Archibald Leman Cochrane

Archibald Leman Cochrane (born January 12, 1909, Galashiels, Scotland—died June 18, 1988, Dorset, England) was a British physician who contributed greatly to the development of epidemiology, emphasized the necessity for randomized control trials (RCTs) in medical studies, and was a pioneer in evidence-based medicine. His ideas eventually led to the creation of the international Cochrane Collaboration, which tracks, evaluates, and synthesizes the results of clinical trials and other studies in all areas of medicine.

Cochrane was born to a wealthy tweed-manufacturing family in Scotland. He received first-class honours in natural sciences from King’s College, Cambridge, in 1930 and continued his studies at the university as a laboratory research student. After an interlude during which he underwent psychoanalysis in Europe with Theodor Reik and received training in the field from him, Cochrane began his medical education in 1934 at University College Hospital in London. He interrupted his studies in 1936 to provide medical support to Republican troops in the Spanish Civil War (1936–39); he first served in a field ambulance unit of the Spanish Medical Aid Committee and then joined a medical unit of the International Brigade. He returned to Great Britain in 1937 and finished his medical degree the following year.

With the outbreak of World War II in 1939, Cochrane enlisted and served as a captain in the Royal Army Medical Corps. While on duty in Crete, Greece, in 1941, he was captured and taken prisoner by the Germans. For the rest of the war, he was a medical officer in various prisoner-of-war camps in Greece and Germany. Many prisoners he treated suffered from tuberculosis, and he became interested in studying the disease. During his captivity, he managed to conduct a clinical trial with 20 of his fellow prisoners who were suffering from edema in the lower extremities, and he persuaded their captors to provide nutritional supplements to improve the prisoners’ health. After the war, through a Rockefeller scholarship in preventive medicine, Cochrane attended the London School of Hygiene & Tropical Medicine and, in 1947, the Henry Phipps Institute in Philadelphia, to study the epidemiology of tuberculosis.

Having returned to the United Kingdom, from 1948 to 1960 Cochrane was a member of the Medical Research Council (MRC) Pneumoconiosis Research Unit in Penarth, Wales. His work at the council included the study and classification of pneumoconiosis, a common occupational lung disease of coal miners in Wales. Cochrane became increasingly interested in the reproducibility of all clinical and related measurements, as well as in many aspects of field epidemiology, such as the standardization of collected data and the validation of diagnoses. He remained committed to obtaining the best possible results from his epidemiological studies and later completed 20- and 30-year follow-ups of his original study population.

In 1960 Cochrane was appointed the David Davies Chair of Tuberculosis and Diseases of the Chest at the Welsh National School of Medicine in Cardiff. He also became the director of the Medical Research Council Epidemiology Research Unit. In 1972 the Nuffield Provincial Hospitals Trust awarded Cochrane its Rock Carling fellowship; his fellowship lecture, “Effectiveness and Efficiency: Random Reflections on Health Services,” was subsequently published as a book that became influential in the field. In the book Cochrane stressed the need to use the evidence from RCTs.

Cochrane’s ideas were instrumental in the 1993 founding of the Cochrane Collaboration, an international nonprofit organization named for him. It conducts and publishes systematic reviews of health care interventions (such as medicines, supplements, vaccinations, tests, and treatments), and it promotes clinical trials and studies of interventions. Its major product is the Cochrane Database of Systematic Reviews, published quarterly as part of the Cochrane Library, a collection of databases maintained by the organization.