Evidence-Based Health Care

Dr Gordon Guyatt provides a guest talk on how we should teach evidence-based medicine in the 21st century This free guest lecture is part of the Teaching Evidence-Based Practice module, part of the Oxford University Evidence-Based Health Care (EBHC) programme. About the speaker: Dr Gordon Guyatt is a Distinguished Professor in the Department of Clinical Epidemiology and Biostatistics, McMaster University and one of the founders of Evidence-Based Medicine. He has played a key role in over 30 major clinical studies (including both large-scale observational and randomized trials) and has extensive expertise in study methodology. As co-founder and co-chair of the GRADE working group, he has been intimately involved in the development and evolution of the GRADE approach. Questions? Please contact the Evidence-Based Health Care (EBHC) team by emailing: cpdhealth@conted.ox.ac.uk To stay informed of programme news, including lectures and research news, sign up to the EBHC mailing list: https://conted.us6.list-manage.com/subscribe?u=b349338a9a&id=9769482733

Dr Annalise Weckesser will discuss her qualitative studies exploring women’s experiences of endometriosis and doctors’ perspectives on treating the condition and how to improve care. This episode explores what this research, and the growing body of social research on endometriosis more generally, contributes to efforts to improve care and address health disparities at the intersections of gender and race, and reflect on the ‘work to be done’ going forward in qualitative investigations of the condition.

Dr Rob Salguero-Gomez, Associate Professor in Ecology, Department of Zoology, gives a talk on lessons for a longer, better human life for the EBHC podcast series.

The logic and principles behind the drive for evidence-based health care are so compelling that often the limitations of evidence go unacknowledged. Despite a strong evidence base demonstrating the health risks associated with higher body weights, and health professionals routinely instructing patients to lose weight to improve their health, the incidence of obesity is predicted to continue to rise. Calling on his research into the relationships between obesity, inequality and health, Oli Williams - a fellow of The Healthcare Improvement Studies Institute - will argue that when it comes to reducing the burden on, and improving, health care a more critical approach to the way we generate, select, apply and communicate evidence is needed. Oli Williams completed his PhD in the Department of Sociology at the University of Leicester. He was subsequently awarded the NIHR CLAHRC West Dan Hill Fellowship in Health Equity which he held at the University of Bath. He later re-joined the University of Leicester in the Department of Health Sciences working in the SAPPHIRE Group and is now based at King's College London after being awarded a THIS Institute Postdoctoral Fellowship. His research focuses on health inequalities, the promotion of healthy lifestyles, obesity, weight stigma, equitable intervention and co-production. He co-founded the art collective Act With Love (AWL) to promote social change. The Weight of Expectation comic is one example of their work, view others at: www.actwithlove.co.uk In recognition of his work on weight stigma the British Science Association invited Oli to deliver the Margaret Mead Award Lecture for Social Sciences at the British Science Festival 2018. This talk was held as part of the Qualitative Research Methods course which is part of the Evidence-Based Health Care Programme.

Making decisions and choices about health and social care need access to high-quality evidence from research. Systematic reviews provide this by both highlighting the quality of existing studies and by themselves providing a high-quality summary. Mike Clarke and Iain Chalmers [1], Iain Chalmers (James Lind Library and Fellow of CEBM), Carl Heneghan ( Professor of EBM and Director CEBM) and Kamal Mahtani (Associate Professor and Director of the MSc in Systematic Reviews) talk about the history and development of systematic reviews, their current delivery and the shortcomings in current review production and the future directions of systematic reviews, including the launch of CEBM's Evidence Synthesis Toolkit. This talk was held as part of the Practice of Evidence-Based Health Care course which is part of the Evidence-Based Health Care Programme. [1] Clarke M, Chalmers I Reflections on the history of systematic reviews. BMJ Evidence-Based Medicine 2018;23:121-122.

Sir Muir Gray and Lucy Abel debate: Is value-based health care nothing more than health economics re-packaged or is health economics nothing more than only one of the six contributors to value-based healthcare? Health economics is concerned with how to allocate resources in healthcare to optimise outcomes. Health economists have developed a variety of methods to evaluate whether the cost of providing healthcare interventions is worth the benefits. In other words, whether they are good value. These are based on preferences expressed by wider society relating to the value of increasing the length and quality of life. These values can be applied to an intervention by linking them via clinical outcomes. Sir Muir Gray is now working with both NHS England and Public Health England to bring about a transformation of care with the aim of increasing value for both populations and individuals and published a series of How To Handbooks for example, How to Get Better Value Healthcare, How To Build Healthcare Systems and How To Create the Right Healthcare Culture. Lucy Abel is a health economist working within the field of primary care and is part of the Nuffield Department of Primary Care Health Sciences at the University of Oxford. She collaborates with research groups to bring the tools of economic evaluation to primary care health science research.

The overwhelming volume of evidence and its lack of relevance to patient care and decisions means health professionals require skills to sift evidence more efficiently: discarding what doesn't make a difference to focus on evidence that matters for health This talk will present a simple effective appraisal system based on two first steps to rapidly appraise and sift the evidence for its relevance and application to actual patient care, prior to assessing its validity. Professor Carl Heneghan is Director of CEBM, and an NHS Urgent Care GP, and has been interested for over twenty years in how we can use evidence in real world practice. This talk is being held as part of the Practice of Evidence-Based Health Care module which is part of the MSc in Evidence-Based Health Care and the MSc in EBHC Systematic Reviews.