Case Studies

Cochrane Library: relaunched site shows 16.8% rise in impact factor in two years

Cochrane is a global independent network of researchers, professionals, patients, carers, and people interested in health. By providing trusted evidence, Cochrane drives informed decisions across the health sector, leading to better health.

The Cochrane Library is its flagship product; a collection of databases that contain high-quality independent evidence, widely regarded as the gold standard for evidence-based medicine. It provides a vital resource for researchers and healthcare professionals across the globe. Built upon HighWire Hosting, the online platform was launched in 2018, providing greater features and functionality.


Cochrane was seeking a flexible platform which could meet the complex content requirements of Cochrane Library, which are key to its success in meeting user needs. HighWire was selected as a collaborative partner in developing a best-fit solution to meet its content needs.

To enable discoverability and drive connections between content, the platform needed to support a wide variety of content types and deliver an integrated search across all content. Cochrane also wished to increase its international user base by developing a new Spanish portal, which could later be scaled and expanded to support other languages. At the same time, Cochrane wished to improve visibility and discoverability of other non-English language content in order to make evidence-based resources globally available.

Cochrane Library needed to meet and support five key strategic goals for the organization, each of which will be addressed in this case study:

  1. Empower users to discover relevant evidence.
  2. Make Cochrane evidence universally accessible.
  3. Increase impact of Cochrane content in health decision making.
  4. Attract Cochrane contributors and submissions.
  5. Build a sustainable business and access model.

Specific objectives were also defined, in order to support and clarify the above strategic goals:

  • 20% increase in unique full-text accesses.
  • Over 2 million unique page views in Spanish.
  • 200,000 unique page views in other non-English languages.
  • Over 85% search completion.
  • < 65% bounce rate for articles, < 35% bounce rate for homepage.


HighWire’s emphasis on configuration and ability to support multi-content formats made it a match for the intricacies of Cochrane’s complex content requirements. 

By prioritizing flexibility, discoverability, and responsiveness, the collaboratively redesigned Cochrane Library now offers:

  • Integrated search allowing users to search across all content types within one centralized platform.
  • Improved UX to allow users of Cochrane Library to navigate content more easily and intuitively. 
  • Powerful multilingual capabilities and underpinning technology designed to enable the easy addition of further languages in future.

Empower users to discover relevant evidence.

The new Cochrane Library includes powerful integrated search functionality, enabling users to get to the information they need quickly, no matter where it is stored or originated. Users can now search across Cochrane Reviews and Protocols, CENTRAL trials, Cochrane Clinical Answers, Editorials, Special Collections, and systematic reviews from external databases. 

Cochrane Library is integrated into Google Scholar, helping to ensure that articles and content are as accessible and discoverable as possible. HighWire has a close and distinct relationship with Google, having worked together 15 years ago to create ‘The HighWire Tag Set’, which became the metatags now recommended by Google Scholar. The HighWire team continues to meet with Google on a regular basis to ensure that all sites are not only being properly indexed, but also to maximize the presence of hosted content in the Google search engine results. 

Further enhancements to search functionality utilize sophisticated techniques including custom search syntax, multi-line search strategies, multiple taxonomies including MeSH, and now also integration with highly structured PICO (population, intervention, comparator, outcome) Search that enables users to search in a structured and complex manner (e.g. “what outcome results from giving X medication/intervention to X demographic?”).

Cochrane Library drives content discovery in a manner that is fast, seamless and intuitive. As Cochrane covers the broad field of healthcare, it is key that different users are signposted to the content within their disciplines or areas of research. Integrated alerting pushes content out to subscribed users via article-level, topic-level and search-level alerting. Cochrane Library drives content discovery in a manner that is fast, seamless and intuitive. There are multiple alerting options to push content out to relevant users: topic-level alerting targets specific healthcare disciplines; article-level alerting ensures users are kept up to date when articles change over time; and search-level alerting leverages the powerful search manager feature to identify new articles meeting defined criteria.

Make Cochrane evidence universally accessible.

To support Cochrane’s target of making evidence universally accessible, HighWire added a Spanish language portal along with support for SEO in Spanish. The technology underpinning this was specifically designed to be expandable and scalable, giving Cochrane the ability to support multilingual content, as well as to create iterations of the entire site in a given language within separate portals. The launch of the new Spanish portal has been a key factor in driving discoverability within Spanish-speaking regions and achieving the goal of over 2 million unique page views in Spanish during 2019. The Cochrane Library also supports 15 content languages (and counting), including support for right-to-left content in Farsi. HighWire continues to work closely with Cochrane to further global accessibility, adding abstracts and plain language summaries in Spanish in 2019, and developing support for further non-English languages.

Cochrane Library supports multiple content types and formats (including reviews, trials, editorials, special collections, and clinical answers), making it possible to deliver content to readers in a variety of ways. A series of user testing sessions before launch helped determine which features would be most useful for the target users. Diversity requirements also meant that the site had to be fully responsive and in line with UX and WCAG accessibility guidelines.

Increase impact of Cochrane content in health decision making.

The impact of each review is now clearly presented to the user as part of the header by displaying links to guidelines, social media articles, and other third-party linked content in which the review is referenced. 

Through content types such as Cochrane Clinical Answers, Cochrane delivers readable, digestible, actionable information designed to directly inform point-of-care decision making. The PICO search interface has been configured to meet the needs of healthcare professionals, allowing them to create detailed search strategies which can then be directly referenced in Cochrane’s systematic reviews. 

Attract Cochrane contributors and submissions.

The impact factor of Cochrane Library has increased by 16.8% in two years (from 6.754 in 2017 to 7.755 in 2018 and then 7.890 in 2019), helping Cochrane to attract and retain the best talent from the scholarly community.

Reduced homepage bounce rates indicate that Cochrane’s enhanced content discoverability has been able to keep users on-site and improve the reach of Cochrane Library content. Increasing discoverability and widening the impact of Cochrane’s evidence is hugely important in terms of how the Cochrane brand is regarded, not only by end-readers but by contributors and submitters. 

Build a sustainable business and access model.

HighWire provides an uptime of >99.9% as standard, ensuring reliable and responsive access to this hugely important library of evidence.  

Cochrane and HighWire collaborate together on ongoing development on the platform with the goal of making content evidence more accessible, more discoverable and more actionable, and has delivered 108 user stories to the Cochrane Library during 2019 alone. 


Now achieving over 1 million unique accesses per month, Cochrane Library provides growing international access to trusted, evidence-based information and resources, and plays a critical role on the front lines of global health.

In meeting the goals set out by Cochrane, the relaunched Cochrane Library has fulfilled targets for unique page views in Spanish and other non-English languages and delivered a 26% year-on-year increase in full-text accesses. The platform has also achieved: 

  • 26% year-on-year increase in unique HTML full-text accesses in 2019, with increase as high as 45% in July 2019. 
  • 2,008,939 unique page views in Spanish.
  • 633,231 unique page views in other non-English languages.
  • Reduced bounce rate to 66% for articles, 21% for homepage.

Cochrane’s content has seen an increase in The Cochrane Database of Systematic Reviews’ impact factor, rising from 6.754 in 2017 to 7.755 in 2018 following the relaunch and then growing further to 7.890 in 2019.