Evidence-Based Health Care

Kirsten Prest discusses the 'Encompass' study on care for disabilities in Uganda and its wider application in the NHS, where narrative-driven mixed methods research shaped phases from grants to implementation This talk will explore how a small qualitative study was able to inform a wider body of work, which includes both qualitative and quantitative methods. It will be framed within the “Encompass” study which aims to adapt and pilot test a group programme for parents/carers of children with disabilities originally developed in Uganda, to be implemented in an NHS setting in the UK. The initial qualitative work supported every phase of the mixed methods study from grant applications to key decisions around implementation, to informing the adaptation phase, to considering objectives and outcomes, and finally dissemination and future work. It has provided a wealth of knowledge and rich insights, much of which continues to inform future grant applications. Kirsten is a paediatric occupational therapist and HARP doctoral research fellow. Her clinical and research interests include supporting the wellbeing of families who have children with complex disabilities, improving family-centred services, global child health, global innovation including knowledge transfer from low-resource settings to high-income countries, and research capacity building among allied health professionals.

Kirsten Prest discusses the 'Encompass' study on care for disabilities in Uganda and its wider application in the NHS, where narrative-driven mixed methods research shaped phases from grants to implementation This talk will explore how a small qualitative study was able to inform a wider body of work, which includes both qualitative and quantitative methods. It will be framed within the “Encompass” study which aims to adapt and pilot test a group programme for parents/carers of children with disabilities originally developed in Uganda, to be implemented in an NHS setting in the UK. The initial qualitative work supported every phase of the mixed methods study from grant applications to key decisions around implementation, to informing the adaptation phase, to considering objectives and outcomes, and finally dissemination and future work. It has provided a wealth of knowledge and rich insights, much of which continues to inform future grant applications. Kirsten is a paediatric occupational therapist and HARP doctoral research fellow. Her clinical and research interests include supporting the wellbeing of families who have children with complex disabilities, improving family-centred services, global child health, global innovation including knowledge transfer from low-resource settings to high-income countries, and research capacity building among allied health professionals.

Professor Karl Roberts, University of New England, NSW, Australia gives a talk on generative AI and large language models as applied to healthcare. Dr Karl Roberts is the Head of the School of Health and Professor of Health and Wellbeing at the University of New England, NSW, Australia. Karl has over thirty years-experience working in academia at institutions in Australia, the UK and USA. He has also acted as an advisor for various international bodies and governments on issues related to wellbeing, violence prevention and professional practice. Notably, this has included working with policing agencies, developing policy and practice on suicide, stalking, and homicide prevention. Interpol developing guidance for organisational responses to deliberate events such as biological weapon use. The UK government SAGE advisory group throughout the Covid19 pandemic focusing upon security planning. The European Union advising on biological terrorism, and extremist use of AI. World Health Organisation where he worked in a unit developing policy and practice related to deliberate biological threat events. There has been substantial recent interest in the benefits and risks of artificial intelligence (AI). This has ranged from extolling its virtues as a harmless aid to decision making, as a tool in research, and as a means of improving economic productivity. To those claiming that unchecked AI is a significant threat to human wellbeing and could be an existential threat to humanity. One area of significant recent advancement in AI has been the field of Large Language Models (LLMs). Exemplified by tools such as Chat-GPT, or DALL-E, these so-called generative AI models allow individuals to generate new outputs through interacting with the models using simple natural language inputs. Various versions of LLMs have been applied to healthcare, and have variously been shown to be useful in areas as diverse as case formulation, diagnosis, novel drug discovery, and policy development. However, as with any new technology, there is a potential 'darkside,' and it is possible to utilise these tools for nefarious purposes. This talk will give a brief introduction to generative AI and large language models as applied to healthcare. It will then discuss the potential for misuse of these models, seeking to highlight how they may be misused and how significant a threat they could pose to health security. Finally we will consider strategies for managing the risks set against the possible benefits of generative AI. This talk is based on work carried out by the author and colleagues at the World Health Organisation and the Royal United Services Institute.

An introduction to OHA!, a tool currently being developed which aims to assist dentists in accessing the most reliable evidence regarding the effectiveness of common dental treatments. The OHA! repository has been purposefully crafted to be exceptionally selective and compact, ensuring that users can easily find straightforward and valuable answers to their dental clinical questions. During the presentation, Professor Paulo Nadanovsky will show two sample dental fact boxes (in draft form) that have been developed. One pertains to the success rate of root canal treatment, while the other focuses on the impact of shorter versus longer intervals between dental check-ups on oral health. Patients expect doctors to take action to help them, and the more treatment or diagnostic tests, the better they feel. Doctors genuinely want to help and can often come up with various treatment or testing options to try. Consequently, this leads to a situation where everyone becomes perpetual patients, regardless of their actual health needs and potential benefits – essentially, an overuse of healthcare. Furthermore, there is a pervasive illusion of certainty among healthcare professionals, including physicians and dentists. This illusion entails the belief that treatments are always effective, diagnostic tests are infallible, and there exists only a single, optimal treatment or management approach. Consequently, there is often a lack of systematic comparisons between the pros and cons of different options. To dispel this illusion of certainty, reduce excessive healthcare practices, and promote clear thinking when considering interventions, the provision of clear information is essential. The practice of evidence-based healthcare involves two distinct roles: that of evidence consumers and evidence producers. Consumers, including clinicians and the general public, often lack the expertise needed to evaluate and choose the most reliable evidence. Hence, it falls upon those producing healthcare evidence to assume the role of experts and develop tools that simplify the integration of the best available evidence into the decision-making process for clinicians and patients alike. Bio: Professor Nadanovsky graduated as a dentist in Rio de Janeiro, Brazil. He worked for a few years in the clinic (mainly periodontics), then migrated to public health and epidemiology and obtained a PhD from the University of London in 1993. He witnessed the birth of the evidence-based medicine movement and of the Cochrane Collaboration while working as a lecturer at the London Hospital Medical College and at University College London (afterwards it was renamed Queen Mary and Westfield College). Professor Nadanovsky taught evidence-based dentistry between 1993 and 1997 and since 1997 has been teaching epidemiology and evidence-based health care to physicians, dentists, nutritionists, and other health care professionals. He supervises PhD and MSc students, and his main interest is in overdiagnosis and overtreatment in health care in general, and more specifically, in dentistry.

Using a variety of examples of fast and slow qualitative research this talk explores the affordances of rapid methods, and help researchers decide if and where to use them in their own work. Methodologies of rapid qualitative research have been around for decades, gaining particular prominence during the Covid-19 pandemic. They spark intense debate about the place of rapid qualitative methods in healthcare research. What questions are they best suited to answer? Is speed a trade-off for quality? Which parts of the qualitative process can and can't be done at pace? If can do research quicker, should we? Dr Anna Dowrick (https://www.phc.ox.ac.uk/team/anna-dowrick) is an interdisciplinary social scientist, spanning medical sociology, medical anthropology and science and technology studies. Her research explores how social injustice can be seen and acted upon through understanding experiences of health and illness, with a view to informing and improving the design of public services. She has used rapid and slow qualitative designs to explore issues including: improving access to support for domestic violence and abuse, food poverty interventions, cancer detection, Covid and Long Covid, and beauty 'injectables'.

Dr Sara Van Belle, Institute of Tropical Medicine, Antwerp gives a talk on the practice of realist inquiry in global health. Dr Sara Van Belle, Researcher at the Institute of Tropical Medicine, Antwerp provides an overview of the practice of realist inquiry origins and points of attraction or interest for global health systems and policy research. Specific challenges are discussed with some examples of applications in complex health programmes in LMIC and suggestions offered for further methodological development.

Professor Seena Fazel, University of Oxford gives a talk on recent advances in prognostic modelling in psychiatry. Professor Seena Fazel, a Professor of Forensic Psychiatry at the University of Oxford gives a talk gives a talk on recent advances in prognostic modelling in psychiatry. A number that examine risk for adverse outcomes, such as self-harm suicide, and violent crime, have been developed in Oxford (OxRisk tools), and further research on their feasibility, useability and impact will be outlined. Methodological challenges in their development and validation will be discussed, and how impact can be tested.

Dr Derrick Bennett, University of Oxford gives a talk on the epidemiological evidence of alcohol and cardiovascular disease. Dr Derrick Bennett, Associate Professor at the Nuffield Department of Population Health, University of Oxford, presents an overview of the epidemiological evidence of alcohol and cardiovascular disease (CVD), describes how bias may have impacted on this observational evidence, and finally presents evidence for the causal relevance of alcohol for CVD disease based on MR studies.

In this episode EBHC DPhil Director, Jamie Hartmann-Boyce and Dr. Anne Marie Boylan discuss intrauterine contraception commonly known as the coil. Given the uncertainty around who feels pain, they speak with Dr Neda Taghinejadi, a sexual and reproductive health doctor and academic clinical fellow, who specialises in fitting coils for those who have had problems having them fitted by their GP or who have experienced trauma and require a highly trained specialist. This podcast series on evidence in women's health is brought to you by the Centre for Evidence-Based Medicine and the postgraduate programme in evidence based health care. Dr. Anne-Marie Boylan, a senior researcher and lecturer in the programme, and Associate Professor Jamie Hartmann-Boyce, interview relevant experts discussing the strengths and limitations of different sources of evidence as they relate to women's health and considering their implications for future research. In this episode EBHC DPhil Director, Jamie Hartmann-Boyce and Dr Anne Marie Boylan discuss intrauterine contraception commonly known as the coil. Given the uncertainty around who feels pain, they speak with Dr Neda Taghinejadi, a sexual and reproductive health doctor and academic clinical fellow, who specialises in fitting coils for those who have had problems having them fitted by their GP or who have experienced trauma and require a highly trained specialist.

Surgeon Commander Charlotte Evans is Royal Navy Hudson Visiting Fellow at St. Anthony's College and gave a talk about her dissertation work in relation to military mental health patients.

Dr Alexandra Burton reports on the SHAPER-PND study exploring singing's effect on postnatal depression in new mothers Singing has shown positive effects on maternal mood and mother–child bonding. The Scaling-Up Health-Arts Programmes: Implementation and Effectiveness Research-Postnatal Depression (SHAPER-PND) study will analyse the clinical and implementation effectiveness of a 10-week programme of singing sessions for PND in new mothers. This talk will present findings from the evaluation of an adapted online programme during the COVID-19 pandemic and describe the methods used to evaluate the main in-person programme. This free guest lecture is part of the Mixed Methods in Health Research module, part of the Oxford University Evidence-Based Health Care (EBHC) programme (https://www.conted.ox.ac.uk/courses/mixed-methods-in-health-research?code=O22C212B9Y). About the speaker: Dr Alexandra Burton is a Senior Research Fellow in Behavioural Science/Behaviour Change at University College London. She currently leads the qualitative component of the Shaper-PND implementation trial exploring the experiences of new mothers with postnatal depression who take part in group singing sessions, and the INSPYRE study evaluating social prescribing for young people who are on waiting lists for child and adolescent mental health services. Questions? Please contact the Evidence-Based Health Care (EBHC) team by emailing: cpdhealthadmin@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 Links: Dr Alexandra Burton: https://iris.ucl.ac.uk/iris/browse/profile?upi=ABURT01? Evidence-Based Health Care Programme Overview: https://www.conted.ox.ac.uk/evidence-based-healthcare Mixed Methods in Health Research: https://www.conted.ox.ac.uk/mixed-methods-in-health-research

We discuss evidence around delays in diagnosis of endometriosis and speak with Dr Annalise Weckesser and Dr Sharon Dixon, who have both researched endometriosis from the perspective of women as patients and from that of GPs. This podcast series on evidence in women's health is brought to you by the Centre for Evidence-Based Medicine and the postgraduate programme in evidence based health care. Dr. Anne-Marie Boylan, a senior researcher and lecturer in the programme, and Associate Professor Jamie Hartmann-Boyce, interview relevant experts discussing the strengths and limitations of different sources of evidence as they relate to women's health and considering their implications for future research. In this episode EBHC DPhil Director, Jamie Hartmann-Boyce and Dr. Anne Marie Boylan discuss research evidence around delays in diagnosis of endometriosis and speak with Dr Annalise Weckesser and Dr Sharon Dixon on this, who have both researched endometriosis from the perspective of women as patients and from that of GPs. Contributors: Dr Jamie Hartmann-Boyce, Dr Anne-Marie Boylan, Dr Annalise Weckesser and Dr Sharon Dixon Production: Megan Carter

EBHC DPhil Director, Jamie Hartmann-Boyce and Dr. Anne Marie Boylan discuss menopause and hormone replacement therapy (HRT) In this episode EBHC DPhil Director, Jamie Hartmann-Boyce and Dr. Anne Marie Boylan discuss menopause and hormone replacement therapy (HRT). We hear from Dr. Elizabeth Spencer and Professor Carol Coupland, both of whom have conducted research on the risks of HRT using large databases, including the landmark million women's study. This podcast series on evidence in women's health is brought to you by the Centre for Evidence-Based Medicine and the postgraduate programme in evidence based health care. Dr. Anne-Marie Boylan, a senior researcher and lecturer in the programme, and Associate Professor Jamie Hartmann-Boyce, interview relevant experts discussing the strengths and limitations of different sources of evidence as they relate to women's health and considering their implications for future research. In this episode EBHC DPhil Director, Jamie Hartmann-Boyce and Dr. Anne Marie Boylan discuss menopause and hormone replacement therapy (HRT) with interviews from Dr. Elizabeth Spencer and Professor Carol Coupland, both of whom have conducted research on the risks of HRT using large databases, including the landmark million women's study.

Dr Clare J Taylor, Academic GP, explores how we can use large, anonymised GP datasets to improve our understanding of heart failure management in primary care. Nearly all UK residents are registered with a general practice and data collected during routine consultations can be used by researchers to understand more about common diseases. Heart failure occurs when the heart has been damaged and is struggling to pump enough blood to meet the needs of the body. Patients can feel breathless, exhausted and have swollen legs but treatments to improve quality of life and outlook are available. In this lecture, Dr Taylor explores how we can use large, anonymised GP datasets to improve our understanding of heart failure management in primary care. With a focus on the patient throughout, she presents her recent work on heart failure diagnosis and survival to illustrate the power, and limitations, of using big GP data for research and to ultimately improve patient care. Part of the Evidence-Based Health Care programme. About the speaker: Dr Clare J Taylor is a Clinical Lecturer in the Nuffield Department of Primary Care Health Sciences. Her research explores heart failure in primary care using big data epidemiology, prospective studies, and qualitative work. The findings have been published in high-impact journals and informed national and European heart failure policy. Clare is also experienced in postgraduate teaching and doctoral supervision and was a member of the National Institute for Health and Care Excellence Chronic Heart Failure guideline committee. She also works as an NHS general practitioner.

In 2022 a Canadian population based retrospective cohort study hit the headlines in the U.K. by claiming that women were 32% more likely to die if operated on by a male surgeon. The study was led by Christopher Wallace who sought to examine the link between surgeon patient sex discordance and postoperative outcomes. Data was collected for over 1.3 million patients and nearly 3000 surgeons were included. It found that 14.9% of patients had one or more adverse postoperative outcome. But that worse outcomes were seen for female patients operated on by male surgeons, but not for males operated on by female surgeons. Together with Director of the Centre for Evidence-Based Medicine, Professor Carl Heneghan, and EBHC DPhil Director, Dr. Jamie Hartmann-Boyce, Dr. Anne Marie Boylan discusses what this means for women, the accuracy of the study and whether it has any relevance here in the U.K. They also speak to Emily McFadden, a Senior Statistical Epidemiologist here at Oxford, Sunil Patel, a Canadian surgeon completing his DPhil in evidence based healthcare and Sharon Dixon, a GP and academic who's researching women's health in the department.Together with Director of the Centre for Evidence-Based Medicine, Professor Carl Heneghan, and EBHC DPhil Director, Jamie Hartmann-Boyce, Dr. Anne Marie Boylan discusses what this means for women, the accuracy of the study and whether it has any relevance here in the U.K.

Dr Anthony Webster, University of Oxford gives a talk on combining mathematical modelling with big data statistics to distinguish between sporadic, late-onset, and multi-stage diseases. Dr Anthony Webster, a statistician at the University of Oxford gives a talk gives a talk on combining mathematical modelling with big data statistics to distinguish between diseases strongly linked to ageing and those that could potentially be avoided by making good choices throughout life.

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

Joanne Greenhalgh, Professor of Applied Social Research Methodology (University of Leeds) on the experiences of conducting a realist synthesis of the feedback of aggregated patient reported outcome measure (PROMs) data to improve patient care. Her talk addresses two methodological questions (1) how do you carry out a realist synthesis of an intervention when there's 'no evidence'? and (2) how can you deal with the complexity of ‘context'?

Dr Anne-Marie Boylan and Dr Laura Griffith, ​explore the value of qualitative health research and discuss what it's really like to undertake qualitative research. Qualitative research is a naturalistic mode of inquiry. It is used to answer a variety of research questions that have relevance to health policy and practice. In this podcast, Dr Anne-Marie Boylan, Director of the Postgraduate Certificate in Qualitative Health Research Methods at the University of Oxford, and Dr Laura Griffith, a former academic who now works in public health, explore the value of qualitative health research and discuss what it's really like to undertake qualitative research. Speaker biography Dr Laura Griffith completed her PhD in Anthropology about Motherhood in the East End in 2006 completing research in London and Bangladesh. During this time she also worked as a consultant and was the Chair of the Management Board for Sure Start and actively involved in other public health projects. From there she started as a Research Fellow in Warwick as the PI for a project investigating the experiences of minority ethnic populations of acute psychiatric services. Next was leading a project at Aston University about multi-professional team working in Mental Health teams, and from there she moved to the Health Experiences Research Group, University of Oxford, where she completed modules on psychosis, giving up smoking and experiences of ECT for the renowned healthtalk.org. She went on to lecture at the University of Birmingham in the sociology of health, and led the Health and Well-being stream in the Institute for Research into Superdiversity. At Birmingham she left the academic side of health research and moved into health consultancy - normally working with partners from the third sector. She now works in public health. Date: 18 May 2021

Professor Kamal Mahtani and David Nunan interview Professor Paul Glasziou, Director of the Institute for Evidence-Based Healthcare at Bond University, about his experience of leadership and his work in capacity building through teaching and supervision. Professor Kamal Mahtani is Director of the Evidence-Based Health Care Leadership programme and David Nunan is Director of the PGCert in Teaching EBHC

Professor Kamal Mahtani and David Nunan interview Professor Paul Glasziou, Director of the Institute for Evidence-Based Healthcare at Bond University, about his experience of leadership and his work in capacity building through teaching and supervision. Professor Kamal Mahtani is Director of the Evidence-Based Health Care Leadership programme and David Nunan is Director of the PGCert in Teaching EBHC

Professor Kamal Mahtani continues his interview with Professor Carl Heneghan, discussing where your motivation as a leader comes from, succession planning, seeking mentoring, how leaders can engage with the wider world. Plus strategies for managing your work life balance.

Professor Kamal Mahtani continues his interview with Professor Carl Heneghan, discussing where your motivation as a leader comes from, succession planning, seeking mentoring, how leaders can engage with the wider world. Plus strategies for managing your work life balance.

Professor Kamal Mahtani interviews Professor Carl Heneghan, exploring his leadership; how it all started, the challenges he has faced, emotional intelligence, the importance of clear communication and being a tortoise rather than a hare as a leader.

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.

Recent results of the NELSON Lung Cancer Screening Trial reports reductions in lung-cancer survival but not overall survival - The desire to detect disease even earlier means Overdiagnosis is on the rise. However, the interpretation of screening trial results is problematic and often gives rise to significant uncertainties that go unanswered. Carl Heneghan, Professor of Evidence-Based Medicine, employs evidence-based methods to research diagnostic reasoning, test accuracy and communicating diagnostic results to a wider audience. This talk was held as part of the Evidence-Based Diagnosis and Screening module which is part of the MSc in Evidence-Based Health Care and the MSc in EBHC Medical Statistics.

Recent results of the NELSON Lung Cancer Screening Trial reports reductions in lung-cancer survival but not overall survival - The desire to detect disease even earlier means Overdiagnosis is on the rise. However, the interpretation of screening trial results is problematic and often gives rise to significant uncertainties that go unanswered. Carl Heneghan, Professor of Evidence-Based Medicine, employs evidence-based methods to research diagnostic reasoning, test accuracy and communicating diagnostic results to a wider audience. This talk was held as part of the Evidence-Based Diagnosis and Screening module which is part of the MSc in Evidence-Based Health Care and the MSc in EBHC Medical Statistics.

Dr Jamie Hartmann-Boyce discusses a case study of systematic reviews of electronic cigarettes for smoking cessation, looking across meta-analyses in this area. Dr Jamie Hartmann-Boyce is Senior Researcher, Health Behaviours team at the Nuffield Dept of Primary Care Health Sciences.

Dr Jamie Hartmann-Boyce discusses a case study of systematic reviews of electronic cigarettes for smoking cessation, looking across meta-analyses in this area. Dr Jamie Hartmann-Boyce is Senior Researcher, Health Behaviours team at the Nuffield Dept of Primary Care Health Sciences.

Should doctors with commercial interests lead research on their products? Should we forget ‘conflicts' and discuss ‘declarations of interest' instead? Who should hold and maintain conflicts of interest registers for doctors? Should practicing doctors work with the pharma industry as well as serve on guideline committees? Should researchers with extensive financial interests be disqualified from studies of their own products? The Physician Payments Sunshine Act requires US manufacturers to collect, track and report all financial relationships with clinicians and teaching hospitals. Professor Heneghan will discuss the failings with the current system of reporting of conflicts in medicine, what's been tried so far, and why it is time for a UK Sunshine Act. Carl Heneghan, Professor of Evidence-Based Medicine, employs evidence-based methods to research diagnostic reasoning, test accuracy and communicating diagnostic results to a wider audience. This talk was 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. Members of the public are welcome to attend.

Should doctors with commercial interests lead research on their products? Should we forget ‘conflicts’ and discuss ‘declarations of interest’ instead? Who should hold and maintain conflicts of interest registers for doctors? Should practicing doctors work with the pharma industry as well as serve on guideline committees? Should researchers with extensive financial interests be disqualified from studies of their own products? The Physician Payments Sunshine Act requires US manufacturers to collect, track and report all financial relationships with clinicians and teaching hospitals. Professor Heneghan will discuss the failings with the current system of reporting of conflicts in medicine, what’s been tried so far, and why it is time for a UK Sunshine Act. Carl Heneghan, Professor of Evidence-Based Medicine, employs evidence-based methods to research diagnostic reasoning, test accuracy and communicating diagnostic results to a wider audience. This talk was 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. Members of the public are welcome to attend.

Professor Karla Hemming discusses using evidence-based policy in the evaluation of policy interventions and answers the question 'how useful is the stepped-wedge study as an evaluation design? Professor Karla Hemming is the Professor of Biostatistics at the Institute of Applied Health Research, University of Birmingham.

Professor Karla Hemming discusses using evidence-based policy in the evaluation of policy interventions and answers the question 'how useful is the stepped-wedge study as an evaluation design? Professor Karla Hemming is the Professor of Biostatistics at the Institute of Applied Health Research, University of Birmingham.

Professor Bruno Marchal gives a talk illustrating the principles of realist evaluation using the case of the development of a new Tuberculosis control policy in Georgia. The talk focuses specifically on the central role of the programme theory, how this theory was developed and how it informed not only the policy, but also the study design. Professor Bruno Marchal is Associate Professor at the Health Systems and Equity unit, Department of Public Health, Institute of Tropical Medicine, Antwerp.

Professor Bruno Marchal gives a talk illustrating the principles of realist evaluation using the case of the development of a new Tuberculosis control policy in Georgia. The talk focuses specifically on the central role of the programme theory, how this theory was developed and how it informed not only the policy, but also the study design. Professor Bruno Marchal is Associate Professor at the Health Systems and Equity unit, Department of Public Health, Institute of Tropical Medicine, Antwerp.

The increased reliance of health systems on the digital record as the primary mechanism for storing data on consultations and other health interactions has opened new opportunities for research, healthcare innovation, and health policy. The electronic health record (eHR) is now ubiquitous in many countries, in hospital and primary care settings, and in some countries their health systems in terms of reporting patient care activity are essentially 'paperless'. Health systems globally are also facing accelerating challenges as they seek to deliver better value healthcare against the background of increasing levels of chronic disease, ageing populations, financial pressures and demands on public spending. Digital health tools and services are held up to be part of the solution to these challenges, potentially offering low-cost and patient-centred solutions. There has been huge investment in Big Data research in health, particularly in relation to digitised imaging and automated reporting and predictive modelling using phenotypic and increasingly genetic data. There have also been similar gains in more applied research that explores the potential of accessing the huge quantum of data held in the eHR, and linkage of these data to other national or regional databases, such as mortality records or cancer data. This session will explore some of the applications for routine data research, illustrated by projects that have resulted in research success and better healthcare. This will include the exemplars of using large eHR platforms and prescribing data platforms to create infrastructure for i) common disease surveillance, such as the UK RCGP RSC; ii) generation and validation of disease risk assessment tools, such as QRisk scores; iii) pragmatic electronic follow up trials; iv) within practice systems dashboard feedback reports, eg data normalised to regional and national rates on prescribing and investigation physician activity; v) traditional epidemiological linkage studies; and vi) linkage to long term phenotypic follow up of established disease cohorts. Richard Hobbs is Nuffield Professor of Primary Care at the University of Oxford, and Head of the Nuffield Department of Primary Care Health Sciences. He has served a decade as National Director of the National Institute for Health Research's School for Primary Care Research and was Director of the NHS Quality and Outcomes Framework (QOF) Review panel from 2005-09. He has served many national and international scientific and research funding boards in UK, Ireland, Canada, and WHO, including the BHF Council, British Primary Care Cardiovascular Society, and the ESC Council for Cardiovascular Primary Care. He currently chairs the European Primary Care Cardiovascular Society, a WONCA Special Interest Group. He is one of the world's leading academics in primary care, and has developed at Oxford one of the largest and most highly ranked centres for academic primary care globally. He has also made major contributions to growing primary care academic capacity, in terms of people development and research networks. A highly cited primary care clinical scientist, he has authored over 450 peer reviewed publications, has an h-index of 90, with over 63000 citations (36000 since 2013) and 81 papers cited over 100 times, 14 papers cited over 1000 times and 7 papers with over 2000 citations. He has an outstanding track record in cardiovascular research, delivering trials that changed international guidelines and practice, especially in the areas of stroke prevention in atrial fibrillation (BAFTA, SAFE, and SMART trials), heart failure burden and diagnosis (ECHOES and REFER trials), and hypertension self-management (TASMINH series). He is only the fifth ever recipient of the RCGP Discovery Prize in 2018 (an occasional award made since 1953) and received an inaugural Distinguished Researcher Shine Prize plus Best Presentation Prize at the WONCA World Congress in 2018. He was awarded a CBE for services to medical research in the 2018 New Year's Honours. This talk was held as part of the Big Data Epidemiology course which is part of the Evidence-Based Health Care Programme.

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.

The increased reliance of health systems on the digital record as the primary mechanism for storing data on consultations and other health interactions has opened new opportunities for research, healthcare innovation, and health policy. The electronic health record (eHR) is now ubiquitous in many countries, in hospital and primary care settings, and in some countries their health systems in terms of reporting patient care activity are essentially 'paperless'. Health systems globally are also facing accelerating challenges as they seek to deliver better value healthcare against the background of increasing levels of chronic disease, ageing populations, financial pressures and demands on public spending. Digital health tools and services are held up to be part of the solution to these challenges, potentially offering low-cost and patient-centred solutions. There has been huge investment in Big Data research in health, particularly in relation to digitised imaging and automated reporting and predictive modelling using phenotypic and increasingly genetic data. There have also been similar gains in more applied research that explores the potential of accessing the huge quantum of data held in the eHR, and linkage of these data to other national or regional databases, such as mortality records or cancer data. This session will explore some of the applications for routine data research, illustrated by projects that have resulted in research success and better healthcare. This will include the exemplars of using large eHR platforms and prescribing data platforms to create infrastructure for i) common disease surveillance, such as the UK RCGP RSC; ii) generation and validation of disease risk assessment tools, such as QRisk scores; iii) pragmatic electronic follow up trials; iv) within practice systems dashboard feedback reports, eg data normalised to regional and national rates on prescribing and investigation physician activity; v) traditional epidemiological linkage studies; and vi) linkage to long term phenotypic follow up of established disease cohorts. Richard Hobbs is Nuffield Professor of Primary Care at the University of Oxford, and Head of the Nuffield Department of Primary Care Health Sciences. He has served a decade as National Director of the National Institute for Health Research’s School for Primary Care Research and was Director of the NHS Quality and Outcomes Framework (QOF) Review panel from 2005-09. He has served many national and international scientific and research funding boards in UK, Ireland, Canada, and WHO, including the BHF Council, British Primary Care Cardiovascular Society, and the ESC Council for Cardiovascular Primary Care. He currently chairs the European Primary Care Cardiovascular Society, a WONCA Special Interest Group. He is one of the world's leading academics in primary care, and has developed at Oxford one of the largest and most highly ranked centres for academic primary care globally. He has also made major contributions to growing primary care academic capacity, in terms of people development and research networks. A highly cited primary care clinical scientist, he has authored over 450 peer reviewed publications, has an h-index of 90, with over 63000 citations (36000 since 2013) and 81 papers cited over 100 times, 14 papers cited over 1000 times and 7 papers with over 2000 citations. He has an outstanding track record in cardiovascular research, delivering trials that changed international guidelines and practice, especially in the areas of stroke prevention in atrial fibrillation (BAFTA, SAFE, and SMART trials), heart failure burden and diagnosis (ECHOES and REFER trials), and hypertension self-management (TASMINH series). He is only the fifth ever recipient of the RCGP Discovery Prize in 2018 (an occasional award made since 1953) and received an inaugural Distinguished Researcher Shine Prize plus Best Presentation Prize at the WONCA World Congress in 2018. He was awarded a CBE for services to medical research in the 2018 New Year's Honours. This talk was held as part of the Big Data Epidemiology course which is part of the Evidence-Based Health Care Programme.

Professor Jeffrey Aronson, Consultant Physician and Clinical Pharmacologist, Department of Primary Care Health Sciences, gives a talk on dose-response curves for the EBHC podcast series.

Professor Jeffrey Aronson, Consultant Physician and Clinical Pharmacologist, Department of Primary Care Health Sciences, gives a talk on dose-response curves for the EBHC podcast series.

Carl Heneghan, Professor of Evidence-Based Medicine, employs evidence-based methods to research diagnostic reasoning, test accuracy and communicating diagnostic results to a wider audience. Professor Carl Heneghan will talk about his involvement in Tamiflu research that led to the discovery of 170,000 pages of clinical study reports, the subsequent development of Alltrials he was involved in and the current epidemic of publication and reporting bias that plagues much of the current research evidence. This talk was 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.

Carl Heneghan, Professor of Evidence-Based Medicine, employs evidence-based methods to research diagnostic reasoning, test accuracy and communicating diagnostic results to a wider audience. Professor Carl Heneghan will talk about his involvement in Tamiflu research that led to the discovery of 170,000 pages of clinical study reports, the subsequent development of Alltrials he was involved in and the current epidemic of publication and reporting bias that plagues much of the current research evidence. This talk was 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.

This talk was delivered by Martin Bland. Martin Bland joined the University of York as Professor of Health Statistics in 2003, retiring and becoming Emeritus Professor in 2015. Earlier posts were at St. George's and St. Thomas's Hospital Medical Schools and in industry with ICI, working on agricultural experiments. He is the author of An Introduction to Medical Statistics, now in its fourth edition, and co-author of Statistical Questions in Evidence-based Medicine, both Oxford University Press, 303 refereed journal articles, and, with the late Prof. Doug Altman, the Statistics Notes series in the British Medical Journal. He and Doug Altman also invented the limits of agreement method for comparing methods of measurement, which led to the most highly cited papers in six different journals and one of the top 30 most highly cited papers over all fields. This is an account of a little research study which I carried out, using myself as the only research subject. I shall describe how I came to do it and some of the practical statistical problems which I encountered. These include serial P-values, the effect of other factors, and generalisability from a single subject.

This talk was delivered by Martin Bland. Martin Bland joined the University of York as Professor of Health Statistics in 2003, retiring and becoming Emeritus Professor in 2015. Earlier posts were at St. George's and St. Thomas's Hospital Medical Schools and in industry with ICI, working on agricultural experiments. He is the author of An Introduction to Medical Statistics, now in its fourth edition, and co-author of Statistical Questions in Evidence-based Medicine, both Oxford University Press, 303 refereed journal articles, and, with the late Prof. Doug Altman, the Statistics Notes series in the British Medical Journal. He and Doug Altman also invented the limits of agreement method for comparing methods of measurement, which led to the most highly cited papers in six different journals and one of the top 30 most highly cited papers over all fields. This is an account of a little research study which I carried out, using myself as the only research subject. I shall describe how I came to do it and some of the practical statistical problems which I encountered. These include serial P-values, the effect of other factors, and generalisability from a single subject.

This guest lecture draws on nearly thirty years' experience of doing qualitative research in a variety of health settings that contain people, blood, injury, disease, emotions, and technologies. Prof Catherine Pope will describe some of the practical difficulties and everyday challenges of doing ethnography in these environments, and reflect on what it feels like to be an embodied researcher. Catherine Pope is Professor of Medical Sociology, and, from July 2019, will be based at the Nuffield Department of Primary Care Health Sciences, University of Oxford. She has championed the use of qualitative methods in health research, and played a leading role in developing qualitative evidence synthesis. Her research includes studies of NHS urgent and emergency care, evaluations of health service organisation and reconfiguration, and projects about everyday health care work. This talk was held as part of the Qualitative Research Methods course which is part of the Evidence-Based Health Care Programme.

The global health burden of heart failure is high, both as the common end-point for many cardiovascular diseases (e.g. hypertension and heart attacks) and a common point on the trajectory of non-cardiovascular diseases (e.g. chronic respiratory disease). Despite advances in treatment, our ability to tailor strategies for prevention or management to individuals with heart failure is currently limited. Large-scale electronic health records and novel data analysis techniques have great potential to improve the status quo in both research and practice. In this talk, Amitava Banerjee examines the real progress and the limitations of recent big data research in heart failure, from epidemiology to machine learning. Amitava Banerjee is Associate Professor in Clinical Data Science at University College London, and Honorary Consultant Cardiologist at University College London Hospitals and Barts Health NHS Trusts. He is a pragmatic researcher, a passionate educator and a practising clinician, with interests spanning data science, cardiovascular disease, global health, training and evidence-based healthcare. After qualifying from Oxford Medical School, he trained as a junior doctor in Oxford, Newcastle, Hull and London. His interest in preventive cardiology and evidence-based medicine led to a Masters in Public Health at Harvard (2004/05), an internship at the World Health Organisation(2005) and DPhil in epidemiology from Oxford (2010). He was Clinical Lecturer in Cardiovascular Medicine at the University of Birmingham, before moving to UCL in 2015. He works across two busy tertiary care settings: University College London Hospitals and Barts Health NHS Trusts with both inpatient and outpatient commitments. Although he is subspecialised in heart failure, he has ongoing practice in acute general cardiology and a keen interest in the diagnosis and management of atrial fibrillation. His clinical work very much informs his research and vice versa, whether in the evaluation of medical technology or the ethics of large-scale use of patient data. This talk was held as part of the Big Data Epidemiology module which is part of the MSc in Evidence-Based Health Care and the MSc in EBHC Medical Statistics.

This guest lecture draws on nearly thirty years' experience of doing qualitative research in a variety of health settings that contain people, blood, injury, disease, emotions, and technologies. Prof Catherine Pope will describe some of the practical difficulties and everyday challenges of doing ethnography in these environments, and reflect on what it feels like to be an embodied researcher. Catherine Pope is Professor of Medical Sociology, and, from July 2019, will be based at the Nuffield Department of Primary Care Health Sciences, University of Oxford. She has championed the use of qualitative methods in health research, and played a leading role in developing qualitative evidence synthesis. Her research includes studies of NHS urgent and emergency care, evaluations of health service organisation and reconfiguration, and projects about everyday health care work. This talk was held as part of the Qualitative Research Methods course which is part of the Evidence-Based Health Care Programme.

The global health burden of heart failure is high, both as the common end-point for many cardiovascular diseases (e.g. hypertension and heart attacks) and a common point on the trajectory of non-cardiovascular diseases (e.g. chronic respiratory disease). Despite advances in treatment, our ability to tailor strategies for prevention or management to individuals with heart failure is currently limited. Large-scale electronic health records and novel data analysis techniques have great potential to improve the status quo in both research and practice. In this talk, Amitava Banerjee examines the real progress and the limitations of recent big data research in heart failure, from epidemiology to machine learning. Amitava Banerjee is Associate Professor in Clinical Data Science at University College London, and Honorary Consultant Cardiologist at University College London Hospitals and Barts Health NHS Trusts. He is a pragmatic researcher, a passionate educator and a practising clinician, with interests spanning data science, cardiovascular disease, global health, training and evidence-based healthcare. After qualifying from Oxford Medical School, he trained as a junior doctor in Oxford, Newcastle, Hull and London. His interest in preventive cardiology and evidence-based medicine led to a Masters in Public Health at Harvard (2004/05), an internship at the World Health Organisation(2005) and DPhil in epidemiology from Oxford (2010). He was Clinical Lecturer in Cardiovascular Medicine at the University of Birmingham, before moving to UCL in 2015. He works across two busy tertiary care settings: University College London Hospitals and Barts Health NHS Trusts with both inpatient and outpatient commitments. Although he is subspecialised in heart failure, he has ongoing practice in acute general cardiology and a keen interest in the diagnosis and management of atrial fibrillation. His clinical work very much informs his research and vice versa, whether in the evaluation of medical technology or the ethics of large-scale use of patient data. This talk was held as part of the Big Data Epidemiology module which is part of the MSc in Evidence-Based Health Care and the MSc in EBHC Medical Statistics.

This evening lecture is given in conjunction with the Introduction to Study Design and Research Methods accredited short course, part of the Evidence-Based Healthcare programme at the University of Oxford's Department for Continuing Education. Carmen is a Public Health Nutrition scientist at the Department of Primary Care Health Sciences (University of Oxford). Her principal research interests lie in the prevention and management of non-communicable chronic disease through dietary improvements, in particular, obesity and cardiovascular disease. Diet is an important determinant of health, and food purchasing is a key antecedent to consumption hence improving the nutritional quality of food purchases presents a clear opportunity to intervene. She has been involved in a recent systematic review of interventions implemented in grocery stores which suggested that price manipulations, healthier swap suggestions, and perhaps manipulations to item availability change food purchasing and could play a role in public health strategies to improve health. However, the evidence base for interventions in grocery stores or at the individual level is still very limited. She is currently working on a range of studies aiming to examine the effectiveness of interventions based around healthier swaps on the quality of the food purchased and eaten as well as the short term effects on relevant health outcomes. She has recently conducted a complex behavioural intervention based in primary care to improve diet quality among patients with high cholesterol (PC-SHOP study). The intervention consisted of health professional (HP) advice alone, or in combination with personalised feedback based on the nutritional analysis of grocery store loyalty card data from one of the largest UK supermarkets. Overall her research aims to develop and test simpler and inexpensive ways to help people improve diet and prevent cardiovascular disease and obesity. This evening lecture is given in conjunction with the Introduction to Study Design and Research Methods accredited short course, part of the Evidence-Based Healthcare programme at the University of Oxford's Department for Continuing Education. Find out more.

This evening lecture is given in conjunction with the Introduction to Study Design and Research Methods accredited short course, part of the Evidence-Based Healthcare programme at the University of Oxford's Department for Continuing Education. Carmen is a Public Health Nutrition scientist at the Department of Primary Care Health Sciences (University of Oxford). Her principal research interests lie in the prevention and management of non-communicable chronic disease through dietary improvements, in particular, obesity and cardiovascular disease. Diet is an important determinant of health, and food purchasing is a key antecedent to consumption hence improving the nutritional quality of food purchases presents a clear opportunity to intervene. She has been involved in a recent systematic review of interventions implemented in grocery stores which suggested that price manipulations, healthier swap suggestions, and perhaps manipulations to item availability change food purchasing and could play a role in public health strategies to improve health. However, the evidence base for interventions in grocery stores or at the individual level is still very limited. She is currently working on a range of studies aiming to examine the effectiveness of interventions based around healthier swaps on the quality of the food purchased and eaten as well as the short term effects on relevant health outcomes. She has recently conducted a complex behavioural intervention based in primary care to improve diet quality among patients with high cholesterol (PC-SHOP study). The intervention consisted of health professional (HP) advice alone, or in combination with personalised feedback based on the nutritional analysis of grocery store loyalty card data from one of the largest UK supermarkets. Overall her research aims to develop and test simpler and inexpensive ways to help people improve diet and prevent cardiovascular disease and obesity. This evening lecture is given in conjunction with the Introduction to Study Design and Research Methods accredited short course, part of the Evidence-Based Healthcare programme at the University of Oxford's Department for Continuing Education. Find out more.

Fiona Godlee, Editor in Chief of The BMJ, gives a talk for the EBHC podcast series Fiona Godlee is the Editor in Chief of The BMJ. She qualified as a doctor in 1985, trained as a general physician in Cambridge and London, and is a Fellow of the Royal College of Physicians. She has written and lectured on a broad range of issues, including health and the environment, the ethics of academic publishing, evidence based medicine, access to clinical trial data, research integrity, open access publishing, patient partnership, conflict of interest, and overdiagnosis and overtreatment. After joining The BMJ as an assistant editor in 1990, she moved in 2000 to help establish the open access publisher BioMedCentral as its founding Editorial Director for Medicine. In 2003 she returned to BMJ to lead its Knowledge division and was appointed Editor in Chief of The BMJ in March 2005. Fiona is honorary professor at the Netherlands School for Primary Care Research (CaRe), honorary fellow of the Royal College of General Practitioners, a senior visiting fellow at the Institute of Public Health at the University of Cambridge, honorary fellow of the Faculty of Public Health and a by-fellow of King's College Cambridge. She is on the advisory or executive boards of the Health Improvement Studies (THIS) Institute (thisinstitute.cam.ac.uk), Alltrials (alltrials.net), the Peer Review Congress (peerreviewcongress.org), the International Forum for Quality and Safety and Healthcare (internationalforum.bmj.com), Evidence Live (evidencelive.org), Preventing Overdiagnosis (preventingoverdiagnosis.net), the UK Health Alliance on Climate Change (ukhealthalliance.org) and the Climate and Health Council. She was a Harkness Fellow (1994-5), President of the World Association of Medical Editors (WAME) (1998-2000), Chair of the Committee on Publication Ethics (COPE) (2003-5), and PPA Editor of the Year (2014). Fiona is co-editor of Peer Review in Health Sciences. She lives in Cambridge with her husband and two children.