Cochrane is an international network that produces and updates new knowledge through systematic reviews for the health sector. Knowledge is a shared resource, and can be viewed as a commons. As Cochrane has been in existence for 25 years, we used Elinor Ostrom's theory of the commons
and Institutional Analysis and Development Framework to appraise the organisation. Our aim was to provide insight into one particular knowledge commons, and to reflect on how this analysis may help Cochrane and its funders improve their strategy and development. An assessment of Cochrane product
showed extensive production of systematic reviews, although assuring consistent quality of these reviews is an enduring challenge; there is some restriction of access to the reviews, open access is not yet implemented; and, while permanence of the record is an emerging problem, it has not
yet been widely discussed. The assessment of the process showed that the resource, community, and rules-in-use are complex, vary between different groups within Cochrane, and are not well understood. Many of the rules have been informal, and the underlying ethos of volunteerism where reviews
get done are important features and constraints to the organisation. Like all collective efforts, Cochrane is subject to collective action problems, particularly free-riding and variable commitment, and the under-production of public goods and internal processes, such as surveillance of product
quality and procedures for transparent resolution of conflicts.
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