Please see below abstracts for workshops that are taking place throughout Evidence Live 2016.
Workshops are open to everyone attending the conference but must be booked in advance, please use the Click Here to Register button for the Eventbrite booking page. Once registered you will receive confirmation by email, please print and bring this with you. Numbers are capped to make the most of the space available – please book early to avoid disappointment.
Wednesday 22nd
Thursday 23rd
Friday 24th
Dr Ben Goldacre, Anna Powell-Smith, Vitor Baptista – OpenPrescribing and OpenTrials: What open source and open data tools can do for evidence based medicine.
Dr Khurshid Talukder – Conflicts of Interest in Global Nutrition Research
11:45 – 13:00 Weds June 22nd
Global nutrition intervention research has been characterised by conflicts of interest in the past couple of decades. Business Interest NGOs (BINGOs) as opposed to Public Interest NGOs (PINGOs) are increasingly involved in both nutrition advocacy and research funding. They are also in league wth private foundations and the UN agencies in making room for these BINGOs in the policy making table for national nutrition programmes in both LMICs and high income countries. Nutrition scientist objectivity is now compromised across the globe due to their funding from industry. In this environment of scientific compromise, there is need for training of health care professionals on conflicts of interest in nutrition research. This workshop aims to provide a short introduction to this important topic for participants of Evidence Live 16.
Dr Peter Oettgen – Rapid Creation of GRADE-labeled recommendations before guidelines are available using systematic multi-expert process
11:45 – 13:00 Weds June 22nd
Delays of months to years occur between the publication of practice-changing clinical studies and formal creation or updates of clinical practice guidelines. To overcome this delay and provide GRADE-labeled recommendations for clinical use we developed an 8-step process that includes 1) identification of the need for a recommendation; 2) formulation of clinical questions for all outcomes of interest; 3) systematic searching for evidence; 4) summarization of evidence for each outcome; 5) selection of a recommendation panel with pertinent clinical expertise, methodological expertise, and guideline development experience; 6) disclosure of conflicts of interest (COI) and replacement of panel members if significant COI; 7) panel deliberation to make Strong, Weak, or no recommendation; and 8) transparent publicly accessible reporting of all documents supporting the recommendation development process and deliberation.
During this workshop we will introduce the process by showing how we have used this process to make a recommendation for the use of sacubitril-valsartan in symptomatic patients with heart failure. Workshop participants will then be provided evidence summaries and guideline summaries related to potential recommendations for or against the screening and treatment of pregnant women with asymptomatic bacteriuria. Workshop participants will be divided into groups of 5-10 and participate in the panel deliberation process. If there is sufficient audience interest, materials can be sent before the workshop and participants can follow up after the workshop to publish an “Evidence Live panel recommendation”
Dr Clive Adams – Cochrane Reviews: what works and what doesn’t for dissemination
14:00 – 15:30 Weds June 22nd
Large organisations such as NHS Trusts, universities, journals and Cochrane take pride in promoting and disseminating “best health evidence”. Funders specifically request the dissemination of research results in an accessible way for the public. As a consequence, much effort is invested in planning and implementing micro-blogging, blogging, online social networking services, generation of clips for video sharing, and seeding of the popular online encyclopaedias. Although it might lead to wide accessibility, how effective is this investment and could we do it better? Leaders in social media generate large followings and one Tweet, blog or Facebook comment can have enormous impact. For example, a micro-blogged image of Prime Minister David Cameron and Premier Xi Jinping drinking a pint of Greene King IPA in a British pub sent its sales though the roof in China. Such range and immediacy of influence could be of great value for “product placement” of best health evidence, but which technique is best?
Ms Sian Jones & Ms Alison Turner – The good, the bad and the evidence: the challenges of decision making in health service commissioning
09:30 – 11:00 Thurs June 23rd
Commissioning of healthcare varies according to political, economic and social contexts and is complex, [1] which has implications for decision making. The NHS must deliver unprecedented improvements in NHS and productivity by taking into account local need, availability of resources and relevant information and evidence. Within this context, using evidence to get things right first time is key.
This workshop explores, from direct experience, the challenges that commissioning organisations encounter in the use of best available evidence for informed decision making. These challenges include defining what constitutes ‘evidence’ within local contexts; integrating multiple sources and types of evidence; accessibility and applicability of evidence; organisational culture; and capacity and capability issues. Examples will be used to illustrate the multi-layered problems that are faced.
Reference will be made to EBM, to consider what commissioning can learn from this approach, recently described as in crisis (Greenhalgh et al 2014[2]). Case studies will be used to provide examples of how evidence is used to inform commissioning strategy and decision-making. Participants will be actively involved in discussion and a key output from the session will be the development of high level principles that contribute to a Manifesto for Evidence Informed Commissioning.
[1] Chris Ham (2008) World Class Commissioning: a health policy chimera? Journal of Health Services Research and Policy13(2): 116-121.
[2] Greenhalgh T, Howick J and Maskrey N (2014) Evidence based medicine: a movement in crisis? BMJ; 348 :g3725.
Helen Macdonald & Rafael Perera – Communicating Actionable Evidence
09:30 – 11:00 Thurs June 23rd
In this workshop participants will get a chance to consider different ways of presenting quantitative results and the impact that these have on the overall message. In particular we will explore in small groups through examples the concepts of risk, the different ways of quantifying it and ways of comparing risk levels.
We will focus on:
Dr Amitava Banerjee – Big Data and Evidence-Based Medicine – the promises and the pitfalls
09:30 – 11:00 Thurs June 23rd
Clinical practice and biomedical research have historically moved from opinion to EBM, and now the era of precision medicine and personalised medicine is upon us. Regardless of the jargon used, data is at the centre of healthcare and therefore, the age of health informatics is returning us to perhaps the most patient-centred approach of all: “data-centred medicine”.
The volume, variety and value of the data have led to the term “big data” being used in healthcare as well as other sectors and this offers tremendous opportunities for EBM. In the context of the “learning health system”, where science, education and clinical practice mutually feedback, big data has even greater potential to allow a system to continuously evolve and learn. For example, real world data may be used to evaluate the true effectiveness of drugs in populations versus trials and enable better reward mechanisms for pharmaceutical innovation.
Machine learning and big data approaches are already being used to increase the efficiency of performing systematic reviews. There are also global health implications as mobile and internet communications reach ubiquity. However, there are limitations of observational data and legitimate concerns regarding ethics of using large-scale routinely collected data for research. In addition, a large proportion of healthcare “big data” lies in the private sector and so more than for other spheres of EBM, novel public-private partnerships are required. In an interactive workshop, the strengths and limitations of big data with respect to EBM will be analysed. As research and clinical practice become more sub-specialised and exist more and more in silos, EBM can offer approaches which cut across disciplines and big data, used appropriately, is perhaps the strongest tool in the toolbox.
Dr Heather Murray & Dr Melanie Walker – Training the next generation of ‘Evidence Creators’ and ‘Evidence Consumers’ – Tips and tricks for curriculum development in EBM
15:30 – 17:00 Thurs June 23rd
Over the last 6 years at Queen’s University in Kingston, Ontario, Canada, we created an embedded curriculum in EBM that extends through the four years of undergraduate medical training. The full curriculum consists of a foundational critical appraisal course in year 1, research skills course in year 2 and a series of embedded critical appraisal sessions with increasing complexity across all 4 years. The curriculum culminates in individual student assignments in clerkship, which demonstrate expertise in the process of using EBM by posing and answering a clinical question based on a clinical encounter. Tools such as freestanding modules that reinforce key elements of critical appraisal were developed and used to enhance the curriculum. This highly successful curriculum has recently been acknowledged with a major institutional award for curriculum development. The workshop will focus on the building block of this (and any) EBM curriculum – how to develop effective EBM learning events and accompanying assessments.
Through this workshop, participants will work through the creation of a learning event in a challenging area of EBM, build complexity so that the learning event can be delivered at three levels of training, and employ strategies to increase engagement and align appropriate assessment tools.
Participants will be provided with a summary transcript of the results of the workshop group activities, as well as an outline of the Queen’s University EBM curriculum, including sample learning events and access to online modules used to supplement the curriculum. There will be templates and examples provided for each workshop activity. Contact information for interested participants will be collected to form an interest group with the goal of ongoing connection and support for teaching EBM to students.
Prof Sharon Mickan – Barriers and Facilitators for Implementing Research in Practice
15:30 – 17:00 Thurs June 23rd
This interactive workshop – a mix of presentations, discussion, and group work – will investigate how clinicians can systematically and efficiently identify barriers and facilitators in their local context and therefore use research to inform and improve their clinical practice. The Canadian Institute of Health Research’s model of knowledge translation will be reviewed to identify the importance and timing of identifying barriers and facilitators in the sequential knowledge–to-action process. Theories of organisational readiness for change will be introduced along with practical tools for stakeholder analysis.
Practical examples of clear knowledge-practice gaps will be shared as a guide for small group work. Participants will be facilitated to apply research evidence to their local practice; beginning with a critical appraisal of the research evidence, focussing on comparisons to their local context. In order to identify key barriers and facilitators, participants will be guided to identify and analyse the motivation and power of key stakeholders, within a broader analysis of their local context.
Key barriers and facilitators will then be identified and mapped against the Knowledge to Action process. Participants will continue to discuss and compare ways they could maximise the potential impact of facilitators, while managing the identified barriers in applying specific research evidence to their own clinical practice.
The COMPare Trials Project: How do journals respond to corrections on misreported trials?
Dr Ben Goldacre, Henry Drysdale, Eirion Slade, Ioan Milosevic, Carl Heneghan.
15:30 – 17:00 Thurs June 23rd
Discrepancies between prespecified and reported outcomes are a well recognised source of bias in clinical trials. The prevalence of this problem in academic journal reports on trials has been assessed in approximately 30 cohort studies to date, and been found to be high. However over 500 journals, including those covered in many of these prevalence studies, are listed as endorsing detailed guidelines such as CONSORT, which commit journals to best practice in trial reporting, including correct outcome reporting. The COMPare trials project set out to shed light on the reasons for this apparent contradiction. All trials in 5 leading journals listed as endorsing CONSORT (NEJM, Annals, JAMA, Lancet, BMJ) were assessed for outcome discrepancies. Then, rather than only publishing a prevalence figure on the problems found, COMPare sent a correction letter on all misreported trials. Lastly, COMPare monitored the response of both the journal and the trialists, recording time to publication (or non-publication); identifying discrepancies between CONSORT and real-world practice; and documenting misunderstandings about correct outcome reporting among trialists and editors.
In this session you will:
Trish Groves – How to get published
11:00 – 12:30 Friday June 24th
In this workshop journal editors will share their experience and knowledge in publishing peer-reviewed papers. We aim to provide guidance in selecting the right journal for your paper, properly submitting a paper such that it receives due consideration (including attention to instructions for authors, reporting guidelines, structure and sections of papers), and in interpreting editorial decisions and responding to reviewer comments. We also aim to help assure that the research question and results are properly reported in a paper that has the right study design. Finally, guided by participant experience and wishes, time-permitting, we can also address other issues such as predatory journals, authorship, plagiarism, and post-acceptance issues.
Dr Eve O’Toole & Dr Niamh O’Rourke – Developing evidence-based clinical guidelines – from clinical questions to implementation
11:00 – 12:30 Friday June 24th
In 2011 the national cancer control programme (NCCP) in Ireland commenced developing guidelines for common cancers. These guidelines were to be evidence based rather than consensus based which was a paradigm shift. It necessitated education for Guideline Development Group members in both evidence based healthcare and guideline development. This workshop is designed to address the challenge of developing clinical guidelines, demonstrating how to integrate the best research evidence with clinical expertise to generate recommendations and outlines how to implement those recommendations in practice.
The participants will have the opportunity to convert a knowledge gap in an answerable question in PICO format. They will be introduced to the principles of critical appraisal and appraisal tools. They will simulate the generation of a guideline recommendation including; consideration of the evidence base, the quality of the evidence, its applicability to a population and health care system, benefit and harm to patients and cost implications.
For implementation of clinical guidelines changing clinical behaviour is more likely if the behaviour is identified and clearly specified in the implementation plan. This workshop will discuss the use of theory to identify barriers and facilitators to implementation of evidence based healthcare including; the Behaviour Change Wheel which uses the COM-B system (capability, motivation, opportunity) to analyse target behaviours and select the appropriate intervention functions. The Theoretical Domains Framework (TDF) can describe these factors in more detail and aid implementation design.
This interactive workshop will combine evidence based practice with implementation science and behaviour change theory, using practical examples to apply evidence to practice and policy.
Klara Brunnhuber – BMJ Evidence Centre
11:00 – 12:30 Friday June 24th
Come and join the BMJ Evidence Centre for a workshop on evidence-based clinical decision support (CDS) tools for the point of care. We will focus on three key areas where such tools face major challenges:
Participants will:
Facilitators – Caroline Blaine, BMJ (Uncertainty) Julie Costello, BMJ (SDM) Klara Brunnhuber, BMJ (Complex patients)
Introduction to Covidence, the online tool for systematic review production
11:00 – 12:30 Friday June 24th
Objective: To familiarise new users with the features of Covidence and with the support team behind it
Description: Covidence is a new online systematic review production platform, recommended by the Cochrane Collaboration, aimed at improving the efficiency and experience of producing systematic reviews.
Covidence supports import and de-duplication of citations, title / abstract and full text screening, risk of bias assessment and data extraction, and export of data into RevMan.
The workshop will be a hands-on opportunity to get to know Covidence and the support team. The first half of the workshop will be a real-time demonstration of Covidence’s features, with opportunities for specific questions after each area of the tool. Following this, information on support will be provided, including an indication of materials available for trainers and editors. Finally, the workshop will wrap up with time for questions, and an opportunity for participants to use Covidence with the presenter available for one-to-one guidance.
Participants should bring a laptop or arrange to share in order to get a hands-on experience of using Covidence.
Dylan Collins & Stefania Marcoli – Designing The Cardiovascular Risk Communication Toolkit
12:30 Lunch session
In this session, Dylan Collins (CEBM) and Stefania Marcoli (frog) will discuss their ongoing work integrating evidence-based medicine and human-centred design. Participants will get a behind-the-scenes look at how human-centred design and evidence-based medicine were used to develop the The Cardiovascular Risk Communication Toolkit, and learn how design principles can be used to improve clinical practice and shared decision making.
Dr Ben Goldacre, Anna Powell-Smith, Vitor Baptista – OpenPrescribing and OpenTrials: What open source and open data tools can do for evidence based medicine.
13:30 – 15:00 Friday June 24th
OpenPrescribing and OpenTrials are live online services developed by the EBM DataLab in Oxford, combining the skills of academics, clinicians, and software developers to produce tools driven by data, rather than only academic papers. This seminar will demonstrate two tools, and discuss this approach. OpenPrescribing.net is a live explorer for prescribing data that allows anyone to examine what is being prescribed by any practice or CCG in England, month by month. It can be used to identify outliers for using more expensive, higher risk, or less evidence-based treatments; time trends can be graphed; and bespoke atlases of variation produced with a single click for any numerator over any denominator. Over 26,000 individual bespoke data analyses have been run by visitors, in the six months since prototype launch. OpenTrials.net is being built in collaboration with Open Knowledge: an open, threaded, collaborative database aiming to aggregate all publicly accessible data and documents on all clinical trials using techniques such as web-scraping and probabilistic record linkage.
Anne Weist & Fran Wilkie – Training the next generation of leaders in applied science: the NICE Evidence search student champion scheme model
13:30 – 15:00 Friday June 24th
The NICE Student Champion Scheme uses a peer to peer facilitation model to help develop information literacy skills. The Student Champions receive bespoke training on how to use NICE Evidence search to support their study and practice. Their training also enables them to disseminate information about NICE Evidence search and its resources to their fellow undergraduates in structured hands-on learning sessions. NICE Evidence search contains over 300,000 references from more than 800 sources of high quality evidence. An important part of the training that the students receive focuses on which sources of information are appropriate to use in different situations. External evaluation has shown that the peer to peer model works well and that many students take an early leadership role in evidence based practice. The evaluation by partner schools and student reflective reports have also indicated that the scheme can inspire and develop leaders in healthcare improvement.
Following this workshop, participants will have:
There will be a discussion covering:
There will also be an interactive component focussing on how NICE Evidence search can be used to support evidence-based practice, and the tools that NICE has created in response to students’ needs.
Carl Heneghan In 2019, EBM Live set out to identify and fix some of the problems with how research evidence is developed and disseminated to end-users. Issues outlined in the
David L. Sackett (1934-2015) was a Clinical epidemiologist, pioneer of evidence-based medicine and the founder of the Centre for Evidence-Based Medicine. The David L. Sackett Fellowship provides awardees with EBMLive