minutes of the annual general meetings (agms) of the cochrane collaboration and the collaboration trading company limited ===================

Minutes of the Annual General Meetings (AGMs) of the
Cochrane Collaboration and the Collaboration Trading Company Limited
====================================================================
Barcelona, Spain
Wednesday 29 October 2003
[These minutes were approved on 3 October 2004.]
Present (only the named entity representatives, Steering Group
members, Trading Company Directors and Secretariat staff are listed
here; other members of The Cochrane Collaboration also attended these
meetings):
Catherine Acquadro, Clive Adams, Claire Allen, Henning Keinke
Andersen, Gerd Antes, Elizabeth Arnold, Lorne Becker, Sally Bell-Syer,
Lisa Bero, Jacqueline Birks, Sue Brennan, Livia Candelise, Paul
Chinnock, Rachel Churchill, Kathie Clark, Mike Clarke, June Cody,
Mandy Collingwood, Jane Cracknell, Mark Davies, Jon Deeks, Vittorio
Demicheli, Jane Dennis, Liz Dooley, Susanne Ebrahim, Marco Esposito,
Frances Fairman, Yngve Falck-Ytter, Cynthia Farquhar, Graziella
Filippini, Josep Maria Garcia, Davina Ghersi, William Gillespie, Sally
Green, Jeremy Grimshaw, Diane Haughton, Gemma Healy, Sonja Henderson,
David Henderson-Smart, Jini Hetherington (minutes), Kate Hey, Julian
Higgins, Sue Jessop, Kate Jewitt, Gail Kennedy, Terry Klassen, Jos
Kleijnen (Chair for items 4-9), Monica Kjeldstrøm, Thilo Kober, Peter
Langhorne, Steff Lewis, Youping Li, Alessandro Liberati, Janet
Lilleyman, Roderick MacDonald, Mark Lodge, Eric Manheimer, Heather
Maxwell, David Moher, Marijke Moll, Theresa Moore, Miranda Mugford,
Jim Neilson (Chair for items 1-3 and item 10), Dimitrinka Nikolova,
Samuel Ochieng, Arne Ohlsson, Nancy Owens, Jordi Pardo, Sharon Parker,
Elizabeth Paulsen, Vicki Pennick, Kim Pollard, Jennie Popay, Tracey
Remmington, Sarah Richardson, Jacob Riis, Reive Robb, Caroline Rouse,
Nick Royle, Rob Scholten, Nandi Siegfried, Silvana Simi, Lesley
Stewart, Brenda Thomas, Elinor Thompson, Peter Tugwell, Huib van
Vliet, Janet Wale, Elizabeth Waters, Liz Whamond, and Narelle Willis.
1. Welcomes, apologies for absence, and approval of the agenda
Jim Neilson, Co-Chair of The Cochrane Collaboration Steering Group,
welcomed everyone to the meeting. There were no apologies for absence,
and the agenda was approved. Jim explained that The Cochrane
Collaboration is a registered charity and that the purpose of the
first part of the meeting (items 1 to 9) was to fulfil the legal
requirements of the charity and its wholly-owned subsidiary, the
Collaboration Trading Company, and that the second part of the meeting
(item 10) was for open discussion. Jim also explained that it is the
Cochrane entities that constitute the membership of The Cochrane
Collaboration, and one representative of each entity has a vote at
this meeting, should anything need to be put to the vote.
2. Steering Group membership
Jim introduced the elected members of the Steering Group, explaining
that Vittorio Demicheli (representing Fields) and Samuel Ochieng
(representing the Consumer Network) were stepping down from the
Steering Group, and Janet Wale was joining it (representing the
Consumer Network), all with effect from the date of this meeting.
There had been no nominations to replace Vittorio Demicheli as Field
representative on the Steering Group; therefore the Group is one
member short until a representative for Fields is elected.
3. Approval of minutes of The Cochrane Collaboration's AGM of 1 August
2002
No corrections were suggested for the minutes of the Charity’s
previous AGM of 1 August 2002. Davina Ghersi proposed that these
minutes be approved; Kathie Clark seconded the proposal, and the
minutes were approved. No matters arising from that meeting were
raised for discussion. The minutes should now be made publicly
available on the Collaboration web site.
Action: Jini Hetherington
4. Approval of minutes of the Trading Company's AGM of 1 August 2002
In his capacity as Director of the Trading Company, Jos Kleijnen took
over chairing the meeting at this point. With reference to item 5 of
the minutes of the previous AGM, Jos explained that the criterion for
appointing a new Director of the Trading Company was that she or he
should be an ex-member of the Steering Group, or alternatively someone
could be appointed as the result of a proposal from an entity
representative. No corrections were suggested for the minutes of the
Trading Company’s previous AGM of 1 August 2002. Jim Neilson moved
their approval; Monica Kjeldstrøm seconded the proposal, and the
minutes were approved. They should now be made publicly available on
the Collaboration web site.
Action: Jini Hetherington
5. Annual report to Companies House
Jos Kleijnen explained that the annual report to Companies House for
the year ended 31 March 2003 had been circulated to all entities by
e-mail in PDF format at the beginning of October. He asked if there
were any questions about the annual report and there were not. Mike
Clarke, Treasurer of The Cochrane Collaboration, proposed acceptance
of the annual report; Gerd Antes seconded this proposal, and it was
approved.
6. Financial Statements for the year to 31 March 2003
Jos Kleijnen explained that the figures contained in the financial
statements had been prepared by the auditors, Mazars. The auditors’
own report would not be added to the financial statements until they
had received signed copies of the Charity and Trading Company
documents. Jos asked if there were any questions about these financial
statements and there were not. Mike Clarke proposed acceptance of the
financial statements of the Charity and the Trading Company for the
year to 31 March 2003; Sally Green seconded the proposal, and the
financial statements were approved.
7. Resignation of Malcolm Newdick as Trading Company Director, and
appointment of a new Director
Jos Kleijnen explained that he had circulated a message to all
entities at the beginning of October 2003, announcing Malcolm
Newdick’s resignation as a Director of the Trading Company with effect
from the date of this meeting. He had asked for anyone interested in
replacing him to make her or himself known to Jos, twenty-one days in
advance of this Annual General Meeting in accordance with the Articles
of Association. If someone had come forward through that process the
Trading Company Directors would have considered appointing such a
person, but no-one had. The current Directors had therefore decided
not to replace Malcolm at this time, to assess whether three Directors
is a sufficient number, and to report on this at the next Annual
General Meeting in October 2004. Jos noted his appreciation of the
tremendous contribution that Malcolm had made while a Director of the
Trading Company. Malcolm’s business background had been a great asset,
and Jos thanked him on behalf of his Co-Directors, Monica Kjeldstrøm
and Peter Langhorne, for his invaluable input and the dedication with
which he had fulfilled his responsibilities as Director.
8. Appointment of auditors
Jos Kleijnen said that the current auditors, Mazars, had been doing a
satisfactory job. There were no objections to their reappointment. Jon
Deeks therefore proposed their reappointment; Jordi Pardo seconded the
proposal, and it was approved.
9. Approval of accounting policies
Jos Kleijnen reported that it was good practice for The Cochrane
Collaboration to keep the accounting policies used under review and
pointed to these within the annual report that had been circulated in
advance. He asked if there were any questions about these policies and
there were not. Mike Clarke proposed the approval of the accounting
policies currently in use; David Henderson-Smart seconded the
proposal, and the accounting policies were approved.
THE PART OF THE AGMs NECESSARY TO FULFIL LEGAL REQUIREMENTS WAS
CONCLUDED.
10. Any other business
Jim Neilson took over again as Chair for this part of the meeting. He
explained that the issue of commercial sponsorship had been widely
discussed throughout the past year, and had been the subject of the
opening plenary at the current Colloquium and other meetings over the
previous few days. This had been at the request of the Steering Group
as a way for it to collect feedback on the next steps. He said that
the Steering Group was to meet again the following day to decide on a
strategy and timetable for handling this complex issue. Entities would
then be asked to give their views to the Steering Group in time for
the Steering Group to discuss what the appropriate policy should be,
during their next face-to-face meeting in Bergamo, Italy, at the end
of February 2004. Feedback given to the Steering Group so far had been
that there were many aspects of sponsorship to be considered, and that
The Cochrane Collaboration should not be rushed into deciding on a
policy in this regard.
Luis Gabriel Cuervo of BMJ Knowledge (Clinical Evidence) asked whether
there had been any progress on developing country issues, as
contributors to The Cochrane Collaboration in those parts of the world
needed more support. Jim Neilson explained that Xavier Bonfill was
leading the developing country initiative, and that the group working
on this issue would be making recommendations to the Steering Group
for discussion at its next meeting in February 2004.
Vicki Pennick of the Cochrane Back Group asked whether the potential
for influence by vested interests was wider than the pharmaceutical
industry. Jim Neilson said that there are other commercial and
non-commercial entities with a vested interest in Cochrane reviews;
for example, governments have a vested interest, due to financial
constraints.
Marco Esposito of the Cochrane Oral Health Group said that the
influence of medical insurance companies was potentially positive.
Lisa Bero of the San Francisco branch of the US Cochrane Center said
this was an important point, and that concerns about industrial
sponsorship should not focus solely on the pharmaceutical industry.
Lisa said that there should be a focus on potential funders for which
there is evidence of association of outcome, and perception of bias,
and that lots of data exist relating to the oil industry, high
intensity farming and the effects of waste.
Nancy Owens of the US Cochrane Center said that The Cochrane
Collaboration’s existing policy on corporate sponsorship is pretty
clear. She asked what had changed in the last two years to make it
necessary to consider a change in policy. Miranda Mugford of the
Health Economics Methods Group said she had been advised by the UK
Cochrane Centre five years ago to seek funding from the pharmaceutical
industry as no other sources of funding for her work seemed available
at that time. Jim Neilson said that part of the reason for the current
discussion was prompted by a document on this issue that had been
circulated to entities by Peter Gøtzsche, Jos Kleijnen and others in
the Collaboration last year.
Jos Kleijnen explained that he was speaking as a Cochrane reviewer,
and that their document had been triggered by the realisation that the
wording of the Collaboration’s policy on sponsorship of individual
reviews said that they must not be funded “solely” by industry. He
said that this word seemed meaningless, and that one doesn’t want
people with a clear interest in the outcome to fund an individual
review, even in part, if one is concerned about potential bias. He
also said that the perception of the organisation as being independent
should not be compromised. He suggested that funding should be at the
entity level rather than directly linked to a specific review.
Nancy Owens said that some of the discussions during the Colloquium
seemed to be about relaxing the restrictions on commercial sponsorship
and she asked, “If we want to have closer links with industry, what
has changed?”
Alessandro Liberati of the Italian Cochrane Centre said that Italian
reviewers had spent some time discussing this matter during the
current Colloquium. He said that the different types of sponsorship
should be made clearer, and asked what was the point of changing the
policy. The problem was the many different ways in which the
Collaboration could accept commercial sponsorship. The other issue, he
said, was the danger of distorting the agenda of an individual entity.
He thought the Steering Group should make a clearer distinction
between the different sorts of sponsorship under discussion.
Jim Neilson said that it was very important not to be rushed into any
hasty decisions about this complex issue and that this had been the
clear message to the Steering Group from the entity meetings at which
this had been discussed during the Colloquium.
Tom Jefferson of the Vaccines Field expressed concern that the agenda
of The Cochrane Collaboration had been hijacked by pharmaceutical
sponsorship, but he pointed out that governments could heavily
influence the agenda as well, for example in relation to vaccines.
Jeremy Grimshaw of the Effective Practice and Organisation of Care
Group said that The Cochrane Collaboration places much emphasis on
minimising bias, but that there is strong empirical evidence that the
pharmaceutical industry biases the research it funds. He asked what
would happen, if the policy is changed to prohibit any industry
funding of individual reviews, should a Collaborative Review Group
accepted such funding for its work. “We should be very cautious,” he
said, “not to lose the most important thing about The Cochrane
Collaboration.”
Kay Dickersin of the US Cochrane Center asked the Steering Group to
describe what the process would be for making a decision on this
topic, including how individual and entity views would be taken into
consideration. She asked whether, for example, this would be a vote or
a consensus decision, and whether entity representatives would be
bound to represent the views of their entity’s members. If a process
had not yet been decided upon, she asked the Steering Group to give
the timeline for deciding the process, and at what stage any updates
could be expected. Jim Neilson explained that a formal process would
be put in place. He re-stated that the entity representatives on the
Steering Group had each given an account of the discussions that had
taken place within their entity on this topic during the Colloquium,
and there would be more formal consultation throughout all entities
over the next few months.
Clive Adams of the Cochrane Schizophrenia Group said it was touching
how the pharmaceutical industry was interested in supporting The
Cochrane Collaboration. He suggested that they could save the
organisation a great deal of time and money by making all their data
freely available to it.
Lisa Bero of the San Francisco branch of the US Cochrane Center agreed
that governments do have financial interests in the findings of some
reviews, and in light of the supporting evidence, she urged that the
discussion should be kept focussed on financial gain.
Mark Lodge of the Cochrane Cancer Network asked whether, if a health
care guideline was being written and it was possible to commission a
review to meet that information need, this could be interpreted as a
‘clean’ transaction. He said that there are genuine cases where
Cochrane reviewers might be able to obtain funds for legitimate needs
but the money could be ’unclean’. “It is not that we are unworldly,”
he said, “but that we are currently just unworldly enough.”
Jeremy Grimshaw of the Effective Practice and Organisation of Care
Group asked what would be the process of consultation in the
Collaboration. “It feels a very passionate issue,” he said, “and the
process should be made very clear.”
Mike Clarke, Co-Chair of the Steering Group, said that process was a
very important point for the Steering Group to discuss in its meeting
the following day and that that meeting had been arranged in order to
allow consideration of the comments made during this Annual General
Meeting. He noted the difficulty of carrying out a consultation
process within a democratic and diverse organisation such as The
Cochrane Collaboration. He said that the Steering Group hopes to
identify a consensus within the views expressed about this issue so
that at its next meeting in February 2004 in Italy, the decision and
policy can be discussed and then announced. It could, of course, be
discussed again at the next Annual General Meeting in Ottawa in
October 2004. He re-stated that the Steering Group had been asked to
avoid doing anything too quickly and that there were many people
within The Cochrane Collaboration who had not yet been able to express
their views on this topic. However, he said that there was also a need
to ensure that the discussion about how to reach a decision would not
be endless, and that when a decision had been made, the Steering Group
would be accountable for it at the next Annual General Meeting.
Cindy Farquhar of the Cochrane Menstrual Disorders and Subfertility
Group asked whether the decision would be reached by consensus or by a
vote. Mike Clarke, Co-Chair of the Steering Group, asked what entities
thought of that. Kay Dickersin of the US Cochrane Center said that
many questions had been raised, that some could be answered by vote
and some by consensus, and that everyone should have the chance to
comment on the consultation process. Miranda Mugford of the Economic
Methods Group said that whatever decision was made, people should
declare their conflicts of interest in The Cochrane Library for the
sake of transparency. Lisa Bero of the San Francisco branch of the US
Cochrane Center agreed that such conflicts of interest should be
declared. Jeremy Grimshaw of the Effective Practice and Organisation
of Care Group said that Co-ordinating Editors should declare any
conflicts of interest in their modules in The Cochrane Library.
Nancy Owens of the US Cochrane Center asked again whether there was
any need to change Collaboration policy on this issue. Jim Neilson
said that the Steering Group would be looking at reviews already
published in The Cochrane Library that might breach the
Collaboration’s policy on conflict of interest. Kay Dickersin of the
US Cochrane Center said that the Steering Group should also declare
their financial conflicts of interest as part of this process.
There appeared to be no-one else who wished to comment on this issue
at this time.
In closing, Mike Clarke said that the Steering Group had agreed at
their meeting on 25 October 2003 that The Cochrane Collaboration’s
core funds would be used to sponsor the registration fee for one
member of each entity to attend the Ottawa Colloquium (this excludes
the cost of travel and subsistence). He said that use of core funds
for this purpose would be reviewed for future years, following the
Ottawa Colloquium. Tom Jefferson of the Vaccines Field asked that this
sponsored registration be applied to people from developing countries.
Mike said the Steering Group would be considering issuing guidance on
how the person to use each entity’s sponsored registration should be
chosen. Jim Neilson thanked everyone for attending, and closed the
meeting at 3.30 p.m.
The meeting lasted for 75 minutes.
/var/www/doc4pdf.com/temp/802129.doc 19 October 2004 - 5 -

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