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Cochrane Archive: Rhondda Fach Scheme

Working in the mining communities of South Wales, whom Archie Cochrane deeply respected, the Rhondda Fach Scheme was launched in 1950. Its main objective was to test the hypothesis that progressive massive fibrosis (PMF) derived from interaction between pneumoconiosis and tuberculosis. Reducing the level of infectious tuberculosis in one of two mining valleys, and then monitoring the subsequent attack rate of PMF in the two communities would test the hypothesis.

In his manuscripts in the Archive Catalogue, Archie noted that: " . . . at that time . . . one in every twenty of the country's miners [was] certified as disabled, and as many as one in five lost to some of the collieries of South Wales."

Tyntyla Hospital Ward (Cochrane Archive)
The Matron of Tyntyla Hospital in Rhondda chatting to some patients with tuberculosis being cared for under the Rhondda Fach Scheme in 1950.
(Picture: Crown copyright. From Archie Cochrane's autobiography "One Man's Medicine". Reproduced with permission of the Controller of HMSO and Queen's Printer for Scotland.)

The Rhondda Fach Scheme was an ambitious plan, involving x-raying everyone over the age of 15 in one of the selected valleys. The response rate was never less than 90% and the accuracy of the measurements was comparable to that achieved in laboratory research. It also afforded great opportunities for follow-up studies.

The Rhondda Fach Scheme was the start of Archie's lifelong scientific interest in making full use of representative population samples - it also helped to establish epidemiology as a quantitative science.

Archie Cochrane in the Rhondda Valleys

For many years after the Rhondda Fach Scheme was completed, Archie used to return regularly to the mining communities, to meet and talk to the friends he had made during his early research in the 1950s.

He was interviewed, about his life and extensive work in the South Wales valleys, for the Health and Social Service Journal, which was published in November 1978: