Present: Hilda Bastian, lain Chalmers, Carl Counsell, Kay Dickersin, Peter Gøtzsche, Brian Haynes, Alessandro Liberati, Andy Oxman, David Sackett, Chris Silagy
Apologies: Muir Gray
In attendance: Ian Fullerton Smith, Cynthia Mulrow, Jos Kleijnen
Notes: Jo-anne Henden
I. Announcements:
There were no formal announcements made though it was proposed by Andy Oxman that several agenda items could be moved forward to the Monday 9 October meeting.
II. Approval of the minutes of the previous meeting:
(Refers to Steering Group meetings of 30 September and 5 October 1994).
A.) Comments or corrections to the minutes of 30 September 1994:
1. Andy Oxman suggested removing the table from page 2. 2. Kay Dickersin noted that on page 3 paragraph 2 last sentence should read "KD suggested a greater ratio of, ethnic and gender diversity would be sensible". 3. Chris Silagy noted that item 4e should read "DS and the EO will edit public information for CRGs, Methods Groups, Fields and individuals".
David Sackett proposed that the minutes of the meeting on 30 September 1995 be approved as amended.
B) Comments or corrections from the meeting of 5 October 1994:
1. Carl Counsell was not present at the meeting.
2. Hilda Bastian page 2, 1 d orphan reviews. It was confirmed that orphan reviews would not be entered on CDSR.
David Sackett proposed that the minutes of the 5 October to be approved as amended.
Action points and any other matters arising from the minutes:
111) Action points from the meeting of 30 September 1994
1 . Incorporation and Constitution of The Cochrane Collaboration Completed (David Sackett)
2. Systems for managing the review group registration process. This item carried forward to item 14 of today's agenda.
3. Representation of CRGs on the Steering Group. This item carried forward to item 3 on today's agenda.
4. Directories of individuals, CRGs, Fields, Methods Groups, etc. Carried forward to item 14 of today's agenda
5. Use of MeSH terms and the need for a Methods Group to devise a system of indexation. This item to be carried forward to the meeting of Monday 9 October 1995.
6. Setting up directories for contacts and groups. This items carried forward to item 15 of today's agenda.
7. Communication within the Collaboration. To be reviewed on Monday 9 October.
8. Format of Internet documents To be discussed under item 5 of today's agenda.
9. Dealing with imposters. To be incorporated into item 8 of today's agenda.
B) Review of action points from the meeting of 5 October 1994
1. Development of Review Manager
Andy Oxman reported that Update Software were working very hard in developing Review Manager. They have recruited Gordon Dooley as an assistant to help develop the software further. The Nordic Cochrane Centre is to take responsibility for developing the DOS version. lain Chalmers notified the Steering Group that the UK Cochrane Centre will cease to seek funding for further software development. He suggested that the Collaboration should become responsible for the development of software after the Adelaide Colloquium.
2. Modification to the content of a Cochrane Review
lain Chalmers reported that this had been done, and that Chris Silagy was developing a section called Implications.
3. CDSR on the Internet
This item passed over to item 5 on today's agenda.
4. Dealing with orphan reviews
This matter has been resolved previously.
5. 1995 Edition of the Handbook
This will be taken in item 18 of today's agenda.
6. Communication, managing the Contact Directory and the Newsletter
This will be dealt with under item 14 of today's agenda.
7. Territorial responsibility for each Centre
Chris Silagy asked that an update could be prepared for the meeting on Monday 9 October.
8. Steering Group composition This item is on today's agenda as item 3.
9. Analysis of the Hamilton Colloquium and the format of the Oslo Colloquium
To be discussed at the meeting on Monday 9 October,
10. Report on future Colloquia
To be discussed at the meeting on Monday 9 October.
11. Sponsoring representatives from the third world
This subject has not moved forward though a proposal was made that sponsorship should be extended to other groups such as consumers and not be restricted only to the third world. David Sackett requested that the members of the Steering Group consult with their colleagues from the third world to determine whether we could establish a more appropriate terminology.
12. Conflict and non-production resolution
This item to be carried forward to item 3 of today's agenda.
13. Registering new Centres, Groups and Fields
These items will be addressed in today's agenda.
14. Proposed new field in Socio-Economic Factors
David Sackett would like to address this at the meeting of Monday 9 October.
David Sackett asked whether there were any other issues arising from the action points of the previous minutes.
Peter Gøtzsche asked whether any progress had been made in seeking assistance from either organizations or institutions regarding organizational development. David Sackett reported that he and Ian Fullerton Smith had commenced negotiations with Templeton College, Oxford. Additionally Richard Smith, Editor of the BMJ had volunteered to assist the Collaboration with the development with organizational strategy. Andy Oxman reported several conversations with the Director of the National Hospital in Norway. The Director has trained in organizational management and has taken an interest in how the Collaboration might organize itself. Andy Oxman suggested that this item be carried forward to item 19 on today's agenda.
There were no further matters to discuss under this item.
IV. CONSTITUTIONAL MATTERS:
1. Annual Report:
Ian Fullerton Smith introduced the first Annual Report of The Cochrane Collaboration. A major omission was noted that the funding agencies for all the Cochrane Centre's had been left out of the document. The Steering Group discussed the content, structure and format of the report and concluded that it would be in the best interest of the Collaboration to issue an amended draft of the Annual Report before Christmas 1995. Alessandro Liberati proposed that the format of the Annual Report be discussed and finalized at the meeting of Monday 9 October. lain Chalmers proposed that a public announcement be
made at the plenary session on the morning of Thursday 5 October to acknowledge the omissions of this first draft of the Annual report. Action: Ian Fullerton Smith
2. The election process and its implications; the Italian Cochrane Centre and charitable status
David Sackett outlined the present situation regarding membership of The Cochrane Collaboration. At this time there are only ten members of the Collaboration. They are the members of the Steering Group who signed the Memorandum and Articles of Association. A discussion followed which explored the relationship between membership of the Collaboration, the right of the Collaboration to charge a subscription fee and the desire for the Collaboration to move towards self sufficiency. Classes of membership where then discussed fully. There was debate about whether membership should be extended to every individual involved in the Collaboration. This was thought to be unworkable as the Memorandum and Articles of Association require that each application for membership be vetted by the Steering Group. This was judged to be too large a task to be carried out in the time available to the Steering Group. A decision was made to extend membership to the registered entities of the Collaboration namely, the Review Groups, the Fields, the Methods Groups and the Centres.
The discussion then turned to the issue of subscriptions. This aspect was fully discussed encompassing not only Collaboration membership, but the possible inclusion o corporate membership, refired membership and other classes. The Steering Group decided that this body of persons singular and bodies corporate should be known as subscribers. The Steering Group proposed that the decision to levy a subscription will be announced at the plenary session on the morning of the 5 October 1995. Action: Ian Fullerton Smith
3. The role of the Cochrane Collaboration Chair and the composition of the Steering Group
The Steering Group reviewed a discussion paper prepared by Ian Fullerton Smith that laid out a possible composition of a new Steering Group. A debate followed where the merits of having a Centre Administrator's representative on the Steering Group was discussed. From this discussion it was decided that this post was not necessary, due to the fact that Centre Administrators in different Centres do not perform the same functions. It was agreed that there should be a representative from a Cochrane who was not a director or co-director. The merits of having a representative of Administrators from the Cochrane Review Groups had been discussed previously and it was decided that this should be implemented. Proposals were made that the Editor of the Handbook and the Director of the Baltimore Cochrane Center were to be permanent members of the Steering Group. This proposal was turned down. The final composition of the Steering Group was decided as follows.
1 . 4 Centre representatives, one of whom should not be a director 2. 4 Collaborative Review Group representatives, one of whom should be an Administrator 3. 2 consumer representatives 4. 1 Field representative 5. 1 Methods Group representative 6. 1 policy maker representative
There being no entry for policy makers at present this position is temporarily unelectable.
The Role of the Chair
David Sackett outlined his present functions as Chair of The Cochrane Collaboration. He stated his time was spent dealing with conflict resolution, promotion of the Collaboration, and fulfilling the figure head role. The Executive Group discussed whether the new Chair of the Collaboration should be a figure head or a working chair. The group decided that in future the chair would be elected from the members of the Steering Group and to ensure continuity, the tenure of the Chair would be restricted to two years, and further, that no one person could serve more than two consecutive terms as Chair.
To assist the Chair and to maintain continuity and consistency throughout the Collaboration it was then decided that an executive group should be formed to work within the Steering Group itself. The Steering Group will comprise the Chair, the Executive Officer and three member of the new Steering Group, those persons appointed to the new executive group will be nominated by the new Steering Group in February 1996.
4. Royalties
David Sackett outlined the present situation regarding royalties paid to the Collaboration from the sales of CDSR. The Collaboration receives the equivalent of 2.2% of the total selling price, not 10% as is often quoted. A debate followed, regarding the merits of the Collaboration taking a royalty from the sale of their products. The conclusion was that it was in the best interests of the Collaboration to take such a royalty from this existing contract and from any future contracts. It was agreed that the disbursement of these funds should be transparent to the Collaboration as a whole. The Steering Group decided that a sub-committee should be formed to examine the question of royalties, cost recovery and other financial matters relating to the sale of their products or information. This group is to consist of Carl Counsell, Hilda Bastian and [an Fullerton Smith. Action: Carl Counsell, Hilda Bastian, Ian Fullerton Smith
5. Internet, SYNAPSE and HIRU
Brian Haynes invited the Steering Group to review the work of the Informatics Group that was currently on display at the Colloquium. He praised the work of Rob Hayward and the staff at McMaster University and asked, that this work be protected from commercial pressures that may be exerted when an Internet contract is negotiated.
Brian Haynes explained that the Executive Officer had asked him to provide a specification to form the basis of an Internet contract this was required in case the Collaboration sought multiple tenders to provide an Internet service. Ian Fullerton Smith reported that he had approaches from the BMJ to provide Internet services to the Collaboration, as well as an approach from Synapse Publishing Incorporated. The merit of these two companies were then discussed. Fears were raised about the BMJ gaining a monopoly position on the Cochrane Collaboration information. No conclusion was reached on this item and it was decided to carry the matter forward to the meeting on Monday 9 October 1995.
6. BMJ contract
Chris Silagy raised concern that the price of CDSR was greater in Australia than in the UK. A discussion followed to explore the reasons why this price differential existed. It was noted that Richard Smith, the Editor of the BMJ, was concerned about the differential pricing systems that exist around the world and that he had commissioned a survey about what the BMJ policy and strategy was, and what it should be in future.
The Steering Group then discussed the provision of free copies for Reviewers under the terms and conditions of the BMJ contract. Opinion was divided as to who should receive these complimentary copies. David Sackett pointed out to the Steering Group that there were no free copies. The Collaboration paid for these to be produced and distributed by Update Software. It was proposed that Alessandro Liberati and Ian Fullerton Smith prepare a discussion paper of the meeting to be convened on Monday 9 October. This paper is to explore the various options open to the Steering Group regarding the provision of complimentary copies of CDSR to Reviewers. Action: Alessandro Liberati, Ian Fullerton Smith
7. Confidentiality of Steering Group meetings and communications
Kay Dickersin raised a concern that matters discussed at the Steering Group were not being treated as confidential. There had been instances where e-mail that was intended to be confidential had been forwarded to third parties causing discomfort to certain individuals. The discussion widened to cover the use of the CCSG mail list and it was revealed that not everyone presently on the list was a member of the Steering Group. A decision was made that the CCSG list should be restricted to Steering Group members. lain Chalmers was concerned that vital information could be constrained by using this system. He sought clarification of how one should decide whether a piece of information could be forwarded to a third party outside of the Steering Group. After further discussion the Steering Group decided that application to register with the Collaboration and the ,feedback to applications should remain confidential at all times. Other items of information could be released, but only to specific individuals or groups. This information is not to be broadcast on any mail list. Brian Haynes was asked to review the CCSG list and remove any individuals who were not presently serving on the Steering Group. Action: Brian Haynes
8. Registering the Cochrane name and logo
The Executive Officer raised concerns that the Collaboration had no protection for its name or logo in any country in the world. Whilst this was not a problem at present, he asked the Steering Group for permission to explore the costs and legal requirements of registering the Collaboration's name and logo. He explained the 'Madrid protocol's mechanism which allows registration in thirty countries for one fee, whereas, the registration of names and logos usually involves an individual fee in an individual country. The Steering Group asked the Executive Officer to explore this matter and report back. Action: Ian Fullerton Smith
9. Cochrane operating strategies in North America
This item was deferred to the meeting on Monday 9 October.
V. PROCEDURAL MATTERS
At this point an invitation extended to all the Centre Directors of the Collaboration to join in the meeting.
Those joining the meeting: Jos Kleijnen, Cindy Mulrow, Gil Ramirez
10. Registration of Methods Groups
Chris Silagy sought clarification of the process that Methods Groups have to go through before they become registered. He enquired whether or not in future all Methods Groups would be reviewed by the Steering Group, as had recently happened with the Coding and Classification Group. Andy Oxman, the Methods Group representative, confirmed that this would be the procedure for the future. He explained that registration in the past had been carried out in a different format normally by himself and David Sackett. Hilda Bastian enquired about the specific criteria a Methods Group needed to meet Does the Collaboration need all the Methods Groups that presently exist or indeed does it need any future Methods Groups? Andy Oxman replied that the criteria for Methods Groups was laid out in the Handbook in Section I and that, in future, all Methods Groups would be subject to the same application process as any other Cochrane Entity this being informal and then formal exploratory meetings, followed by an application to register.
11. Ethical guidelines with relation to the involvement of the pharmaceutical industry, etc
Chris Silagy introduced this items and raised the matter of whether the Collaboration should develop its own ethical guidelines, not only in relation to the pharmaceutical industry but to other sources of funding. Andy Oxman supported the creation of a set of guidelines for the Collaboration. A broad ranging discussion followed to try to define those areas where the Collaboration was in need of guidance. It was proposed that Chris Silagy take this forward and produce a report. Action: Chris Silagy
12. Methods to ensure Methods Groups respond to Cochrane Review Groups needs
This item to be carried forward to the meeting of 9 October.
13. Consumer Network and Consumer Participation
The Steering Group reviewed the application from the Consumer Network submitted by Hilda Bastian. At this point Hilda Bastian left the meeting at 1 1.00 am). Chris Silagy explained that the Network had financial support and commitment for the next three years from the Australasian Cochrane Centre. The Steering Group reviewed the application and decided unanimously that the Consumer Network could be registered with the Collaboration. A discussion followed about the use of the term "network", it had been Hilda Bastian's understanding that the" term" network was to be applied to Consumer Network only and she was concerned that the use of the term " network" was being used elsewhere within the Collaboration. A further discussion followed where it was decided that the term "network" should be removed from the other entities of the Collaboration and that in future they should be called "fields". lain Chalmers asked if someone could define what a network is and why the term should be restricted to consumers contributing to the Collaboration. The Steering Group requested that Hilda Bastian should justify why consumers are called a "network". Chris Silagy was asked to convey the message to Hilda Bastian.
Chris Silagy stated that the term Network had suddenly been introduced with introduction of the Cardiovascular Network and the Cancer Network. He thought the term was being used confusingly. Dave Sackett asked for suggestions how wee should go forward with this. After a full discussion it was decided that in future the term Network would be reserved for the Consumer Network and the all other networks were to be re-classified as fields.
Action: Hilda Bastian
14. Review of Procedures Applications to Register, Timing, Communication and Contact Directory.
Chris Silagy introduced a paper prepared by Philippa Middleton that discussed the difficulties; and shortcomings of operating the present Contact Directory. An analysis of five hundred individuals had shown they had between them four thousand main interests. To confuse matters further at least half of these individuals were already involved in existing groups and thus should not be on the Contact Directory. It was further stated that many centres used the present Contact Directory for different purposes and provided different levels of information. Some centres do not forward the names of individuals who wish to be registered on the list. At present there is no way of linking an individual to an existing group, and therefore no way of tracking an individual whose speciality or interests change, Chris Silagy suggested that the way to manage this system was to create a single unified database that provided information about each individual's interests, review group or Methods Group, names, address etc. The Executive Officer fully supported this and saw this as a very positive way forward for handling communications within the Collaboration. Hilda Bastian also saw the potential for increasing the circulation and accuracy of distribution of Cochrane News. Bryan Haynes stated that in his opinion a singledatabasewasthebestsolutiontotheCollaborations'communicationneeds. lain Chalmers suggested that the Contact Directory should remain as a temporary directory but there needed to be a link between temporary directory and names and contact details for contributors to the registered entities. The Executive Officer stated that he could not inform the meeting of who was actually involved in The Cochrane Collaboration as no comprehensive list exists. Chris Silagy and Ian Fullerton Smith were asked to prepare a discussion document for the meeting of Monday 9 October. Action: Chris Silagy, Ian Fullerton Smith
The next discussion concerned the registration and application process for new entities of the Collaboration. The Steering Group was concerned that at present only one field was registered, although another was going through the application process at this moment. A discussion followed to explore why Fields, in particular, have not registered with the Collaboration. Some members of the Steering Committee were also concerned that non- registered groups were using the Cochrane logo implying there were registered. It was decided that non-registered groups should not use the Cochrane name and logo until registration had been approved. Andy Oxman proposed that Chris Silagy and Ian Fullerton Smith prepare a discussion paper that would identify the way forward to control both the use of the Cochrane logo and encourage fields to register with the Collaboration. Ian Fullerton Smith to write to non-registered groups to inform them that the rights to the Cochrane logo would be withdrawn.
Action: Chris Silagy, Ian Fullerton Smith
15. Editorial Process for Material Distributed on Behalf of The Cochrane Collaboration
lain Chalmers was concerned that a recent journal article had stated there were 67 pages of cyberjunk on The Cochrane Collaboration's pages on the Internet. He urged the Steering Group to consider the setting up of an editorial board to review all materials, print or electronic, distributed in the name of the Collaboration. A discussion followed and the members of the Steering group considered which aspects of The Cochrane Collaboration's publications should be edited. Specific items included the Handbook, any materials put onto the Internet, Cochrane Collaboration Brochures and information leaflets. Dave Sackett called for volunteers to form the editorial sub-committee. The members of the committee are as follows: lain Chalmers, Kay Dickersin, Peter Gøtzsche, Alessandro Liberati and Hilda Bastian. Action:
16. Notifications of Intent, Preparatory and Exploratory Meetings This item was carried forward to the meeting of Monday 9 October.
17. Cochrane Review Group Operating Guidelines
Peter Gøtzsche stated that vie need firm guidelines, and this was support by lain Chalmers and Andy Oxman. Dave Sackett called for a strategy to take this issue forward. It was agreed that Carl Counsell would prepare a paper for the meeting of Monday 9 October. Action: Carl Counsell
18. The Collaboration Handbook
Andy Oxman gave an overview of the content of this year's edition of the Handbook. Most sections had been revised and re-printed successfully. Section VI remained an outstanding item although it was hoped that this would be completed in the near future. Some improvements to the layout and content of the Handbook were suggested.
Suggested modifications to the format for a Cochrane Review were as follows: a) abstracts should become obligatory b) types of studies should be listed as sub-headings? c) there should be change from 'trials' to 'studies' d) ongoing studies should have structured information? There was a discussion that highlighted the problem of the registration of titles in RevMan that never turned up as reviews. This was described as defensive registration. lain Chalmers suggested that there should be an objective method to remove the problem of vague statements. Peter Gøtzsche suggested that there should be a three month deadline between the registration of a title and the development of a Protocol. It was proposed that Alessandro Liberati will draft guidelines to assist review authors in accurately defining the title and timeline of any new title registered in RevMan. Action: Alessandro Liberati
19. Strategic Planning Forum
This item is carried forward to the meeting Monday 9 October.
20. Supply of Free Copies of CDSR to all Reviewers who have Contributed to a Review
Alessandro Liberati and Ian Fullerton Smith have been tasked to produce a discussion paper on this subject on Monday 9th October. Action: Alessandro Liberati and Ian Fullerton Smith
VI. OPERATIONAL MATTERS
21. How Do we Secure that More Groups have a Non-UK Leadership
This item is carried forward to the meeting Monday 9th October.
22. Special Tasks of Cochrane Centre
This item is carried forward to the meeting Monday 9th October.
23. Evaluation of Colloquia, Distribution of Monies
This item is carried forward to the meeting Monday 9th October.
24. Use of the Term Network
It was agreed that centres, countries and regions can still have 'networks' (eg Canadian Cochrane Network, Nordic Cochrane Network).
25. Specialised Databases
This matter was deferred.
26. Training for Editors
This matter was deferred.
27. Baltimore Cochrane Center and trials Register
This matter to be carried forward to the meeting 9th October,
28. Training of Reviewers
This matter was deferred.
29. Handsearching of General Journals
This item was deferred to the meeting Monday 9th October.
VII. EXCEPTIONAL ITEMS
30. Tom Chalmers Prize
lain Chalmers enquired whether the prize was being awarded for best abstract or best oral presentation of poster, on what criteria the judgements were being made. Kay Dickersin replied that the judgement was made upon the abstract submitted. Brian Haynes suggested that the judges should be informed that there were 55 separate posters on display at the Colloquium. Peter Gøtzsche enquired whether there would be any reward for the winners of the Tom Chalmers prize, Dave Sackett stated he was opposed to the awarding of a cash prize. It was agreed that this matter required further discussion. Chris Silagy and Cynthia Mulrow were asked to prepare a paper to discuss this aspect. Action: Chris Silagy, Cynthia Mulrow
31. Archie Cochrane Trust
lain Chalmers noted that the first Colloquium had recommended that an "Archie Cochrane Trust' should be established. The Steering Group agreed that a separate fund should be operated from within the Collaboration's bank account and that a committee could be formed to oversee the disbursement of funds in this account. As agreed at the first Colloquium, a committee should be formed of members who are not members of the Steering Group. Action: Ian Fullerton Smith
VIII. ANY OTHER BUSINESS 32. Application to Register the Consumer Network This item had been previously dealt with under Item 13 of today's agenda.
There being no more time the Meeting closed at 16.20 hours.
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