How should we teach evidence-based medicine in the 21st century?

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.

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.

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.

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 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.