Archie Cochrane

Archibald Leman Cochrane CBE (12 January 1909 – 18 June 1988) was a Scottish doctor noted for his book Effectiveness and Efficiency: Random Reflections on Health Services. This book advocated the use of randomised control trials to make medicine more effective and efficient. His advocacy of randomised controlled trials eventually led to the development of the Cochrane Library database of systematic reviews, the establishment of the UK Cochrane Centre in Oxford and the international organisation Cochrane. He is known as one of the fathers of modern clinical epidemiology and evidence-based medicine and is considered to be the originator of the idea of evidence-based medicine in the current era.

Cochrane was born in Kirklands, Galashiels, into a family he described as “industrial upper-middle class”. His father was killed whilst serving with the KOSB during World War I. He won a scholarship to King’s College, Cambridge, achieving first-class honours in Parts I and II of the Natural Sciences Tripos and completing 2nd MB studies in physiology and anatomy in 1930. He qualified in 1938 at University College Hospital, London, at University College London.

Cochrane was born with porphyria. This caused health problems throughout his life. He tried treatment in Berlin, then Vienna and the Hague combining his treatment with undertaking medical studies in Vienna and Leiden. He became fluent in German, which was useful later on in life. His travels also convinced him of the importance of the anti-fascist cause.

During the Spanish Civil War, Cochrane served as a member of a British Ambulance Unit within the Spanish Medical Aid Committee. In World War II, he joined the British Army and was captured during the Battle of Crete and subsequently worked as a Medical Officer in prisoner of war camps. His experience in the camps led him to believe that much of medicine did not have sufficient evidence to justify its use.

He said: “I knew that there was no real evidence that anything we had to offer had any effect on tuberculosis, and I was afraid that I shortened the lives of some of my friends by unnecessary intervention.” As a result, he spent his career urging the medical community to adopt the scientific method.

After the war, he studied for a Diploma in Public Health at the London School of Hygiene & Tropical Medicine and spent a year at the Henry Phipps Institute in Philadelphia on a Rockefeller Fellowship. Cochrane joined the Medical Research Council’s Pneumoconiosis Unit at Llandough Hospital, part of the Welsh National School of Medicine, now Cardiff University School of Medicine, in 1948. Here he began a series of studies on the health of the population of Rhondda Fach — studies which pioneered the use of randomised controlled trials (RCTs).

For his “gallant and distinguished” services in prisoner of war camps he was awarded an MBE by the British Government; for his contributions to epidemiology, he was later appointed a CBE.

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