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Table 3 Themes and supporting statements from open-ended questions

From: Publication of reviews synthesizing child health evidence (PORSCHE): a survey of authors to identify factors associated with publication in Cochrane and non-Cochrane sources

Theme Sample supporting statements from survey respondents
Cochrane is recognized as producing high-quality, methodologically rigorous systematic reviews. “It can be a very long process, but the rigour of the reviews is ensured through much of this.”
“I love the structured nature of the review and the way that all the questions you have a clearly answered within the handbook.”
“Once completed, very happy. But the process was very long. However, this was for fine tuning and ensuring high quality, so justifiable in the end.”
“The support and enthusiasm for high quality reviews is excellent. Best evidence reviews endorsed by Cochrane and reputable journals are fundamental to clinical decision-making.”
“In the forefront of methodological development.”
Cochrane is considered an excellent organization with which to work. “Fantastic. An excellent organisation to work with.”
“All very professional and I always received responses in a timely manner.”
“…my best colleagues and the people I respect more professionally are in the Cochrane Collaboration. I think that is much more than an editorial group, it is rather an approach to health care.”
“I think the Cochrane collaboration is a great organisation. I think it is great that anybody can get involved in writing Cochrane reviews…”
The support in producing systematic reviews offered through Cochrane is highly valued. “The access provided to an specialist to help develop the search and to run the searches is invaluable in the preparation of reviews.”
“They were extremely patient, helpful, provide adequate and timely guidance for the statistical analysis and ensured the review's completion.”
“They were very supportive throughout the process.”
“The support given by the group was brilliant throughout.”
“A very enjoyable and rewarding process. All the review writing software and other resources are easy to access and use.”
“Far more editorial support than ordinary journals would give.”
The process is standardized but application of standards varies by review group. “The process is standardised, though quality and quantity of the process is very different by each review group.”
“I think that the process involved in getting these reviews done can be improved and streamlined across the review groups.”
The process of producing a Cochrane systematic review is lengthy. “Good support. Total procedure was far too long.”
“It took longer than I had initially anticipated.”
“There is a long gap of time between finishing protocol and the first submission for review? This causes loss of momentum. This should be cut short and an intermediate stage of filling in the data should be introduced. A tutorial on analysis After data collection will be useful and decrease the dependence on the Cochrane expert author.”
“Submitting a title and wait to hear if it is accepted. Submitting a protocol and the lengthy process that follow for it to be published. The lengthy peer review process of the review itself. I think that that submission from a third World country is not treated fairly.”
“Takes more time than a traditional journal.”
“The review process and clearing the protocol thought the specialty sub-groups is long and dampens momentum on projects. The ongoing commitment to review and update emerging evidence after the completion of the review is also daunting.”
Some Cochrane requirements (e.g., search completed within 12 months) conflict with process (e.g., time for editorial review). “Peer review and iterations of the protocol and review added an unacceptable time lag to completing the review. The requirement for searches to be done within 6-12 months of publication of the review conflicts with the time involved in the editorial processes and peer review of the final review.”
Time requirements often prohibit trainees (e.g., graduate students) from working with Cochrane. “Excellent support, but too long procedure to be included in regular PhD trajectories.”
“Most of the SRs I have published over the years start as graduate student projects to understand what is available around the topic of their thesis. When we finally decide to pursue publication it just does not make sense to start a Cochrane process.”
The increasing methodological requirements (e.g., GRADE) are adding complexity for authors, require additional training, and increase production time. “There should be a standard checklist for things to do especially with regards to use of GRADE criteria. Authors should be helped with this relatively new concept and be offered more help and encouragement.”
“My only caveat is that it is hard at times to get every detail of the process exactly as the Cochrane editor wishes (though I understand the benefits as well as the disadvantages of a formulaic approach)”
“Difficult as the rules and regulations are much more onerous I would probably advise people to now avoid the Cochrane process. MECIR guidelines are being interpreted by review groups in different ways and are putting the onus on authors to check about compliance to all the guidelines”
“My experience is that people [are] in general scared by the amount of work needed.”
The increasing methodological requirements may have an adverse impact on the readability and utility of the systematic reviews. “I think that the ever increasing requirements e.g., MECIR, summary of findings tables etc. is making the process for reviewers even more difficult and is having an adverse impact on the readability of the reviews.”
Publication in non-Cochrane sources may reach a wider audience, or specific audience of interest (e.g., clinical specialty). “To increase coverage and readership”
“To give wide audience to a topic we consider extremely important.”
“It was an important clinical question and we used advanced methods which we thought would be of interest to journals”
“We think CDSR is limited in some countries so publishing in paper journal may produce more impact to public and health care.”
“More publications for the same work”
The scope of Cochrane is restrictive (e.g., only randomized controlled trials, clinical topics of interest, quantitative focus). “Cochrane…very strict on what it accepts. They are also more [topics] which can fall outside the Cochrane remit”
“We believe that SRs are justified even when no RCTs are available. Clinicians need to make decisions based on the best available evidence even if it not RCT driven. The Cochrane SRs do have as condition to include only RCTs.”
“I think that The Cochrane Collaboration is often associated with very strict rules and regulations”
“I dislike working with Cochrane because they are so slow and believe their way is the only/right way, even when there are alternative perspectives.”
  1. CDSR Cochrane Database of Systematic Reviews, RCTs randomized controlled trials, SRs systematic reviews