Following the initial claims in 1998, multiple large epidemiological studies were undertaken. Reviews of the evidence by the Centers for Disease Control and Prevention,[9] the American Academy of Pediatrics, the Institute of Medicine of the US National Academy of Sciences,[10] the UK National Health Service,[11] and the Cochrane Library[12] all found no link between the MMR vaccine and autism. While the Cochrane review expressed a need for improved design and reporting of safety outcomes in MMR vaccine studies, it concluded that the evidence of the safety and effectiveness of MMR in the prevention of diseases that still carry a heavy burden of morbidity and mortality justifies its global use, and that the lack of confidence in the vaccine has damaged public health.[12] A special court convened in the United States to review claims under the National Vaccine Injury Compensation Program rejected compensation claims from parents of autistic children.[13][14]