The Cochrane Collaboration is dedicated to fulfill Archie Cochrane’s vision of producing systematic compilations of the all the randomized trials that have addressed medical patient management issues.  Up to now, the collaboration has produced over 3,000 reviews.

Patient-reported outcomes (PROs) represented an explicit focus for the XVth Cochrane Colloquium in Sao Paolo and therefore gave the co-conveners of the PRO methods group, Donald Patrick and I, an opportunity to play a major role.  The opportunity was well-timed: we were just completing the PRO chapter for the Cochrane Handbook, and the Colloquium provided an opportunity to highlight the guidance that the chapter presents.

Donald’s participated on one of the Colloquium’s plenaries, addressing the fundamental issue “Why PROs”.  He answered the question by noting that key outcomes such as pain, symptoms and feelings are known only to the patient.  Donald further pointed out the physiological measures on which clinicians formerly relied often do not reflect patients’ experience.  Finally, he emphasized that the measurement properties of many PROs are now well-established and compare favorably to many traditional endpoints.

Donald led us in a meeting of the PRO methods group and subsequently in conducting a workshop addressing the evaluation of translations and cultural adaptations in global clinical trials included in Cochrane reviews.  An engaged workshop audience reflected the growing interest in PROs within the collaboration.

I conducted a well-attended special session addressing how to make summaries of PROs in systematic reviews more interpretable for clinical audiences.  I introduced concepts of the minimal important difference, and a number of alternatives for summarizing results in clinically compelling ways.  The fundamental theme was the usefulness of expressing results as a dichotomy (such as improved or not improved) and providing differences in proportions of patients crossing, or not crossing, thresholds of improvement and deterioration.

MAPI support for the PRO methods group also facilitated an invited presentation I made at the opening plenary regarding the relationship between Cochrane and evidence-based medicine, and an abstract I presented regarding misuse of composite endpoints.

Donald and I felt gratified at the opportunity of raising the profile of PROs within the collaboration and the positive response we received.