Getting Useable Knowledge From Research Into Your Hands: Practical Use of the Cochrane Database of Systematic Reviews

The notion of "using research to inform programming" has been getting a lot of buzz recently. It is true that the application of current research findings can be an important part of what makes HIV programs and services effective. However, accessing relevant and useful research-based evidence is no small task. There is an amazing amount of research evidence related to HIV available, but as a service provider, with limited time and resources, finding and accessing this information can be challenging at best.

What is a front-line service provider to do, knowing that current research can have a profound impact on programming and the future directions of organizations in general? You might ask yourself: where do I find current research information? How do I identify the important information to take away from a particular article or report? How do I know how one study relates to another? Who has the time to do all this searching, reading and synthesizing anyway?

The Cochrane Database of Systematic Reviews can be your answer.

What Is the Cochrane Database of Systematic Reviews?

The Cochrane Database of Systematic Reviews (the Cochrane Reviews) is an online collection of high-quality, health-related research-based evidence that is currently free to use and easy to access. Cochrane Reviews, published online four times per year, is the major product of an international not-for-profit organization called The Cochrane Collaboration (see box).

The Cochrane Reviews links service providers and researchers to timely, accurate and evidence-based information that can support front-line program development and delivery. Importantly, it includes research evidence related to HIV prevention and treatment and support of people living with HIV.

The Cochrane Reviews database is available free of charge to all Canadians until at least January 31, 2010. At this time, we do not know if the free trial period will be extended. If after this date you can't access the database, please contact CATIE for assistance.

What Is Contained in the Cochrane Reviews?

The Cochrane Reviews is a database of systematic reviews.

A Systematic Review -- a highly useful decision-making tool -- is a summary of a number of research studies that are focussed on a single question or health-related topic. A systematic review identifies a program (intervention) for a specific health-related issue, and determines whether or not this program "works." An example of an intervention is a program designed to increase condom use among young women for HIV prevention purposes through educational workshops. To determine if this type of intervention "works," authors locate, appraise and synthesize evidence from as many research projects that study this topic as possible. By summarizing conclusions about effectiveness, the end product is one detailed research paper that outlines the most rigorous research on the topic -- a single source for research evidence on one topic vs multiple individual research papers. Eureka!

Systematic reviews can be incredible tools to support decision-making and program planning. They effectively summarize large amounts of information, including conclusions about a program (or "intervention").

What Kind of Information Do Cochrane Reviews Have About HIV?

The Cochrane Reviews has a large amount of research-based evidence on the prevention and treatment of HIV/AIDS. You can browse Cochrane Reviews by topic, one of which is HIV/AIDS. Reviews are divided into four subtopics for easy searching:

• Behavioral, Social and Policy Prevention;
• Biomedical Prevention;
• Therapeutics, Prognostics and Diagnostics;
• Health Services and Care.

Canadian people living with HIV can use the information that Cochrane Reviews contains about HIV to help them make health-related decisions. Canadian service providers and policy makers can use systematic reviews to help them make decisions about what types of health care or HIV programming to provide.

How Do I Access the Cochrane Reviews?

The entire Cochrane Library, of which Cochrane Reviews is a part, is now available to Canadians for free until at least January 31, 2010. The free trial period may be extended beyond this date, but at this time we do not know if this will happen. The pilot has been made possible by the contributions from subscribers, hospitals, academic and government libraries, The Canadian Health Libraries Association, the Canadian Cochrane Network and Centre, and the Canadian Institute for Scientific and Technical Information.

In addition to the free access trial for all Canadians, certain regions of Canada have negotiated ongoing free access beyond the free trial through various library and government projects:

New Brunswick: Free access through New Brunswick Public Library Service

Northwest Territories, Nunavut, Yukon: Free access through the Pan-Northern Agreement and the Indian and Inuit Branch of Health Canada

Nova Scotia: Free access through Public Libraries of Nova Scotia

Saskatchewan: Free access through provincial libraries

If you can't access the Cochrane Reviews database though any of these methods, please contact CATIE for assistance.

How Do I Search the Cochrane Reviews for Relevant HIV Research Evidence?

You can search for relevant systematic reviews to inform your decision making and program planning in a number of ways:

1. By topic
2. Alphabetically by title
3. By date of publication
4. By author's country of origin
5. By language (some reviews are available in Spanish and some are available in German)

There is also a more traditional search box -- like that you would use to search www.google.ca -- where you can enter specific search terms, such as "HIV prevention."

Examples of HIV-Related Systematic Reviews Found in the Cochrane Reviews

The Cochrane Reviews contain over 95 systematic reviews related to HIV prevention, care, treatment or support. Many of these reviews will be relevant to Canadian HIV service providers. Some examples of HIV-related reviews found in the Cochrane Reviews are:

Sex-related HIV risk reduction:
Behavioural interventions to reduce the risk for sexual transmission of HIV among men who have sex with men

Drug-related HIV risk reduction:
Psychosocial interventions for the reduction of injection and sexual risk behaviour for preventing HIV in drug users

Pre-exposure prophylaxis:
Antiretroviral pre-exposure prophylaxis (PrEP) for preventing HIV in high-risk individuals

Take Advantage of Free Access Today!

The Cochrane Reviews is a useful tool that can be used to inform decision making and program planning. Why not take advantage of the free access to the Cochrane Reviews while it lasts to find what information is available that may help you in your day-to-day work?

Lauren Plews is currently the Information Specialist at CATIE. A certified bookworm, Lauren earned her Masters of Science in Information with a specialization in Library Sciences from the University of Michigan in Ann Arbor, Michigan. Before coming to CATIE, she worked in a Public Library and also assisted faculty and researchers at the School of Rehabilitation Science at McMaster University, Hamilton, Ontario.