FINAL WORKSHOP PROGRAMME FINAL by ashrafp

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									   STUDY EXCURSION PROGRAMME



                FOR

        THE DELEGATION ON

   THE COCHRANE COLLABORATION,
HEALTH TECHNOLOGY ASSESSMENT, AND
 EVIDENCE-BASED CLINICAL PRACTICE


               FROM

      THE MINISTRY OF HEALTH,
             P.R. CHINA




                 The Cochrane Hepato-Biliary Group
                           The Copenhagen Trial Unit
             Centre for Clinical Intervention Research
                     Copenhagen University Hospital
                                     H:S Rigshospitalet
                                              July 2002
Contents



Foreword……………………………………………………………………….………………3

Members of the Delegation…………………………………………………………………..4

Programme of the study excursion…………………………………………..……….……..5

List of speakers and instructors…………………………….…………………………..….14

Introduction to the institutions….………………………………….………………………..18

Suggested reading…………………………………………………………………………..49

Practical information……………………….………………………………………………..50




This study excursion for The Delegation from The Ministry of
  Health, P.R. China, to Denmark is partly sponsored by an
                   educational grant from
    Novo Nordisk A/S, Denmark, and Novo Nordisk China




                                                                2
                                       Foreword
To all members of The Delegation stud ying The Cochrane Collaboration, Health
Technology Assessment, and Evidence-based Clinical Practice from The Ministry of
Health, P.R. China, I want to express my sincere and warm welcome to Denmark. I do
hope that you will enjoy your study excursion to Europe.

Denmark is a small country and I am proud that you have chosen Denmark for your
study excursion and that you have wished to spend so much of your precious time here.
The Cochrane Hepato-Biliary Group and The Copenhagen Trial Unit, Centre for Clinical
Intervention Research, Copenhagen University Hospital, H:S Rigshospitalet, have - in
collaboration with representatives from the Danish Government, the Danish Counties,
The Medical Faculty, Copenhagen University, Danish health care institutions (The
Danish National Board of Health, The Danish Medicines Agency, H:S Rigshospitalet,
H:S Hvidovre Hospital, H:S Bispebjerg Hospital, The Danish Institute for Health
Services Research, The Copenhagen Hospital Corporation), The Cochrane
Complementary Medicines Field in Munich, Germany, as well as The Nordic Cochrane
Centre and the two other Cochrane Collaborative Review Groups with Editorial Team
Offices in Copenhagen (The Colorectal Cancer Group and The Anaesthesia Group) -
strived to arrange a comprehensive programme that should give you some
understanding of

   the management system for randomised clinical trials,
   The Cochrane Collaboration and systematic reviews,
   health technology assessment,
   regulation of complementary/alternative medicine,
   evidence-based medicine and clinical practice, and
   The Danish health-care system and corporation.

If you miss anything or if you would like further information, please ask for it! We shall
do our best to fulfil your wishes.

I would like to express my sincere gratitude to all institutions and individuals
participating in this educational programme. They have with a fairly short notice all
willingly accepted to receive you and provide you with the best knowledge and
information they can provide. I am very thankful for this collaboration. Also many thanks
to Jianping Liu and Wendong Chen for having translated this programme into Chinese
and last, but not least, to Jianping Liu for having been an excellent liaison between
China and The Copenhagen Trial Unit.

It is my hope that your study excursion will not only benefit the further implementation of
evidence-based medicine in clinical practice in China but also accelerate its
implementation in clinical practice in Denmark. Lastly, I hope it will foster increased
collaboration between our countries – for the benefit of patients in both our countries.

Christian Gluud
The Cochrane Hepato-Biliary Group,
The Copenhagen Trial Unit
July 2002


                                                                                          3
    Members of the Delegation from The Ministry of Health, P. R. China

                 Gen-     Age                           Professional
Name                              Organisation                            Position
                 der      (yrs)                         post
Guoming Qi       male     55      Ministry of Health    Professor         Director-
                                                                          general
Xiucheng Yu      male     53      Ministry of Health    Professor         Director
Jianping Liu     male     40      Chinese Cochrane      Professor         Deputy
                                  Centre                                  Director (as
                                                                          interpreter)
Jianping Yuan    male     48      Jiangsu               Chief physician   Director
                                  Administration of
                                  Health
Hui Dai          male     45      Jilin                 Deputy chief      Director
                                  Administration of     physician
                                  Health
Dongchang        male     56      Helongjiang           Deputy chief      Director
Chu                               Administration of     physician
                                  Health
Shenghui Wu      female   45      Guangdong             Deputy chief      Deputy
                                  Administration of     physician         Director
                                  Health
Rong Gao         male     47      Zhejiang              Deputy chief      Deputy
                                  Administration of     physician         Director
                                  Health
Mingyan Jia      female   52      Beijing               Deputy chief      Director
                                  Administration of     physician
                                  Health
Fengshen Ding    male     47      Shandong              Deputy chief      Deputy
                                  Administration of     physician         Director
                                  Health
Xubo Chen        male     53      Hunan                 Chief physician   Director
                                  Administration of
                                  Health
Xiangyi Tian     male     41      Shanxi                Deputy chief      Deputy
                                  Administration of     physician         Director
                                  Health
Wei Peng         male     46      Hebei                 Chief physician   Director
                                  Administration of
                                  Health
Xiaohong Chen female      51      304 Hospital of       Chief physician   Dean
                                  Ministry of Health
                                  of PLA
Yanhong Sun      female   37      Ministry of Health,   Deputy chief      Deputy
                                  Telemedicine Edu.     physician         Director
                                  Ctr.
Li Xu            female   35      Gansu                 Deputy chief      Deputy
                                  Administration of     physician         Director
                                  Health
                                                                                         4
Program for training excursion for
The Chinese Delegation, Ministry of Health, P.R. China

on

The Cochrane Collaboration, Health Technology Assessment, and Evidence-
based Clinical Practice - August 2002

Day 1    9 Aug. (Friday)     Beijing-Copenhagen
                             Arrival in Copenhagen 22.00,
                             Hotel SCANDI C COPENHAGEN
Day 2   10 Aug. (Saturday)   Week-end - jet lag readjustment

                             Welcome dinner 19.00, Kastelsvej 27
                             Copenhagen Trial Unit
Day 3   11 Aug. (Sunday)     Week-end - sightseeing in Copenhagen

Day 4   12 Aug. (Monday)     10.00-12.30
                             Copenhagen Trial Unit, Tagensvej 18 B,
                             H:S Rigshospitalet

                                     - Welcome – and presentation of the
                             10.00-10.20
                             programme
                             Chri stian Gluud

                                       Evidence-based medicine and
                             10.20-10.40 -
                             evidence-based clinical practice
                             Chri stian Gluud

                             10.40-11.30 -   History of evidence-based
                             medicine
                             Chri stian Gluud

                                      Methodological quality of
                             11.30-12.00 -
                             randomised clinical trials I
                             Lise Lotte Kjaergard

                                      Methodological quality of
                             12.00-12.30 -
                             randomised clinical trials II
                             Bodil Al s-Nielsen

                                              at Copenhagen Trial Unit,
                             12.30-13.30 - Lunch
                             H:S Rigshospitalet

                             13.30-15.00
                             Copenhagen Trial Unit, Tagensvej 18 B,
                             H:S Rigshospitalet

                             13.30-14.00 -   Methodological quality of Chinese
                             trials
                             Jianping Liu

                                                                                 5
                             14.00-14.30 - The    Cochrane Collaboration
                             Chri stian Gluud

                             14.30-15.00 -   Organisation of health care in
                             Denmark
                             Chri stian Gluud

Day 5   13 Aug. (Tue sday)
                             9.30-12.00
                             Copenhagen Trial Unit, Tagensvej 18 B, H:S
                             Rigshospitalet

                                      The Copenhagen Trial Unit:
                             09.30-10.00 -
                             achievements and challenges
                             Chri stian Gluud

                             10.00-10.30 – Good     clinical practice
                             Chri stian Gluud

                             10.30-10.50 – The    CLARICOR trial
                             Bodil Al s-Nielsen

                             10.50-11.10 – The DIPOM trial
                             Anne Benedicte Juul

                                         Standard operating procedures for
                             11.10-11.35 -
                             clinical research
                             Jette V Petersen

                             11.35-12.00 -Data management in randomised
                             clinical trials
                             Nader Salasshahri

                                              at Copenhagen Trial Unit,
                             12.00-13.00 - Lunch
                             H:S Rigshospitalet

                             13.00-18.00
                             The Cochrane Hepato-Biliary Group,
                             Copenhagen Trial Unit,
                             Tagensvej 18 B, H:S Rigshospitalet

                                       The Cochrane Hepato-Biliary
                             13.00-13.30 -
                             Group: achievements and challenges
                             Chri stian Gluud

                             13.30-14.00 - Systematic   Reviews on traditional
                             Chinese medicine
                             Jianping Liu

                             14.00-14.30 - Systematic   Review on bile acids for
                             viral hepatitis
                             Wendong Chen


                                                                                   6
                                 Systematic Review on antibiotics
                      14.30-15.00 -
                      for coronary heart disease
                      Bodil Al s-Nielsen

                               Hands on exercises on how to use
                      15.00-17.00 -
                      The Cochrane Library
                      Trainers: Bodil Al s-Nielsen, Jianping Liu, Wendong
                      Chen, Sarah Frederiksen, Dimitrinka Nikolova, Chri stian
                      Gluud

                                 Systematic Review on combination
                      17.00-17.30 -
                      therapy with ribavirin plus interferon for
                      chronic hepatitis C
                      Lise Lotte Kjaergard

                                 Health economic evaluation of
                      17.30-18.00 -
                      interventions
                      Hans Keiding

                      18.00 –
                           Dinner, The Cochrane Hepato-Biliary
                      Group at Jette V Petersen’s house
                      Dønnergårds Alle 79, Greve

Day 6   14 Aug.
        (Wednesday)   09.00-12.30
                      Department of obstetrics and gynaecology,
                      H:S Hvidovre Hospital, Kettegård Alle, Hvidovre
                      Main entrance

                      How to bring evidence-based knowledge into
                      practice at departmental level?
                      Chair: Lars Krag Møller

                      9.00-9.10 - Welcome
                      Peter Hornnes

                      9.10-9.30 – Evidence in    daily practice
                      Hanne Kjærgaard Nielsen

                                     to teach evidence-base
                      9.30-10.20 - How
                      medicine in daily practice
                      Lisbeth Nilas

                      10.30-10.40 -   Clinical guidelines
                      Tom Weber

                               - Guidelines on the Internet –
                      10.40-11.10
                      obstacles and advantages
                      Lars Krag Møller

                                 Documentation. Errors and
                      11.10-11.30 -
                      complications
                      Lars Krag Møller

                                                                                 7
                             11.45-12.30 -   Lunch at H:S Hvidovre Hospital

                             Sightseeing in Copenhagen
Day 7   15 Aug. (Thursday)
                             9.00-13.00
                             The Danish National Board of Health, Islands
                             Brygge 67 (entry through Artellerivej)

                             The Danish Strategy for Health Technology
                             Assessment (HTA) and its implementation

                             9.00-9.20 -Welcome. The National Board of
                             Health, organisation and tasks, including the
                             role of its Centre for Evaluation and Health
                             Technology Assessment
                             Jens Kri stian Gøtrik

                                            Danish strategy for HTA with
                             9.20-10.00 - The
                             special reference to clinical management and
                             practice
                             Finn Børlum Kri stensen

                             10.00-10-15 -   Tea/coffee break

                                       Giving early warning to health care
                             10.15-10.45 -
                             systems on emerging technologies
                             Torben Jørgensen

                                      - The international collaboration
                             10.45-11.15
                             between HTA agencies, INAHTA, and its
                             database of ongoing projects and published
                             HTA-reports
                             Malene Fabricius

                                      - Two examples of national HTA:
                             11.15-12.00
                             Diagnosis of colorectal cancer and treatment
                             of rheumatoid arthritis with special reference
                             to new drugs
                             Helga Sigmund and Finn Børlum Kristensen

                                      - Lunch at The Danish National
                             12.00-13.00
                             Board of Health

                             13.30-16.00
                             The Danish Medicine Agency
                             Frederikssundsvej 378, 2700 Brønshøj.
                             Meeting room: Gingko Biloba.

                             13.30-13.40 - Welcome
                             Jytte Lyngvig


                                                                              8
                                     - The Danish Medicine Agency:
                           13.40-14.00
                           organisation, etc.
                           Mogens Bjørnbak-Hansen
                           14.00-15.00 - Approval of   new medicines
                           Per Helboe

                           15.00-15.15 -Tea/coffee   break

                                     - The work in the Institute for
                           15.15-16.30
                           Rational Pharmacotherapy
                           Jens Peter Kampmann and Karin Friis Bach

                           16.30-16.40 – Discussion
                           Jens Peter Kampmann


                           18.00-21.00
                           Novo Nordisk A/S, Denmark and Novo Nordisk
                           China host a Mini-symposium and a dinner at
                           Hvidøre Conference Centre, Emiliekildevej 1,
                           Klampenborg

                           Speakers:
                           Anders Dejgaard
                           Knut Borch Johnsen
                           Tang Yan
                           Jørgen Dirach

Day 8   16 Aug. (Friday)
                           10.30-13.30
                           The Danish Ministry of the Interior and Health,
                           Christiansborg Castle
                           Meeting Room A, third floor

                           10.30-10.35 - Welcome to The Ministry
                           Kjeld Kjeldsen
                           10.35-12.00 - Health Care in Denmark
                           Mogens Jørgensen

                           12.00-12.30 - Visit to The Danish Parliament
                           12.30-13.30 - Lunch at The Danish Ministry of   the
                           Interior and Health in the dining hall of The
                           Parliament/ ‘Snapsetinget’

                           14.00-17.00
                           The Association of County Councils in
                           Denmark,
                           Dampfærgevej 22
                           Lone Chri stiansen
                           Peter Ring
                           Eva Zeuten Benzen


                                                                                 9
                              Program details to follow
Day 9    17 Aug. (Saturday)   Week-end
Day 10   18 Aug. (Sunday)     Week-end
Day 11   19 Aug. (Monday)
                              9.30-12.00
                              DSI - Danish Institute for Health Services
                              Research,
                              Dampfærgevej 22

                                      - Evidence based standards in quality
                              9.30-10.00
                              assurance
                              Jes Søgård

                                         Barriers and bridges to evidence-
                              10.00-11.00 -
                              based clinical practice
                              Pia Kürstein

                                        - Use of cost-effectiveness analyses
                              11.00-12.00
                              in the Danish health care system
                              Jes Søgård

                              12.00-13.00 -   Lunch at DSI

                              14.00-17.00
                              Lectures at The Faculty of Health Sciences,
                              University of Copenhagen, The Panum
                              Institute

                              - Introduction
                              Ralf Hemmingsen

                              - Basic research in a clinical department
                              Bente Klarlund Pedersen

                              - Evidence/bedside          training
                              Torben Schroeder

                              - Danish/Chinese      research collaboration
                              Niels Høiby

                              - Medical education         at The University of
                              Copenhagen
                              Pernille Due

                              - Pre-graduate     training and education
                              Henrik Galbo

                              - Basicnatural science in the medical
                              curriculum
                              Hans Sjöström

                                                     Faculty of Health Sciences,
                              - Ph.D.-education at The
                              University of Copenhagen

                                                                                   10
                              Jørgen Vinten

                              - International    health as seen from a Danish
                              perspective
                              Ib Bygbjerg.


                              19.00 - Dinner at The University of
                              Copenhagen,
                              Frue Plads

                              Rector Linda Nielsen, University of
                              Copenhagen

Day 12   20 Aug. (Tue sday)
                              08.00-10.00
                              Hospital Direction, H:S Rigshospitalet,
                              Department 5222, room AB2

                                         Presentation of The University
                              08.00-09.00 -
                              Hospital of Copenhagen (H:S Rigshospitalet)
                              Ulrik Meyer

                                      - Quality Improvement at H:S
                              09.00-10.00
                              Rigshospitalet
                              Brian Lerche

                              10.00-10.15 - Tea/coffee   break

                              10.15-12.00
                              The Nordic Cochrane Centre, H:S
                              Rigshospitalet

                                         Things to be cautious about when
                              10.15-12.00 -
                              making policy recommendations based on
                              systematic reviews, randomised trials, cohort
                              studies, and expert opinion
                              Peter Gøtzsche

                              12.00-13.00 -   Lunch at H:S Rigshospitalet

                              13.15-18.15
                              The Cochrane Colorectal Cancer Group and
                              The Cochrane Anaesthesia Group,
                              H:S Bispebjerg Hospital
                              Conference room, Department of Surgery K

                              13.15-13.20    - Welcome to H:S Bispebjerg
                              Hospital
                              Steen Werner Hansen

                              13.20-13.40    - The Cochrane Colorectal Cancer
                                                                                11
                              Group history and achievements
                              Henning Keinke Andersen

                                         The value of preoperative bowel
                              13.40-14.00 -
                              cleansing and control-programmes after
                              radical surgery for colorectal cancer
                              Peer Wille-Jørgensen
                                                     intravenous fluid
                              14.00-14.20 - Restricted
                              therapy in colorectal surgery
                              Birgitte Brandstrup

                              14.20-14.35 - Guidelines   in clinical practice
                              Peer Wille-Jørgensen

                              14.35-15.00 -   Tea and coffee

                                        The Cochrane Anaesthesia Review
                              15.00-15.45 -
                              Group: achievements and challenges
                              Tom Pedersen and Jane Cracknell

                              15.45-16.00   Discussion

                              16.00-16.15 - Evaluation   of the programme
                              Chri stian Gluud

                                        Tour of the garden in H:S
                              16.15-16.45 -
                              Bispebjerg Hospital
                              Peter Skanning

                              16.45-18.15 -   Dinner at H:S Bispebjerg Hospital

                              18.51 - Departure for Am sterdam, The Netherlands
Day 13   21 Aug.              08.56 - Arrival in Amsterdam
         (Wednesday)

                              Sightseeing Amsterdam
Day 14   22 Aug. (Thursday)   Sightseeing Europe
Day 15   23 Aug. (Friday)
                              10.00-17.00
                              Cochrane Complementary Medicine Field
                              Centre for Complementary Medicine
                              Research, Department of Internal Medicine II,
                              Technische Universität Munich
                              Kaiserstr. 9
                              80801 München

                              10.00-11.00 -Complementary medicine in
                              Europe: epidemiology, regulation, and
                              political situation
                              Klaus Linde


                              11.00-12.30   - The Cochrane Complementary
                                                                                  12
                              Medicine Field
                              Klaus Linde


                              12.30 - 13.30 –   Lunch

                              13.30-14.30       - The evaluation of acupuncture
                              in Germany
                              Klaus Linde


                              14.30 – 15.00 –   Tea/coffee break

                              15.00 – 16.00 -   Traditional Chinese Medicine in
                              Germany
                              Dieter Melchart


                              16.00 – 17.00
                                       - Electronic documentation of
                              complementary therapies including
                              acupuncture
                              Dieter Melchart

Day 16   24 Aug. (Saturday)   Sightseeing in Munich


Day 17   25 Aug. (Sunday)     Sightseeing Europe

Day 18   26 Aug. (Monday)     Sightseeing Europe

Day 19   27 Aug. (Tuesday)    Sightseeing Europe


Day 20   28 Aug.              Sightseeing Europe
         (Wednesday)          19.45 – Departure for Beijing, China
Day 21   29 Aug.              09.50 - Arrival in Beijing, China
         (Thursday)




The meetings and local transportation will be arranged by The Copenhagen Trial Unit,
H:S Rigshospitalet, + 45 35 45 71 75, e-mail: cgluud@ctu.rh.dk

Translation from English into Chinese will be provided by The Copenhagen Trial Unit –
As the translation is not simultaneous, please consider that it will take the double time of
normal to get the message through!




                                                                                          13
         List of speakers and instructors
Last name         First name       Title                   Organisation
Al s-Nielsen      Bodil            Ph.D.-student,          Cochrane Hepato-Biliary Group,
                                   Clinical assi stant,    Copenhagen Trial Unit,
                                   MD                      H:S Rigshospi talet
Andersen          Henning Keinke   Review Group Co-        Cochrane Colorectal Cancer Group,
                                   ordinator,              H:S Bi spebjerg Hospital
                                   Cand. scient.
Bach              Karin Friis      Pharmacist              The Institute for Rational
                                                           Pharmacotherapy,
                                                           The Danish Medicine Agency
Borch Johns en    Knut             Chief Physician,        Steno Diabet es Cent re
                                   MD, Dr. Med. Sci
Brandstrup        Birgitte         Ph.D.-student,          Clinical Unit of Preventive Medicine
                                   MD                      and Health Promotion,
                                                           H:S Bi spebjerg Hospital
Bjørnbak-Hansen   Mogens           Director of             The Danish Medicine Agency
                                   International
                                   Secretariat
Bygbjerg          Ib               Professor, Head of      Faculty of Health Sciences,
                                   department, MD, Dr.     Copenhagen Universi ty
                                   Med. Sci.
Chen *            Wendong          Researcher,             Cochrane Hepato-Biliary Group,
                                   MD                      Copenhagen Trial Unit,
                                                           H:S Rigshospi talet
Chri stiansen     Lone             Director                The Association of County Council s in
                                                           Denmark
Cracknell         Jane             Co-ordinator            Cochrane Anaesthe sia Group,
                                                           H:S Bi spebjerg Hospital
Dejgaard          Anders           Vice President          Novo Nordi sk A/S, Denmark
                                   Clinical Development,
                                   MD, Dr. Med. Sci.

Dirach            Jørgen           Research Counsellor     Corporate Research Affairs
                                   MD, MFPM                Novo Nordi sk A/S, Denmark,




Due:              Pernille         Dean of Medical         Faculty of Health Sciences,
                                   Education, Senior       Copenhagen Universi ty
                                   lecturer
Fabricius,        Malene           Information             Centre for Evaluation and Health
                                   specialist, librarian   Technology Asse ssment,
                                                           The Danish National Board of Health
Frederiksen       Sarah            Handsearch              Cochrane Hepato-Biliary Group,
                                   Co-ordinator,           Copenhagen Trial Unit,
                                   Cand. scient.           H:S Rigshospi talet
Frydendall        Ninna            Assi stant co-          Cochrane Hepato-Biliary Group,
                                   ordinator               Copenhagen Trial Unit,
                                                           H:S Rigshospi talet
Galbo             Henrik           Professor, MD, Dr.

                                                                                                  14
                                Med. Sci.
Gluud         Chri stian        Chief of                  Cochrane Hepato-Biliary Group,
                                Department,               Copenhagen Trial Unit,
                                A/profe ssor,             H:S Rigshospi talet
                                Dr. Med. Sci.
Gøtrik        Jens Kri stian    Director General,         The Danish National Board of Health
                                MD
Gøtzsche      Peter Christian   Director,                 The Nordic Cochrane Centre,
                                A/profe ssor,             H:S Rigshospi talet
                                Dr. Med. Sci.
Hansen        Steen Werner      Medical Director,         Direction,
                                MD                        H:S Bi spebjerg Hospital
Helboe        Per               Director of Licensing     The Danish Medicine Agency
                                Division
Hemmingsen    Ralf              Dean of Faculty,          Faculty of Health Sciences,
                                Profe ssor, MD,           Copenhagen Universi ty
                                Dr. Med. Sci.
Hornne s      Peter             Head of                   Department of Obstetrics and
                                Department,               Gynaecology,
                                A/profe ssor,             H:S Hvidovre Hospital
                                Dr. Med. Sci.
Høiby         Niels             Professor,                Faculty of Health Sciences,
                                Cons ultant, MD           Copenhagen Universi ty
Juul          Anne Benedicte    Ph.D.-student,            Copenhagen Trial Unit,
                                Clinical assi stant       H:S Rigshospi talet
Jørgensen     Mogens            Head of Divi sion         The Danish Mini stry of the Interior and
                                                          Health
Jørgensen     Torben            HTA Advi ser,             Centre for Evaluation and Health
                                Biomedical                Technology Asse ssment,
                                Engineer, B.Com.          The Danish National Board of Health
Klarlund      Bente             Professor,                Faculty of Health Sciences,
Pedersen                        Cons ultant, MD,          Copenhagen Universi ty
                                Dr. Med. Sci.
Kampmann      Jens Peter        Director of Institute ,   The Institute for Rational
                                Dr. Med. Sci.             Pharmacotherapy,
                                                          The Danish Medicine Agency
Keiding       Hans              Profe ssor,               Institute of Economics,
                                Cand.stat.                University of Copenhagen
Kjeldsen      Kjeld             Deputy Permanent          The Danish Mini stry of the Interior and
                                Secretary,                Health
                                Cand. stat.
Kjærgard      Lise Lotte        Senior researcher,        Cochrane Hepato-Biliary Group,
                                MD                        Copenhagen Trial Unit,
                                                          H:S Rigshospi talet
Kri stensen   Finn Børlum       Director,                 Centre for Evaluation and Health
                                Profe ssor,               Technology Asse ssment,
                                MD, PhD                   The Danish National Board of Health
Kürstein      Pia               Ph.D-student,             DSI - Danish Institute for Health
                                Cand. Rer. Soc.           Services Re search
Lerche        Brian             MD, DEAA, MPA             Quality- & Ri sk Management
                                                          Department of QI & UR,
                                                          H:S Rigshospi talet
Linde         Klaus             Senior researcher,        Cochrane Complementary Field,Centre
                                MD                        for Complementary Medicine
                                                          Research, Department of Internal
                                                          Medicine II, Technische Universität
                                                          München
                                                          Germany

                                                                                                15
Liu *         Jianping          Deputy Director,         Chinese Cochrane Centre,
                                Profe ssor,              Chengdu and
                                MD                       Cochrane Hepato-Biliary Group,
                                                         Copenhagen Trial Unit,
                                                         H:S Rigshospi talet
Lyngvig       Jytte             Chief Executive          The Danish Medicine Agency
                                Officer
Melchart      Dieter            Director, MD             Centre for Complementary Medicine
                                                         Research, Department of Internal
                                                         Medicine II, Technische Universität,
                                                         München
Møller        Lars Krag         Chief of                 Department of Obstetrics and
                                Department,              Gynaecology,
                                A/profe ssor,            H:S Hvidovre Hospital
                                Dr. Med. Sci.
Meyer         Ulrik             Chief of Staff           Admini stration,
                                                         H:S Rigshospi talet
Nielsen       Hanne Kjærgaard   Chief midwife            Department of Obstetrics and
                                                         Gynaecology,
                                                         H:S Hvidovre Hospital
Nikolova      Dimitrinka        Review Group Co-         Cochrane Hepato-Biliary Group,
                                ordinator,Cand.          Copenhagen Trial Unit,
                                mag.                     H:S Rigshospi talet
Nilas         Lisbeth           Senior consultant,       Department of Obstetrics and
                                MD                       Gynaecology,
                                                         H:S Hvidovre Hospital
Otte sen      Bent              Chief of                 Department of Obstetrics and
                                Department,              Gynaecology,
                                Profe ssor,              H:S Hvidovre Hospital
                                Dr. Med. Sci.
Petersen      Jette V           Trial Coordinator,       Copenhagen Trial Unit,
                                Head nurse               H:S Rigshospi talet
Pedersen      Tom               Chief of                 Cochrane Anaesthe sia Group,
                                Department,              H:S Bi spebjerg Hospital
                                A/profe ssor,
                                Dr. Med. Sci.
Ring          Peter             Head of Divi sion        The Association of County Council s in
                                                         Denmark
Salasshahri   Nader             Head of information      Cochrane Hepato-Biliary Group,
                                technology,              Copenhagen Trial Unit,
                                Engineer                 H:S Rigshospi talet
Schroeder     Torben            Professor, consultant,   Faculty of Health Sciences,
                                MD, Dr. med. Sci.        Copenhagen Universi ty
Sigmund       Helga             Advi ser, M.Sc.          Centre for Evaluation and Health
                                (Tech.Soc.)              Technology Asse ssment,
                                                         The Danish National Board of Health
Skanning      Peter             Senior Consultant,       Department of Anaesthe siology,
                                MD                       H:S Bi spebjerg Hospital
Søgård        Jes               Director,                DSI - Danish Institute for Health
                                Profe ssor               Services Re search
Sjöström      Hans              Professor, MD, Dr.       Faculty of Health Sciences,
                                Med. Sci.                Copenhagen Universi ty
Vinten        Jørgen            Dean of Ph.D.-           Faculty of Health Sciences,
                                studies, Senior          Copenhagen Universi ty
                                lecturer
Weber         Tom               Senior consultant,       Department of Obstetrics and
                                MD                       Gynaecology,
                                                         H:S Hvidovre Hospital

                                                                                                16
Wille-Jørgensen     Peer                    Chief of                Cochrane Colorectal Cancer Group,
                                            Department,             H:S Bi spebjerg Hospital
                                            A/profe ssor,
                                            Dr. Med. Sci.
Yan                 Tang                    International Product   Novo Nordi sk China and Novo Nordi sk
                                            Manager, MBA            A/S, Denmark
Zeuten Benzen       Eva                     Head of Divi sion       The Association of County Council s in
                                                                    Denmark

      * Chen and Liu will function as translators from Engli sh into Chine se.




                                                                                                        17
Introduction to the institutions

The following pages will give you a short introduction to the many institutions that you
are going to visit during yours stay in Denmark and Germany. They appear in the order
you are going to visit these institutions.

Organisationally, some of them are more closely linked than others.

If you prefer to read about the Danish health care system „from the top‟ you should start
on page 32 (The Danish Ministry of the Interior and Health),
then go to page 27 (The Danish National Board of Health) and page 28 (Danish Centre
for Evaluation and Health Technology Assessment),
and to page 30 (The Danish Medicines Agency) and to page 31 (Institute of Rational
Pharmacotherapy) ,
then to page 34 (The Association of County Councils in Denmark) and to
 page 19 (H:S – Copenhagen Hospital Corporation) followed by the pages 41, 23, and
44 (H:S Rigshospitalet, H:S Hvidovre Hospital, H:S Bispebjerg Hospital).

The Nordic Cochrane Centre (page 43), The Copenhagen Trial Unit (page 21), and The
Cochrane Hepato-Biliary Group (page 22) form parts of the H:S Rigshospitalet and H:S
Copenhagen Hospital Corporation.

The Cochrane Colorectal Cancer Group (page 46) and The Cochrane Anaesthesia
Group (page 47) form parts of the H:S Bispebjerg Hospital and H:S Copenhagen
Hospital Corporation.


The Department of Gynaecology and Obstetrics (page 26) forms part of the H:S
Hvidovre Hospital H:S Copenhagen Hospital Corporation.


The Faculty of Health Sciences, Copenhagen University (page 39), The DSI – Institute
for Health Services Research (page 38), and The Cochrane Complementary Medicine
Field, Munich, Germany (page 48) are independent institutions.




                                                                                       18
The H:S – Copenhagen Hospital Corporation
December 15, 1994 a new law on the Copenhagen Hospital Corporation was passed by
a majority in the Danish Parliament. The law lays down, among other things, the
following:

   that The Copenhagen Hospital Corporation is to ensure that the residents of
    Copenhagen and Frederiksberg municipalities can be treated at a hospital.
    Furthermore, H:S must provide national and regional treatment. Being a university
    hospital, the Corporation must ensure a high professional standard and in addition
    help to develop the health promoting and preventing achievements

   that the Copenhagen Hospital Corporation must ensure the Rigshospital to be a
    medical centre for research and development with special duties

   that the common regulations in the hospital legislation and the economic legislation
    within the municipality are also valid for the Copenhagen Hospital Corporation,
    unless it is otherwise stipulated. Budget processing is to be coordinated with the
    budget negotiations i n Copenhagen and Frederiksberg municipalities. Each of the
    two municipalities pays the Corporation a share corresponding the consumption

   that all planning shall be in coherence with the health-care planning of Copenhagen
    and Frederiksberg municipalities

   The Ministry of the Interior and Health supervises that the Copenhagen Hospital
    Corporation observes the legislation

H:S was formed January 1, 1995 as an association of seven hospitals. Today H:S
consists of: Bispebjerg Hospital, Frederiksberg Hospital, Hvidovre Hospital, The
Rigshospital, Sct. Hans Hospital and Amager Hospital, run in cooperation with The
Copenhagen County. H:S forms part of the Copenhagen University Hospital.
Furthermore, the following main transverse units are to be found in the H:S:


          H:S Pharmacy
          H:S Collective Purchasing
          H:S Nurse Education
          H:S Blood Bank
          H:S Unit of Patient‟s Security
          H:S PMI
          The Bartholin Institute
          Centre for Research and Development among the Elderly
          Institute of Preventive Medicine
          Centre for Osteoporosis
          The Nordic Cochrane Centre
          Centre for nursing-and care research of The University Hospitals
          Montebello, which is run in cooperation with The Copenhagen County

                                                                                           19
         The office of emergency preparedness which is run in cooperation with The
          Copenhagen County
         The Community Secretariat for Patent Files

The highest authority in H:S is the Executive Committee. In December 1995 the
Executive Committee adopted “Hospital Plan H:S 2000” which partly provides highly
specialized functions put together, and partly ensures that diseases, which frequently
and repeatedly lead to hospital admittance, can be treated at the local hospitals.

Copenhagen Hospital Corporation (H:S) is led by a Board of three directors, the
administrative director, the medical director and the director of finance.

The objectives of H:S are:

         service and professional performance of high quality
         equal access to the Hospital service benefits
         respect for the personal integrity of the residents
         coherence and continuity in treatment and information
         work is done on the least resource requiring level
         intensification of research, development, and education
         effective utilisation of resources.




                                                                                         20
The Copenhagen Trial Unit
The Copenhagen Trial unit (CTU) is a centre for clinical intervention research. CTU is
not speciality orientated. CTU is situated at H:S Rigshospitalet, part of The Copenhagen
University Hospital and The Copenhagen Hospital Corporation.

CTU was established in 1995 and was officially inaugurated in January 1996. The
Copenhagen Hospital Corporation (H:S) funded salaries and drift initially with 2 million
DKK, which funding is now increased to 4 million DKK per year.

The defined objectives of CTU are to:
 Support, coordinate, and perform scientifically relevant randomised clinical trials with
   preventive, diagnostic, therapeutic or nursing aim in the primary and secondary
   health-care sector.
 Support, coordinate, and perform scientifically relevant systematic reviews, including
   meta-analyses, which among other things led up to the international Cochrane
   collaboration.
 Participate in the further development of methods and technology related to the
   randomised clinical trial.
 Teach students and graduates about randomised clinical trials and the methods of
   meta-analyses.

CTU is the Editorial Team Office for the Cochrane Collaboration‟s liver and bile
diseases group (The Cochrane Hepato-Biliary Group).




                                                                                           21
The Cochrane Hepato-Biliary Group
The Cochrane Hepato-Biliary Group (CHBG) was formally registered with the
international clinical research organisation The Cochrane Collaboration on March 29,
1996, after five exploratory meetings at international conferences. Since that time the
Group has established an Editorial Base in The Copenhagen Trial Unit, H:S
Rigshospitalet. forming the Editorial Team with 7 other international Co-Editors and 5
Assistant Editors and working with a growing group of engaged systematic reviewers
and peer reviewers. At the end of 2001 there were about 500 members of the CHBG, of
which about 150 are actively working, and many new people with i nterest in the group
are contacting us with a wish to get involved in the work.

The CHBG has the following tasks

   to collect intervention literature (primarily randomised clinical trials) pertinent to the
    management of patients with hepato-biliary diseases
   to prepare systematic Cochrane Reviews on intervention for patients with hepato -
    biliary diseases
   to disseminate this information through The Cochrane Library as well as by other
    means.




                                                                                                 22
The H:S Hvidovre Hospital

The H:S Hvidovre Hospital is part of the H:S (Copenhagen Hospital Corporation) and
constitutes part of the Copenhagen University Hospital.

The H:S Hvidovre Hospital shall be known as a prominent hospital competing with the
best ones as concerns examination, treatment, and nursing of patients.

Further, the H:S Hvidovre Hospital will also in the future be one of the leading hospitals
in Denmark when it refers to research, tuition, education, and development. This,
among other things, will be accomplished by maintaining a scientific environment in
which research and development constitute a dynamic part of the hospitals‟ activities.

The co-workers‟ assistance and engagement in fulfilling the visions shall be secured,
among other things, through experimental culture in which the professional
development of the hospital staff is a natural element in the daily work.

The hospital board of directors will work that the Hvidovre Hospital establishes both
national and international contacts in the endeavours to live up to the hospital‟s profile
and strategy.


The areas of main efforts are:

Patient information
In 1998 a project for improving the collected patient information in the hospitals was
launched. Hence the results have to be stuck to. The aim with the subsequent work is to
ensure that the need of the patients and the relatives will stay in focus.

Research and University affiliation
The activities in the clinical research unit and the research council shall be strengthened
and further carried out in order to support the research activities in the hospital.

A continues work should be done to propagate the university- and the educational
activities.

Quality development
The hospital will work with accrediting following an international standard for quality in
the hospitals. Accrediting is understood as a means to improve the quality of the
gathered services.

Competence development
A systematic work will be performed on developing professional and personal
competence as well as organisational resources of the employed people.

Other areas for contribution
A close and constructive cooperation with the remaining partners within the health-care
system is one of the prerequisites to fulfil the objective of the Hvidovre Hospital.
                                                                                             23
That is why the departments should continue to be investigative in their endeavours to
reach a common understanding with the collaborative parties for values, objectives, and
scope of contribution. This applies both across the hospitals in H:S and across the
sectors.

Information technology
Information technology is an important tool for the employees in their daily work with
examination, treatment, and care of patients. Information technology is equally a tool for
documenting contributions and for communication between departments, hospitals, and
sectors. The H:S Hvidovre Hospital will continue to maintain a leading position in the
health-care sector when it concerns information technology and particularly will put
emphasis on the usefulness of information technology as an aid to the clinical work.

The public
The Hvidovre Hospital shall have a positive image in the public and a natural connection
to the citizens from the region of admittance. It is crucial that the citizens have
knowledge about the hospital and experience a constructive cooperation across
hospitals and sectors. A public image shall be created not only with the citizens in focus
but also of the professionals within the health-care sector in Denmark in general.

The Hospital Departments

The departments are divided into three groups and the names of the departments are in
alphabetic order in each group.

- Treatment of patients
Emergency Ward (AMA)
Alcohol Units
Department of Anaesthesiology
Blood bank
Department of Paediatrics
Clinics of Endocrinology
Department of Physio- and Ergotherapy
Gastroneterology Unit
- Surgical Gastroenterological Section
- Medical Gastroenterological Section
Department of Gynaecology and Obstetrics
Clinics of Geriatrics
Department of Infectious Medicine
Clinics of Cardiology
Clinics of Neurorehabilitation
- Unit for Apoplexy
- Unit for Traumatic Brain Damage
Lung Medical Clinics
Medical Centre
Clinics of Rheumatology
Department of Orthopaedic Surgery
Department of Psychiatry


                                                                                        24
Emergency Room

- Examination of patients
Clinics for Osteoporosis Research
Department of Clinical Biochemistry
Department of Clinical Physiological/Nuclear Medicine
Department of Clinical Microbiology
MR Centre of Knowledge
Department of Pathology
Department of Radiotherapy

- Service Departments
The Administration
The Central Supply
The Central Kitchen
The Research Unit
The department of Health Technology Assessment
Information Technology Department
Hospital Porters‟ Central
Department for Social Counselling
Technological Central
The Tutors Centre
The Department of Development and Education




                                                        25
Department of Gynaecology and Obstetrics, H:S Hvidovre
Hospital

The Department of Gynaecology and Obstetrics is a big department with about 6,000
deliveries and more than 55,000 ambulatory patients. In addition, yearly about 4,000
patients are hospitalised at the gynaecologic part of the ward. Practically 4,000
operations are performed each year.

The total grand budget for the department amounts to about 115 million DKK, of which
the greater part is spent on salaries. From the total grand budget about 4 million DKK
are used for research.

The Department of Gynaecology and Obstetrics, H:S Hvidovre Hospital works primarily
to offer our patients at any time the optimal counselling, diagnostic, care, and treatment.
Therefore, the department wishes to participate actively in the de velopment and the
research work around new medical initiatives within the specialty. Therefore we should
be able both to contribute to the advancement of the specialty and assess new methods
critically. Each procedure shall be based on all available evidence and shall be
quantitatively monitored. The optimal patient care is further secured through educational
activities at all level.

From the departments homepage it emerges clearly that:

   "The principle about patients’ self-decision is today commonly recognised. And it is
   acknowledged that hospitals get engaged in important public issues and priorities
   that require broad open discussion. Neither self-decision nor discussion can become
   reality without information and knowledge. The hospital departments have received
   evidence-need and evidence-duty”.
   Gitte Myer, journalist




                                                                                         26
The Danish National Board of Health
The National Board of Health has the following fields of authority:
    to monitor health and follow developments within health issues
    to advise the Ministry of Health and other public authorities
    to supervise health care professionals.

Senior and junior staff in various specialist sections and institutes established within
coherent specialist fields handles the fields covered by the National Board of Health.
This is utilised by medical officers of health whose highly important role consists of
monitoring the state of health in each county, plus various specialist advisers who are
involved in any issues requiring highly specialised knowledge. The National Board of
Health Management is in charge of management and co-ordination together with the co-
ordination committee, which comprises the Management and the heads of divisions and
institutes.

The objectives of the National Board of Health are:
    to contribute to define and implement health political goals set up by the
      Government and the Danish Parliament (Folketinget);
    to provide sound and balanced guidance and information services, making them
      available to patients, relatives, health care decision makers and staff and the
      citizens in general;
    to appear as an organisation providing professional health guidance and making
      high quality decisions, after careful weighting of all aspects involved;
    to contribute to collaboration in the health sector to achieve state-of-the-art
      prevention and treatment;
    to participate in the public debate on health issues through development projects
      and other initiatives;
    to appear to the public and the media as a visible, professional and forthcoming
      Board of Health based on a clear organisation and well worked out strategies.




                                                                                      27
Danish Centre for Evaluation
and Health Technology Assessment

The first of April 2001 the Danish Institute for Health Technology Assessment (DIHTA)
and The Danish Hospital Evaluation Centre merged to form a new Danish Centre for
Evaluation and Health Technology Assessment (DACEHTA). The centre is established
as a unit in The National Board of Health and is headed by the director.

Key aims include carrying out health technology assessments (HTAs) and integrating
HTA-principles into the running and planning of the public health service at all levels.
DACEHTA also carries out evaluations of public health services with the aim of
improving quality, standards, and value for money.

The centre primarily targets health professionals and decision-makers at all levels as
well as related research communities. DACEHTA is charged with employing those
activities and methods that will contribute most effectively to quality, efficiency and
standards of care in the Danish health service.

Key aims include carrying out health technology assessments (HTAs) and integrating
HTA-principles into the running and planning of the public health service at all levels.
DACEHTA also carries out evaluations of public health services with the aim of
improving quality, standards and value for money. DACEHTA‟s HTA-activities is guided
by The National Strategy for Health Technology Assessment

The centre primarily targets health professionals and decision-makers at all levels as
well as related research communities. DACEHTA is charged with employing those
activities and methods that will contrib ute most effectively to quality, efficiency and
standards of care in the Danish health service.

DACEHTA and its multidisciplinary staff provides a professional and financial basis for a
number of initiatives focused at both national and regional/local levels:

 A yearly HTA-pool varying between $1 and $2 mil. is provided by DACEHTA in order
  to support regional and local HTA-projects – DACEHTA now supports approx. 60
  ongoing HTA-projects;
 3 local HTA units has been set up by DACEHTA in co-operation with regional health
  authorities and universities
 DACEHTA provides political, administrative and clinical decision-makers with broad
  and focused HTA-reports and systematic reviews on health technologies with broad
  implications for the health care sector and patients (examples of subjects covered by
  DACEHTA is low back pain, interferon-beta for multiple sclerosis, PET-scanning,
  influenza vaccination of elderly, colorectal cancer – DACEHTA will this year publish
  reports on diabetes mellitus type 2 and rheumatoid arthritis)
 DACEHTA has established an early warning system in order to provide decision-
  makers with information on new and emerging health technologies with expected
  consequences for the Danish health services. DACHTA will each year publish 10-12
  early warning reports.


                                                                                           28
 DACEHTA is a member of several international organisations for HTA and
  participates actively in international projects – both as participant in joint international
  HTA-projects and in terms of co-ordinating international HTA activities.

In terms of HTA methodology, a broad and interdisciplinary approach has guided
Danish HTA. Many resources have been put into the strengthening of the “softer”
aspects of HTA provided by disciplines such as ethics, social and political science,
humanities and organisational theory, thereby balancing the traditionally “dominant”
clinical and economical aspects.




                                                                                            29
The Danish Medicines Agency
The Danish Medicines Agency is an agency under the Ministry of the Interior and
Health.

The Danish Medicines Agency administers the legislation on medicinal products,
reimbursement on medicinal products, pharmacies, medical equipment and euphoriant
substances. The main objective of The Danish Medicines Agency is to ensure that
medicinal products that are used in Denmark are of satisfactory quality, are safe to use
and have the desired effect.

Assignments and Objectives
The Danish Medicines Agency's three main professional assignments are:
    to authorise the marketing of medicinal products,
    to inspect and monitor medicinal products, companies, pharmacies etc.,
    to follow the development in the economy and consumption of medicinal
      products.

The legislative basis for the Danish Medicines Agency's work is the Danish Medicines
Law, the Pharmacy Law, the Health Insurance Law and the Law on Medical Devices.

The Danish Medicines Agency's objectives and visions are:
    to ensure that the population has access to effective and safe medicinal products
      of a high quality for both people and animals,
    to monitor and inspect the area of medicinal products and the area of medicinal
      equipment,
    to contribute to both a healthy and economically appropriate use of medicinal
      products,
    to prioritise the solution of the agency's assignments starting with the citizens'
      and society's needs,
    to maintain and improve the Danish Medicines Agency's position in the European
      pharmaceutical system,
    continue to offer both the pharmaceutical industry and the medico-technical
      industry service of a high quality,
    to support the counties and doctors in their work with the appropriate use of
      medicinal products.




                                                                                       30
Institute for Rational Pharmacotherapy

The Institute was erected as a unit of the Danish Medicines Agency in 1999.

The institute has the task of ensuring the population the most rational utilisation of the
range of medicinal products available on the basis of both effectual and financial points
of view. It provides information on medicinal products directly to the public as well as to
the health care professionals.




                                                                                          31
The Danish Ministry of the Interior and Health
The ministerial grounds of the Danish Ministry of the Interior and Health encompass one
department and a number of institutions (administration offices, councils, and health
boards).

The department functions as Central Office of the Minister of the Interior and Health,
which was combined into one ministry at the last election in 2001. The department
manages coordinating issues with respect to the relationship between the Government,
the Parliament, the organisations of interes t, and the public. The department develops
legislation, regulations, and municipal practice. The department advises on planning
within health-political and municipality-political areas. The department has a superior
responsible position for the working organisation of the minister, personnel, licenses,
and balance sheets.

The Ministry of the Interior and Health is in charge of administrative functions and
account issues with respect to the relationship between counties and municipalities
(today Denmark is divided into 275 municipalities and 14 counties).


   Municipalities and counties

- Economy, structure and tasks of the municipalities, economic management; budget
and balance sheets and accountability, municipalities‟ economic development and
finance.

- The economic balance of the municipalities; overall subsidies and ways of payment,
special grants to municipalities, municipal borrowing of money, payment of tax, key
figures (statistics) and hospital throughput analyses, bench marking, service
information, consumer information and quality development, invite tenders to do a job,
and other administrative political issues on municipality level.

Finally, the Danish Ministry of the Interior and Health manages tasks concerning
regional development, among other things development of risk areas and country
regions in general.

The Danish Ministry of the Interior and Health is in charge of legislation concerning
municipalities‟ organisation and administration, municipalities‟ tasks, which are not
regulated within the legislation (municipal written authority), as well as together with the
municipalities and counties supervision of the traffic company of the city area (HT) and
the Copenhagen Hospital Corporation (H:S).

Fourteen supervisory committees supervise the daily practices of the municipalities. The
Ministry of Health supervises the counties, the Copenhagen County, Frederiksberg
County and the fourteen supervisory committees.

The Danish Ministry of the Interior and Health carries out tasks related to general
elections, referenda, and election for board of directors and county council as well as for
the European Parliament.
                                                                                           32
Furthermore, the Danish Ministry of the Interior and Health approves names of new
parties and carries out control of party registration.

In addition to this, the ministry administrates the national party support system and
renders secretarial attendance (service) to the Electoral Committee and the Eligibility
Committee as well as the Supporting Party Committee.

   The treating health-care service

The Danish Ministry of the Interior and Health manages administrative issues and keeps
accounts referring to:
- the health-care structure, steering, and funding,
- the quality assurance, medical informatics, and advanced education of the health-care
personnel,
- the legal status of patients and the health-care personnel,
- psychiatry
- public health insurance,
- drugs and pharmacy services.


   Prevention and analysis

The Danish Ministry of the Interior and Health manages administrative issues and keeps
accounts referring to:
- prevention of diseases and health promotion
- peoples‟ health status
- health-care expenditures, consumption of health services,
- measurement of the activity and productivity of the health-care services
- research
- information on the waiting time and statistics on operations.


   The Emergency Preparedness Unit

The tasks of the Emergency Preparedness Unit are performed in cooperation with the
Danish Emergency Management Agency, the National Institute for Radiation Hygiene,
The Committee for Conscientious Objectors, the state counties for compulsory military
service, and a number of authorities under the Ministry of Defence.

   International public relations

In the Ministry there is an Agency for international relations.




                                                                                          33
The Association of County Councils in Denmark
The Association of County Councils in Denmark represents the interests of all 14
Danish counties, and provides them with services and information. It promotes and
supports the principles of regional autonomy and acts as spokesman for the county
councils in all matters related to the central government and other national associations,
and serves as the central collective wage bargaining organisation of the counties.


County tasks
Today, Denmark is divided into 14 counties and 275 municipalities. A whole range of
administrative functions and services are carried out by the counties and the
municipalities. The counties carry out the functions which are too comprehensive to be
handled by a municipaliy, for instance the provision of hospitals, post-16 secondary
education, vocational training, public transport, and social welfare for the disabled. The
municipalities deal with the tasks close to the citizens, for instance nurseries, primary
and secondary schools, libraries, social security, and care of the elderly.

Administrative set-up
Today, Denmark is divided into 14 counties and 275 municipalities. The latter include
the cities of Copenhagen and Frederiksberg, which are unitary authorities being at one
and the same time counties and municipalities covering both tiers of local government.
In terms of population, Bornholm County is the smallest with 45,000 inhabitants, while
Copenhagen and Aarhus counties rank as the two largest with more than 600,000
inhabitants each. The average population in the counties is 325,000.

Expenditure and income
The total county expenditure in 1999 is approximately DKK 70 billion. The counties'
largest single expense is the hospital sector and the health insurance which take up
about 63% of the total spending (DKK 45 billion).

The single most important source of county income - about 80% - derives from personal
income tax. The counties are free to set their own tax rates individually. In 1999, West
Zealand, Funen and Viborg County have the highest tax level at 12.0% while Vejle
County with 10.9% has the lowest. The average county tax level is at 11.5%.


County council elections
The counties are governed by county councils. The county councils are elected for 4 -
year periods by direct election using the system of proportional representation. The next
county elections will take place in November 2005.

Everyone over the age of 18 who is permanently resident in the county is entitled to
vote. Citizens who are not Danish nationals may only vote if they have resided
permanently in Denmark for the three years immediately preceding the election. All who
are entitled to vote may also stand as candidates.

                                                                                         34
The main tasks of the counties and municipalities

A whole range of administrative functions and services are carried out by the counties
and the municipalities.

The municipalities deal with the tasks close to the citizens, for instance nurseries,
primary and secondary schools, libraries, social security, and care of the elderly.
The counties carry out the functions which are too comprehensive to be handled by a
municipaliy, for instance the provision of hospitals, post-16 secondary education,
vocational training, public transport, and social welfare for the disabled.

Since the 1970 local government reform the counties have gradually taken over more
and more tasks, for instance health service (1973), psychiatric hospital services (1976),
nature protection and conservation (1979), responsibility for the severely disabled and
education of severely disabled children (1980), and post-16 secondary schools and
courses (1986).


   Hospitals and health
The counties are responsible for all public hospital services in Denmark, and they also
administer the National Health Insurance Service. Under this service all persons with
permanent residence in Denmark have a right to receive help from doctors and
specialists free of charge. Contributions are also provided for dental work, medicine and
physiotherapy.


   Public transport
The counties are responsible for a major part of public transport at the regional level. In
collaboration with the municipalities, most of the counties have established regional
transport companies, which are responsible for all bus transport within the county.
The transport companies arrange preparation of timetables and fixing of fares, while bus
driving is contracted out to public or private companies. The counties also arrange
special fares for disabled citizens.

   Roads
An important part of the counties' tasks is the pla nning and placing of major transport
facilities. At the same time, the counties have a number of maintenance and
construction functions connected with the road system. The secondary roads which
come directly under the counties have a joint length of approximately 10,000 kilometres.


   Protection of nature and environment
The counties have a wide range of vital tasks in the field of protection of nature and
environment. The counties supervise and license industries potentially dangerous to the
environment, and lay down the rules governing the amount of waste materials which
may be discharged into both water and the air.

                                                                                         35
The counties are responsible for the maintenance of rivers with a view to preserving the
natural environment, water quality and water flow. The counties are also responsible for
administering the Protection of Nature Act whose aim is to safeguard Denmark's
countryside and historic sites.

   Education
The counties are responsible for further education at upper secondary schools and in
higher preparatory courses. The counties are also responsible for all education within
health services, adult education and special education for children and adults.


   Social services
The municipalities are responsible for most tasks in the social field, e.g. the running of
kindergartens and day nurseries, care of the elderly and administration of social
benefits. However, the counties are responsible for more specialised tasks which the
municipalities cannot manage.

The counties provide institutions and other facilities for physically and mentally disabled
persons, children and young people with serious behavioural difficulties, and mentally ill
persons.

   Culture

The counties grant contributions to the cultural sector to ensure all citizens access to
cultural activities. In particular, the counties support theatres with grants to regional
theatres. The counties also grand funds to museums, orchestras and libraries as well as
special cultural projects.


   Regional economic development

The counties take a range of initiatives to stimulate business-promoting activities at the
regional level, and many counties have worked out their own plans of action for
economic development. The EU's regional policy initiatives play an increasing role in
this area.

   The EU and international relations

International relations and co-operation with regions in other countries are increasingly
significant in the work of the counties. A number of counties participate in international
co-operation projects with countries in the EU or in Central and Eastern Europe.
EU legislation directly touches upon county competencies in several areas, and since
1986 the environment, research and the labour market have been designated as areas
for co-operation under the Treaty of Rome with the environment in particular giving rise
to a number of EU directives affecting county administration.


                                                                                             36
Over a number of years, the counties have been active participants in the EU's
structural Funds programmes. The counties administer most of the Danish share of the
funds.




                                                                                   37
DSI - Danish Institute for Health Services Research
DSI Danish Institute for Health Services Research is an independent, not-for-profit
research institute. The Institute provides research, communication, and consultancy
services for and with the health sector.

The main field of activity is health care. This includes the hospitals, the primary sector,
the pharmaceutical sector, and community health services provided by municipalities
and counties.

DSI offers its expertise to the planning and governing health authorities at all
administrative levels, be that internationally, nationally, regionally, and locally, to
professional groups in the health sector, research environments, and the
pharmaceutical sector etc.




                                                                                              38
The Faculty of Health Sciences, Copenhagen University

The Faculty of Health Sciences encompasses the graduate studies of medicine,
dentistry, human biology, and public health as well as a three-year Ph.D. study
programme. There are presently some 3,550 students and some 485 Ph.D. students a t
the Faculty of Health Sciences. In addition, a new study programme has been
introduced, a master‟s degree in International Health.

The pre-clinical section of the Faculty is located at the Panum Institute. The Panum
Institute consists of 10 academic departments that embrace all aspects of basic and
applied medical and dental science and other public health related studies. The clinical
section consists of departments at the Copenhagen University Hospital, which is the
name for 15 different university hospitals in greater Copenhagen. These departments
are associated with 6 clinical institutes. The Panum Institute is located opposite the
main Copenhagen University Hospital, H:S Rigshospitalet.


   Areas of teaching
The present medical curriculum is divided into two parts: the pre-clinical (3 years) and
the clinical part (31/ 2 years). The first part consists primarily of theoretical subjects
such as chemistry, anatomy, physiology, biochemistry, psychology, and medical
sociology as well as an integrated course in cell biology. The second part consists
primarily of para-clinical and clinical courses such as microbiology, pathology and
pharmacology, surgery and internal medicine. The pre-clinical teaching takes place at
the Panum Institute and the clinical teaching at the Copenhagen University Hospital.
The present curriculum is undergoing some changes leading towards an integration of
the theoretical and clinical disciplines. It also includes more problem -based and case-
oriented teaching with a high rate of student activity.

Dentistry students take some of the courses jointly with medical students during the first
two years of their studies, and clinical training is likewise an important part of the latter
three years of their study. Both theoretical and
clinical teaching take place at the Panum Institute.

A degree in human biology provides students with medical knowledge as well as a
strong research profile. The human biology programme is particularly appealing to pre-
medical and pre-doctoral students and may also appeal to those students seeking
careers in pharmaceutical or biotechnology industries, or to those wishing to work in the
public sector with biological problems of relevance to the health of human beings. The
major disciplines are human patho-physiology and cell biology, as well as microbiology,
pharmacology, gene technology, philosophy of medicine, laboratory animal science and
two clinical periods. One full year is spent on an individual, supervised research project.
Courses in common human diseases as well as a theoretical and practical introduction
to the health sector are also important aspects of the programme.

Students were admitted to the Public Health programme for the first time in the autumn
of 1996. Public health students study the health status of the population and the efforts
at improving the health of the population.
                                                                                             39
   Areas of research
All departments are actively involved in research within several major areas. Particular
emphasis is given to biomedical, clinical, dental and public health oriented research.
Some of the departments within the pre -clinical area focus on the basic molecular
biology of the brain. Another area of interest is to analyse problems such as the
regulation of insulin in diabetic patients, the active me tabolism of liver and muscle cells
and the regulation of blood pressure. Another section researches in the genetic
variation and the cause and effect of changes in DNA and chromosomes, which may
result in, for example, breast cancer or Huntington‟s chorea. Another department
conducts experimental research in cancerous tumours. These examples only cover a
minor part of the ongoing projects.

A large part of the dental research covers problems particularly related to children,
youth and the elderly. An extended study of the normal and pathological development of
the jaws is an important issue. Other research areas focus on the general health and
quality of life for patients.

The public health research comprises many topics, including medical philosophy and
clinical theory, occupational and environmental health, social medicine and
psychosocial health and epidemiology.


   Theoretical departments/institutes

       Department of Medical Anatomy
       Department of Medical Biochemistry and Genetics
       Department of Medical Physiology
       Department of Pharmacology
       Institute of Eye Pathology
       Institute of Forensic Medicine
       Institute of Medical Microbiology and Immunology
       Institute of Molecular Pathology
       Institute of Odontology
       Institute of Public Health

   Clinical Departments/Institutes
       Institute of Clinical Biochemistry, Clinical Physiology/Nuclear Medicine, and
        Radiology
       Institute of Gynaecology/Obstetrics, Paediatrics and Growth and Reproduction
       Institute of Internal Medicine and Geriatrics
       Institute of Neurology, Neurosurgery and Psychiatry
       Institute of Oto-Rhino-Laryngology, Ophthalmology and Dermato -Venerology
       Institute of Surgery and Anaesthesiology




                                                                                           40
    H:S Rigshospitalet
H:S Rigshospitalet is a highly specialised hospital with tasks within patients‟ care,
research, development, and education.

The H:S Rigshospital is part of the Copenhagen Hospital Corporation (H:S), in which
the Rigshospital as a health-care centre for research and development has specific
tasks within the patients‟ health-care, development, and education.

The H:S Rigshospital, as an institution, is obliged to participate in and influence the
development in the short and in the long term. Five main topics constitute the scope of
the strategic work of the H:S Rigshospital, and they are specifically utilised in the yearly
contracts with the separate centres:

   Special functions
   Cooperation with the counties, the other hospitals within the hospital corporation
    (H:S), and the primary health-care sector
   Staff, development, and education
   Quality, service, and informational communication
   In-house management

Patient treatment at the H:S Rigshospital

The H:S Rigshospital has a national and regional function within almost all the medical
specialties – apart from dermatology, occupational medicine, and child psychiatry.


The H:S Rigshospital is a local hospital for about 70.000 inhabitants in Copenhagen
(primarily for the city centre and the central part of Østerbro). The remaining – and
largely important – part of the hospital‟s obligations are connected with the specialty
functions that the Rigshospital has in comparison with the remainder H:S, county district
hospitals, as well as the hospital services in Greenland and the Faeroe Islands.

Research within the H:S Rigshospital

The H:S Rigshospital is part of the Copenhagen Hospital Corporation (H:S) and
constitutes a part of the Copenhagen University hospital (in collaboration with the other
five H:S Hospitals and the hospitals in the Copenhagen County).

As University Hospital – and as the largest research institution within the Danish
Hospital Corporation – the H:S Rigshospital has an extensive collaboration with Danish
and foreign research environments and educational institutions. Especially, the close
cooperation with the Copenhagen University is of particular importance for performing
the research activities and the educational tasks within the hospital.


Professional development within the H:S Rigshospital

The goal of the H:S Rigshospital is mapped out by the Danish Parliament, and it is
                                                                                           41
evident from the legislation of the Hospital Corporation ((§2): ”The Hospital Corporation
shall secure The Rigshospital as a health-care development centre with specialised
tasks within treatment of patients, research, and education.

Putting together medical specialties in connection with the Hospital Plan H:S 2000 has
created a substantial prerequisite for carrying out the hospital‟s objectives. Accordingly,
the Rigshospital has possibilities of actively marking the hospital‟s development as well
as the professional development and the innovation process, which, however, takes
currently place in the Danish health-care services.

Education at the H:S Rigshospital

The H:S Rigshospital is one of the Danish largest educational centres within the
scientific health-care educations. The hospital has basic and advanced educational
programmes within all specialties.

The H:S Rigshospital endeavours to offer basic, advanced, and in-service training at
high professional level. A great part of the medical staff in the remaining health-care
sector is completely or partly educated or has received advanced training at the
Rigshospital.




                                                                                          42
The Nordic Cochrane Centre
The Nordic Cochrane Centre opened on 13 October 1993. National branches of the
Centre have been established in Norway, Finland and Russia.


   Objectives
       Helping to ensure that reports of all relevant controlled trials are made accessible
        for inclusion in Cochrane reviews.
       Improving the quality of Cochrane reviews.
       Software development in the Cochrane Collaboration.
       Supporting Cochrane groups and individuals in the Nordic area.
       Promote awareness of, access to and use of Cochrane reviews.


   Tasks assumed on behalf of the collaboration

       Support Cochrane entities with a coordinating base in one of the countries
        serviced by the centre: Cochrane Hepato-Biliary Group, Copenhagen; Cochrane
        Colorectal Cancer Group, Copenhagen; Cochrane Anaesthesia Group,
        Copenhagen; Cochrane Methodology Review Group, Oslo; Cochrane Non-
        Randomized Studies Methods Group, Copenhagen.
       Coordinate and develop The Cochrane Collaboration Information Management
        System (RevMan, ModMan, and Contact Management Software).
       Edit The Cochrane Database of Methodology Reviews.
       Edit The Cochrane Reviewers' Handbook.


   Countries for which the Centre is the reference Cochrane Centre

       Nordic countries: Denmark, Finland, Iceland, Norway, Sweden.
       Other countries: Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan,
        Kyrgyzstan, Latvia, Lithuania, Moldova, Mongolia, Poland, Russia, Tajikistan,
        Turkmenistan, Ukraine, and Uzbekistan.




                                                                                          43
H:S Bispebjerg Hospital

The H:S Bispebjerg Hospital is one of the hospitals within the Copenhagen Hospital
Corporation (H:S). The hospital together with the remaining hospitals within the H:S, the
hospitals of the Copenhagen County, and the Copenhagen University constitutes the
Copenhagen University Hospital.


The H:S Bispebjerg Hospital is situated in the north-western part of Copenhagen and is
the local hospital in the district. Within some specialties the hospital treats also patients
from other parts of the city, and within some areas the hospital has a regional function.
The Bispebjerg Hospital is an exemplary hospital for prevention.

The Bispebjerg Hospital has at its disposal the following departments:

   Examination, treatment, and interdisciplinary


Department of Anesthesiology R
Clinics of occupational and environmental health
Department of Audiology
Department of Child Psychiatry
Department of Central Surgery
Department of Dermatology and Venereology (D)
Organisation of Hygiene
Department of Gastroenterology and Surgery (K)
Department of Clinical Biochemistry (KBA)
Clinical Unit of Preventive Medicine and Health Promotion

Department of Clinical Physiological/Nuclear Medicine
Medical Centre
Emergency Ward (AMA)
Ergotherapy
Physiotherapy
Clinics of Geriatrics (G)
Unit for Research and Development of Sports Medicine
Clinics of Internal Medicine (I)
Clinics of Cardiology (Y)
Unit of Clinical Pharmacology (KFE)
Clinics of Rheumatology H
Department of Neurology (N)
Department of Orthopaedics (M)
Department of Palliative Medicine (P20)
Department of Pathology
Department of Psychiatry (E)
Radiotherapy Department
Casualty Department
Sterile centre
Centre for knowledge of wound healing (S)
                                                                                            44
   Service and administration

Social workers
Department of Development and Education
Medicotechnical department (MIT)




                                          45
The Cochrane Colorectal Cancer Group
In May 1996 the first meeting was held in order to explore which efforts it would take to
put up a Colorectal Cancer Group. A letter was subsequently sent to about 170 people
identified as 1) first authors of conference reports of randomised controlled trials within
the field of colorectal cancer from the last three years 2) people with an interest in the
area as listed in the Cochrane Directory, and 3) other well-known persons within the
field. This group of interested persons represents the
following specialities:
- Surgery (both general and colorectal specialists)
- Oncology
- Radiation oncology
- Pharmacology
- Biostatistics
- Endoscopy
- Economics
- Specialised nurses
- Consumers.

A pre exploratory meeting was held in connection with the Cochrane Cancer Network
meeting February 1st. 1997. It was decided to go on with the work and aim for an
exploratory meeting in September, in Copenhagen. Through the year of 1997 the
interested persons were informed of all progress in four newsletters. The exploratory
meeting was held in Copenhagen 12-13 September, 1997. It was decided that the
editorial office should be placed in Copenhagen. The editorial base was established
November 1997. The Colorectal Cancer Group was officially registered with the
Cochrane Collaboration on January 27th 1998. Except for the directly employed
administrative persons and some part-time handsearchers, all participation in all
aspects of the work of the CCCG is on a voluntary basis. The CCCG is always open to
new collaborators. New editors might be appointed if appropriate. Members not fulfilling
their obligations will be asked to resign.

Scope
The main focus of CCCG is on reviews of interventions (prevention, treatment and
rehabilitation) designed to improve professional practice and the delivery of effective
health services. This includes various forms of interventions that can affect the ability of
health care professionals to deliver services more effectively and efficiently. The scope
of CCCG encompasses primarily randomised controlled trials (RCTs) and controlled
clinical trials (CCTs) of interventions evaluating the clinical outcomes for treatment of:
- Colorectal diseases (specified in the topics)
- Appendiceal diseases
- Small bowel diseases (excluding duodenum) (specified in the topics)
- Abdominal hernias (excluding diaphragmatic hernias)
Our current contact includes collaboration with the Cochrane groups listed in the original
application. CCCG have established contact with The Cochrane Cancer Network Group
(CCN) in Oxford, UK.



                                                                                          46
The Cochrane Anaesthesia Review Group
The first informational meeting was held during the European Society of
Anaesthesiologists' Annual Meeting in Barcelona (April 1998), followed by informational
meetings in Orlando during the American Society of Anaesthesiologists' annual meeting
(1998) and at the Cochrane Colloquium in Baltimore (October 1998). The exploratory
meeting was held in Amsterdam (May, 1999) and the Cochrane Anaesthesia Review
Group was registered within the Cochrane Collaboration on February 8, 2000.

Scope
All randomised controlled trials (RCTs) and controlled clinical trials (CCTs) of
interventions in
anaesthesiology, specifically in the areas of:
-Anaesthesia
-Perioperative Care Medicine
-Postanaesthetic Care
-Intensive Care Medicine
-Prehospital Medicine
-Resuscitation
-Emergency Medicine
The group avoids duplication of work by collaborating closely with collaborative review
groups which have overlapping scopes such as the Cochrane Pregnancy and Childbirth
Group, the Cochrane Injuries Group and the Cochra ne Pain, Palliative Care and
Supportive Care Group. The Cochrane Anaesthesia Review Group is committed to
collaborate on topics that are on the borderline between groups, both in performing the
reviews as well as in the editorial process.




                                                                                     47
The Cochrane Complementary Medicine Field,
Munich, Germany
Virtually every clinician has been faced with the earnest patient seeking a professional
opinion about an unconventional treatment which promises cure or, at the very least,
temporary palliative relief. While many questions about the effectiveness of
complementary therapies remain unanswered, millions of hopeful or convinced
consumers are spending billions of dollars each year on complementary medical (CM)
treatments in the United States alone (1,2) and simila r trends exist in the United
Kingdom and Australia (3-5).

Furthermore, as people utilise these therapies in ever growing numbers, clinicians are
increasingly being called upon to make thoughtful, informed, evidence-based
recommendations about them. A survey of primary care specialists demonstrated that
these therapies already have a marked presence in medical practice. Over half the
respondents reported referring patients to some type of unconventional therapy, and
knowledge of a particular alternative or complementary therapy was strongly predictive
of physician acceptance (6).

Therefore, the Complementary Medicine Field was established to meet this growing
need for evidence-based research in complementary and alternative medical practices.
Functioning as a Field will help meet this need in three ways: Firstly, many RCTs of CM
interventions have not been published in standard and/or listed medical journals and
may not be identified by the search strategies of established Cochrane collaborative
review groups. Therefore, access to CM studies requires specialised searches and the
construction of a specialised database. Secondly, the evaluation of complementary
interventions often presents unique methodological challenges that are not common
issues among conventional interventions (e.g., chemical comparability in herbal drugs,
different nosology in homeopathy or traditional Chinese medicine, and inactive placebos
in acupuncture). To address these issues successfully requires the close co-operation
of both methodologists and CM practitioners. Finally, common conditions for which
people seek CM treatments are diverse: low back pain, allergies, digestive disorders,
insomnia and depression (1,2). As such the Field will develop working relationships with
a variety of Cochrane Collaborative Review Groups.


   Aims and activities

The Complementary Medicine Field mission is to facilitate the systematic review of
existing randomised controlled trials (RCTs) to provide information that will be beneficial
for clinical decision-making and planning of future research. To fulfil this mission, the
Complementary Medicine Field members endeavour to perform the following activities:
1. To co-ordinate the search for RCTs of complementary medicine interventions
particularly in journals which specialise in complementary medicine and are not
presently being searched by established Cochrane Collaborative Review Groups. This
information will be made accessible to facilitate reviews and to formulate relevant
questions for future research.
2. To establish one registry with paper copy archives of: a) RCTs of complementary and
alternative medical treatments, and b) existing systematic reviews of RCTs on CM.
                                                                                           48
3. To identify and contact CRGs who are investigating diseases for which CM
interventions are commonly utilised, and facilitate systematic reviews of CM
interventions within these CRGs, thus assuring that the specific features of CM are
considered in the review process.
4. To promote the objectives of the Cochrane Collaboration within the various
disciplines and schools of complementary medicine.
5. To present the Field's work at national and international meetings, symposia and
conferences in order to raise awareness about the Cochrane Collaboration and the role
of the Complementary Medicine Field.

   Scope and topics

The Complementary Medicine Field faces a unique challenge in defining its scope
because what are considered complementary or alternative practices in one country
may be considered conventional medical practices in another. Therefore, our definition
is broad and general: complementary medicine includes all such practices and ideas
which are outside the domain of conventional medicine in several countries and defined
by its users as preventing or treating illness, or promoting health and well being (7).
These practices complement mainstream medicine by 1) contributing to a common
whole; 2) satisfying a demand not met by conventional practices; and 3) diversifying the
conceptual framework of medicine. The list of Complementa ry Medicine Field topics
encompassed in our database comprises the entire spectrum of health delivery
mechanisms including treatments a person largely administers to him or herself (e.g.,
botanticals, nutritional supplements, health food, meditation, magnetic therapy);
treatments providers administer (e.g., acupuncture, massage therapy, reflexology, laser
therapy, balneotherapy, chiropractic and osteopathic manipulations, certain types of
psychological counseling, naprapathy); and treatments a person administers to him or
herself under the periodic supervision of a provider (e.g., yoga, biofeedback, Tai Chi,
homeopathy, hydrotherapy, Alexander therapy, nutritional therapy, Ayurveda).
In addition to the CM treatments listed in the above paragraph, CM interventions also
include Qi Gong, Doman Delcato patterning, Anthroposophical medicine, Unani
medicine, Traditional African Medicine, Bach flower remedies, clinical ecology, colon
cleansing or irrigation, and music or sound therapy. CM diagnostic techniques, a
subgroup in the list, include iridology, kinesiology, Vega testing, biofunctional diagnostic
testing, electroacupuncture by Voll, and hair analysis.

   Structure

The advisory board, consisting of both methodologists and clinicians from a variety of
CM backgrounds in 8 countries, serves as the central coordinating body of the CM
Field. Claire Allen of the UK Cochrane Centre in Oxford (UK) is the CM Field's
consumer representative. Beyond the advisory board, two other coordinator positions
exist to assure that specific Field functions are performed. The Registry Coordinator,
currently Mac Beckner in Baltimore, MD (USA), fulfils the Field's function
of identifying reports of trials and making them accessible. Towards this end, his
responsibility requires the compilation of a specialised CM database to meet the needs
of those in the field. CISCOM (the database of the Research Council of Complementary
Medicine in London) provided much of the original data for the CM registry. Other
sources of information include databases such as Medline and Embase, and hand
                                                                                          49
searched sources such as complementary medicine journals, conference proceedings,
dissertations and contact with researchers in the Field. Unpublished studies, when
identified through contacts with medical sc hools and universities, will be added.
Because some of these studies are unpublished, a paper copy archive is presently
being developed. Finally, to reduce publication bias, the Registry Coordinator will be
establishing a trials registry of ongoing and planned CM trials.
The Field Coordinator, currently Brian Berman in Baltimore, Maryland (USA), assures
that the Field's perspectives and priorities are promoted within and outside of the
Cochrane Collaboration and acts as a liaison to oversee the smooth functioning of the
Field. Promoting the Field's perspectives within the Cochrane Collaboration involves
regularly informing the Cochrane Centers and Steering Committee of the present
endeavors and future plans of the Field. Promoting the Field's perspectives outside of
the Cochrane Collaboration involves networking with interested persons, particularly in
under represented countries (e.g., developing countries), presenting the
Cochrane Collaboration and Field's perspectives at pertinent conferences, and
maintaining a registry of all persons interested in the Field. This registry catalogues the
type and extent of Field participation that each registrant desires to have, and the Field
Coordinator uses this information to facilitate participation. Additionally, t he Field
Coordinator chairs the advisory board and he and his staff publish the CM Field bi -
annual newsletter.

The Cochrane Complementary Medicine Field will be represented by one of its Board
Members:


Klaus Linde, MD
Projekt Munchener Modell
Technical University
Kaiserstrasse 9
80801 Munchen
Munchen Germany
Email: Muenchener.Modell@lrz.uni-muenchen.de
Tel: + 49-89-330-41048
Fax: + 49-89-393484

References
1. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC.
Trends in alternative medicine use in the United States, 1990-1997: Results of a follow-
up national survey.
JAMA 1998;280(18):1569-75
2. Eisenberg DM, Kessler RC, Foster CF, Norlock FE, Calkins DR, Delbanco TL.
Unconventional medicine in the United States: Pre valence, costs, and patterns of use.
N Engl J Med
1993;328:246-52.
3. Fulder SJ, Munroe RE. Complementary medicine in the United Kingdom: patients,
practitioners and consultations. Lancet 1985;2:542-5.
4. Maclennan AH, Wilson DH, Taylor AW. Prevalence a nd cost of alternative medicine
in Australia. Lancet 1996;347:569-73.
5. Maddocks I. Alternative medicine. Med J Aust 1985;142:547-51.
                                                                                          50
6. Berman BM, Singh BB, Hartnoll SM, Singh BK, Reilly D. Primary Care Physicians
and Complementary-Alternative Medicine: Training, Attitudes, and Practice Patterns.
J Am Board Fam Pract 1998;11(4):272-81.
7. Ernst E, Resch K, Mills S, Hills R, Mitchell A, Willoughby M. Complementary
medicine - a definition. British Journal General Practice. 1995;45:506.




                                                                                      51
Suggested reading
For those of you who are best at Chinese please read:

About The Cochrane Collaboration at the home page of The Chinese Cochrane Centre
(http://www.chinacochrane.org)

Wang J, Gluud C, eds. Evidence-based medicine and clinical practice. Science
Publisher: Beijing 2002;1-339 (will be distributed at The Copenhagen Trial Unit).


For those of you who are also good at English please consider to read:

Clarke M, Oxman AD, editors. Cochrane Reviewers' Handbook 4.1.5 [updated April
2002]. In: The Cochrane Library, Issue 2, 2002. Oxford: Update Software. Updated
quarterly (available free of charge through www.cochrane.org)

Sackett DL, Straus SE, Richhardson WS, Rosenberg W, Haynes RB. Evidence-based
Medicine. How to Practice and Teach EBM (Second Edition). Edinburgh: Churchill
Livingstone 2000.

Kristensen FB, Hørder M, Poulsen PB (eds.). Health Technology Assessment
Handbook . Danish Institute for Health Technology Assessment. 2001
(available free of charge at Danish Centre for Evaluation and HTA : www.dacehta.dk
and will be distributed at the visit to The National Board of Health).

Jonsson E, Banta HD, Henshall C, Sampietro-Colom L (eds) (2002) “Special section.
European Collaboration for Health Technology Assessment: Developing an Assessment
Network”, International Journal of Technology Assessment in Health Care, vol. 18, no.
2, p. 211-459 (a few copies will be distributed at the visit to The National Board of
Health)

Goodman CS (1998) “TA 101. Introduction to Health Care Technology Assessment “
(available free of charge at National Library of Medicine at
http://www.nlm.nih.gov/nichsr/ta101/ta101.pdf ).




                                                                                     52
Practical information

In case of any problems arise, call either


The Copenhagen Trial Unit
Centre for Clinical Intervention Research
H:S Rigshospitalet
Visiting address: Tagensvej 18 B
2100 Copenhagen
Phone: (+ 45) 35 45 71 75

or

Embassy of the People's Republic of China in Denmark
Øregaards Alle 25
2900 Hellerup, Copenhagen
Office Hours: Monday-Friday
09.00-12.00; 14.00-16.30
Phone: (+45) 39 46 08 89
Fax: (+45) 39 62 54 84

or
Jianping Liu mobile phone 51 27 74 33

or

Ninna Frydendall mobile phone 51 27 49 86

or

Christian Gluud mobile phone 40 40 11 82




In case of any emergency in Denmark, call 112




                                                       53
HANDOUTS TO SOME OF THE LECTURES




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