Every Cochrane Review reflects both a substantial commitment of time and expertise on the part of the review author team and all the editors, information specialists and peer reviewers based at the relevant Cochrane Review Group. The work undertaken and the rigour of the process are both focused on ensuring that the best quality evidence from research may inform decision makers. Therefore we are always on the lookout for metrics that indicate usage of our reviews.

In this message we review the success stories in terms of access for reviews published in 2014. Access is only one marker for use, but it is nonetheless an important guide. The reviews listed below represent a diverse range of topics, and many that I would challenge anyone to have predicted. We also present some of the reviews most frequently commented on by people using social media, and content presented as podcasts, journals clubs and our derivative products: Cochrane Clinical Answers and Dr Cochrane.

We know from feedback that usage and impact are important incentives for both review authors and Cochrane Review Groups. These data provide one part of a larger jigsaw, and I hope that you will find the lists interesting and stimulating.

David Tovey, Editor in Chief
The Cochrane Library

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Top-downloaded new Cochrane Reviews
This list represents the most frequently downloaded new reviews published in the Cochrane Database of Systematic Reviews in 2014.

1. Repositioning for pressure ulcer prevention in adults
2. Long-acting inhaled therapy (beta-agonists, anticholinergics and steroids) for COPD: a network meta-analysis
3. The WHO Health Promoting School framework for improving the health and well-being of students and their academic achievement
4. Inhaled steroids and risk of pneumonia for chronic obstructive pulmonary disease
5. Effectiveness of different nursing handover styles for ensuring continuity of information in hospitalised patients

Most-downloaded updated Cochrane Reviews
The Cochrane Reviews below represent the five most frequently downloaded updates of 2014.

1. Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children
2. Risk assessment tools for the prevention of pressure ulcers
3. Decision aids for people facing health treatment or screening decisions
4. Vaccines for preventing influenza in healthy adults
5. Antidepressants for smoking cessation

2014’s most-shared Cochrane Reviews
According to Altmetric data, the following 2014 Cochrane Reviews were the most often mentioned across newspaper stories, tweets, blog posts, and more. Click here for more information on how Altmetric scores are calculated.

1. Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children
2. Inhaled corticosteroids in children with persistent asthma: effects on growth
3. Vaccines for preventing influenza in healthy adults
4. Pharmacological interventions for sleepiness and sleep disturbances caused by shift work
5. Echinacea for preventing and treating the common cold

Most popular Cochrane Podcasts of 2014
A number of podcasts were produced in 2014 to better disseminate Cochrane evidence. These were the most popular podcasts of the year:

1. Intravenous magnesium sulfate for treating adults with acute asthma in the emergency department
2. Echinacea for preventing and treating the common cold
3. Hip protectors for preventing hip fractures in older people
4. Healthcare outcomes assessed with observational study designs compared with those assessed in randomised trials
5. Pharmacological interventions for sleepiness and sleep disturbances caused by shift work

2014’s most-accessed Cochrane Journal Clubs
Cochrane Journal Club offers an introduction to a recent Cochrane review together with relevant background information, a podcast explaining the key points of the review, discussion questions to help you to explore the review methods and findings, and downloadable PowerPoint slides containing key figures and tables. The following are the most-accessed Journal Club entries of 2014:

1. Pharmacological interventions for sleepiness and sleep disturbances caused by shift work
2. Exercise programs for people with dementia
3. Assisted reproductive technology: an overview of Cochrane Reviews
4. Thrombolysis for acute deep vein thrombosis
5. Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis

Top-viewed Cochrane Clinical Answers
In 2014, the following were the five most-viewed topics on Cochrane Clinical Answers.

1. What are the benefits and harms of calcium antagonists in people with acute ischemic stroke?
2. How does advanced trauma life support training for ambulance crews affect patient outcomes?
3. What are the benefits and harms of antibiotics in children with bronchiolitis?
4. In women with fibroids, is there randomized controlled trial evidence to support the use of interventions to reduce hemorrhage during myomectomy?
5. How do acellular vaccines compare with whole-cell pertussis vaccines for preventing whooping cough in children?

Most-accessed Dr. Cochrane modules
Cochrane Learning is a new health professional development resource built upon the independent, high-quality evidence found in the Cochrane Library. The top five most-accessed Dr. Cochrane modules on the Cochrane Learning platform in 2014 were as follows: 

1. Antibiotics for Stomach Pains
2. Exercise as a Treatment for Knee Osteoarthritis
3. Prevention of Osteoporotic Fractures – Risedronate
4. Prevention of Osteoporotic Fractures – Alendronate
5. Physical Examination for Lumbar Radiculopathy due to Disc Herniation in Patients with Low-back Pain

Most popular Cochrane Reviews in the Cochrane Library iPad edition
The Cochrane Library iPad Edition is a monthly publication presenting the latest up-to-date evidence from the Cochrane Library in an iPad-optimized format. The most-accessed reviews in the iPad app for 2014 were as follows:

1. Treatment for primary postpartum haemorrhage
2. Long-acting inhaled therapy (beta-agonists, anticholinergics and steroids) for COPD: a network meta-analysis
3. Exercise programs for people with dementia
4. Decision aids for people facing health treatment or screening decisions
5. Trastuzumab-containing regimens for metastatic breast cancer