The Cochrane Injuries Group Column

Paul Chinnock

Injury is one of the main causes of global mortality and morbidity. The greatest concern is road traffic injury, currently ranked ninth as a cause of mortality but, if trends continue, it will be the third most important killer by 2020. Already, it is the second biggest killer between the ages of five and thirty years. It is vital that we should respond with an evidence-based approach; in other words we must conduct a thorough examination of the evidence to find out which interventions for the prevention and the treatment of injury work, and (just as important) which do not work. ‘Systematic reviews’ of the evidence form the basis of evidence-based medicine and the leading organisation in this field is the Cochrane Collaboration (www.cochrane.org), which is an international network registered as a charity in the UK.

There is much to be done to build the evidence base on injury, so one of the 50 specialist review groups within the Cochrane movement is the Cochrane Injuries Group (CIG), based at the London School of Hygiene & Tropical Medicine. (There is also a separate Cochrane Bone, Joint and Muscle Trauma Group.) CIG has three staff but most of our reviews are written by authors working in hospitals, universities and other institutions in many different countries. Currently, two reviews are being undertaken by authors in India .

Our authors have so far completed reviews of the effectiveness of 62 different injury interventions. These reviews have all been published on the Cochrane Library, which is available on the Internet and on CD-Rom. Internet access is free in many countries, including those developing countries able to use the HINARI system. It is unfortunate that free access to the Library has not yet been arranged in India . However, anyone in any part of the world may read the abstract of any Cochrane review via www.cochrane.org.

So what exactly is a systematic review? In one short column it is not possible to explain what is involved in conducting reviews and how to make use of a review when it has been published. We recommend reading some of the learning materials on the Cochrane website. A good place to start is www.cochrane.org/docs/newcomersguide.htm. And for more information about CIG itself please see www.cochrane-injuries.lshtm.ac.uk. Future issues of this column will also seek to demonstrate how systematic reviews work and why they are so important.

The latest interventions to receive our attention, which are published in the April 2005 issue of the Cochrane Library, demonstrate the range of topics that we cover:

• Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma
• Gangliosides for acute spinal cord injury
• Non-legislative interventions for the promotion of cycle helmet wearing in children
• Red-light cameras for the prevention of road traffic crashes
• The 'WHO safe communities' model for the prevention of injury in whole populations.