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Epidemiology:
doi: 10.1097/EDE.0b013e3181aff391
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The Remarkable Archie: Origins of the Cochrane Collaboration

Winkelstein, Warren Jr

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Most epidemiologists are familiar with the Cochrane Collaboration, which provides critical and systematic reviews of randomized trials relevant to medical practice and health policy. The Cochrane Collaboration has so far enlisted 15,000 volunteers worldwide in the preparation of these reviews.1 Today, more people are familiar with the Cochrane Collaboration than with Cochrane himself. But the man is worth remembering—Archibald Leman Cochrane was one of the most colorful medical scientists of the 20th century.

Archie, as he was known, came from a wealthy family, thereby enjoying lifelong financial security. As a young man, he suffered from a sexual dysfunction for which he could not find treatment in the United Kingdom.2 He underwent psychoanalysis in Germany. While there, he became fluent in German—and infuriated by the Nazis. When his Jewish analyst fled to Vienna and subsequently to Holland, Archie followed. On returning to England, he enlisted in the International Brigade to fight fascism in Spain. During World War II, he was held prisoner for 4 years.

After the war, Archie studied the chest diseases of mining populations in Wales, launching a series of remarkable surveys that reached more than 90% of their target populations. His studies of lung diseases and his papers on quality of health and medical care services are characterized by innovation and even audacity.

The Cochrane Collaboration grew from ideas Cochrane presented in a 93-page book titled Effectiveness and Efficiency: Random Reflections on Health Services,3 published in 1972. The gist of the book is that evaluation of clinical procedures should depend on the results of randomized clinical trials. In his words, “I concentrated mostly on one simple idea—the value of randomized controlled trials in improving the NHS [National Health Service].” About the actual writing, he said “… I ended up writing the book… between the hours of 10:00 pm and 1:00 am when I had finished everything else. I date the real beginnings of my love of whiskey to this period.” This slim volume got rave reviews. It was quickly translated into Spanish, French, Italian, and Polish, and reprinted in paperback. With one small book, Cochrane revolutionized the approach to evidence in medicine.

Cochrane retired to his home, Rhoose Farm House, in the Vale of Glamorgan, Wales, where he created a prize-winning garden, hung an impressive art collection, and entertained epidemiologists from around the world. He died in 1988 at the age of 79.

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REFERENCES

Figure. Archibald Le...
Figure. Archibald Le...
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1. Chalmers I. Archie Cochrane (1909–1988). In: The James Lind Library. Available at:www.jameslindlibrary.org. 2006.

2. Cochrane AL, Blythe M. One Man's Medicine: An autobiography of Professor Archie Cochrane. London: The British Medical Society; 1989.

3. Cochrane AL. Effectiveness and Efficiency: Random Reflections on Health Services. Cambridge: Royal Society of Medicine Press Limited; 1999.

© 2009 Lippincott Williams & Wilkins, Inc.

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