Why not to keep the clinical granularity of the current Cochrane Review Groups (CRGs) as a way of addressing global challenges and building new partnerships for the future?

Retaining the clinical expertise that Cochrane currently has within the evidence synthesis unit structure is important, however keeping granularity at our current level – 52 individual CRGs – creates significant challenges as we look to streamline our systems and processes. Our current structure does not illustrate how interdisciplinary, collaborative, and nimble we can be. From an external point of view, the siloed approach of creating evidence syntheses via many different and seemingly segregated groups makes Cochrane a complex organization to understand and partner with. In creating a new production model, we need to think how best to preserve all that is good in Cochrane’s current structures whilst striving to make the organization more outward- looking, and to foster new partnerships and funding opportunities. In seeking to achieve this balance, we are mindful of the rich, subject-specific knowledge that CRGs have and want to work with them to ensure that Cochrane’s fundraising strategy does not endanger their local funding arrangements.

Can independent authors teams submit manuscripts on any topic?

The global challenges framework is intended as a way of focusing Cochrane’s effort on the ‘big’ health and social care questions, but it is not intended to cut off the flow of submissions in topics that do not fall within the framework. For some author teams the pathway to publication may be via a Thematic Group that is focused on a particular priority area (e.g., Cardiovascular Disease or Maternal and Child Health). Teams that believe they are addressing an important global always have the option of submitting directly to the Central Editorial Service if there is no Thematic Group that is a ‘good fit’ for their manuscript.

CRGs act as hubs to help Cochrane cover almost all healthcare topics including common but overlooked topics. Loss of these hubs could mean these topics will go back to being overlooked. How can Cochrane avoid this?

We hope that, with a broad range of funders, we will be able to identify funding for a wide range of healthcare topics.

Will Evidence Synthesis Units be topic-related like current CRGs/Networks? How will this affect the topics that Cochrane covers in terms of health evidence?

The way we prioritise topics within CRGs has been very challenging to explain and share with people outside Cochrane. We hope that a global challenges framework will provide an overarching structure to the units and provide us with a way to respond to global health and care challenges in an agile way. Adjustments to the framework have been made as a result of feedback received in Q4, 2021, about the key areas that Cochrane should be engaged in. Chronic conditions, Cancer, Climate Change, Maternal & Child Health and Infectious Diseases came out on top during the community engagement process. The absence of Mental Health & Wellbeing from the framework was noted but will be added going forward. Further consideration of the framework and discussion with the wider community will occur as the new model evolves..

Cochrane is a global organization and so must be conscious of global health priorities, whereas some partners are country-focused (e.g., NICE in the UK). How will this be reconciled to ensure effective collaboration?

Organizations such as the NIHR and NICE in the UK or NHMRC in Australia are important, however Cochrane’s has many key partners and stakeholders. We are a global organization and thus must consider global priorities and partners when thinking about how best to collaborate and restructure.

If health equity could be embedded more into regional priority setting, could this help to better address global challenges?

The fact that we are an international organization with centres all around the world makes this challenging. Equity at the local level and equity at the global level are very different things. We likely need to be looking at equity at the local level (within countries) as well as internationally when relevant. We need to work with our local partners in countries all over the world to better define what ‘equity’ means and looks like both regionally and globally.

Why are Evidence Synthesis Units important and what impact will they have?

The Evidence Synthesis Units (ESUs) are intended to play a pivotal role by improving product consistency and accountability, alongside the Thematic Groups and expanded Central Editorial Service. The fact that the ESUs are interdisciplinary will allow them flexibility to deliver evidence synthesis in a range of health and social care areas, and draw on the topic and methods expertise in the Thematic Groups. The ESUs are also important because they are outward facing, signalling to funders and users of our evidence that Cochrane is responsive to important global health and social care needs. By creating ESUs that are accountable to Cochrane centrally we plan to coordinate and speed up production of the highest priority topics.

Will Cochrane Evidence Synthesis Units replace the current Cochrane Review Group structure and when will this happen?

Cochrane Evidence Synthesis Units (ESUs) will play a vital role in producing Cochrane evidence syntheses in the future but Cochrane Review Groups (CRGs) are more likely to transform into Thematic Groups, than into ESUs. This was born out in the first round of pilot Thematic Group pilots, many of which are made up of CRGs. We are striving not to disrupt Cochrane Groups with stable funding during the transition period (2023-25), with no pressure to transform into an ESU or join a Thematic Group.

Will the Evidence Synthesis Units be geographically or thematically organized?

The model as originally proposed presented the Evidence Synthesis Units as geographically organized, multi-topic and interdisciplinary. Throughout the community engagement process, we heard clearly and consistently that keeping Cochrane’s content expert volunteer community was vital to the new model. As a result, the new model was adjusted to include Thematic Groups, which would sit alongside the Evidence Synthesis Units. The Thematic Groups will help to provide the right topic expertise to the ESUs, which will be organised geographically.

Is there a risk that Evidence Synthesis Units will not have the right topic expertise?

The potential loss of topic expertise is an acknowledged risk in setting up the Evidence Synthesis Units as multitopic and interdisciplinary, which is why Thematic Groups have been added to the model. The Thematic Groups will act as a reservoir of topic expertise for Evidence Synthesis Units and serve as a liaison between Cochrane and its stakeholders, e.g., guideline developers, government agencies, health and care associations and health care consumer groups.

Will there be an application process for setting up Cochrane Evidence Synthesis Units?

Yes, an open, transparent application process will be launched in Q2 of 2023, similar to the process created to set up the Thematic Group pilots.

What is the likely timeline for setting up Evidence Synthesis Units?

We do not expect change of this magnitude to happen quickly; there will inevitably be a period of transition, where the model takes shape, and new funding opportunities emerge. The first step is to establish two pilot ESUs at the end of an open application process.

Where will the new Evidence Synthesis Units be based?

The location of the first two pilot Evidence Synthesis Units will be determined through a transparent application process. The ultimate aim is to have 10 ESUs spread across the world reflecting the health and care needs and perspectives of both high and low- and middle-income countries.

Is there a risk that we may not identify funds for the Evidence Synthesis Units?

The challenge of securing funding for Evidence Synthesis Units in a competitive environment is not being under-estimated. Cochrane is in the process of creating a fundraising team and fundraising strategy, which will include identifying potential funding sources for the Units. In presenting the case for supporting Evidence Synthesis Unit to national funders we will stress the value of Cochrane’s expert global community, with topic expertise provided through Thematic Groups, and methodological expertise by Methods Groups. Cochrane leaders continue to discuss new model with several national funders. We are confident the Units can be established through a stepwise approach, allowing us to test, learn and revise where necessary.

Will the staff of the Evidence Synthesis Units be Cochrane employees?

We will need to be flexible in how we think about funding the ESUs, so there may be different models of funding implemented in different units and therefore different employment arrangements. Staff of the Evidence Synthesis Units might be employees of Cochrane or of host institutions. However, it is important that there is a line of accountability to Cochrane to matter the funding/employment arrangements.

What is ideal range of expertise needed in the Evidence Synthesis Units?

There is not a one-size-fits-all approach to this; the driving force for these units needs to be production of the highest quality, gold standard reviews. Each ESU will depend on its own funding, leadership, etc., and whether it will be feasible to have separate experts on various methodological topics in each ESU. It may be necessary to share this expertise across ESUs depending on resources. Some ESUs may have specific topic experts, however others may be involved across various ESUs.

How will volunteer review authors be integrated into the Evidence Synthesis Units?

The close working relationships between Evidence Synthesis Units (ESUs) and Thematic Groups, will be the key to integrating volunteer authors into the ESUs. ESUs will built around professional and experienced reviewers doing the high-quality Cochrane reviews, but with topic experts sources via Thematic Groups as needed. In addition, author teams will be able to undertake Cochrane reviews and submit them directly to the Central Editorial Service. If they are of high-priority, and meet the quality standards set by Central Editorial Service, they may be published in the Cochrane Library.

What is the advantage of the Evidence Synthesis Units model compared to the direct submission pathway?

The Evidence Synthesis Units (ESUs) and the direct submission pathway have been envisaged as complementary. Having the ESUs provides a way of creating content that ensures stakeholder needs are addressed in a structured and co-ordinated way. The shift toward multi-topic, interdisciplinary units increase Cochrane’s attractiveness to the international global donor market. The direct submission pathway allows us to remain flexible and open to submission of high-quality manuscripts that may not fit neatly within a global challenges framework.

How will the ongoing infrastructure costs new Cochrane Evidence Synthesis Units be funded? What external funders are being approached to fund these?

We have been working on a fundraising strategy that will enable us to diversify our funding streams and support the units and other strategic activities in the coming years. Early indications are that some current national funders are interested in at least partially funding Evidence Synthesis Units within their jurisdiction but no firm commitments have been made and we also want to explore funding opportunities with international partners. A close relationship between Cochrane and the funders will be critical to the success of these Units, not least in securing funding in the medium- and long-term.

How much are funders prepared to pay for Cochrane reviews?

That is uncertain but what we do know is that funders want to pay for the evidence synthesis that fits their local context and needs, and that they want those syntheses to be of high quality and delivered quickly.

If we move away from large national funders like the NIHR funding, toward other donors, should we pause the move to Open Access (OA)?

Many funders and stakeholders have pressed Cochrane to adopt an Open Access (OA) model and the Governing Board has emphasised the importance of responding to this challenge well before the NIHR announcement was announced. In the global donor market place the OA model also has a great deal of currency, so OA is a challenge the organization must face, regardless of funding diversification. To that end Cochrane has prioritized the creation of a sustainable OA plan as part of the Cochrane Strategy for Change.

Is Cochrane willing to accept funding from well-funding from reputable charities in return for a relatively high level of visibility on the Cochrane Library/Cochrane.org?Cochrane could certainly focus on better ways of working with donors that are beneficial to both Cochrane and donor organizations.

Various business models that Cochrane has explored have failed in the past, so how can we be . confident that we can replace the lost revenue from going Open Access?

It is true that previous initiatives have not been as successful as we’d have hoped, therefore it is now vital that we learn from the past and make significant and lasting changes that will enable us to respond to global health and care challenges and demonstrate Cochrane’s value to external stakeholders. The major difference in this point in our history is the sense of urgency arising from the many challenges we are facing – insecure funding, Open Access pressure, and a structure and processes that are no longer fit for purpose. Cochrane’s leadership is working on a fundraising strategy that will support whatever new, sustainable operating model is chosen by the Governing Board.

Is there a risk, with funding bodies having more of a say in the review priorities, that the reviews will be focused on the types of interventions that are cheap enough to be recommended in guidelines?

To remain relevant and make Cochrane a sustainable organization for the future, we must diversify our sources of funding. It is not clear at this stage that this imperative will lead to a conflict between the needs of funders and the needs of clinicians. Nevertheless, we are mindful of the possibility, which it is why we are focused on ensuring that we retain Cochrane’s clinical expertise, and that the clinician “voice” is integrated into the Evidence Synthesis Unit structure.

What about the Cochrane groups that have stable funding?

The importance of not jeopardizing the stable funding that some groups have is well understood. One possible approach might be for groups with stable funding to become affiliated research groups working with Cochrane as the Evidence Synthesis Units are set up. Alternatively, they may choose to join with other Cochrane Groups (Reviews Groups, Fields, etc.) and apply to become a Thematic Group.

How do we ensure that Cochrane Groups don’t compete for funding?

For any new production model to be efficient and sustainable it must be coordinated and collaborative. It is possible to imagine situations where the Evidence Synthesis Units may be eligible to bid for the same the funds, indeed there may be cases in which competition is healthy, helping to drive excellence. However, as an organization we must guard against putting too much energy into internal competition. Cochrane’s fundraising strategy, as it matures over time, will hopefully give the groups producing reviews the financial stability they need to avoid excessive competition. Cochrane’s central team will likely have an important role to play, not only in leading fundraising activities to identify infrastructure funding, but also to manage and coordinate programme grant funding in a way that supports the groups but maximizes organizational efficiency.

Do we know if NIHR would help to fund Cochrane evidence synthesis units? Do you anticipate that the Evidence Synthesis Units will apply for funding through the forthcoming NIHR call?

It is important to understand that there are two distinct types of evidence synthesis units. The “Cochrane evidence synthesis units” which have been mentioned in several earlier answers, and the proposed “NIHR evidence synthesis units” that NIHR have signalled it is planning to fund in the UK. It is our clear understanding that these will be funded primarily to undertake commissioned non-Cochrane evidence syntheses. We would like to see NIHR encourage these units to submit the evidence syntheses they produce for publication in the Cochrane Library. However, we know that NIHR will want these syntheses to be published Open Access. We also realize that these evidence syntheses will not necessarily be (and are unlikely to be) classic Cochrane-style reviews. It is important for Cochrane to broaden and expand the types of the evidence syntheses published in the Cochrane Library, and this may therefore be a route to do so. We are continuing in a regular dialogue with the NIHR.

Is our commitment to Open Access a done deal, and if so, why?

Our commitment to Open Access is longstanding, and Cochrane has committed to be fully open access by 2025. Undoubtedly, there challenges to going Open Access, but we have learned the importance of making the evidence that we generate accessible to all over the past 2 years with our response to the COVID-19 pandemic. The open science movement is rapidly gaining momentum and if we don’t make all our content Open Access in a reasonable timeframe, we may experience reputational risk. Making the change is a complex proposition and there are various paths that Cochrane could take, all of which come with risks. We must balance our commitment to Open Access and the speed of transition, with our sustainability as an organization. The Governing Board is very focussed on this issue and we have been looking at how other organizations are managing the transition. We will share plans with the community as soon as decisions are made.

Do you know yet how many MEs, ISs, etc will make up each Cochrane evidence synthesis unit?

Wherever possible we would want to see existing Cochrane staff find roles within the new Units, however, it is too early to answer this question. During the community engagement period we heard some of the community’s views on how the current CRG roles could be adapted to new ways of working in the future and this will be considered as the new model evolves.

How much influence will the CET have over the composition of Evidence Synthesis Units, if some of them are funded through an open NIHR process to which various institutions will be bidding?

The Evidence Synthesis Units (ESUs) proposal recommends that each unit is composed by diverse author teams with sufficient knowledge and expertise to guarantee high-quality, timely delivery and that they are supported by a skilled and experienced core team. The ESUs would be multi-topic and interdisciplinary and there will be scope for sharing content and methods expertise between units. It is important that all ESUs use consistent standards and processes wherever they are based. The units will need to follow the strategic direction of the organization, have a governance structure with clear lines of accountability for meeting key performance indicators. In terms of how much influence the CET will have over who will be appointed to the ESU’s that would probably have to be devolved. To preserve Cochrane’s gold standard for evidence synthesis a clearer distinction between authorship and editorial review must be established as well as a good process for quality assurance. In the new model we envisage the editorial process for all evidence syntheses to be managed centrally to ensure that all reviews follow the same independent editorial process and adhere to quality standards.

What is ideal range of expertise needed in the Evidence Synthesis Units?

There is not a one-size-fits-all approach to this; the driving force for these units needs to be production of the highest quality, gold standard reviews. Each ESU will depend on its own funding, leadership, etc., and whether it will be feasible to have separate experts on various methodological topics in each ESU. It may be necessary to share this expertise across ESUs depending on resources. Some ESUs may have specific topic experts, however others may be involved across various ESUs. Ultimately, this will be a question about leadership and funding for the ESUs.

How will volunteer review authors be integrated into the Cochrane evidence synthesis units?

This new model of Cochrane Evidence Synthesis Units is built around professional and experienced reviewers doing the high-quality Cochrane reviews and other evidence syntheses that funders require in a timely fashion. Teams of review authors working anywhere in the world will be able to undertake Cochrane reviews and submit them directly to the Central Editorial Service. If they are of high-quality, on important topics, they will be published in the Cochrane Library.

Is there a proposal to move to accepting other types of reviews, and has consideration been given as to how to develop / ensure methodological quality across a wide range of different types of reviews?

To meet the needs of our stakeholders, we may need to address different types of questions in the future. Cochrane has a history of methodological innovation, but we will need to develop expertise in other methodologies to retain our relevance. In Cochrane’s response to the COVID-19 pandemic, we had to tackle questions that relied on study designs that we have not traditionally worked with. In responding to COVID and in the future, we will look to our own community of methods experts, bearing in mind that there will inevitably be a period of transition in which Cochrane builds on existing expertise to deliver new types of evidence syntheses. We acknowledge the risk of ‘spreading ourselves too thin’ methodologically, but we have confidence in the network of individuals who have shown in the past how willing they are to rise to methodological challenges.

How do we ensure authors who obtain funding to do reviews, publish in the Cochrane Library rather than other journals?

Detail relating to contractual obligations of authors who receive funding to conduct Cochrane evidence syntheses is something that we would need to consider carefully when we have settled on a new model. One important way that Cochrane can ensure that authors remain committed to publishing with us to ensure a good author experience, based on clear, timely processes and the availability of support when it is needed.

The Evidence Synthesis Units will take time to get established - during which time, could our reputation for producing high quality reviews substantially diminish?

Whatever the timeframe for establishing the evidence synthesis units, only high-quality Cochrane reviews and related evidence syntheses will be published in the Cochrane Library. We do want to find a way to preserve the clinical and patient expert knowledge and expertise that resides in the members of the different CRGs, as noted in prior answers.

With this model, how are we planning to preserve the clinical, methodological & patient expertise that rests in the current CRGs?

We recognise that our biggest asset is our people and that there is a tremendous amount of expertise – clinical, methodological, patient and carer – within Cochrane. We want to recognize this as we go through this process of change, with the goal of retaining this expertise. We have discussed this with Cochrane members throughout the Community Engagement Workshop Series, and recordings of these workshops are available here. Collaboration is central to Cochrane’s identity, and we hope to continue to work together to ensure we preserve this expertise.

What will Cochrane do to address any racism or biases that are affecting people involved in Cochrane? Are we ensuring that the new Cochrane can be built with mechanisms to hold people accountable when they are discriminatory in all forms?

While Cochrane acknowledges that there are societal issues beyond our control, our role is to help authors have a good, and consistent experience. Identifying which steps of the review process are more susceptible to this type of bias and establishing a mechanism to pre-empt language, or any other bias would help to tackle some of the issues that are affecting people in Cochrane. Cochrane is actively working developing a set of recommendations on how to improve diversity and inclusion for the organization as a whole.

Can the community contribute to the development of the Evidence Synthesis Units?

The proposal introduced in September 2021 is one proposal only; we were clear that it could either be modified or that alternative approaches could have emerged during the community engagement period. We welcomed feedback and ideas from the community which was solicited input through a workshop series and via a survey on the Future Cochrane website. We also received a number of formal written responses which can be viewed here. We understand how important it is to communicate with the wider Cochrane community, other stakeholders and our funders after the Governing Board has reached a decision and as the project evolves throughout 2022.

How will the Thematic Groups fit with other Cochrane groups (geographic groups, fields, CRGS, etc.)?

The Thematic Groups could perhaps be thought of as an overhaul of how the CRGs, Fields, Geographic Groups, Methods, and Consumers work together and a redefining of who can produce Cochrane evidence syntheses. A current CRG can elect to join forces with other CRGs or with other Cochrane Groups, but equally so can a current Field. We heard many times in the community engagement process that our expert volunteers find their entry point into Cochrane via a specific clinical topic or method which is why it’s important to preserve the thematic focus that Evidence Synthesis Units won’t necessarily have.

It is equally an opportunity for members of a wide range of Cochrane Groups (e.g., Fields, Methods Groups, etc) to use their considerable topic expertise to enter fully into the Cochrane evidence synthesis production process. Some Geographic Groups have expressed interest in being involved in the creation of Evidence Synthesis but they might also be involved in supporting the creation of Thematic Groups given their regional knowledge and ties to national funding bodies.

How do Thematic Groups improve content or other Cochrane processes?

The value and importance of the Thematic Groups relates to the fact that the ESUs must be multi-topic and geographic. They must respond to the different evidence needs of a national/regional funder, not just focus on a particular clinical area. No ESU is going to have all the clinical and lived experience expertise it needs to cover any topic the funder wants, but that wide range of expertise DOES exist now in the wider Cochrane community. The Thematic Groups facilitate evidence synthesis production by ensuring that ESUs have access to the right experts at the right time, and keep Cochrane’s loyal contributors engaged

If the Thematic Groups can produce evidence syntheses will they be competing with the Evidence Synthesis Units?

Thematic Groups can also produce reviews, although they don’t have to. We don’t believe this will set up competition, in fact the Thematic Groups will be an important source of content to help Cochrane maintain the publication pipeline as funding dries up and CRGs shut down. In addition, there’s scope for Thematic Groups to work in tandem with ESUs and provide expertise in the definition of a review question, choice of outcomes, and the interpretation of evidence.

When will all manuscripts have to be processed through the Central Editorial Service?

The aim is that the editorial process for all new protocols, reviews and update will be handled by the Central Editorial Service by December 2023.

How will the new Central Editorial Service be funded?

Currently, this service is funded from the income that Cochrane (the charity) receives from Wiley (our publisher). Work on how all Cochrane’s central functions (not just the Central Editorial Service) will be part of the review of how Cochrane is funded.

What criteria are used to an accept/reject decision in the Central Editorial Service?

The Central Editorial Service team uses a basic submission checklist to ensure that the author team adheres to the Conflict of Interest policy for Cochrane Library content and Cochrane’s authorship and contributorship policy, and that the submission complies with Cochrane’s plagiarism policy. Submissions not compliant with these policies would be rejected. At the second stage an assessment by a Central Editorial Service Manging Editor is carried out using the Criteria for submission to Central Editorial Service. A decision is then made on whether to take the submission forward. If the submission appears to meet the criteria a parallel peer review (methods, search, content/clinical and consumer review) may take place instead of a sequential peer review (methods and search review before content/clinical and consumer review). An outline of the editorial process steps for the Central Editorial Service is available on the Editorial Independence and Efficiency Project webpage.

Could a review be rejected if it was not considered to address a priority topic?

Reviews submitted via the direct pathway may be rejected based on the perceived priority of the topic. It is important to note however, that the Central Editorial Service team are aware of the need to consult topic experts who can advise us on whether the review addresses a priority topic or overlaps with other reviews in the area.

Can reviews rejected on quality grounds be resubmitted?

Submissions rejected based on quality would not qualify for revision and resubmission. Authors can appeal the rejection decision and their appeal will be considered according to the Cochrane appeals policy and process. Other reasons for rejection may be that the review overlaps with another Cochrane review already published that is up to date or in the process of being updated. If a review is deemed not ready for peer review on submission but it is a high priority topic and the issues highlighted can be addressed, a major revision round would be permitted before peer review.

How are consumer referees identified and supported within the service?

We have worked with the Consumers' Executive and Cochrane’s Consumer Engagement Officer to identify consumer reviewers. For Covid reviews we would approach the Covid Consumer group. Cochrane review groups with strong consumer relationships may recommend consumer peer reviewers for the editorial process Other methods include using Cochrane’s Task Exchange and promoting these on social media, asking advocacy groups or specific patient representative groups if they can recommend someone who could be a consumer author.

How can information specialist peer reviewers be identified?

From March 2022, post-submission search peer review across Cochrane has been available from a dedicated team of information specialist (IS) peer reviewers. The team is made up of volunteer Cochrane IS who have agreed to receive requests for search peer review. The IS Search Peer Review Team performs post-submission search peer review for any Cochrane editorial team in Editorial Manager, replacing the previous arrangement of searches being peer reviewed by an IS within the same Network as the Cochrane Review Group where the article was registered. For more information about search peer review for Cochrane, please see FAQs for Information Specialist Search Peer Reviewers.

Will information specialist peer reviewers be expected to peer review search strategies not designed by Information Specialists?

The Information Specialist Search Peer Review Team performs post-submission search peer review for any submission, regardless of who designed the search strategies.What are the timeframes for non-priority reviews going through the service?

The Editorial Independence and Efficiency Project will end in June 2022, so by then we hope to have more robust data about time to publication for manuscripts going through the service. The aim is for all the steps of editorial process to be completed within twelve weeks, but this may vary depending on the recommendation that we send back to authors following peer review. Reviews requiring only minor revisions are likely to go through faster than those requiring major revisions.

How will discrepancies between conclusions in reviews that partly overlap be addressed in the service?

One way of addressing this would be to do more commentaries on Cochrane Reviews and editorials to describe the differences and similarities between the reviews. Having linked commentaries to Cochrane Reviews, particularly where we have got multiple reviews in an area, is something worth pursuing.

What will the direct submission pathway for authors outside units look like?

The direct submission pathway exists already and was used as part of Cochrane’s response to Covid-19. Like any other journal focused on quality, we will expect (and require) a high standard of submissions. For our part, we will aim for speedy turn-round of decisions. Authors whose work is rejected will be able to submit to other journals.

Q: Will authors still use RevMan?

A: Yes. All Cochrane reviews are now available to edit in RevMan Web, which has replaced the previous desktop version of RevMan. Please watch our 5-minute YouTube tutorial if you need any guidance on getting started with RevMan Web.

Q: Will RevMan change to reflect changes to the Cochrane Library?

A: Yes. RevMan will be updated to reflect the changes we are making on the Cochrane Library. There will be a new ‘supplementary materials’ section with parts of the review like the Characteristics of studies and Appendices. Additionally, some standard headings have been moved and new subheadings have been added, such as a new ‘Consumer involvement’ section that highlights the importance of public and patient involvement in Cochrane reviews.

Q: Can I continue to use RevMan for reviews that are not Cochrane reviews when RevMan 5 is no longer available?

A: Yes. RevMan Web is available for all reviews and there are options for either a low subscription cost, free access or a discounted price depending on your situation. For more information, please visit the RevMan Web site

Q: How do authors use study-centric data in RevMan?

A: The study-centric data workflow enables authors to structure all data around studies rather than analyses. This means result data can be reused for several analyses and covariates can be used to include/exclude results in a more structured way than previously available. Authors have told us that the new workflow minimises transcription errors and helps them think more critically about the structure of analyses.

Q: Can Cochrane Review data be shared and reused in RevMan Web?

A: Cochrane now provides a data package containing all downloadable files associated with the review's analyses data. This includes the analyses data and other data associated with the review such as study characteristics and data, risk of bias data and references. These datasets are available in non-proprietary formats such as CSV and RIS. This encourages more effective reuse of Cochrane Reviews, increases visibility and discovery for research data and brings improved transparency and reproducibility. It is a step towards FAIR principles (Findability, Accessibility, Interoperability, Reusability) for Cochrane content.

Q: Will users need to purchase a RevMan license to view data files downloaded from the Cochrane Library?

A: No, you do not need a license to view and run analyses on downloaded data files. The data downloads will now be in CSV format, which makes them useful for analysis using other tools.

Q: Will authors in lower and middle income countries have the bandwidth to use RevMan Web?

A: Our analytics show that users from low- and middle-income countries are able to engage effectively with RevMan Web, which suggests there is no problem with equity for its use. We are checking in with users in those countries and we will continue to monitor the situation carefully.

How should NIHR-funded, UK-based CRGs manage new title registration until funding ceases?

As of Friday 24 June 2022, authors submit proposals for new Cochrane Reviews to the central Editorial Manager site. Authors include basic information about their proposed review in Editorial Manager: title, author names, review type, topic area, why it’s important to do the review, whether the proposed review overlaps with other published Cochrane content, and information about the size of the proposed review. Editors from the relevant Cochrane Review Group will then be invited to a discussion about the proposed review in Editorial Manager, and asked to consider if the topic is of importance and suitable for a Cochrane Review, and whether there is overlap with current content participate. Cochrane Review Groups may choose to pursue the proposed review further within their group (with either more detail being requested via a full review proposal form, or inviting authors to submit a protocol); for the Evidence Production and Methods Department (EPMD) to take forward the proposal by sending authors information about how to submit a protocol to the Central Editorial Service; or to reject the proposal. Decisions about whether to take the proposal forward within a CRG or by EPMD will be based largely on whether the CRG has sustained resourcing. If some CRGs do not continue to function, alternative topic experts will be sought to discuss author proposals. Further information about this process is available from the recordings from the Editorial Manager demonstration sessions from Wednesday 15th June (recordings available here), and in Cochrane's Editorial and Publishing Policy Resource.

Should CRGs that are losing funding prioritize ongoing protocols or reviews?

The leaders of CRGs will have to consider, with their teams, and knowing the resources that have available, what can be accomplished in the relevant timeframe. It may be helpful to think about the priority of the title rather than the stage it’s at and focus on publishing the most important reviews. It is important to remember that it is possible for authors to submit high-quality manuscripts for consideration by the Central Editorial Service. UK-based CRGs can also seek guidance from the Cochrane UK Transition Support Team.

Will reviews funded/commissioned now still have a pathway to publication, especially when some grants have a 3–5-year timeline?

If team, working with their host institution (University, hospital, etc.) are bidding for money to do a suite of Cochrane reviews, can continue. Those reviews can always be submitted directly to the Cochrane Library via the Central Editorial Service. If they are of sufficiently high quality, they will be published.

What is the vision for the Cochrane Library considering this new model?

While this has not been decided yet, one idea is to find different ways to publish other types of evidence synthesis that are likely to be shorter and less complex. We must also remember that it is extremely important that we share information in ways that people want to consume it. This will need to be done through the geographic groups, which serve their local populations and best understand their needs.

We have an ongoing and unwavering commitment to publish high-quality reviews in the Cochrane, so any changes to the way we publish reviews (new types, for example) will not happen all at once; they will come after due consideration and user testing during the transition period.

In this model, what are the plans for updating reviews in the Cochrane Library?

There are no plans to discontinue the practice of updating, as this element of Cochrane reviews distinguishes us from many other evidence synthesis organizations. However, the proposed model presents an opportunity to re-examine all our editorial and publishing policies and practices so the Evidence Production & Methods Directorate is planning to revisit Cochrane’s updating policy.

What if current CRGs are approached directly for collaboration by the WHO or guideline makers and this funding / collaboration extends beyond the 18 months?

If the host institutions of a CRG have agreed to undertake work for the WHO or other guideline producers, and this has been properly costed, we would expect that work to be completed. But we can see difficulties if some of that work was to use – for example – NIHR resource, and those are no longer available.

What will be the role of the Fields?

We are exploring ways in which the clinical and patient expertise within not only CRGs but also Fields can be preserved. Many Cochrane Fields have longstanding relationships with external stakeholders so could play a pivotal role in the new approach to prioritization that is being proposed in the model. Indeed, some Fields are already engaged with priority global health and care challenges that have been identified by Cochrane (e.g., healthy ageing, disability, climate change). Fields members may also contribute as authors themselves and/or as contacts points with practitioners in the field.

Will Fields become Thematic Groups?

An underlying principle of this transformation process is that where a Cochrane Group, of any type, has stable funding, no action should be taken which would disrupt that funding. This is true for Cochrane Review Groups but equally for Fields and Geographic Group.The conception of a global challenges framework is based on the idea that focussing on the big global health and social care challenges will make Cochrane more relevant and attractive to funders. Some existing Cochrane Fields take this “big issue” approach, but not all. For Fields that focus on a broad area (e.g., Global Ageing, Sustainable Healthcare) the option to apply to become a Thematic Group may be attractive. However, Fields with a narrower focus are not under threat from the new model, as there is no expectation of ‘automatic conversion’. Fields with stable funding can continue to operate largely as they do now regardless of scope. One notable and positive difference is that the new model offers more opportunities for Fields to contribute to evidence synthesis production either as authors (submitting directly to the Central Editorial Service) or by providing content expertise to support the Central Editorial Service. In addition, one of the assessment criteria for setting up a Thematic Group is to outline how the Group will interact with other parts Cochrane Groups, which would include Fields.

Would Geographic Groups still exist alongside the evidence synthesis units?

Cochrane is a complex organization, with expertise in the CRGs, but also across our other groups. Our people are our asset; it’s what allows us to differentiate ourselves as an organization and produce and disseminate high quality reviews. Cochrane’s COVID-19 response showed us that Geographic groups can play an important role in synthesizing evidence, without having to make drastic structural changes. There are several core activities that Geographic groups should continue, such as training, knowledge translation, capacity building, and stakeholder engagement. Perhaps in time we will want to change the way Geographic groups are organized , however at this stage the proposed model does not aim to resolve all these issues, it is primarily focused on how we produce evidence syntheses. Nevertheless, we will be considering how collaborative working will happen with ESUs and other Cochrane Groups - we are all part of Cochrane and we should be working together.

What will the role of regional centres outside UK be, specifically in relation to ESUs?

As with CRGs outside the UK, we are keen not to disrupt the activities of Cochrane Geographic Groups that have stable funding. We welcome feedback from Cochrane Geographic Groups on how their local knowledge can strengthen the evidence synthesis unit structure.