Podcasts about ebhc

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'?

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.

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.

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 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.

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 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.

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.

For many good reasons, semi-structured interviews, focus groups, thematic analysis, and realist tales have become key tools within the qualitative researcher's methodological toolkit. In this presentation, Dr Cassandra Phoenix invites the audience to consider the extent to which they may have (inadvertently) become the only tools within their toolkit. Drawing on examples from across the social sciences, she considers how else we might collect, analyse and represent qualitative data within health research, asking what it means and involves to truly advance qualitative research methods in this field. The short video played for the audience can be seen at: https://vimeo.com/43182928. Dr Cassandra Phoenix is a Reader in the Department for Health at the University of Bath. Her research examines ageing, health and wellbeing from a critical-socio-cultural perspective. She has authored numerous publications on topics including the social and cultural dimensions of: physical activity in mid and later life; the lived experiences of chronic conditions (e.g. late onset visual impairment, vestibular disorders); and engagement with nature. Cassandra's work is supported by a range of funders including ESRC, Wellcome Trust, Leverhulme Trust, WHO and the NIHR. This talk was held as part of the Advanced Qualitative Research Methods course which is part of the Evidence-Based Health Care Programme.

Carl Heneghan asks the question, "What is driving the increase in diagnostic testing in healthcare?" and discusses why expectations, technology and the media are contributing to the problems of too much medicine and overdiagnosis. 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.

Professor Alan Silman is an epidemiologist and a rheumatologist and is the co-author of 'Epidemiological Studies: A Practical Guide', which is the recommended textbook for the module 'Introduction to Study Design and Research Methods'. Alan Silman is currently Professor of Musculoskeletal Health at the University of Oxford. He was Director of the UK's Arthritis Research Epidemiology Unit in Manchester from 1988-2006, and then Medical Director of Arthritis Research UK, before moving to Oxford to take up his current position. He has published over 500 articles in the broad field of arthritis and musculoskeletal disease epidemiology. This talk was held as part of the Introduction to Study Design and Research Methods module, which is part of the MSc in Evidence-Based Health Care.

Jamie Hartmann-Boyce is a Senior Researcher in Health Behaviours, based at the Nuffield Department of Primary Care Health Sciences, University of Oxford. Her work focusses on obesity and tobacco control and her particular interests lie in evidence synthes Though the vast majority of people trying to lose weight do so on their own, without support from healthcare professionals or formal weight loss programmes, most research into weight loss focuses on more intensive programmes. We therefore set out to find out more about what people do when trying to lose weight on their own. As part of this work, we conducted three qualitative systematic reviews to explore people's experiences with self-directed weight loss. The first review provides an overview of the cognitive and behavioural strategies used during self-directed weight loss attempts, and the second two reviews delve further into particular weight loss strategies that emerged as part of the overview, namely self-monitoring and reframing. In this talk, I'll cover key findings from each of the three reviews, and also use these reviews to illustrate how qualitative syntheses can be conducted and used to shed light on people's experiences. This talk was held as part of the Qualitative Research Methods module which is part of the MSc in Evidence-Based Health Care.

Professor Carl Heneghan gives a talk for the Evidence Based Healthcare series. Patients are being let down by serious flaws in the creation, dissemination, and implementation of medical research. Too much of the resulting research evidence is withheld or disseminated only piecemeal. As the volume of clinical research activity has grown, the quality of evidence has often worsened, which has compromised medicine's ability to provide affordable, effective, high-value care for patients. Professor Carl Heneghan will discuss the CEBM initiatives that have grown out of EBM Live, a yearly conference designed to "develop, disseminate, and implement better evidence for better healthcare. He 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. In preparation for this talk you are invited to read the following: https://doi.org/10.1136/bmj.j2973

There has never been such a high demand for our personal data, such that it is often said that individuals are the product, not just the client. Using the donation of general personal data and health data in example scenarios, areas such as: the unknown element in data content; trust and trustworthiness in data custodians; and meaningful public engagement, will be explored. The alternative is that data are not used, with the corresponding harms this may bring. Ironically, this is not an unusual situation in settings where having adequate data on which to base decisions is paramount for individual well-being. By drawing upon an international case study of health data non-use, it will be shown that this is a complex, global problem with multiple explanations resulting in untold harms to individuals and society. But there are many scenarios where our personal data are in demand, not just for public good. As individuals we need to consider the bioethical balance between individual autonomy, personal exploitation and social responsibility in making our donation decisions. Ultimately, the question is whether we, as individuals and society, want to 'gift' our data in some circumstances and grant its use under licence in others; and whether we can really make informed choices with the panoply of issues that may influence our decisions. Kerina Jones is an Associate Professor of Health Informatics at Swansea University, where she is the academic lead for Information Governance and Public Engagement to ensure data protection and maximise socially-acceptable data utility across the various Swansea University-based data intensive/linkage initiatives, including: the SAIL Databank, Administrative Data Research Centre Wales, Farr@CIPHER and the recently awarded HDRUK collaboration between Swansea University and Queen's University Belfast. Kerina leads the active Innovative Governance working group of the Farr Institute, which works collaboratively to advise and influence the developing data governance landscape to promote the safe reuse of data. She leads an IG research programme including work to inform cross-centre research and how emerging data types, such as genetic data, can be used in conjunction with health record data. This includes a programme of public engagement and Kerina enjoys working with the public on the use of anonymised data for research. This talk was held as part of the Big Data Epidemiology module which is part of the MSc in Evidence-based Health Care.

In this talk Karolina presented various types of study design she has used in trials of treatments for chronic pain. Karolina also discussed why blinding is important and why a placebo control may be necessary, even in surgical trials. This talk was held as part of the Introduction to Study Design and Research Methods module, which is part of the MSc in Evidence-Based Health Care.

Communication taboos surround many aspects of women’s health and wellbeing, from menstruation to menopause to sexual pleasure. This presentation will briefly discuss the historical and socio-cultural roots of such stigmas before outlining the latest research on how these taboos come to negatively impact girls’ and women’s health. Dr Weckesser will focus on her qualitative research on endometriosis as a case study for how cultural codes of silence around menstruation play a part in the delayed diagnosis of the condition. She will also discuss her STEAM-funded project, ‘The VQ: A Women’s Health, Sex and Pleasure Pop Up,’ which is an impact initiative that creates spaces and events for women to learn about, and purchase products related to, their (sexual) health. Dr Annalise Weckesser is a Senior Research Fellow at the Centre for Social Care and Health Related Research at Birmingham City University. She trained as a medical anthropologist at the University of Warwick and specialises in qualitative research on women’s sexual and reproductive health. This talk was held as part of the Qualitative Research Methods module which is part of the MSc in Evidence-based Health Care.

Professor Carl Heneghan and Dr David Nunan from the Oxford Centre for Evidence-Based Medicine presented the launch of a new website that catalogues the important biases affecting health and medical research. The website is in response to a call-to-arms raised nearly 40 years ago by the late David Sackett, where he called for 'The continued development of an annotated catalog of bias. Each citation should include a useful definition, a referenced example illustrating the magnitude and direction of its effects, and a description of the appropriate preventive measures, if any. I volunteer for this task, would welcome collaboration, and would appreciate receiving nominations and examples of additional biases.' In honour of David's memory and legacy, the CEBM have taken up where he left off. We are now ready to share the catalogue with the rest of the world for welcome feedback, discussion and further evolution. Additional input from Professor Sir Iain Chalmers. 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.

Point-of-care or near-patient-tests, are as these descriptors suggest, medical diagnostic tests which can be performed by a clinician, patient, or carer of a patient, without the need for samples to be transported to laboratories. These tests usually yield results rapidly, with clear convenience benefits for patients but with the potential to variably impact on clinicians. Our research suggests that evaluations of point-of-care tests usually focus on the accuracy of these tests when compared to the ‘reference standard’ laboratory tests, with manufacturers aiming to achieve equivalence or non-inferiority. This is admirable and essential, however the broader impact of tests on the relevant clinical pathways and patient health are often neglected. This talk will outline the areas of evidence which are frequently underrepresented in point-of-care test evaluations and will explore some of the more nuanced and unusual barriers and impacts of test introduction using some true and hypothetical examples to illustrate the inherent complexity of the test-pathway nexus. Phil Turner is a diagnostics researcher and Manager of the Community Healthcare MIC. His role incorporates responsibility for liaising with members of the in vitro diagnostics industry and for facilitating interactions with the MIC research team. His research has focussed on the diagnostic needs of clinicians, barriers to implementation, and the identification of evidence gaps which commonly exist in the evidence base for point-of-care diagnostic tests. He has a personal interest in IVDs which could be deployed in resource-limited settings. His background is in cell physiology, membrane transport processes and signalling and he has a particular interest in the control of ventilation and in particular how humans respond to changes in the partial pressure of inspired oxygen. He has an associated interest in the physiology and medicine of life in remote regions and at high altitude. This talk was held as part of the Evidence-Based Diagnosis and Screening course which is part of the Evidence-Based Health Care Programme.

Dr Katherine Pollard gives a talk for the Evidence Based Healthcare seminar series. This talk focuses on mixed methods research in health care education and practice, drawing on Kathy's experience of two large mixed methods projects to demonstrate salient issues: a longitudinal evaluation of an interprofessional undergraduate curriculum and a case study of quality measurement in community nursing. Kathy discusses research design and implementation, highlighting the challenges that arose, and the strategies employed to ensure successful project delivery. Dr Pollard has been an active researcher since 1998 and is currently employed as a Senior Research Fellow at the University of the Wet of England, Bristol. She has a clinical background in midwifery.

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. Here he gives a talk on improving healthcare systems. Here are some questions we cannot answer after nearly 70 years of a purportedly National Health Service. The lecture will address these questions and how they can be answered. 1. Is the service for people with seizures and epilepsy in Manchester of higher value than the service in Liverpool? 2. How many liver disease services are there in England and how many should there be? 3. Which service for people at the end of life in London provides the best value? 4. Is the service for people with asthma of higher than the service in Somerset? 5. How many services are there for people with MusculoSkeletal Disease in the North East, and which gives best value? We cannot answer them because we deliver care that is institutionally based not population based but to do so will need new knowledge and skills to answer questions such as: 1. What do you understand by the term complexity? 2. What is meant by the term system and how does it differ from a network? 3. What is meant by population based healthcare rather than bureaucracy based care? 4. What are the three meanings of the term value in 21st Century healthcare? Not ‘values’ as in 'we value diversity' but the economic meanings 5. What is the relationship between value and efficiency? 6. What is meant by the optimal use of resources? 7. What is meant by the term quality and how does it relate to value? 8. What is a system and a standard? 9. How would you assess the culture of an organisation? 10. How would you decide if an organisation had a strong culture of stewardship? 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. His hobby is ageing and how to cope with it and he has published a book for people aged seventy called Sod 70! and one for the younger decade called Sod 60! This with Dr Claire Parker, and his book for people aged 40-60, titled Midlife, appeared in January 2017. Other books in the series on Sod Ageing are Sod it, Eat Well, with Anita Bean and Sod Sitting, Get Moving with Diana Moran, the Green Goddess. For people of all ages Dr Gray’s Walking Cure summarises the evidence on this wonderful means of feeling well, reducing the risk of disease and minimising disability should disease strike. 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.

Professor Paul Aveyard, Nuffield Department of Primary Care Health Sciences gives a talk on behavioural change in evidence based medicine. In our society, we tend to view motivation, the state of 'wanting it' as a prime mover of behaviour. However, research calls this into question both directly and by showing that, even among people with lukewarm motivation, we can enable behaviour change. Using randomised data mainly from randomised trials and other research, we will examine what these forces are and show how they can be harnessed to change behaviour, even when people have seemingly strong preferences.

Dr John MacArtney gives a talk for the Evidence Based Healthcare seminar series. Qualitative researchers employ a range of different approaches to conducting qualitative analyses. In the process, they describe and interpret data, explaining the relationships between the patterns they find and interrogating their findings in various ways to provide thick descriptions of phenomena or explanatory theories. Drawing on his own qualitative analyses on experiences of cancer, Dr John MacArtney will explore some of the ways in which qualitative analysts approach these processes. This lecture will provide the opportunity to demystify an often intangible process and tackle some of the challenges facing qualitative health researchers today. Dr MacArtney is a Senior Researcher with the Nuffield Department of Primary Care Health Sciences at the University of Oxford and is a sociologist of health and illness with specific interests in the diagnosis of cancer, end of life and palliative care, and bereavement. He specialises in qualitative research. This talk was held as part of the Qualitative Research Methods module which is part of the MSc in Evidence-based Health Care.

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.

The integration of evidence with clinical expertise and patient values which underpins the delivery of high quality evidence-based medicine. Hard though this often is to achieve in practice, one fundamental principle is that evidence integrated into decision making should be the “current best evidence.” Whilst the amount of research, funded and published, has grown enormously, there is little to suggest concomitant increases in outputs that have led to real improvements in patient care. Equally worrying, the growth and volume of evidence has been accompanied by a corrosion in the quality of evidence, which has compromised medicine’s ability to provide affordable, effective, high value care.

Overdiagnosis is the diagnosis of "disease" that will never cause symptoms or death during a patient's lifetime. Newer, more accurate technologies, and the desire to detect disease even earlier means Overdiagnosis is on the rise. Understanding the impact of Overdiagnosis, how to detect it and what to do about it might stem its inexplicable rise and prevent the epidemic of unnecessary testing. Professor Carl Heneghan is a board member of the Preventing Overdiagnosis conference and has an active interest in diagnostic reasoning and how this can, or in some cases cannot, make a real difference to patient outcomes. He is also Professor of Evidence-Based Medicine at the Department of Primary Care Health Sciences at the University of Oxford, Director of the Centre for Evidence-Based Medicine, a fellow of Kellogg College and an NHS Honorary Clinical Consultant and GP.

Healthcare research is all too often plagued by biases that are rooted in poor methods, leading to the wrong result and conclusions and preventing uptake into practice. We need a better understanding of what constitutes rigorous research; what are the different types of research that underpin decision making that matters to patients and how we should go about fixing the problems of poor quality research. There are major structural problems with the current production and use of evidence that needs resuscitating. If left unaddressed, these inherent problems may become entrenched and unsolvable.

Dr Merlin Willcox gives a talk for the Evidence Based Healthcare series. Merlin’s research focuses on global health, particularly primary health care in low-income countries. In such countries, maternal and child mortality is significantly greater than in the UK – one in five children die before their fifth birthday. Primary health care has the potential to save most of these lives, if it is implemented according to best evidence. In this talk Merlin talks about the different studies and designs he has used in his work trying to address child mortality in Africa.

Prof Neal Maskrey gives a talk for the Centre for Evidence Based Medicine seminar series. Decisions made in health care are not strongly based on the best available evidence. There is 40 years of research which explains why this is normal, but we don’t learn much about it from health care curricula because it comes from cognitive psychology and behavioural economics. How do individuals make decisions, how might they make them better, and how does all this fit into the complex skill set I hope the health care professionals looking after me will possess when I need them, hopefully about 20 years from now.

Dr Kamal Mahtani is an NHS GP, NIHR Clinical Lecturer and Deputy Director at the Centre for Evidence Based Medicine. His talk explores why so much research is wasted.

Professor Carl Heneghan gives a talk for the MSc in Evidence-Based Health Care programme

Talk by Dr Helen Ashdown regarding three rather different diagnostic studies People: Helen Ashdown

Carl Heneghan gives a talk held on January 11th 2016 Kellogg College. Recommended reading: Strunk Jr, W. and White, E.B. (1999) The Elements of Style, 4th Ed. Longman. ISBN: 978-0205309023. King, G. (2014) Improve Your Writing Skills, 1st Ed. Collins. Mathews, J., Bowen, J M. and Matthews, R W. (2000) Successful Scientific Writing, 2nd Ed. Cambridge University Press. ISBN: 978-0521789622. Seely, J. (2004) Oxford Everyday Grammar. Oxford University Press. ISBN:978-0198608745 Forsyth, M. (2014) The Elements of Eloquence: How to turn the perfect Englis phrase. Icon Books Ltd. ISBN: 978-1848317338 Gwynne, N M. (2013) Gwynne's Grammar. Ebury Press. ISBN: 978-0091951450 Murray, R. (2011) How to Write a Thesis, 3rd Ed. Open University Press. ISBN: 978-0335244287 Kane, T S. (1994) The New Oxford Guide to Writing. Oxford University Press. ISBN: 978-0195090598 King, S. (2012) On Writing. Hodder Paperbacks. ISBN:978-1444723250

Managing clinical trials, of whatever size and complexity, requires efficient trial management. Barbara Farrell shares from her wide experience.

The patient as storyteller and the story as ‘self management’

If we are going to take impact seriously, we need to be clear about the philosophical assumptions underpinning different kinds of research and also the different kinds of links between research, practice and policy.

Professor Trish Greenhalgh gives a talk on the crisis facing evidence based medicine and offers a solution for its rennaissance within healthcare.

Annette Pluddermann, Senior researcher DPCHS, gives an introduction to the Practice of Evidence-Based Health Care

Dr Janet Martin, Director of Health Technology Assessment, London Health Services Centre gives a special lecture for EBM entitled; Know4Go: An Instrument for decision-making when resources are limited and demands are relentless.

Sir Muir Gray, Chief Knowledge Office, NHS, gives a special guest lecture for the Centre for Evidence Based Medicine.

Professor Paul Glasziou, Director of the Centre for Evidence Based Medicine, gives a special lecture on the future of EBM.

Dr Amanda Burls delivers a talk for the Centre for Evidenced Based Medicine.

Dr Carl Heneghan delivers a talk for the Centre for Evidence Based Medicine.

Dr Carl Heneghan delivers a talk for the Centre for Evidence Based Medicine.

Dr Rafael Perera delivers a talk for the Centre for Evidence Based Medicine.

Professor Paul Glasziou gives an introduction to evidence-based medicine and healthcare.