Archie Cochrane

Archibald (Archie) Leman Cochrane (1909 - 1988) was a pioneer of the randomized clinical trial (RCT).

Biography

Born in Scotland in 1909, Archie Cochrane graduated from medical school at University College Hospital in 1934. He served in the Spanish Civil War as a British Ambulance Unit member and in World War II as a Captain in the Royal Army Medical Corps.

In his influential book, Effectiveness and Efficiency: Random Reflections on Health Services (a critique of Britain's National Health Service) Cochrane commented on the impact his military experience’s had on his medical practice:

“I remember at that time reading one of those propaganda pamphlets, considered suitable for POW medical officers about 'clinical freedom and democracy'. I found it impossible to understand. I had considerable freedom of clinical choice of therapy: my trouble was that I did not know which to use and when. I would gladly have sacrificed my freedom for a little knowledge. I had never heard then of 'randomized controlled trials', but I knew there was no real evidence that anything we had to offer had any effect on tuberculosis, and I was afraid that I shortened the lives of some of my friends by unnecessary intervention."

Randomized Clinical Trials (RCTs)

After the war, Cochrane studied tuberculosis and championed the used of RCTs. Seven year later, he challenged the medical profession to create critical summaries of RCTs so data would be synthesized for users. In 1987, he gave high praise to a ground-breaking review of RCTs that dealt with pregnancy and childbirth. He described it as "a real milestone in the history of randomized trials and in the evaluation of care" and encouraged all medical specialties to duplicate the systematic methods.

Cochrane’s advocacy work led to the creation in 1993 of the Cochrane Collaboration, a loose knit international network of volunteers that create systematic reviews. In 1996 these reviews began being compiled in the Cochrane Library. The Library includes a register of controlled trials and quality appraisals of reviews published elsewhere. The Cochrane Library is a highly regarded source of quality evidence about healthcare treatments.