The Remarkable Archie

Abstract

Most epidemiologists are familiar with the Cochrane Collaborati n, which provides critical and systema ic reviews of randomized trials relevant to medical practice and health policy. The Cochrane Collaboration has so far enlisted 15,000 volunteers worldwide in the preparation of these reviews.1 Today, more people are familiar with the Cochrane Collaboration than with Cochrane himself. But the man is worth remembering?Archibald Leman Cochrane was one of the most colorful medical scientists of the 20th century. Archie, as he was known, came from a wealthy family, thereby enjoying lifelong financial security. As a young man, he suffered from a sexual dysfunction for which he could not find treatment in the United Kingdom.2 He underwent psy choanalysis in Germany. While there, he became fluent in German?and infuriated by the Nazis. When his Jewish analyst fled to Vienna and subsequently to Holland, Archie followed. On returning to England, he enlisted in the Inter national Brigade to fight fascism in Spain. During World War II, he was held prisoner for 4 years. After the war, Archie studied the chest diseases of mining populations in Wales, launching a series of remark able surveys that reached more than 90% of their target populations. His studies of lung diseases and his papers on quality of health and medical care services are characterized by innovation and even audacity. The Cochrane Collaboration grew from ideas Cochrane presented in a 93-page book titled Effectiveness and Effi ciency: Random Reflections on Health Services? published in 1972. The gist of the book is that evaluation of clinical procedures should depend on the results of randomized clin ical trials. In his words, concentrated mostly on one simple idea?the value of randomized controlled trials in improving the NHS [National Health Service]. About the actual writ ing, he said ... I ended up writing the book . . . between the hours of 10:00 pm and 1:00 am when I had finished everything Archibald Leman Cochrane