This week I’ve been in Oxford at the Evidence live conference – side note: Oxford is currently hotter than the surface of the sun and I genuinely miss Autumn and Winter. As I’m at Evidence Live I thought if would be cool to blog each day; there’s lots of people I have spoken to that wanted to attend but couldn’t, so here’s a run down for those that missed day 1.
As expected, Carl started Evidence Live in a really enthusiastic way. He introduced the Evidence-Based Medicine (EBM) manifesto (more on that later), revealed his new post as Editor-in-Chief of the BMJ’s EBM Journal, and told us how we are currently relying on readers to have ‘a good nose’ when it comes to evidence. Yes, in the 21st century, ‘a good nose’ is apparently a real thing we’re using to distinguish decent research from crap research. Carl highlighted that lots of the things that can have an impact on research are types of biases; when paired with the fact that effects of new interventions are often very small, and we’re left with an evidence-base that’s incredibly vulnerable.
Here Carl talk more here in this short clip recorded after his welcome address.
Workshop – Routinely collected health data (RCD) for randomised controlled trials (RCTs)
Lars Hemkens, Kimberly McCord and Heidi Gardner (yes, me!)
I can’t really give you an unbiased report of this workshop since I was one of the speakers, so I’ll try to remain objective. We uncovered the links between trialists and coffee (the stress of doing trials); why clinical research often fails; what RCD could do for RCTs and why we shouldn’t be thinking of the two concepts as opposites; and also gave a few examples of trials where RCD has been used successfully. Lots of brilliant discussion, and a feeling that we need the infrastructure and IT systems to catch up with our thought process; some cases where a trial team has had to wait over a year for data to be released from NHS Digital, and that’s when the trial’s been up and running for a while beforehand. I really enjoyed this session because the audience were so engaged, ideas exchanged and barriers/solutions brain-stormed. Looking forward to working further with Lars and Kim on this over the next few months; we’ve got a paper almost ready to submit so fingers crossed we’ll have that published before my PhD is over too.
Keynote session – Transparency of trial data, improvement in safety and better quality research to improve healthcare
Chaired by Kamal Mahtani, presentations from Fergal O’Regan, Mary Dixon-Woods and Doug Altman
SUCH A GOOD SET OF KEYNOTE LECTURES. If I can present half as well as these guys one day I’ll be so chuffed with myself. Anyway, fangirl moment over – this session looked at transparency of clinical trial data and pharmacovigilance data from the perspective of the European Medicines Agency (EMA); how we can improve the evidence for improving healthcare, and we finished off with a cracker of a talk from Doug Altman on the scandal of poor medical research. This was my highlight of day 1. Doug published a paper titled ‘The scandal of poor medical research‘ in the BMJ in 1994, and this talk was a reflection on what’s changed in the 23 years since. Sadly, not much. Doug strengthened his message, “let’s start calling it bad research, it’s not just poor, it’s plain bad“, and also gave some brilliant words of wisdom on when to do research, “Ignorance of research methods is no excuse; if you can’t do it well, don’t do it.”
Here Mary talk more here in this short clip recorded after her talk.
Workshop – How to write papers that add value in health research and deserve publication
A brilliant session for early-career researchers and students – and one I found really valuable. Trish gave a few tips on resources that will help budding resources (e.g. checklists as found on the EQUATOR Network website), revealed the acceptance rate for submissions to the BMJ (~4%), and encouraged us to never give up when it comes to publishing; if the science is solid, it will get published somewhere. She also drew attention to the research methods we use, which I thought was a brilliant topic to highlight in this talk. Many people think journals publish based on ‘positive’ results, but the good ones don’t; they’re looking for new, interesting and relevant research questions with solid methodology. After that it doesn’t really matter what the results show. In Trish’s own words, “Methods are the most important part of any paper, without them the rest won’t make sense.”
A final word of advice from Trish; keep the writing simple. For the slide below ‘the cow jumped over the moon’ would have worked better.. (slide taken from the Students 4 Best Evidence Twitter page)
Here Trish talk more here in this short clip recorded after her workshop.
Parallel session – Evidence synthesis
Chaired by Jeffrey Aronson, presentations from Tone Westergren, Sietse Wieringa, Carme Carrion, Lyubov Lytvyn, Izhar Hasan and Karolina Wartolowska
A really interesting session that covered lots of different aspects of evidence synthesis. Highlights from Sietse Wieringa who gave a thought-provoking talk titled ‘Has evidence based medicine ever been modern? A Latour inspired understanding of the changing EBM’; Lyubov Lytvyn who gave an overview of the RapidRecs we see in the BMJ with a talk titled, ‘Innovative patient partnership in creating trustworthy guidelines, from protocol to publication: Case studies of BMJ Rapid Recommendations’; and Karoline Wartolowska who discussed the placebo effect and how it changes over time in ‘Temporal characteristics of effect size in the placebo arm of surgical randomised controlled trials – a meta-analysis.’
Open session – Carrots, sticks, or stones? Audit and accountability to improve research quality
Before I came to Oxford I was describing Evidence Live to a friend, I mentioned the usual faces and topics I expected would be discussed, and my friend did not focus on anything academic, none of the topics I’d mentioned; she just said, “Ben Goldacre is kind of a big deal.” I guess she was right, and this talk demonstrated just how many projects/initiatives he is involved in that are working to improve research quality. He talked at length about the need for ‘sustained pressure’ when it comes to getting reporting standards up – this isn’t something that will change over night, but the TrialsTracker will hopefully help.
He specifically asked that sections of the talk weren’t tweeted, and I nodded along when he asked for agreement – so that’s all I’m giving you.
Open session – Better evidence for better healthcare: Consultation
Ben Goldacre and Carl Heneghan
If you haven’t seen or heard of the EBM Manifesto then take a look here. Essentially this aims to kick us into action; we know that evidence generation is not at the standard it should be, patients are being let down as a result, and this manifesto aims to get a sort of action plan together of what we can do to improve things. The infographic below gives a summary of the 9 steps of the EMB Manifesto – which will hopefully lead to us changing the landscape of EBM for the better. I’ll just say that this session started at 6pm and the audience were getting restless at this point; there was the promise of a cold beer and 33 degree heat on the other side, so we made this session quick. That said, the way this was done was brilliant; super efficient and cut out the waffle that usually comes with a consultation of any kind.
One of the things I love about Evidence Live is how solutions-driven it is – speakers openly say that we no longer need to see hundreds of papers published telling us what the problems are with clinical research, we need to get to work and fix them. The aim of this session was exactly that. We were given the task of creating the jobs lists of different stakeholder groups (funders, journal editors, researchers, patient groups etc). We submitted our ideas for jobs along with the problem it’s trying to fix, and how we could measure its success if implemented. Simple as that!
There’s an online version of the form we completed at the consultation here – it’s still open to submissions so please do contribute if you wish.
Overall, an absolutely brilliant first day at Evidence Live; I’m really looking forward to tomorrow’s discussions – check back tomorrow for a blog post covering day 2!