Exploring the Cochrane library for health information

This post follows on from my earlier post about research. When researching a new topic I ‘dive into the deep end’ by using Google Scholar. The coverage (how much of the literature is captured) of Google Scholar is extensive, sometimes too extensive. In other words, Google Scholar will return a lot of search results but not all of them will be high quality research publications. This can be a problem for the novice researcher.

If you want a quicker (scientific and evidence based) answer on a health related question I would suggest the Cochrane library. The Cochrane collaboration exists to provide the highest possible level of evidence that can be used to inform healthcare decisions. The Cochrane library is a resource that can be used by anyone interested in researching health related material. I first heard about Cochrane via learning about Cochrane reviews. These are systematic reviews of a topic area (eg. use of a particular drug/intervention in a particular disease) that provide up to date as well as the most accurate answers in that area. Basically, if multiple high-level studies have been carried out in a particular area, a Cochrane review will determine if these studies can be compared to yield an overall conclusion. The best part is that a ‘Plain language summary’ will be provided, so that the conclusions are communicated as widely as possible.

The Cochrane library includes more than the systematic reviews though, for instance there is also a database that covers reports from randomised controlled trials (called CENTRAL). This resource is particularly useful if you are looking to find out about a drug. As an example, if you search for ‘dehydroepiandrosterone’ (DHEA) in the CENTRAL database (in advanced search, limit to ‘trials’) you will get 826 results (current to July 2015). That may sound like a lot of abstracts to sift through but if you search the same term in Google Scholar you will get over 85 thousand results. Many of these will not be trials, plenty of them will be studies to find out what DHEA does in the body, seeing as it is produced by our bodies. The CENTRAL database is also useful when looking into new treatments/investigations as these may not be well established enough to warrant a review yet.

Just the other day I used the Cochrane library to answer a quick health query. Earlier that week I had been pushing myself to exercise a little more. One of my old excuses to avoid exercising was that I sometimes get post-exercise headaches. These are probably due to dehydration, perhaps sometimes from too much sun (good sunglasses help) but other times I can’t account for why I get them. Then I found that if I take an ibuprofen pill beforehand it seems to be prophylactic. But that week I had taken a pre-walk ibuprofen each day for three days and then on the fourth day my stomach was ever so slightly upset. I knew that any NSAIDs (nonsteroidal anti-inflammatory drugs) were harmful to your stomach, although I thought that ibuprofen was less damaging than others. It was enough for me to be curious, and besides, I was procrastinating to put off exercise! So I quickly searched the Cochrane library and found this gem: Kohrt et al. 2010 (from the CENTRAL database).

I had no idea that ibuprofen usage might be affecting my bone density! Seeing as I should be looking to increase my bone density (a concern with ovarian insufficiency, but for any woman really), or at least slow any decrease in bone density, this study caught my eye. It was enough to remind me to not make excuses when I knew I would actually enjoy my bone-building walk up the mountain, and to help me decide that I should wait till after my exercise to assess whether I want to take an ibuprofen or not.

In this case my ‘problem’ was a trivial matter, and serious health concerns warrant more cautiously thought out decisions (including real medical advice, from a real doctor). Also, sometimes there just won’t be answers unfortunately. Speaking of which, here is where you will find all of the Cochrane reviews in the group that covers infertility (subfertility), as well as menstrual disorders. Still, I was pleased to see that this resource could be used to quickly inform me of a healthier way to go about my normal daily activity.