Minutes of the Cochrane Collaboration Steering Group meeting,
São Paulo, Brazil,

22 and 25 October 2007


[These minutes were approved by the Executive on 20 November 2007.]



Item no.

Academic versus practical evidence-based health care


Annual General Meetings, agenda for


Cash flow forecast


CENTRAL interim measures and moving forward

10; 21.1.2

Centre issues

21.2; 25

Chief Executive Officer’s report


Clinical trials, Principles for protecting integrity in the conduct and reporting of


Co-Chairs’ report


Cochrane Opportunities Fund


Cochrane Prioritisation Fund


Cochrane Review Group (CRG) issues


Cochrane reviews, changes to the Feedback system for


Collaboration review in 2008


Colloquia, the next three

4.3; 28.1; 28.2

Colloquium 2009 in Singapore


Declarations of interest

2; 25

Developing Countries Network


Diagnostic test accuracy reviews, register progress report; publication arrangements  

5.2; 33

Discretionary Fund expenditure


Editorial board, development and establishment of an

6; 21.1.1; 21.3.1

Entities, deregistering Cochrane (MRG report)


Entities, establishing new Cochrane (MRG report)


Entities, flagging up problems within (MRG report)


Environmental sustainability


Evidence-based health care, academic versus practical


Feedback system, changes to the


Field/Network issues


Financial position and cash flow forecast


Five-year review of the Steering Group


Guidelines International Network (G.I.N.), invitation to join advisory board of


Handbook for Systematic Reviews of Interventions


IMS and workflow


IMS, status report on the development of the


Industry funding of trials, regular reporting of


Information Management System (IMS) , status report on the development of the


Key performance data


Methods Group issues


Monitoring and Registration Group (MRG) report


Ombudsmen, report from the


Opportunities Fund


Plain language summaries


Principles for protecting integrity in the conduct and reporting of clinical trials


Prioritisation Fund


Profit and Loss statements and cash flow forecast


Project Support Officer


Problems within entities, flagging up (MRG report)


Publication arrangements for Cochrane protocols & reviews of diagnostic test accuracy

5.2; 33

Publishing Cochrane products (Wiley-Blackwell report)


Publishing contract, extension of


Register of diagnostic test accuracy studies - progress report


Report and Financial Statements


Review of the Collaboration in 2008


Review of the Steering Group, five-year, in 2006  


RevMan 5 rollout and implementation strategy


RevMan 5 training


São Paulo Colloquium 2007

3; 37

Secretariat staff issues


Singapore Colloquium 2009


Special session in Vellore, discussion topic(s) for


Spreadsheet of outstanding action items


STD Group


Steering Group review in 2006


Steering Group meetings, the next three


Steering Group members’ declarations of interest


Strategic Plan - Management Plan


Succession planning

4.4; 18; 21.1.3

Trading Company Directors’ report


Training in RevMan 5 and other Collaboration training needs

7.1; 7.2

Treasurer’s report


Vellore, discussion topic(s) for special session [April 2008]


Wiley-Blackwell report (publishing Cochrane products)



 Minutes of the Cochrane Collaboration Steering Group meeting,
São Paulo, Brazil,

22 and 25 October 2007


[These minutes were approved by the Executive on 20 November 2007.]


Present: Steering Group members Godwin Aja, Lorne Becker (Co-Chair), Lisa Bero, Jonathan Craig, Jon Deeks, Zbys Fedorowicz, Ruth Foxlee, Donna Gillies (Treasurer), Adrian Grant (Co-Chair), Sally Green, Joy Oliver, Rob Scholten, Peter Tugwell, Janet Wale, Liz Waters, Liz Whamond, Katrina Williams, Narelle Willis and Hans van der Wouden.

Also present: Nick Royle (CEO), Jini Hetherington (Company Secretary and Administrator, minutes), and Claire Allen (Deputy Administrator); Monica Kjeldstrøm (Information Management System Director and Trading Company Director); Deborah Dixon and Deborah Pentesco-Gilbert of Wiley-Blackwell (present for items 6, 12 and the first part of item 13 only). 

1.       Welcomes, apologies for absence, and approval of the agenda
Adrian welcomed everyone to the meeting; apologies had been received from Katrina Williams for the first of the two Steering Group meetings. Lorne and Godwin arrived late to the first meeting due to travel difficulties. The agenda was approved, with the addition of two items of other business.

2.       Steering Group members’ declarations of interest
There were no further declarations of interest in addition to those that had been circulated with the agenda.

3.       Introduction from the Co-Chairs
Adrian described some of the highlights of the past six months, particularly the Prioritisation and Opportunities Funds, and the Co-ordinating Editors’ initiative to develop an editorial board (see also item 6). He said that several people outside Brazil had been involved in helping to organise this year’s Colloquium, especially Karla Soares-Weiser; others included Claire Allen, Jini Hetherington, Julian Higgins, Sally Hopewell, Philippa Middleton, Andy Oxman and Caroline Rouse. In addition, the joint employment of Melissa Mann by the Collaboration and BIREME in São Paulo for the last three months had been a good investment. A large Brazilian contingent had registered within the past two weeks, accounting for about half of the 850 expected Colloquium participants. Other important activities in the past six months had been the negotiations to extend the publishing contract with Wiley-Blackwell (see also item 13), and the approaching early impact factor for Cochrane reviews.

4.       Chief Executive Officer’s report:

4.1              The Collaboration Secretariat:
Nick thanked Adrian also for his input to the organisation of this year’s Colloquium. He expressed appreciation to the Secretariat staff (Claire Allen, Jini Hetherington and Diana Wyatt; also Daisy Gregory [temporary helper]) for their hard work, particularly in preparing for this meeting.

4.2              Governance and structure: Nick reported that the production rate of reviews had picked up since the Steering Group had last met, and highlighted the fact that there had been an increase in the Collaboration‘s income over the previous year. The work on establishing an editorial board was now underway, thanks in particular to the hard work of Sophie Hill; this board might take over some of the current role of the Publishing Policy Group. Nick explained that Deborah Pentesco-Gilbert was about to employ a deputy to help the Collaboration to develop its product. Jeremy Grimshaw would shortly be outlining his plans for leading the Collaboration-wide review. The Co-ordinating Editors and the Monitoring and Registration Group had been focussing on issues pertaining to succession planning.

4.3              Future Colloquia: Nick explained that he was currently working with Steve McDonald, Co-Convenor of the Colloquium Policy Advisory Group, to develop a Memorandum of Understanding (MoU), with timelines and checkpoints, for future Colloquium hosts. He invited suggestions for better management of some of the core functions of Colloquia. Sally pointed out that the Collaboration had a good track record for Colloquia, and that too many bureaucratic expectations in a MoU might put off potential Colloquium hosts: it is the local organisers who bear the risk of hosting a Colloquium, and it was agreed that the proposed MoU should be supportive rather than restrictive. The document, ‘Standard operating procedures for Colloquia’, would form the core of the MoU, and is potentially an extremely helpful resource for future Colloquium hosts, although there could be an accessibility issue for some as it is written in English.

4.4              Secretariat staff issues: Claire, Jini and Nick left the meeting for discussion of extension of the CEO’s contract and Secretariat staff succession planning. It was agreed to extend the CEO’s contract by a further three years, from 1 April 2008. The Co-Chairs and CEO would work together to ensure that the Collaboration could continue to make the best use of the Administrator’s many skills for as long as both parties felt it appropriate. The Co-Chairs were asked to convey the outcome of these discussions to the relevant members of staff after the meeting.
Action: Adrian, Lorne

5.   Progress on projects:

5.1              Prioritisation and Opportunities Funds: Nick reported that formal agreements were now in place for all but one of the successful applications to these two Funds, and that some of the deliverables had already been achieved.

5.2              Diagnostic test accuracy reviews - register second progress report: The second progress report on the Register of Reports of Diagnostic Test Accuracy, prepared by Ruth Mitchell on behalf of the Cochrane Renal Group, was welcomed.

Jon explained that he had been in discussions with Wiley-Blackwell with regard to their supporting this initiative. The negotiations had been somewhat protracted but Wiley-Blackwell had recently suggested a willingness to fund a near-cost level journal for this initiative, including other content. It was clarified that the proposed journal would not include non-Cochrane reviews. There is money up front to employ an executive editor half-time, who would also be responsible for managing the production of this type of review. It was unlikely that there would be royalties until year 3 and they were unlikely to be large. Concerns were expressed that the work involved in launching the journal at this stage could potentially detract from the implementation of diagnostic test reviews in the Collaboration, and associated training activities.

Post hoc note: The decision was made after the Steering Group meeting not to launch a journal at this time.

5.3              Project Support Officer: Nick spoke to the draft job description for the Project Support and Communications Officer. He asked the Steering Group to consider whether the Project Support Officer should be located in the Secretariat or elsewhere. It was agreed that whilst the expectation should be that the post be co-located with the CEO, if the most suitable candidate was unable to relocate to Oxford, this should not prevent her/him from being offered the position. It was highlighted that there is an internal communication aspect to this new position, as well as the aspect of overseeing the management and budgets of approved projects. Jon offered to obtain and share some similar job descriptions for comparison with that produced by Nick for this meeting. This appointment had already been approved in principle at the Steering Group’s previous meeting in Amsterdam in April 2007, and Nick was asked to begin recruiting for someone to fill the position, once the Co-Chairs had seen an amended job description.  
Action: Jon, Nick

5.4              Templates for Plain Language Summaries (PLS): Lorne reported that he had discussed with the Norwegian Branch of the Nordic Cochrane Centre the confusion that had arisen with regard to the grant from the Opportunities Fund to develop templates for Plain Language Summaries (PLS). Recent e-mails concerning this project had included modified Summary of Findings tables with the suggestion that they could be incorporated into the PLS; however, the Steering Group confirmed that no decision had been made to incorporate tables into the PLS.

6.       Development and establishment of an editorial board
[Deborah D and Deborah PG were present for discussion of this item.]
Adrian explained that the Co-ordinating Editors would shortly be having a half-day discussion on this topic in São Paulo. Ruth stressed the need for stronger representation of Trials Search Co-ordinators in the process for developing and establishing such a board. Monica drew attention to the fact that “working closely with key groups in developing and implementing systems for improving and monitoring the quality of reviews, and review production and co-ordination”, was already partly covered within the remit of the Editorial Management Advisory Group (EMAG), which had been discussing minimum standards for many years. Also, Sally pointed out that the Handbook for Systematic Reviews of Interventions was an existing policy document to guide Co-ordinating Editors with regard to the quality of reviews. With respect to developing and implementing an operational plan for an editorial board, Lisa asked about accountability for ultimate decisions, recommending that the board should report to the Steering Group through the Publishing Policy Group rather than through the Executive. Jon flagged that the remit seemed to encompass two different roles of (1) communication between Co-ordinating Editors and (2) oversight of quality assurance and editorial processes, and that the individuals involved may differ between the two. Notably, the Methods Groups had much to offer related to the latter role. Sally suggested that the words “and build a culture of collective responsibility” should be written into the description of the board, in order to encourage a more collective decision-making process.

Adrian recommended and it was agreed that the appointment of an editor-in-chief, should this post be established, should be made by the Steering Group, in close consultation with the Co-ordinating Editors. Previous Co-ordinating Editors should also be able to be considered for this position. There was a strong sense that the Steering Group is supportive of this proposal, with some uncertainty as to its functions, and tension between cohesion of Co-ordinating Editors and implementation of existing quality measures versus an editorial board function in respect of whether or not reviews should be published in The Cochrane Library. There would have to be co-ordination with the editorial board of diagnostic test accuracy reviews. Deborah Dixon welcomed the prospect of an editorial board, as it would give Wiley-Blackwell a focus for dealing with editorial issues, with the Steering Group continuing to be the focus for discussions and decisions on strategic matters.

7.   RevMan 5 rollout and implementation strategy
Monica described an amendment to the background document she had provided: the central automatic conversion will happen in November 2008 rather than December 2008. Monica explained that in principle the conversion of reviews to RevMan 5 could all happen automatically, but that it would be a good opportunity to pick up on some minor but important errors in the existing published protocols and reviews. She reported that two conversion pilots had shown that it takes about eight minutes to convert a review or a protocol to RevMan 5 manually, including checking for potential existing problems with by-lines or missing author affiliations according to a minimum conversion checklist. Correcting the identified errors were not part of the pilot. More than sixty per cent of converted reviews needed some editorial attention before they could be ‘re-marked’ for publication. The Cochrane Library currently contains more than 1700 protocols and 3300 reviews that need to be converted. This would take about four to five months for one person to check all reviews as part of a manual conversion, and cost about 12,000 GBP. The central conversion would result in a report to each Cochrane Review Group (CRG) with a list of reviews that needed editorial attention before ‘re-marking’ the reviews for publication. The alternative would be to ask CRGs if they wished to convert their own reviews, with some financial help from core Collaboration funds. An explicit understanding should be built in that a CRG would be expected to correct those errors in its reviews which had nothing to do with conversion but which had been identified by the conversion process. There was discussion as to whether a CRG could give permission to its satellite(s) to do the conversion in return for funds.


It was agreed that it would be up to CRGs to arrange how they did the conversion, but that funds would go to the main CRG for them to disburse to satellites as they saw fit. This was agreed in principle, in proportion to the number of reviews per CRG. The IMS Support team would contact the Review Group Co-ordinators to discuss the best strategy with them (local or central conversion), explaining what would be involved. The IMS Support team would also collate the CRGs’ decisions. A maximum of 60,000 GBP was set aside from core funds for the manual conversion work. It was agreed that this decision should be announced at the Annual General Meeting in two days’ time, to allay any anxieties about the amount of work involved in converting reviews and protocols to RevMan 5.

Adrian and Lorne agreed to send the proposed letter to all Cochrane authors to give them details of the RevMan 5 rollout plans, copying in the Author and CRG ‘at large’ representatives, Donna, Hans and Zbys.
Action: Monica, Adrian, Lorne, Nick

7.1 & 7.2     Training in RevMan 5 and other Collaboration training needs: Donna spoke about the issue of training needs for Cochrane authors, and the availability of a self-paced tutorial on the website. There are still gaps in provision of training, and some people feel there is no infrastructure in place to support certain training needs. Training in use of the new RevMan 5 software for CRG editorial bases will be provided by the IMS support team, and plans for this training are well in hand. However, there appears to be a need for additional training in new methodologies (for example, risk of bias tables). Donna argued that the Steering Group needs to develop a strategy for methodological training. Bearing in mind that training is one of the core functions of Cochrane Centres, it was decided that the Centre representatives would take this matter to the Centre Directors’ meeting the following day, and report back to the Steering Group on 25 October (see also item 21.2).
Action: Donna, Joy, Lisa, Rob, Sally

8.   Status report on the development of the IMS
As noted in the background paper, the IMS Team, in consultation with the EMAG, is proceeding with the programming of a workflow system that would assist RGCs in moving Cochrane reviews through the entire process from title registration to publication of the completed (or updated) review. The system could also provide data on the time spent in completing some of the critical steps in the review production process, and could therefore be helpful to individual CRGs, the Monitoring and Registration Group (MRG), and the Steering Group in improving the editorial process. This project had previously been given a lower priority than RevMan 5, but is now a high priority project for the IMS. Formation of such a system is also a high priority for Co-ordinating Editors who have noted that journals are increasingly using systems of this sort to track and improve the process of editing and peer review. Definition of the steps and sequences of actions in the Cochrane review production process is an initial step in this process.


The IMSG had asked whether the Steering Group intended to make the system mandatory for all CRGs once it became available. The Steering Group agreed that once the workflow and tracking system had been successfully piloted, it should be rolled out to all CRGs. Some members felt that purchase of an existing system would be preferable to developing our own, but it was pointed out that one year’s work had already gone into development of this system alone, and several years into describing the requirements for the system. A survey had previously been undertaken of commercial systems and at that time it had been found that they did not meet the Collaboration’s needs. Peter pointed out that he did not believe this to be the case: Elsevier, for example, had a powerful electronic system, and he imagined Wiley-Blackwell would have too. The Steering Group agreed that the workflow system should be used uniformly across the Collaboration and be given a high priority by the IMS Director. Monica was asked to provide a detailed plan as soon as feasible, for any additional funding that might be necessary to allow for the implementation of a tracking and workflow system. Monica said she would also try to schedule a review of new commercial systems to see how these had been developed during the last couple of years.


Monica asked the Steering Group to help identify specific groups to be involved in future definitions of workflows. Adrian stressed that CRG representatives on the Editorial Management Advisory Group (EMAG) should become more involved in obtaining feedback on important issues that arise. Jonathan emphasised that workflows to identify data on quality and timeliness are very important. Peter explained that this matter was high on the agenda of the Co-ordinating Editors’ meeting the following day, and he and Jonathan would report back to the Steering Group on 25 October ((see also item 21.1.4). This development would have implications for the workload of CRGs and the Monitoring and Registration Group.  


Post hoc note: Peter reported that there had been unanimous agreement at the Co-ordinating Editors’ meeting that the Collaboration was lagging behind the publishing industry standard, and that resources must be found to solve this as soon as possible. He recommended that Narelle be involved in these discussions as it was such an important issue for Review Group Co-ordinators, as should Cindy Farquhar, who is on the Co-ordinating Editors’ Executive. 
Action: Jonathan, Peter, Monica, Narelle  

Sally expressed appreciation for the enormous contribution of the IMS to the work of the Collaboration. Monica reported that the IMS team was working to full capacity, and requested a moratorium on new initiatives until after the rollout of RevMan 5. She asked the Steering Group to consider increasing the funding to the IMS. Nick recommended that a request for an increase to the IMS budget should follow the model adopted (on the Steering Group’s instigation) by the website development team, with funding to buy in programming assistance as required, rather than employing additional staff, so that work could be progressed concurrently rather than consecutively and therefore achieve the desired deliverables more quickly. He offered to work with Monica on a paper for the next Steering Group meeting in Vellore in April 2008, separating out the platform costs for doing the core business, a stable architecture to sustain growth, the cost of additional new developments, and training and support for entities and authors.
Action: Monica, Nick

9.   Handbook for Systematic Reviews of Interventions
Adrian thanked Sally and Julian Higgins for the enormous amount of work they had put into updating this Handbook.

10. CENTRAL (interim measures and moving forward)

The Steering Group held a preliminary discussion based on Ruth’s report on progress made on the interim measures for CENTRAL, and the paper by Lorne, Nick and Ruth concerning the future of CENTRAL. Ruth agreed to present the issues that the Steering Group had raised, at the joint meeting of RGCs and TSCs the following day, and bring their recommendations to the Steering Group for discussion on 25 October.

When the Steering Group revisited this discussion on 25 October, it was affirmed that a Request for Proposals (RFP) was considered to be a good basis for moving forward, and that this initiative is a priority for the Steering Group, as CENTRAL is a core platform for the Collaboration. It was suggested that the name ‘CENTRAL’ has a market presence which should be retained (i.e. it should not be renamed). It was also suggested that the RFP should include a list of requirements developed by the TSCs’ Working Group in collaboration with the Steering Group; they should provide a clear view of the requirements and not rely on those submitting an RFP to develop the core components of the proposal. The requirements should include the recommendations made by the CENTRAL Vision Group and agreed to by the Steering Group (although it was recognised that the CVG did not cover all aspects of implementation), and the RFP should address the implications for the TSCs’ work plans. The process for selection (including membership of the selection panel) should be clearly defined alongside the fully developed RFP. Jonathan and Nick agreed to work with Ruth on the RFP. Adrian thanked Ruth for all her hard work on this issue. Action: Jonathan, Nick, Ruth


11.  Changes to the ‘Feedback’ system for Cochrane reviews
Thanks were expressed to John Carlisle for his report on behalf of the Feedback Management Advisory Group. Lorne was asked to let John know that it would be unacceptable for the Feedback system on Cochrane reviews to be withdrawn completely from The Cochrane Library.
Action: Lorne

12.  Publishing Cochrane products
[Deborah D and Deborah PG were present for discussion of this item.]
Deborah PG explained that there had been a sixteen per cent growth in revenue on the previous year (compared to only a 3-4 per cent growth in Wiley-Blackwell’s paper journals). Deborah D said that she expected a levelling off in the amount of revenue. Deborah PG reported that there were now several additional options in terms of new platforms for delivery of The Cochrane Library. Deborah announced that as part of its ongoing commitment to the dissemination of The Cochrane Library in low- and middle-income countries, Wiley-Blackwell had switched on all HINARI Band 1 countries (World Bank Figures, 2006, GNP below $1000 per capita) with one-click access free of charge via Wiley InterScience (www.thecochranelibrary.com). Access in these countries is based on IP recognition so all residents and institutions with an Internet connection are now connected. Cochrane Library access via HINARI remains free for registered users and will be free for the same countries via INASP from January 2008. Deborah PG said that free access would soon be publicised widely. Deborah then referred to several areas of future investment and development, and outlined a stream of different strategies. A paper version of the Handbook of Systematic Reviews for Interventions would soon be available for purchase, but Deborah confirmed that the Handbook would continue to be available for free online through The Cochrane Library, the Cochrane website and Cochrane’s authoring software (RevMan).

Deborah D introduced Wiley-Blackwell’s ideas for developing a Cochrane ‘point of care’ strategy (any location where patient care is provided, including at the bedside, in a radiology suite, emergency room clinic or ambulance). The potential market for this would include both system vendors and products. Peter recommended that this should be pursued in more detail within the Publishing Policy Group, and also at the mid-year meeting of the Steering Group in Vellore in April 2008, together with investigating the setting up of the Collaboration’s proposed continuing medical education (CME) strategy. Ownership of the companies with whom we might consider partnerships should be made transparent. Deborah D also raised a suggestion with regard to partnering and developing a joint arrangement for publishing new products such as ‘Cochrane Bottom Lines’. Again, this would be an appropriate topic for discussion in Vellore. The Steering Group should work in partnership with Wiley-Blackwell rather than leaving it to our publisher to develop new avenues for us. Nick would participate in the discussions about this.
Action: Nick
After Deborah D and Deborah PG had left the meeting, Adrian raised his concerns about the fundamental strategic decisions that are needed before we progress some of the suggestions made by our publishers. It would be important to find the right balance between wanting to improve accessibility to our work and sustaining our core product. A commercial pull should not divert us from making The Cochrane Library a better product.  

13.  Extension of publishing contract
Nick summarised the terms of the draft contract extension, and congratulated Mike Clarke and his team for the favourable terms they had negotiated for the initial contract with John Wiley and Sons. He also expressed appreciation for the way that Update Software had ensured continuity of provision of The Cochrane Library during the transition from one publisher to another. He noted that the draft extension would bring considerable additional revenue to the Collaboration, measured on a like-for-like basis with current revenue, and that free one-click access to The Cochrane Library would be considerably expanded in poorer countries, with all 69 HINARI Band 1 countries having free access as a result. This brought the population of countries with free one-click access up to half of the world’s population. The out of date text referring to the transition from Update Software as the Collaboration’s publisher to John Wiley and Sons had been removed from the draft contract extension to reflect the current position. References to appointing an editor-in-chief had already been amended to allow for the potential non-appointment of this post, as discussions about the Collaboration establishing such a post were still underdiscussion. Sally expressed thanks to Nick for all his hard work in negotiating the good terms of the contract extension. Nick was asked to request Wiley-Blackwell to amend the draft contract in the following ways: the definition of The Cochrane Library needs to be more specific about what it does and does not include, and some text should be inserted into the contract so that publication of possible new products should be discussed as and when they arise. The word ‘electronic’ should be reinserted into paragraph 5a(i), and both Handbooks should be listed in paragraph 5a(ii). The Steering Group asked to see a revised contract before it is ready for signing, and asked Nick to arrange for it to be scrutinised by a lawyer beforehand, as good business practice. The proposed outline terms of the contract extension would be publicised at the Annual General Meeting on 25 October.
Action: Nick

14.  Invitation to join Guidelines International Network (G.I.N.) advisory board  
Lorne agreed to represent the Collaboration on the G.I.N. advisory board. He would write and advise them of this, thanking them for their invitation, and suggest to Jeremy Grimshaw that G.I.N.’s view of the Collaboration be sought as part of the forthcoming Collaboration-wide review.
Action: Lorne

15.  Response to the review of the Steering Group
Adrian said how important the review of the Steering Group had been, and reiterated thanks to Alessandro Liberati and his team for having conducted it so thoroughly. Adrian spoke about the need for someone to perform an ambassadorial role on behalf of the Collaboration, who would not necessarily need to be one of the Co-Chairs. The Steering Group discussed the mechanisms through which an external Chair/Chairs could be appointed, and Adrian undertook to prepare a brief discussion document for the next Steering Group meeting in Vellore, with assistance from Jon, Liz and Peter, and input from the Secretariat staff and one or more former Co-Chairs.
Action: Adrian, Jon, Liz, Peter

16.  2008 review of the Collaboration
Nick reported that he had discussed with Jeremy Grimshaw his plans for conducting this review, and they would be communicating weekly during the course of the review. Nick would draw up the remit for this review on Jeremy’s behalf, and circulate it to the Steering Group for approval. He explained that the consultation process would include external stakeholders, but he suggested that such people should not necessarily form the panel undertaking the review itself because the learning curve about the Collaboration was steep and time was precious, since Jeremy would be leading this review during his sabbatical period. Monica suggested revisiting the work done some years ago by Fenella Rouse to see how far the Collaboration had come since then. External credibility of the Collaboration-wide review is important. There should be very clear deadlines, and central funds had already been allocated in order to facilitate the conduct of the review. This should be a standing item at the top of the Executive agenda from now on, and Adrian would invite Jeremy to participate in Executive teleconferences for this item to report on progress on a regular basis. The Steering Group expressed support for Jeremy and would do everything possible to assist him. He should provide a written report to them for their next face-to-face meeting in Vellore. Nick asked for permission to engage an external consultant to work on the review with Jeremy and to provide the external input, and this was agreed, together with approval for some additional funding.   
Action: Adrian, Nick

17.  Monitoring and Registration Group (MRG) report

17.1            Flagging up problems within entities: Rob, as Co-Convenor of the MRG, reported on the issues raised in the background document for this meeting. The timing of making the Steering Group aware of problems within particular entities was discussed; it was agreed that such matters should be flagged up sooner in the future, where possible. Rob was asked to feedback the content of this discussion to the relevant people.

17.2            STD Group: Rob informed the Steering Group about the challenges of moving the STD Group’s editorial base to Brazil. It was agreed that, despite the fact that central funds are not normally used to support individual entities, it would be appropriate for the Executive to consider an application for emergency funding for this Group. The reasons for this exceptional funding should be communicated clearly to entities, and include the fact that STD is an important global health problem, and the Group’s reviews are highly relevant to alleviating the global burden of disease. The emergency funding would be supporting the move of an existing CRG to a new editorial base, not the initiation of a new Group. The Steering Group was reminded that the Cochrane Visiting Fellowship had been recently awarded to the RGC of this Group in order for her to receive training in administering the Group. This is an enabling situation, and there are good reasons to believe that outside funding will come to the Group as the result of providing central support now. This is a directly positive result of the entity monitoring process, and the proposed funding would be in line with the draft succession planning process document currently being developed and discussed by the Co-ordinating Editors.

17.3            Establishing new Cochrane entities: There was lengthy discussion of this matter. Some Steering Group members felt that a campaign to send negative letters to the MRG about a proposed new entity under discussion, in anticipation of its application, was highly inappropriate. It was agreed that the MRG should concentrate on responding to any applications it actually receives.


17.4            Deregistering Cochrane entities: Rob read out a letter from the MRG to explain its approach with regard to managing problems within a particular entity. It was noted that the convenor of that entity had stepped down. The Steering Group agreed to adopt the MRG’s suggestion of the entity going into ‘hibernation’ for two years. If the entity could be re-established within that time, under new leadership and with new funding, re-registration would not be required. A new registration process would need to be undergone if someone emerged who was willing to take the lead after the two years were over, and if funds could be assured. The module in The Cochrane Library should communicate this decision clearly.
Action: Rob


18.  Succession planning for Co-ordinating Editors
Thanks were expressed to Richard Hughes, Co-ordinating Editor of the Neuromuscular Diseases Group, for his helpful background document, which is also being discussed by the Co-ordinating Editors. Steering Group members should send any comments they have directly to Richard. However, the challenge of succession planning should be kept in mind particularly during discussions at the next Steering Group meeting in Vellore.

19.  Discussion topic(s) for special session in Vellore
It was agreed that ‘Academic versus practical evidence-based health care’ should be one of the topics for discussion at the special session before the next face-to-face Steering Group meeting in Vellore in April 2008. Peter asked that he and Jonathan be involved with Adrian, Lorne and Nick in planning this session. The suggestions made by Wiley-Blackwell for the use of Cochrane reviews in point of care and CME products should be included in that discussion.
Action: Adrian, Jonathan, Lorne, Nick, Peter

Other suitable topics suggested for discussion at future special sessions were:
-  How we can use our resources most effectively.

-  Evaluation and monitoring of performance as the result of decisions made.

-  Ensuring sustainability alongside the growth of the organisation.

-  The role of Fields.

-  Equity issues.

20. Regular reporting of industry funding of trials
This item was referred to the Handbook Advisory Group for consideration, and not discussed at this meeting; the matter could be brought to the next Steering Group meeting if necessary.
Action: Sally

21. Issues raised at entity meetings during the Colloquium

21.1            Cochrane Review Group issues:

21.1.1         Proposed editorial board: A strong sense of urgency had been expressed regarding issues surrounding the quality of reviews; the importance of avoiding over-emphasis on bureaucracy; the work overload of RGCs; and the need for better reporting to constituents by the Steering Group’s sub- and advisory groups.

21.1.2         CENTRAL: Concerns were expressed as to whether the tendering process for the development of CENTRAL should be internal alone; the majority of Steering Group members were not in favour of allowing external as well as internal applicants. The RFP was seen as a good way to move this issue forward; concerns had been expressed about the lateness of the background paper, leaving no time to consult with TSCs about it; the TSCs’ desire to establish a group which would look at things other than CENTRAL was acknowledged. This group would ideally provide a streamlined mechanism for TSCs to communicate with the Steering Group effectively and in a timely manner on a range of issues. It would also help to ensure that the breadth of knowledge and experience that TSCs hold collectively informs the decisions that affect their working practices. Steering Group members were uncomfortable about the lack of detail in the report from the CENTRAL Vision Group (CVG) as to the exact requirements of CENTRAL; they had only received summary recommendations, not true system requirements. The details of the CVG’s report should be reflected in the RFP(s). The position of project manager should be built in as one of the project requirements.

21.1.3         Succession planning: The Co-ordinating Editors would be discussing this challenge further and bringing their recommendations to the Steering Group in due course (see also item 18).
Action: Jonathan, Peter

21.1.4         Workflow: The Co-ordinating Editors saw this as a high priority. There was an expectation that the IMS would be uniformly used once it had been fully developed (see also item 8).

21.2            Centre issues:
Concern had been expressed with regard to the need for training in methodological developments, and Centre Directors had agreed that development of training materials would be a priority for Centres. There had also been strong support for involving Cochrane Centres in the proposal to establish a Developing Countries Network (DCN). Lisa explained that she was working with the DCN to this end. Centre Directors had expressed support for a Steering Group member to join the G.I.N. advisory board.

21.3            Methods Group issues: Jon explained that members of Methods Groups had been unable to meet between the two Steering Group meetings during the Colloquium, and would meet the following morning, due to clashes of workshop and meeting slots. He would report back any key issues to the Steering Group by e-mail following the meeting (see post hoc note below). The Handbook Advisory Group had managed to meet, and reminded Co-ordinating Editors that a representative was still required to review the updated Handbook before the end of 2007: Peter and Jonathan undertook to canvass for people to do this.
Action: Peter, Jonathan

Post hoc note:
21.3.1        Editorial board: The Methods Group Convenors welcomed the Co-ordinating Editors' recognition of the importance of review quality and their plans to make a combined effort, in the form of an editorial board, to improve this. The Convenors expressed their desire to work with the editorial board to ensure suitability of protocols and reviews based on methodological quality. The methodologists in the Collaboration provide a source of expertise which is unrivalled in even the most influential medical journals, and the Collaboration should ensure that they make best use of this. 


21.3.2        Methods Groups' activities at the Colloquium: The organisation of workshops at this Colloquium, whereby each Methods Group had been promised one workshop slot, had been well received. It was requested that this policy be continued and if possible one of the co-chairs of the Colloquium workshop panels be a methodologist, since Methods Groups play such a large part in the workshop programme. The scheduling of oral papers against workshops and meetings at the São Paulo Colloquium had caused problems as many methodologists were giving workshops at the same time as oral sessions were timetabled in which they had an interest, and some Methods Groups had not managed to obtain meeting slots at appropriate times because of clashes with workshops or oral papers.

21.4            Field/Network issues: No issues were raised for discussion.


22.  Agenda for Annual General Meetings (AGMs)
The format of the AGMs was discussed. It was agreed that it would be important to be open and transparent about the challenges of having revenue to distribute, and how to do so equitably throughout the Collaboration. Lorne,  Donna and Nick would make presentations at this meeting.

23.  Strategic Plan - Management Plan
This document was used as background to the Steering Group’s discussions.


24.  Key performance data – consent item: no discussion.

25.  Declarations of interest for Cochrane Centres – consent item: no discussion.

26.  Reports from people with special roles:

26.1 The Ombudsmen: Lorne asked for this item to be moved from the consent agenda for discussion and decision of the questions raised by the Ombudsmen at the beginning of their report. It was affirmed that the Co-Chairs and the CEO are the Ombudsmen’s first point of contact on matters pertaining to Collaboration practice and policy. Issues needing discussion and decision by the Steering Group would be brought to them as and when required. There was no need for the Ombudsmen to provide an additional written report to the Steering Group other than the one they had already provided. Lorne would convey this discussion to the Ombudsmen.
Action: Lorne


27.  The next three Steering Group meetings – consent item: no discussion.

28.  The next three Cochrane Colloquia

28.1            Freiburg and Keystone, Colorado:
There was nothing to discuss with regard to the Freiburg and Colorado Colloquia in 2008 and 2010 respectively.

28.2            Singapore Colloquium 2009: Sally explained that the Australasian Cochrane Centre would be supporting the Singapore Branch in hosting their Colloquium.
The dates of the Singapore Colloquium had originally been set for early October but had had to be changed because of the risk of clashing with the Formula One Grand Prix. Efforts to identify alternative dates had been constrained by Singapore's hosting of the Asia-Pacific Economic Co-operation (APEC) forum in November 2009. Thus the only available alternative (11-14 October) would unfortunately clash with Canadian Thanksgiving. In approving the new dates, the Steering Group regretted this clash but accepted that there was no viable alternative. Peter would explain at the next meeting of Canadian contributors why these dates had been chosen. The background to this difficult decision should be explained in the next issue of Cochrane News, and also in the next Steering Group Bulletin.
Action: Peter, Sally, Nick

29.  Treasurer’s report:

29.1            Expenditure of Cochrane Collaboration core funds:
Donna explained the background to the document she had produced with Lorne and Nick, which generated some discussion but no decisions. Lisa agreed to go back to the reviews where there had been some question about funding sources and clarify these, to make sure they were in compliance with the Collaboration’s policy. 

      Action: Lisa   

      29.2            Report and Financial Statements: These documents had been circulated separately, and would be discussed at the Annual General Meeting on 25 October. Lorne would address at that meeting the question from the Pregnancy and Childbirth Group, about which the Steering Group had been notified in advance, as to how the Steering Group intended to spend the increased revenue from royalties to the benefit of Cochrane entities. It was agreed that it would be important to describe how much money was being talked about, and to focus on the establishment of an editorial board and other items of central support which are for the benefit of all Review Groups.


The challenge of how to spend the funds wisely is firmly on the Steering Group’s agenda, and input and advice over the next six months would be welcomed. All options are on the table, and this will be a major part of the Steering Group’s discussions at its next meeting in Vellore. The increased revenue reflects the hard work of everyone in the Collaboration. There had been some discussion of allocating a proportion of the surplus funds to each of the 90 entities, but the Steering Group had not been convinced that this would be the best way to support people across the Collaboration. Collaboration members would be encouraged to send suggestions to their entity representatives, to forward to Donna Gillies as Treasurer, for discussion in Vellore. Donna would develop a formal template for this and send it to entity representatives to circulate to their constituents.
Action: Donna

29.3            Profit and Loss statements, and cash flow forecast: Donna described the change in the Collaboration’s expenditure patterns, which she would be highlighting at the Annual General Meeting. She thanked Graham Carson, the Collaboration’s bookkeeper, for producing the Profit and Loss statements in a clear and understandable format.

30.  Trading Company Directors’ report
Mike Clarke, Monica Kjeldstrøm and Peter Langhorne, the current Directors of the Trading Company, were thanked for their report, and for their work on behalf of the Collaboration in their capacity as Directors of its subsidiary, the Collaboration Trading Company. The proposed reappointment of Peter Langhorne at the AGM was approved without discussion.


31. Discretionary Fund expenditure
This item was for information only, and required no discussion.


32.  Decisions taken at this meeting which might have an impact on environmental sustainability
Some additional travel costs for one of the Co-Chairs were approved because of the Steering Group’s acceptance of the invitation to join the G.I.N. advisory board. Otherwise, no decisions had been taken at this meeting that would have an impact on environmental sustainability.

33.  Minutes of the previous meeting in Amsterdam
There were no matters arising from the minutes of the Steering Group meeting in Amsterdam which had not already been dealt with at this meeting. However, Lorne requested an amendment to item 20.1 of the minutes of the Steering Group meeting in Dublin, as follows:

Item 20.1 - Publication arrangements for Cochrane protocols and reviews of diagnostic test accuracy: Jon explained the challenges of publishing this type of review. The Steering Group agreed to pursue the option offered by Wiley-Blackwell of a new ‘derivative’ journal, ‘Cochrane Diagnostic Reviews’, in which the reviews would be published at the same time as being published in the Cochrane Database of Systematic Reviews. The Steering Group agreed to the creation of an editorial board and to the working arrangement whereby the board would have to sign off Cochrane Diagnostic Reviews [and Protocols] jointly with the relevant CRG before they could be published in The Cochrane Library. The editorial board would be answerable to the Publishing Policy Group. Mark [Davies] expressed thanks to Wiley for actively supporting this initiative.


A post hoc amendment to incorporate the words “and Protocols” (as indicated above) should be made to the version of these minutes on the website.
Action: Jini


34.  Spreadsheet of Steering Group members’ outstanding action items
Steering Group members were reminded that this spreadsheet is a tool to assist them in keeping track of things they have undertaken to do, and they should continue to notify the Secretariat as they complete these items, in order for the spreadsheet to be updated and therefore useful.
Action: Everyone


35.  Allocation of funds to specific proposals
Lorne itemised the amounts of funding which had been allocated to specific proposals during this meeting: 60,000 GBP for RevMan 5 conversion; a maximum of 100,000 GBP towards employing an outside consultant to advise on the Collaboration review; additional Trials Search Co-ordinators’ Working Group funding to support participation in putting together the CENTRAL Request for Proposals; Sexually Transmitted Diseases Group support; possible additional programming costs for the workflow and tracking system; and travel costs involved in one of the Co-Chairs joining the Guidelines International Network advisory board.


36. Any other business:

36.1            Principles for protecting integrity in the conduct and reporting of clinical trials: Thanks were expressed to Kay Dickersin for her background paper. Steering Group members had some concerns as to how the principles outlined in this paper would apply to trial results in registers. They were urged to respond directly to the Chairs of the Writing Committee if they had suggestions. Lisa would report back to Kay and the Writing Committee. In addition, Jon would bring the background paper to the attention of the Bias Methods Group for consideration, and the issue could be brought to the Executive for discussion if thought appropriate.
Action: Lisa, Jon


36.2            Funding: Following the concerns that had been expressed during the AGM, it was agreed that the Steering Group should consult broadly about how to distribute the accumulating funds equitably throughout the Collaboration. Peter Jüni of the Methodology Review Group had said at the AGM that the Collaboration needed to maintain the quality and up-to-dateness of reviews if the Collaboration were to hold onto its market share, and had argued that investment in strategic activities, which would improve the quality and timeliness of reviews, was crucial. Entity representatives were encouraged to consult with their constituents for ideas about equitable distribution and forward them to Donna (see also item 29.1).
Action: Everyone


37.   Thanks to the hosts and organisers of the meeting
Lorne thanked Alvaro Atallah, the staff of the Brazilian Cochrane Centre, members of staff at BIREME, and the local organising committee, for hosting such an enjoyable Colloquium. Karla Soares-Weiser and Melissa Mann had been invited to come in at the end of the meeting so that Adrian could express special thanks to them both on behalf of the Steering Group for their extremely hard work; their input had been crucial to the success of the conference. Lorne also thanked the Secretariat staff for producing the agenda materials, and Jini for taking the minutes.