Archie Cochrane (1909-1988) made many highly significant contributions to medicine and to medical research. Many of us will remember his urgings to ‘randomise’ – even though he himself never conducted a RCT. The nearest Archie got to randomisation was in a remarkable study of the treatment of famine oedema in prisoners of war (BMJ 1984;289:1726-7)! He will however best be remembered for his challenge that the reports of medical research, and in particular, randomised trials, be organised, evaluated and up-dated at intervals to give a valid evidence-base for medical and surgical practice. His frequent challenges led Iain Chalmers to set up the Cochrane Collaboration, which, in turn, led to a paradigm shift in clinical practice summarised in the phrase: ‘evidence-based medicine’.
Archie was a founding member of both the Society of Social Medicine and the International Epidemiological Association. He valued both and was a very frequent attender at their meetings. He often expressed delight at the inclusion of disciplines other than medicine, and later, in playing a key role in the setting up of the Faculty of Community Medicine he was concerned lest this, being within the Royal College of Medicine, might become exclusive to those who were medically qualified.
Archie was a lateral thinker with almost unlimited interests in medicine, and the encouragement he gave to others, and especially to junior research workers – whatever the topic of their research – enriched many a career. On the other hand, he was deeply concerned at the lack of rigour in the evaluation of clinical interventions. Perhaps his attitude to some of the more pompous senior clinicians was summed up by Paul Luke, the first Secretary of the Faculty of Community Medicine, who, having watched him taunt an eminent physician, referred to Archie as ‘a malevolent pixie’!
Archie yearned for more attention to be given to the prevention, rather than the treatment of disease. The origin of this concern of his predates his involvement in clinical activities and was expressed in a poem, written in a prisoner of war camp in Salonica, in 1941.