As we move forward through spring time in China and other parts of the northern hemisphere, we think back twelve months to the earthquake that struck the Wenchuan region of China. Tens of thousands of people were killed and many more were injured, requiring an enormous response by the healthcare community and society more widely. Through the early history of the Journal of Evidence-Based Medicine, we have brought you several articles on the healthcare response to the Wenchuan earthquake, and on the consequences of that natural disaster. We continue this focus in this issue, with research showing how the earthquake affected the lives and health of people in the region, and how it affected systems for delivering healthcare and monitoring health. The whole collection of articles will help in planning for, and responding to, future natural disasters and large-scale health emergencies (1).
It is therefore pertinent to note that, as we write this editorial, the chances of an influenza pandemic appear higher than at any time in several years. A pandemic, or its avoidance, will require a global effort for prevention and treatment. This global effort should be based on reliable evidence and knowledge about which interventions are effective, which are ineffective, which are unproven and which require further research. Those that require further research should be evaluated formally, perhaps within randomized trials, in order to provide the evidence that will reduce uncertainty in the future. Access to the relevant evidence will also be vital to its implementation and The Cochrane Collaboration has built on its experience with Evidence Aid to tackle this (2). A collection of resources, including the 17 relevant Cochrane reviews, audio podcasts and a slideshow have been made available free on the Collaboration's website (http://www.cochrane.org). The podcast on physical barriers to prevent the spread of respiratory viruses, such as influenza A(H1N1), and the slideshow with general advice are available in several languages including Mandarin, Spanish and German, as well as English.
As well as the focus on the response to healthcare emergencies, we include a variety of other articles in this issue. If you're reading this on the internet, you might be especially interested in the article by Silvia Gallagher. She studied the use of the internet by people with mental health problems who were seeking health information. The research found that they are more likely than others to turn to this source of knowledge. This highlights the need to overcome those barriers that may prevent access to the reliable information that is now available online.
Andy Oxman and Atle Fretheim have done a review of systematic reviews of results based financing as a way of improving health. They express caution about the implementation of such initiatives, finding that the interventions may lead to short term gains without giving rise to changes that are sustained in the long term. They also stress the need for care in developing and monitoring results based financing, to avoid unintended consequences and harms.
In addition to the article arising from a review of systematic reviews, we also feature other pieces that discuss and arise from systematic reviews. For those who are unfamiliar with this type of research, this issue's education section discusses the systematic review, in plain language. While the summary of Issue 2, 2009 of The Cochrane Library describes how there are now more than 3600 full Cochrane reviews available within the Library on the internet (http://www.thecochranelibrary.com). We are also pleased to present summaries of three recent Cochrane reviews in which the authors describe, in their own words, the effective use of mupirocin ointment for MRSA (3), the effects of mouthrinses on bad breath (4), and the role of rehabilitation for people who have had surgery on their back for conditions such as sciatica (5).