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A National License to The Cochrane Library for Canada

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What is The Cochrane Library?

The Cochrane Library is an on-line resource that contains the best available evidence regarding the benefits and harms of health care treatments and health policy decisions; that is: what works.  The Library contains syntheses of research (called systematic reviews) that are considered the ‘gold standard’ of their kind; in fact they have been shown to be a superior quality to non-Cochrane systematic reviews[1]. The reviews bring together the most reliable and recent research evidence, they are completed by members of an independent organization, and their goal is to help people make informed decisions about their health care and help health care providers give the best advice and treatment possible to their patients. Systematic reviews not only address if a treatment is effective, but also identify potential risks, harms or ineffective treatments to help improve the health and health care of Canadians and reduce overall costs.

In addition to over 3000 Cochrane reviews, The Cochrane Library contains reliable information from health research organizations around the world: abstracts of other systematic reviews, health technology assessments, economic evaluations, and individual clinical trials. In total the Library holds over 540,000 records. All of this information supports evidence informed health care decisions.

How much would it cost?

Three provinces and a number of organisations in Canada have already recognised the value of The Cochrane Library and have purchased licenses, despite limited funding available. These licenses provide access to approximately 10% of Canada's population. If Canada were to purchase a National License, the economy of scale is enormous. For slightly more than double the current investment in licenses, we increase access by about 90% - with a cost of about 1.5 cents per person per year! Any Canadian - from the general public to your community health care provider - could access the full Cochrane Library from their home or office through IP address recognition.

Are there any other countries with a national license?

Australia, England, Finland, Ireland, India, New Zealand, Northern Ireland, Norway, Poland, Scotland, Spain, Sweden and Wales all have purchased national subscriptions for their citizens. Efforts are underway in the European Union to establish equitable access throughout their 25 member states. The Cochrane Library is also provided free of charge to people in the world’s poorest countries.  In fact, half the world’s population has free access right now!

Why make it available to all Canadians? 

Without a license to access the full Library, people can only read the abstracts (summaries) of the systematic reviews.  In 2006, about 23,000 Canadians attempted to access the full-text of a review from the Cochrane Library and were denied; there were an estimated 38,000 Canadians denied access to the full-text of a review in 2007.  The country of Denmark funded a national license from late 2004 to early 2007, when the government decided to cease funding.  Access became restricted to hospitals, universities and some professional organisations.  As a result, usage of the library in Denmark dropped by 54.5%!  The number one, most accessed review by Canadians in the Cochrane Library is entitled    St. John’s Wort for depression”.  The message is clear: People, patients, want and use this information.

A national license to The Cochrane Library would mean that all Canadians: patients and their families; health care providers working in hospital and in community settings; researchers; policy- and decision-makers; care-givers and research funding agencies would have access to the full contents of this important and reliable source of evidence about what works in health care treatments. 

We, the undersigned, petition the government of Canada to finance a Canadian subscription to The Cochrane Library to provide free access to this wealth of independently produced health information for all citizens of Canada.

Trois provinces canadiennes et des organisations nationales Canadiennes ont reconnu l'intérêt que comporte un accès à la librairie Cochrane pour l'ensemble de leur population et leurs membres. Ceci, malgré des ressources limitées. L'ensemble des licences individuelles permet à environ 10% de la population d'avoir accès à la librairie Cochrane. Si le Canada achetait une licence nationale, l'économie d'échelle serait énorme. Pour légèrement plus du double de l'investissement actuel des trois provinces canadiennes et d'organisation canadiennes en licences individuelles, nous augmenterions de 90% l'accès à la librairie Cochrane, avec un coût d'environ 1,5 cents par personne par année ! Ceci voudrait dire que tous les Canadiens et Canadiennes (citoyens, citoyennes et tous les acteurs du système de santé) pourraient avoir accès à cette libraire de chez eux ou de leur bureau. Une initiative conjointement menée par le Centre canadien Cochrane et le CMAJ assurera dans les prochains mois la disponibilité de résumés Cochrane en langue française. (http://www.ccnc.cochrane.org/fr/index.html)

An Endorsement by:
Canadian Health Libraries Association
Association des bibliothèques de la santé du Canada

The Cochrane Library is universally recognized as one of the best sources of high-quality, research-based clinical information that exists.  However, at present, there is inequitable access to this resource in our country.  The first line of the Canadian Health Libraries Association/Association des bibliothèques de la santé du Canada (CHLA/ABSC) statement of values reads:  "CHLA/ABSC members believe that informed decisions should be based on the best knowledge available".  To that end, CHLA/ABSC endorses this petition circulated by the Canadian Cochrane Network and Centre to garner support for government-funded national licensing of this essential resource. 

With access to the Cochrane Library, CHLA/ABSC believes that all Canadians - health care professionals, policy members, and the general public alike - will be in a better position to make 'informed decisions based on the best knowledge available.' Such licensing would move Canada one step closer to establishing a National Network of Libraries for Health (NNLH), an endeavour our Association, working through its NNLH Taskforce, has committed much time and many resources.

[1] Moher D, Tetzlaff J, Tricco AC, Sampson M, Altman DG (2007) Epidemiology and reporting characteristics of systematic reviews. PLoS Med 4(3): e78. doi:10.1371/journal.pmed.0040078

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