Where do you get your information from?

With so much information available at our fingertips, where do you go to find the most accurate answers, especially to clinical questions? Our Head of Research, Martin Cordiner, investigates.

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Author: Martin Cordiner, Head of Research
Date: 23 May 2018

The radio broadcaster Steve Lamacq once said, ‘everyone used to be a critic of a band, now everyone wants to be the first to recommend a new band’. Equally, it used to be that portals for the release of information were (relatively) few, and our main task was to have an opinion on it. Now, with endless publication opportunities available, we don’t need an alternative opinion to make us stand out, because it’s possible to go and find some alternative information instead.

This may be fine for a music reference, but where do you go to answer a clinical question, when you need to be as informed and as accurate as possible, and how can you evaluate what you find there?

Enter Cochrane. Archibald Leman Cochrane CBE (1909 – 1988) was a Scottish doctor who is now widely credited with being one of the parents of modern evidence-based medicine, through his advocacy for randomised controlled trials. He inspired the creation of the Cochrane organisation, an international, independent, not-for-profit consortium which provides up-to-date, accurate information about the effects of health care, by gathering and summarising the best evidence from research to help make informed choices about treatment.

Cochrane Reviews are seen as the gold standard for answering questions about health care interventions because they identify, appraise and synthesise all the empirical evidence that meets pre-specified eligibility criteria on the question, and use explicit methods aimed at identifying and minimising bias. In doing so, Cochrane reviews take care of two key considerations in thinking about where to find your information: who should I trust, and, what might I have missed?

The College has funded two new updates of Cochrane reviews relevant to optometry (Vision screening for correctable visual acuity deficits in school-age children and adolescents, and Reading aids for adults with low vision). They were undertaken by Cochrane Eyes and Vision (one of over 50 editorial groups), by international and multidisciplinary teams featuring College members, and you can see a quick summary of each of the reviews in our press release.

Cochrane Reviews are seen as the gold standard for answering questions about health care interventions...

Sometimes, the clinical implications of such reviews are not clear-cut. At times there is no evidence comparing one intervention with another, as was the case with screening versus no screening (an evidence gap). Or, based on an evaluation of the quality of the evidence using the methodology outlined at the start of the review, there is found to be a lot of low-to-medium certainty evidence (the case in both reviews). Or the research might not be generalisable to different populations, or countries, a consideration for an intervention like vision screening.

So while you can’t tell a patient about a solution that doesn’t exist, or claim certainty when there is none, you can know that what you’re telling a patient is correct, even if what you’re saying is, ‘I’m sorry it’s not yet clear’.

With Cochrane, you can know that the answer you have found is trustworthy, because the information involved has already been evaluated on the grounds that all the available and relevant information has been included in the one place and in the overall decision. Researchers can also see the most clearly defined and pressing areas for further research, based on the evidence gaps identified, and have faith in them for the same reasons. 

Although the conclusions have not led us to change the College’s Guidance for Professional Practice (due to evidence gaps, the level of certainty and the difficulty in generalising from the available evidence), they are the latest, and best, update in these areas. And as Steve Lamacq alluded to, it has never been so cool to be up-to-date.

Martin Cordiner
Head of Research, College of Optometrists

Martin graduated with a Masters in Modern History from York University in 2005, having completed his BA there in 2003. Since then he has worked in project management in higher education before joining the College and its fledgling research department in 2009, where he now supports the Director of Research and manages the research team to implement all elements of the College’s Research Strategy. 

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