Evidence-Based Health Care - podcast cover

Evidence-Based Health Care

Oxford Universitywww.cebm.net
The broad aim of the Centre for Evidence Based Medicine is to develop, teach and promote evidence-based health care and provide support and resources to doctors and health care professionals to help maintain the highest standards of medicine. Many of the talks are taken from the Oxford Evidence-Based Health Care Programme and delivered by members of the Nuffield Department of Primary Care Health Sciences, the Centre of Evidence Medicine and leaders in the field of Evidence-based Health Care internationally.
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Episodes

Safe and effective drugs: The need to use all the available evidence to inform the effectiveness of commonly used medicines

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 evid...

Oct 21, 201934 min

Diabetes, blood sugar, and red wine: a personal study

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, ...

Jul 17, 201933 min

The secret diary of a health ethnographer - what's it *really* like doing qualitative observation in operating rooms, ambulances, triage call centres and other health care settings?

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 Dep...

Jul 03, 201955 min

Big data in heart failure - opportunities and realities

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...

Jul 03, 201938 min

Behavioural Interventions to Improve the Quality of the Grocery Shopping

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, ...

Jun 11, 201941 min

The BMJ's open data campaign

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 publishi...

May 13, 201940 min

Using evidence to overcome fake news about healthcare

Professor Carl Heneghan has extensive experience of working with the media. In this talk he will discuss some recent case examples, working with the BBC amongst others. This talk will discuss how using an evidence-based approach can help overcome the growing problem of fake news, and provide insights on how to work with the media to ensure your message is not distorted, and will discuss why academics should engage more with the media and the wider public. Professor Carl Heneghan is Director of C...

Apr 09, 201937 min

Are we really advancing qualitative methods in health research?

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...

Apr 08, 201933 min

Size matters a tous les temps, a tous les peuples

Dr. Martyn Sene is Deputy CEO of the National Physical Laboratory (NPL), here, he gives an introduction to the importance of measurement and metrology (the science of measurement). NPL is the UK's National Metrology Institute and is a world-leading centre of excellence in developing and applying the most accurate measurement standards, science and technology available. He is a member of the NPL Management Ltd. Board and also a member of the CIPM (Comite International des Poids et Mesures), estab...

Apr 03, 201949 min

The role of network meta-analysis in the evaluation of antidepressants for depression

Andrea Cipriani is NIHR Research Professor at the Department of Psychiatry, University of Oxford and Honorary Consultant Psychiatrist at the NHS Foundation Trust in Oxford. His main interest in psychiatry is evidence-based mental health and his research focuses on the evaluation of treatments in psychiatry, mainly major depression, bipolar disorder and schizophrenia. Dr Cipriani is author of 267 peer reviewed scientific publications (Scopus), mainly systematic reviews, meta-analyses and randomis...

Mar 26, 201947 min

Why poor diagnostic reasoning is failing patients, the public and health systems

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...

Feb 06, 201933 min

Selection bias in cluster randomised controlled trials

Professor David Torgerson, Director of the York Trials Unit, gives a talk for the Evidence Based Healthcare podcast series. He has published widely with over 250 peer reviewed papers many of them on the design of randomised trials including a student text book 'Designing Randomised Trials in Health Education and the Social Sciences' (2008, Palgrave MacMillan). He has a particular interest in the design and conduct of cluster randomised trials. Randomisation, if conducted properly, will abolish s...

Jan 07, 201949 min

The application of realist approaches at the research/policy/practice interface: NICE work if you can do it

Professor Mike Kelly, Primary Care Unit, Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, gives a talk for the Evidence Based Healthcare seminar series. Professor Mike Kelly is Senior Visiting Fellow in the Department of Public Health and Primary Care at the Institute of Public Health and a member of St John's College at the University of Cambridge. Between 2005 and 2014, when he retired, he was the Director of the Centre for Public Hea...

Dec 12, 20181 hr

How imperfect can a study be?

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 ...

Dec 05, 201849 min

Adults' experiences of trying to lose weight on their own: findings from three qualitative syntheses

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 o...

Nov 06, 201847 min

Evidence-Based Manifesto for better healthcare

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 Ca...

Oct 10, 201836 min

The jugglers and the black cat

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 ...

Jul 31, 201858 min

Fake surgeries and dummy pills – control for bias and study design in trials on treatment efficacy in chronic pain

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.

Jul 02, 201840 min

The shifting evidence paradigm – from literature to data

Carol Lefebvre gives a talk for the Evidence based healthcare seminar series. Carol Lefebvre will address the shift in focus over the last 20 years away from purely ‘literature searching’, i.e. only searching databases such as MEDLINE/PubMed for published literature, such as journal articles and books for identifying studies for evidence synthesis. She will consider the ever-increasing role of unpublished data sources such as trials registers and regulatory agency sources. Carol Lefebvre is an I...

Jun 26, 201830 min

Vagina Dialogues: Challenging Stigmas around Menstruation, Menopause and Female Sexuality

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 di...

Jun 22, 201842 min

The Replication Crisis in Biomedicine. What (kind of) crisis?

Professor Alexander Bird, Professor of Philosophy and Medicine, King's College London, gives a talk for the Centre for Evidenced Based Medicine. The replication (replicability, reproducibility) crisis in clinical medicine and in other fields arises from the fact that many apparently well-confirmed experimental results are subsequently overturned by studies that aim to replicate the original study. The culprit is widely held to be poor science: questionable research practices, failure to publish ...

Apr 11, 201847 min

Real versus rubbish EBM: do you know the difference?

A light hearted account of being treated by the 'wrong' guideline - with a serious conclusion about making sure this doesn’t happen. Professor Trish Greenhalgh is a Professor of Primary Care Health Sciences and the Nuffield Department of Primary Care Health Sciences. Trish Greenhalgh is an internationally recognised academic in primary health care and trained as a GP. She joined the Nuffield Department of Primary Care Health Sciences in January 2015 after previously holding professorships at Uni...

Mar 02, 201832 min

Launch of new website to catalogue biases affecting health and medical research

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 o...

Feb 05, 201840 min

Beyond accuracy: Evidence gaps and unintended consequences. Factors influencing utility of point-of-care diagnostic tests

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 ...

Jan 30, 201839 min

Mixed methods in the real world: a messy business?

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...

Jan 24, 201846 min

The Future of Healthcare - Evidencer and Value Based

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 ...

Jan 19, 201847 min

Life as a trial statistician – the good, the bad and the ugly

Professor Jonathan Cook is a Senior Medical Statistician at the Oxford Clinical Trials Research Unit. His main research interest is in the design, conduct, analysis and reporting of randomised controlled trials (particularly surgical trials). Key areas of interest include specification of the target difference in the sample size calculation, addressing interventional expertise, and methods for improving recruitment. In this light-hearted talk he discusses his experiences during his career as a t...

Dec 06, 201749 min

How we change behaviour and what to do to support it: lessons from randomised controlled trials and other research

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 ...

Nov 28, 201742 min
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