (2.7%) Journal of Trauma, Injury, Infection and Crit

Care (2.2%)Smith E. Ann Emerg Med 2007; 49:344-350.

Developing EMS professionals skilled in performing evidence-based medicine reviews. Course at Monash University in Australia Proposal for online version of course

Two awards annually of AU$5,000 each to fund reviewers, one of which is prioritized to a EMS professional

Cochrane reviews: Comprehensive Rigorous Well accepted

But…

“Absence of evidence is NOT evidence of absence.” – Carl Sagan

Sethi, D. Kwan, I. Kelly, AM. Roberts, I. Bunn, F. Advanced trauma life support training for ambulance crews. [Systematic Review] Cochrane Injuries Group Cochrane Database of Systematic Reviews. 3, 2008.

Lecky, Fiona. Bryden, Daniele. Little, Rod. Tong, Nam. Moulton, Chris. Emergency intubation for acutely ill and injured patients. [Systematic Review] Cochrane Injuries Group Cochrane Database of Systematic Reviews. 3, 2008.

Kwan, I. Bunn, F. Roberts, I. Timing and volume of fluid administration for patients with bleeding. [Systematic Review] Cochrane Injuries Group Cochrane Database of Systematic Reviews. 3, 2008.

Cochrane Collaboration is the International Standard for evidence-based practice reviews.

The Prehospital and Emergency Health Field is active and willing to help support additional development of evidence-based practice for EMS.

Michael R. Sayre, MDEmergency MedicineThe Ohio State UniversityMichael.Sayre@osumc.edu