Canadian recruited for Cochrane Collaboration
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* Charlotte Gray

When Dr. Terry Klassen joined the Emergency Department at the Children's Hospital of Eastern Ontario in 1987, he was surprised to find that some colleagues were not treating asthmatic children with steroids, as he had been taught to do. Moreover, the residents questioned his practice. So he did a systematic review of the literature and demonstrated that the weight of evidence favoured the use of steroids.

This experience persuaded Klassen that research synthesis is a useful tool for resolving differences of opinion in clinical practice. Such reviews have become even more important today, given the pressure on health providers to base decisions on solid evidence. Klassen, who now chairs the Department of Pediatrics at the University of Alberta, is playing a significant role in expanding the scope and availability of such reviews by heading the Child Health Section of the Cochrane Collaboration. This ambitious international effort is designed to collect, synthesize and disseminate all available evidence to clinicians.

"The Cochrane Collaboration is the single best source of high-quality evidence on which clinicians and policymakers can base their decisions," Klassen told the Canadian Association of Pediatric Hospitals last October. The extent of the UK-based project is expanding rapidly: more than 250 000 reports of controlled trials are included on the Cochrane Collaboration register today, compared with 100 000 in 1996. The mission of its recently formed Child Health Field, which Klassen chairs, is to ensure that children aged 0-18 receive services that are effective and based on up-to-date evidence. Studies from around the world are rigorously assessed, and integrated with similar studies from elsewhere.

"One of the biggest challenges," he admitted, "is not the adoption of evidence-based practice but making the findings available. We have to make it user friendly to nurses, doctors, families and patients. And we have to invest in the information technology infrastructure to get it out there."