This Q&A Summary has been compiled from the questions and answers given at the September 2021 Join the Conversation webinar and the Community Engagement Workshop Series. Questions have been compiled into categories, which can be explored below.

Global challenges framework
Evidence synthesis units
    Structure
    Funding & Open Access
    People & expertise
    Collaboration
    Changes to current ways of working
Central Editorial Service
Role of other Cochrane Groups
NIHR funding

 

Global challenges framework

Why not to keep the clinical granularity of the current Cochrane Review Groups (CRGs) as a way of addressing global challenges and building new partnerships for the future?

Retaining the clinical expertise that Cochrane currently has within the evidence synthesis unit structure is important, however keeping granularity at our current level – 52 individual CRGs – creates significant challenges as we look to streamline our systems and processes. Our current structure does not illustrate how interdisciplinary, collaborative, and nimble we can be. From an external point of view, the siloed approach of creating evidence syntheses via many different and seemingly segregated groups makes Cochrane a complex organization to understand and partner with. In creating a new operating model, we need to think how best to preserve all that is good in Cochrane’s current structures whilst striving to make the organization more outward looking, and to foster new partnerships and funding opportunities. In seeking to achieve this balance, we are mindful of the rich, subject-specific knowledge that CRGs have and want to work with them to ensure that Cochrane’s fundraising strategy does not endanger their local funding arrangements. 

CRGs act as hubs to help Cochrane cover almost all healthcare topics - leading to vast improvements in available evidence and research funding on common but overlooked topics. Loss of these hubs could well mean that previously overlooked topics will go back to being overlooked. How can we (Cochrane) avoid this?

We hope that, with a broad range of funders, we will be able to identify funding for a wide range of healthcare topics.

Will evidence synthesis units be topic-related like current CRGs/Networks? How will this affect the topics that Cochrane covers in terms of health evidence?

The way we prioritise topics within CRGs has been very challenging to explain and share with people outside Cochrane. We hope that a global challenges framework will provide an overarching structure to the units and provide us with a way to respond to global health and care challenges in an agile way. On the surface, some clinical areas may not appear to be in the framework, but some categories are very broad (e.g., comorbidities, chronic diseases, healthy aging) and cover multiple, more granular clinical topic areas. The framework presented in the model is not fixed and we have sought feedback about the key areas that Cochrane should be engaged in – specifically, if any elements are missing or if there are suggestions for a different framework. (See the survey on the Future Cochrane website).

How will interdisciplinary teams consider some of the key challenges currently facing evidence synthesis (focus, relevance, equity) and how will they involve a wide variety of stakeholders in addressing these issues during review development. 

We need both, the ESUs and the wider Cochrane Community Network. The ESUs needs to work collaborative with people from different regions, experience and expertise, e.g., consumers, carers, clinicians, researchers, policy makers and guideline developers.
 

Evidence Synthesis Units

Structure

Will Cochrane evidence synthesis units replace the current Cochrane Review Group (CRG) structure and when will this happen?

The current proposal, which may be altered based on the community engagement process, is for CRGs to be replaced by the larger evidence synthesis units. It is too early to say that, or when, CRGs will be “decommissioned”. The first step is to collate all the feedback from the community engagement period and present the Governing Board with options for a future model of producing Cochrane evidence syntheses. NIHR infrastructure funding for the 21 CRGs based in England will stop in March 2023, but until then, those groups have active contracts. Additionally, several CRGs outside the UK have stable funding and any future model must take this into account. What is clear, is that we do not expect change of this magnitude to happen quickly; there will inevitably be a period of transition. 

Will the evidence synthesis units be geographically or thematically organized?

The model as originally proposed presented the evidence synthesis units as geographically organized, multi-topic and interdisciplinary. Throughout the workshop series, we heard clearly from the community that it is important to retain the skills, expertise, and good will of Cochrane’s existing members, and that the best way to do this is to organize the units thematically. A suggestion made during one of the workshops is that topic-specific groups might exist alongside the evidence synthesis units. These groups, along with Fields and Geographic Groups could support the units in producing evidence syntheses. We must think carefully about how many topic groupings we need and how they may be organised, to form a cohesive, efficient, and effective organisation. The Governing Board has asked for a business proposal that includes various options, so the possibility of a thematic structure is one that will be explored further.

Do you envisage the staff of the synthesis units will be employees of Cochrane centrally or will the units be based in a range of institutions, as is the case currently with CRGs? 

Staff of the units might be employees of Cochrane or of host institutions, particularly as we do not want to lose any funding that we currently have. We will need to be flexible as we develop our fundraising effort, so there may be different models of funding that are implemented in different units. However, accountability from these units must be three-fold: to Cochrane, to the funder, and to the host institution itself. We have seen problems where current relationships between the funder and the group have undermined the accountability to Cochrane, and this causes issues for the way we work together and interact.

Will the process for identifying the host institutions for the new Cochrane evidence synthesis units be via a public tender process? 

The process is likely to depend on the wishes of both the funders and Cochrane. The relationship between Cochrane and the funders must be a close one, in which both parties seek maximum benefit. These units must produce the evidence syntheses that the funders want and need.

What is the likely timeline for the setting up, and recruitment to the new units?

The valuable input we have received and continue to receive from the Community will help to shape a more complete proposal, with options and business cases, for the Governing Board to consider early in 2022. We do not expect change of this magnitude to happen quickly; there will inevitably be a period of transition, where the model of production takes shape, new funding opportunities emerge, and our open access plans solidify. When we reach the stage of implementation planning, the initial steps will include: (a) identifying funders who want to fund such units, (b) agreeing with them the process for establishing the units, and thereafter (c) recruiting staff to the units as required. The needs for recruitment will depend on whether there are sufficient existing staff in the host institution who can be redeployed. As will be evident from this answer, there remains much uncertainty.

What evidence is there that moving to 8-10 evidence synthesis units is going to be more efficient/effective than the current model of CRGs?

Cochrane’s current structure of fifty-two CRGs creates a complex and challenging operating model. Providing consistent support for all CRGs is difficult, the lines of accountability are blurred, and the way we work is not easy to understand from an outside perspective. We cannot say with complete certainty that the proposed model of 8-10 evidence synthesis units will be more efficient/effective than the current model of CRG; however, via conversations with some funders and stakeholders, we know there is support for this model. It is important to acknowledge that the proposed structure alone cannot solve all our current issues; a cultural change and new ways of working must happen in parallel with any structural changes. We welcome alternative ideas about how we can make our production processes more efficient, accountable, and sustainable for the long-term future of Cochrane. Models that that can be sustainable and create efficiencies are also being considered. 

Where will the new evidence synthesis units will be based? 

It is too early to confirm where the units might be based; this depends very much on discussions with funders. It is often the case that funding of this type is available mainly in high-income countries, however we are very mindful that for Cochrane to be valued globally, it must reflect the health and care needs and perspectives of low- and middle-income countries as well. In developing a new production model, we will look for ways to strengthen the role of LMICs in producing Cochrane evidence syntheses. 

How will the new unit structure streamline processes which aren’t just related to inconsistency between groups, but complexity of process? 

It is undoubtedly true that the increasing complexity of Cochrane methods and changes to tools, processes and polices have contributed to the challenges we face as an organization. It is very difficult historically to implement change smoothly in model that is based on 52 individual CRGs, however we are clear that the proposed structural changes must be accompanied by a critical evaluation of our evidence synthesis tools and the way that these integrate with methods, policy, and process. 

What is the advantage of the evidence synthesis unit model compared to the direct submission pathway?

In the proposed model, the evidence synthesis units and the direct submission pathway have been envisaged as complementary. Having the evidence synthesis units provides a way of creating content that ensures stakeholder needs are addressed in a structured and co-ordinated way. The shift toward multi-topic, interdisciplinary units increases Cochrane’s attractiveness to the international global donor market. They also provide hubs to which Cochrane’s existing pool of expert contributors can gravitate. The direct submission pathway allows us to remain flexible and open to high-quality submissions that may not fit neatly within a global challenges framework. The direct pathway also represents a way of ensuring that the CRGs that have secure funding can continue publishing evidence syntheses in the Cochrane Library. 

Funding & Open Access

How will the rolling infrastructure costs of the 8-10 new Cochrane evidence synthesis units be funded? What external funders are being approached to fund these? 

We hope that some current funders of CRGs will be interested in at least partially fund evidence synthesis units within their jurisdiction. A close relationship between Cochrane and the funders will be critical to the success of these units, not least in securing funding in the medium- and long-term. We have also been working on a fundraising strategy that will enable us to diversify our funding streams and support the units and other strategic activities in the coming years. The business case underpinning this model and the evidence synthesis units, including funding, will be brought before the Governing at the beginning of 2022. 

Is the plan to seek funding for Cochrane central AND the ESUs? Or will the ESUs be funded separately?

We do not yet know how funding will be allocated. We are looking at various fundraising models that may be able to provide funding for both the Central Team and the ESUs, however ultimately the model for evidence production that the Governing Board decides upon will include plans for fundraising for both these groups.

How much are funders prepared to pay for Cochrane reviews?

That is uncertain. What we do know is that funders want to pay for the evidence synthesis that fits their local context and needs, and that they want those syntheses to be of high quality and done in a timely fashion.

If we move away from large national funders like the NIHR funding, toward other donors, should we pause the move to Open Access (OA)?

Many funders and stakeholders have pressed Cochrane to adopt an Open Access model and the Governing Board has emphasised the importance of responding to this challenge well before the NIHR announcement was announced. In the global donor market place the OA model also has a great deal of currency, so OA is a challenge the organization must face, regardless of funding diversification. To that end Cochrane has prioritized the creation of a sustainable OA as part of the Cochrane Strategy for Change.

Is Cochrane willing to accept funding from well-funded, reputable charities in return for a relatively high level of visibility on the Cochrane Library/Cochrane.org?

This is an interesting question and brings up how Cochrane could better agree ways of working that are beneficial to both ourselves and donor organisations. We should also be working with such organisations as our end-users and ensuring that we meet their evidence needs.

Various business models that Cochrane has explored have failed in the past. What makes you confident that we will find something that can replace the lost revenue from going open access?

It is true that previous initiatives have not been as successful as we’d have hoped, therefore it is now vital that we learn from the past and make significant and lasting changes that will enable us to respond to global health and care challenges and demonstrate Cochrane’s value to external stakeholders. The major difference in this point in our history is the sense of urgency arising from the many challenges we are facing – insecure funding, open access pressure, and a structure and processes that are no longer fit for purpose. Cochrane’s leadership is working on a fundraising strategy that will support whatever new, sustainable operating model is chosen by the Governing Board.

Is there a risk, with funding bodies having more of a say in the review priorities, that the reviews will be focused on the types of interventions that are cheap enough to be recommended in guidelines?

To remain relevant and make Cochrane a sustainable organization for the future, we must diversify our sources of funding. It is not clear at this stage that this imperative will lead to a conflict between the needs of funders and the needs of clinicians. Nevertheless, we are mindful of the possibility, which it is why we are focused on ensuring that we retain Cochrane’s clinical expertise, and that the clinician “voice” is integrated into the evidence synthesis unit structure.

What about the Cochrane groups that have stable funding?

In any new model it is important not to jeopardize the stable funding that some groups have. One possible approach might be for groups with stable funding to become affiliated research groups working with Cochrane as the evidence synthesis units are set up. They could continue to produce systematic reviews and send them directly to the Central Editorial Service for processing and publication.

How do we ensure that Cochrane groups don’t compete for funding? 

For any new production model to be efficient and sustainable it must be coordinated and collaborative. It possible to imagine situations where the units may be eligible to bid for the same the funds, indeed there may be cases in which competition is healthy, helping to drive excellence. However, as an organization we must guard against putting too much energy into internal competition. Cochrane’s fundraising strategy, as it matures over time, will hopefully give the groups producing reviews the financial stability they need to avoid excessive competition. Cochrane’s central team will likely have an important role to play, not only in leading fundraising activities to identify infrastructure funding, but also to manage and coordinate programme grant funding in a way that supports the groups but maximizes organizational efficiency.

Do we know if NIHR would help to fund Cochrane evidence synthesis units? Do you anticipate that the evidence synthesis units will apply for funding through the forthcoming NIHR call?

It is important to understand that there are two distinct types of evidence synthesis units. The “Cochrane evidence synthesis units” which have been mentioned in several earlier answers, and the proposed “NIHR evidence synthesis units” that NIHR have signalled it is planning to fund in the UK. It is our clear understanding that these will be funded primarily to undertake commissioned non-Cochrane evidence syntheses. We would like to see NIHR encourage these units to submit the evidence syntheses they produce for publication in the Cochrane Library. However, we know that NIHR will want these syntheses to be published Open Access. We also realize that these evidence syntheses will not necessarily be (and are unlikely to be) classic Cochrane-style reviews. It is important for Cochrane to broaden and expand the types of the evidence syntheses published in the Cochrane Library, and this may therefore be a route to do so. We are in regular dialogue with the NIHR, and we hope that their upcoming call for proposals related to the NIHR evidence synthesis units may reflect some of this thinking. 

Finally, NIHR is not our only funder. We are working on a plan for fundraising for not only the Central Executive Team, but across the Cochrane Community. We will be in conversation with our funders around the world regarding this model.

Is our commitment to ‘open access’ is a done deal, and if so, why?

Our commitment to Open Access is longstanding, and Cochrane has committed to be fully open access by 2025. Undoubtedly, there are challenges to going Open Access, but we have learned the importance of making the evidence that we generate accessible to all over the past 2 years with our response to the COVID-19 pandemic. The open science movement is rapidly gaining momentum and if we don’t make all our content Open Access in a reasonable timeframe, we may experience reputational risk. Making the change is a complex proposition and there are various paths that Cochrane could take, all of which come with risks. We must balance our commitment to Open Access and the speed of transition, with our sustainability as an organization. The Governing Board is very focused on this issue and we have been looking at how other organisations are managing the transition. We will share plans with the community as soon as decisions are made.

People & expertise

Do you know yet how many MEs, ISs, etc will make up each Cochrane evidence synthesis unit? What would the ME role be for the ME you mentioned would be in the units?

It is too early to answer this question, as the final model has not yet been decided by the Governing Board. We have heard some of the community’s views on how the current CRG roles could be adapted to new ways of working in the future via the workshops and survey, and we welcome your feedback until November 5.

How much influence will the CET have over the composition of evidence synthesis units, if some of them are funded through an open NIHR process to which various institutions will be bidding?

The Evidence Synthesis Units (ESUs) proposal recommends that each unit is composed by diverse author teams with sufficient knowledge and expertise to guarantee high-quality, timely delivery and that they are supported by a skilled and experienced core team. The ESUs would be multi-topic and interdisciplinary and there will be scope for sharing content and methods expertise between units. It is important that all ESUs use consistent standards and processes wherever they are based. The units will need to follow the strategic direction of the organization, have a governance structure with clear lines of accountability for meeting key performance indicators. In terms of how much influence the CET will have over who will be appointed to the ESU’s that would probably have to be devolved. To preserve Cochrane’s gold standard for evidence synthesis a clearer distinction between authorship and editorial review must be established as well as a good process for quality assurance. In the new model we envisage the editorial process for all evidence syntheses to be managed centrally to ensure that all reviews follow the same independent editorial process and adhere to quality standards. 

How will volunteer review authors be integrated into the Cochrane evidence synthesis units? 

This new model of Cochrane evidence synthesis units is built around professional and experienced reviewers doing the high-quality Cochrane reviews and other evidence syntheses that funders require in a timely fashion. Teams of review authors working anywhere in the world will be able to undertake Cochrane reviews and submit them directly to the Central Editorial Service. If they are of high-quality, on important topics, they will be published in the Cochrane Library.

Is there a proposal to move to accepting other types of reviews, and has consideration been given as to how to develop / ensure methodological quality across a wide range of different types of reviews?

To meet the needs of our stakeholders, we may need to address different types of questions in the future. Cochrane has a history of methodological innovation, but we will need to develop expertise in other methodologies to retain our relevance. In Cochrane’s response to the COVID-19 pandemic, we had to tackle questions that relied on study designs that we have not traditionally worked with. In responding to COVID and in the future, we will look to our own community of methods experts, bearing in mind that there will inevitably be a period of transition in which Cochrane builds on existing expertise to deliver new types of evidence syntheses. We acknowledge the risk of ‘spreading ourselves too thin’ methodologically, but we have confidence in the network of individuals who have shown in the past how willing they are to rise to methodological challenges.

How do we ensure authors who obtain funding to do reviews, publish in the Cochrane Library rather than other journals? 

Detail relating to contractual obligations of authors who receive funding to conduct Cochrane evidence syntheses is something that we would need to consider carefully when we have settled on a new model. One important way that Cochrane can ensure that authors remain committed to publishing with us to ensure a good author experience, based on clear, timely processes and the availability of support when it is needed. 

The evidence synthesis units will take time to get established - during which time, could our reputation for producing high quality reviews substantially diminish?

Whatever the timeframe for establishing the evidence synthesis units, only high-quality Cochrane reviews and related evidence syntheses will be published in the Cochrane Library. We do want to find a way to preserve the clinical and patient expert knowledge and expertise that resides in the members of the different CRGs, as noted in prior answers.

With this model, how are we planning to preserve the clinical, methodological & patient expertise that rests in the current CRGs?

We recognise that our biggest asset is our people and that there is a tremendous amount of expertise – clinical, methodological, patient and carer – within Cochrane. We want to recognize this as we go through this process of change, with the goal of retaining this expertise. We have discussed this with Cochrane members throughout the Community Engagement Workshop Series, and recordings of these workshops are available here. Collaboration is central to Cochrane’s identity, and we hope to continue to work together to ensure we preserve this expertise.

What will Cochrane do to address any racism or biases that are affecting people involved in Cochrane? Are we ensuring that the new Cochrane can be built with mechanisms to hold people accountable when they are discriminatory in all forms?

While Cochrane acknowledges that there are societal issues beyond our control, our role is to help authors have a good, and consistent experience. Identifying which steps of the review process are more susceptible to this type of bias and establishing a mechanism to pre-empt language, or any other bias would help to tackle some of the issues that are affecting people in Cochrane. Cochrane is actively working developing a set of recommendations on how to improve diversity and inclusion for the organization as a whole.

Collaboration

Can the community contribute to the development of the evidence synthesis units? 

The proposal being discussed over the past two months is one proposal only; we are clear that it could either be modified or that there may be alternative proposals. We are very interested in hearing ideas from the community about how the evidence synthesis units might work. We have been soliciting input throughout the workshop series and via a survey on the Future Cochrane website, and we welcome input on this by November 5. 

Changes to current ways of working

What will happen to the Cochrane Review Group Network sites on Editorial Manager?

Editorial Manager and all of Cochrane’s IT will need to be adjusted to reflect the changes.

How should NIHR-funded, UK-based CRGs manage new title registration until funding ceases?

It is important that CRGs do not uncritically reject all titles registrations during the transition period. New titles should be evaluated according to the skills and resources available to the author team and the importance of the questions. It is also important to understand that the Central Editorial Service offers a potential pathway to publication even if the CRG does not believe it has the resources to take a title forward.

If a review is a priority topic, and if the author team are highly competent and able to complete both the protocol and review with minimal support from the CRG then CRGs should allow registration of titles in the usual way using the current processes. They should inform authors that:

  • registration of the title will allow access to write their protocol in RevMan;
  • registration of the title does not guarantee publication of a protocol; and
  • they will only receive minimal support from CRGs, and this is “subject to availability”.

They should also make authors aware that if the work of the CRG transfers to the Transition Support Team, the support available will continue to be minimal.

What shall be done regarding ongoing protocols and reviews? Which shall be prioritized? 

The leaders of CRGs will have to consider, with their teams and knowing the resources that have available, what can be accomplished in the relevant timeframe. It is important to remember that it is possible for authors to submit high-quality manuscripts for consideration by the Central Editorial Service. More detailed information about how to manage submissions has been provided to all NIHR-funded, UK-based CRGs by Cochrane UK. 

Is there a commitment from Cochrane that reviews funded/commissioned now will proceed, especially when we are working to a 3–5-year timeline in some of these bids?

If an individual, or a group of individuals, working with their host institution (University, hospital, etc.) are bidding for money to do a suite of Cochrane reviews, there is no reason why that bid cannot continue. Those reviews can always be submitted directly to the Cochrane Library via the Central Editorial Service. If they are of sufficiently high quality, they will be published.

What is the vision for the Cochrane Library considering this new model?

While this has not been decided yet, one vision is that the Cochrane Database of Systematic Reviews might be considered a “premium” library housing commissioned reviews or suites of reviews that are more complex. Alongside that, we will find different ways to publish other types of evidence synthesis that are likely to be shorter and less complex. We must also remember that it is extremely important that we share information, and disseminate information, in ways that people want to consume it. This will need to be done through the geographic groups, which serve their local populations and best understand their needs.

We have an ongoing and unwavering commitment to publish high-quality reviews in the Cochrane Library. We understand that change brings disruption, but any changes to the way we publish reviews (new types, for example) will not happen all at once; they will come after due consideration with the input of our Community and our funders and after a transition period.

In this model, what are the plans for updating reviews in the Cochrane Library?

There are no plans to discontinue the practice of updating, as this element of Cochrane reviews distinguishes us from many other evidence synthesis organizations. However, the proposed model presents an opportunity to re-examine all our editorial and publishing policies and practices so the Editorial and Methods Department is planning to revisit Cochrane’s updating policy.

What if current CRGs are approached directly for collaboration by the WHO or guideline makers and this funding / collaboration extends beyond the 18 months?

If the host institutions of a CRG have agreed to undertake work for the WHO or other guideline producers, and this has been properly costed, we would expect that work to be completed. But we can see difficulties if some of that work was to use – for example – NIHR resource, and those are no longer available.

What role will artificial intelligence play in future review production?

Artificial Intelligence (AI) is already being used to assist review production and there are initiatives in place to improve their effectiveness. It is highly likely that AI will be used more in the future, particularly for identifying relevant studies. Using AI to annotate reviews and facilitate the linkage of ongoing and new studies with protocols and reviews will be a step in the right direction. However, there are some challenges that AI will not be able to solve and the value that we add to the review cannot be replicated by machines. 

Central Editorial Service

How will the new central editorial service be funded?

Currently, this service is funded from the income that Cochrane (the charity) receives from Wiley (our publisher). We are looking at other options, as part of Cochrane’s fundraising strategy.

What criteria are used to an accept/reject decision in the Central Editorial Service?

The Central Editorial Service team uses a basic submission checklist to ensure that the author team adheres to the Conflict of Interest Policy for Cochrane Library Content and Cochrane’s authorship and contributorship policy, and that the submission complies with Cochrane’s plagiarism policy. Submissions not compliant with these policies would be rejected. At the second stage, an assessment by a Central Editorial Service Manging Editor is carried out using the Criteria for submission to Central Editorial Service. A decision is then made on whether to take the submission forward. If the submission appears to meet the criteria, a parallel peer review (methods, search, content/clinical and consumer review) may take place instead of a sequential peer review (methods and search review before content/clinical and consumer review). An outline of the editorial process steps for the Central Editorial Service is available on the Editorial Independence and Efficiency Project website.

Could a review be rejected if it was not considered to address a priority topic?

Reviews submitted via the direct pathway may be rejected based on the perceived priority of the topic. It is important to note, however, that the Central Editorial Service team are aware of the need to consult topic experts who can advise us on whether the review addresses a priority topic or overlaps with other reviews in the area. How inclusive the Central Editorial Service can be will depend, to a great extent, on funding and capacity. The higher the funding level, the more inclusive the service can be; at lower funding levels it may only be possible to take on the highest priority evidence syntheses via the direct pathway. 

Can reviews rejected on quality grounds be resubmitted?

Submissions rejected based on quality would not qualify for revision and resubmission. Authors can appeal the rejection decision and their appeal will be considered according to the Cochrane appeals policy and process. Other reasons for rejection may be that the review overlaps with another Cochrane review already published that is up to date or in the process of being updated. If a review is deemed not ready for peer review on submission, but it is a high priority topic and the issues highlighted can be addressed, a major revision round would be permitted before peer review. 

How are consumer referees identified and supported within the service?

We have worked with the Consumers' Executive and Cochrane’s Consumer Engagement Officer to identify consumer reviewers. For COVID-19 reviews, we would approach the COVID Consumer group. Cochrane Review Groups with strong consumer relationships may recommend consumer peer reviewers for the editorial process. Other methods include using Cochrane TaskExchange and promoting these on social media or asking advocacy groups or specific patient representative groups if they can recommend someone who could be a consumer author. 

How are information specialist peer reviewers identified?

For high-profile, fast track reviews, the Central Editorial Service has an ‘in house’ information specialist who performs peer review using the standard PRESS checklist. For other reviews, Cochrane information specialists working in the topic area of relevance are contacted or a general request to peer review is sent to the information specialist community in Cochrane.

Will information specialist peer reviewers be expected to 'peer review' search strategies not designed by information specialists?

Yes, information specialist peer reviewers will sometimes have to peer review search strategies that were not designed by information specialists, particularly for manuscripts that were submitted via the direct pathway. All manuscripts will be held to the same standard, with no concessions made when the search was not carried out by an information specialist.

What are the time frames for non-priority reviews going through the service?

The Editorial Independence and Efficiency Project started at the end of June 2021, so we only have a very limited number of reviews that have been completed and published, and therefore cannot provide accurate time frames. The aim is for all the steps of editorial process to be completed within twelve weeks, but this may vary depending on the recommendation that we send back to authors following peer review. Reviews requiring only minor revisions are likely to go through faster than those requiring major revisions.

How will discrepancies between conclusions in reviews that partly overlap be addressed in the service?

One way of addressing this would be to do more commentaries on Cochrane Reviews and editorials to describe the differences and similarities between the reviews. Having linked commentaries to Cochrane Reviews, particularly where we have multiple reviews in an area, is something worth pursuing.

What will the “fast-track process” for authors outside units look like?

The direct submission pathway exists already and was used as part of Cochrane’s response to Covid-19. Like any other journal focused on quality, we will expect (and require) a high standard of submissions. For our part, we will aim for speedy turn-round of decisions. Authors whose work is rejected will be able to submit to other journals.

Role of other Cochrane Groups

What will be the role of the Fields?

We are exploring ways in which the clinical and patient expertise within not only CRGs but also Fields can be preserved.  Many Cochrane Fields have longstanding relationships with external stakeholders and so could play a pivotal role in the new approach to prioritization that is being proposed in the model. Indeed, some Fields are already engaged with priority global health and care challenges that have been identified by Cochrane (e.g., healthy ageing, disability, climate change). Fields members may also contribute as authors themselves and/or as contacts points with practitioners in the field.

What will happen to Network Support Fellows and other Network staff?

The Network Support Fellows were funded for a limited term by a grant from NIHR. This is coming to an end.

Would Geographic Groups still exist alongside the evidence synthesis units?

Cochrane is a complex organization, with expertise in the CRGs, but also across our other groups. Our people are our asset; it’s what allows us to differentiate ourselves as an organization and produce and disseminate high quality reviews. Cochrane’s COVID-19 response showed us that Geographic Groups can play an important role in synthesizing evidence, without having to make drastic structural changes. There are several core activities that Geographic Groups should continue, such as training, knowledge translation, capacity building, and stakeholder engagement. Perhaps in time we will want to change the way Geographic Groups are organized, however at this stage the proposed model does not aim to resolve all these issues, it is primarily focused on how we produce evidence syntheses. Nevertheless, we will be considering how collaborative working will happen with ESUs and other Cochrane Groups - we are all part of Cochrane, and we should be working together.

What will the role of regional centres outside UK be, specifically in relation to ESUs? 

As with CRGs outside the UK, we are keen not to disrupt the activities of Cochrane Geographic Groups that have stable funding. We welcome feedback from Cochrane Geographic Groups on how their local knowledge can strengthen the evidence synthesis unit structure. 

NIHR funding

With timelines quite tight to organise transitions, when will a conversation start about whether NIHR funded UK groups should start winding activity down and how our collections and author teams will be managed in a new structure?

Infrastructure funding for the NIHR-funded, UK-based Cochrane Review Groups (CRGs) will cease at the current contract break point at the end of March 2023. Clearly, this decision coincides with the fact that Cochrane is considering changes to its operating model that does not include CRGs as we know them. Whether or not the proposed model is ultimately implemented, it is important that NIHR-funded, UK-based CRGs plan for the transition period between now and March 2023.

Cochrane UK are planning to develop a Transition Support Team to help the UK-based CRGs, the Editor-in-Chief and Cochrane Editorial & Methods Dept through the transition period. The aim of this work will be to ensure a smooth transition to a new model of review production, by providing support to staff of UK-based CRGs in addressing the challenges they face, providing continuity and support to those who contribute to the work of the CRG (editors, peer referees, authors, etc.) helping to maintain the pipeline of review title registration, protocol and review production and publication for priority topics optimizing the use of NIHR resources thereby respecting the very significant contribution NIHR has made to Cochrane activities in the past. 

Whatever changes are agreed, there will be a route to publication in the Cochrane Library for high-quality systematic reviews, via direct submission to the Central Editorial Service. Current authors (whether preparing a protocol, review, or update) will be able to use this submission route, whatever the status of the CRG.

Updated 16 November 2021