Speech by Director of Medical Services, Professor K. Satku at the Opening Session of the 17th Cochrane Colloquium

11 Oct 2009

By Prof K Satku

Prof Lorne Becker, Chair of the Cochrane Collaboration Steering Group;

Mr Nick Royle, CEO of the Cochrane Collaboration;

Dr Edwin Chan, Chairman of the Conference Organising Committee;

Distinguished Guests,

Colleagues, Ladies and Gentlemen

It gives me great pleasure to join you at the opening of the 17th Cochrane Colloquium. Let me begin by extending a warm welcome to all and a special welcome to our overseas delegates and speakers.

2 It is a great testimony to the excellent work, continuing relevance and dynamic spirit of the Cochrane Collaboration that in spite of the challenge of the global economic crisis and the influenza pandemic, that so many of you have travelled to Singapore. On behalf of the organising team and my country, I thank you for your support.

3 It has been 21 years since the death of Archie Cochrane, who challenged the medical community to build on critically appraised work and who was the inspiration for this Collaboration. If he was alive today, I am confident that he would be proud to have his name associated with all that the Cochrane Collaboration has achieved in its 16 years of existence. Today, the Collaboration is recognised for the quality of its systematic reviews and its leadership in evidence-based methodology. What will the future hold for the Collaboration? Allow me to discuss this question from my own perspective.

4 As Director of Medical Services in a small country with limited resources, I need information in order to make evidence-based healthcare decisions routinely. Where a well-performed systematic review of the scientific evidence has been done, it provides clarity to decision-making. Not too long ago, we were drafting our Mental Health (Care and Treatment) Act. An issue that arose was whether we should legislate for community treatment orders that would compel severely mentally ill patients who refuse treatment to receive community treatment. Fortunately, there was a Cochrane review on “Compulsory community and involuntary outpatient treatment for people with severe mental disorders”. The review found that the evidence suggested that compulsory community treatment might not be an effective alternative to standard care. Consequently, we did not include provisions for community treatment orders in our legislation, notwithstanding that many other countries had done so. This is an example of the work of the Cochrane Collaboration contributing to policy development.

5 However, there may not always be a review that covers the topic of immediate relevance. This is particularly true in complex settings, which may require multiple interventions or strategies.

6 Evidence from primary studies is of little practical value if it is not applied. Tools like systematic reviews are useful for knowledge translation, but they need to be done in areas of relevance.

7 I understand that the Collaboration has completed a strategic review of itself and the organisation feels it should engage partners for mutual benefits and should improve the usability of its products for diverse stakeholders. This is reflected in the programme for this Colloquium, which includes sessions on prioritising topics for systematic review and collaboration with other agencies like guideline developers. I welcome these efforts to ensure that the work of the Collaboration continues to be relevant to users of its reviews. I believe that this is the right way forward for the Collaboration and encourage you in your endeavours.

8 Let me end by wishing you all a productive meeting and a valuable new chapter of achievements ahead.

9 Thank you and have a pleasant conference ahead.