Each review is prepared in a defined manner to ensure consistency and high quality. First, before a review is attempted, the reviewers submit a protocol which includes an abstract, background, proposed method of searching the literature and who will check it, how articles will be selected for inclusion, and the type of data to be extracted consistently from these articles. This protocol is assigned to a "lead editor" who is responsible for guiding the authors through this preliminary stage. Support is also available from the Review Group Coordinator, usually via email. The reviewer also familiarises him/herself with the software that must be used for writing the protocol and review. When the lead editor is satisfied, the protocol is sent out for peer review by the editors, an external content expert, a statistician and a consumer. The necessary revisions must be made and accepted by the Coordinating Editor before the protocol can be published in the Cochrane Library.
The review itself can take many months to complete. First, the required papers and other information have to be gathered. Then two independent co-reviewers decide on whether the papers qualify as suitably controlled and randomised trials that meet the inclusion criteria. The quality of these papers, based on the methods and analysis used, is also assessed. The data are extracted and analysed, a metaanalysis is done if appropriate and conclusions are drawn. The completed review is then resubmitted to the lead editor and if s/he is satisfied, it is again sent for peer review and revision before publication in the Cochrane Library.
After publication, comments and criticism about reviews can be made online directly from the Cochrane Library. There is also an obligation for all reviews to be updated every 2 years.
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