The Centre for Evidence-Based Medicine (CEBM), based in the Nuffield Department of Primary Care Health Sciences at the
University of Oxford
The University of Oxford is a collegiate university, collegiate research university in Oxford, England. There is evidence of teaching as early as 1096, making it the oldest university in the English-speaking world and the List of oldest un ...
, is an academic-led centre dedicated to the practice, teaching, and dissemination of high quality
evidence-based medicine
Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. It means integrating individual clinical expertise with the best available exte ...
to improve healthcare in everyday clinical practice. CEBM was founded by
David Sackett in 1995. It was subsequently directed by
Brian Haynes and
Paul Glasziou. Since 2010 it has been led by Professor
Carl Heneghan, a clinical epidemiologist and general practitioner.
There are currently over 25 active staff and honorary members of the CEBM. The staff include clinicians, statisticians, epidemiologists, information specialists, quantitative and qualitative researchers.
Teaching and degrees
CEBM is the academic lead for Oxford University's Graduate School in Evidence-Based Healthcare, together with the university's
Department of Continuing Education
Department may refer to:
* Departmentalization, division of a larger organization into parts with specific responsibility
Government and military
*Department (administrative division), a geographical and administrative division within a country, ...
. The Graduate School includes a MSc in Evidence-Based Health Care and a
DPhil in Evidence-Based Health Care, along with a range of short courses, including a course on the History and Philosophy of Evidence-Based Healthcare which was developed by
Jeremy Howick and
Iain Chalmers.
EBM Live conference
Every year, CEBM organises ''EBM Live'' (previously Evidence Live), a multi-day conference focussing on developments in the area of
evidence-based medicine
Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. It means integrating individual clinical expertise with the best available exte ...
. The conference is organised in collaboration with the
British Medical Journal
''The BMJ'' is a fortnightly peer-reviewed medical journal, published by BMJ Publishing Group Ltd, which in turn is wholly-owned by the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world ...
. Themes for the conference include Improving the Quality of Research; disentangling the Problems of Too Much and Too Little Medicine; transforming the Communication of Evidence for Better Health; training the Next Generation of Leaders and translating Evidence into Better-Quality Health Services.
Notable projects
Levels of evidence
CEBM has developed a widely adopted systematic hierarchy of the quality of medical research evidence, named the
levels of evidence.
Systematic reviews of
randomised clinical trials (encompassing
homogeneity
Homogeneity and heterogeneity are concepts relating to the Uniformity (chemistry), uniformity of a Chemical substance, substance, process or image. A homogeneous feature is uniform in composition or character (i.e., color, shape, size, weight, ...
) are seen as the highest possible level of evidence, as full assessment and aggregated synthesis of underlying evidence is possible.
Tamiflu
In collaboration with the
British Medical Journal
''The BMJ'' is a fortnightly peer-reviewed medical journal, published by BMJ Publishing Group Ltd, which in turn is wholly-owned by the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world ...
,
Carl Heneghan and team found no evidence that
Tamiflu helped to reduce complications of influenza. This has become a controversial topic, as the United Kingdom government spend £473 million () on the purchase of Tamiflu, despite the systematic review claiming to find no evidence for the effectiveness of it.
Sports products
A systematic review conducted in 2012 discovered very little effect of carbohydrate drinks on sport performance of the general population. This work formed part of a joint investigation with
BBC Panorama and the ''
British Medical Journal
''The BMJ'' is a fortnightly peer-reviewed medical journal, published by BMJ Publishing Group Ltd, which in turn is wholly-owned by the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world ...
''. A linked article published in the ''BMJ'' reported a "striking lack of evidence" to back up claims for popular sports brands.
A further analysis of a broad range of sports products showed that the evidence for many sports products is poor quality and insufficient to inform the public about the benefits and harms of the products.
Self care
Systematic review
A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on ...
and individual patient data meta analysis research in the centre has shown that, even with little training, people on oral anticoagulation (
warfarin
Warfarin, sold under the brand name Coumadin among others. It is used as an anticoagulant, anticoagulant medication. It is commonly used to prevent deep vein thrombosis and pulmonary embolism, and to protect against stroke in people who ha ...
) can successfully self-monitor, and even self-manage their disease in the community. Patients capable of self-monitoring and self-adjusting therapy have fewer
thromboembolic events and lower mortality than those who self-monitor alone. In 2014, Carl Heneghan along with Alison Ward became directors of a
World Health Organization Collaborating Centre for self-care in
non-communicable disease
A non-communicable disease (NCD) is a disease that is not transmission (medicine), transmissible directly from one person to another. NCDs include Parkinson's disease, autoimmune diseases, strokes, heart diseases, cancers, Diabetes mellitus, diab ...
.
AllTrials
The centre is one of the co-founders of the
AllTrials
AllTrials (sometimes called All Trials or AllTrials.net) is a project advocating that clinical research adopt the principles of open research. The project summarizes itself as "All trials registered, all results reported": that is, all clinical tr ...
campaign, which has been influential in ensuring that the results of all clinical trials are registered and reported in full.
Diagnostic technologies and reasoning
The centre has a strong diagnostic theme which includes assessing novel diagnostic technologies relevant to improving the diagnosis of disease in primary care and also to improving diagnostic reasoning. In 2015, the centre produced a report for the
Department of Health on
antimicrobial resistance
Antimicrobial resistance (AMR or AR) occurs when microbes evolve mechanisms that protect them from antimicrobials, which are drugs used to treat infections. This resistance affects all classes of microbes, including bacteria (antibiotic resista ...
diagnostics, which highlighted the considerable number of new diagnostic technologies in development to underpin rational prescribing of
antibiotic
An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting pathogenic bacteria, bacterial infections, and antibiotic medications are widely used in the therapy ...
s.
COMPare project
In 2015 the COMPare project was launched, addressing
outcome switching in clinical trials. The project systematically checks every trial published in the top five medical journals, to see if they have misreported their findings, comparing each clinical trial report against its registry entry. The project has found that some trials report their outcomes perfectly, but for many others outcomes specified in the registry entry were never reported. The updates to the trials are updated live on the COMPare website. The project highlights how researchers are duped by the common practice in clinical trial reporting of "outcome switching".
Adverse events
In March 2016, research at the centre systematically identified 353 medicinal products withdrawn worldwide because of adverse drug reactions, assessed the level of evidence used for making the withdrawal decisions, and found that only 40 drugs were withdrawn worldwide. Withdrawal was significantly less likely in Africa than in other continents. Furthermore, in 47% of the 95 drugs for which death was documented as a reason for withdrawal, more than two years elapsed between the first report of a death and withdrawal of the drug.
Notable associates
Notable associates of the centre include:
* Professor
Ben Goldacre
* Sir
Iain Chalmers
* Margaret McCartney
*
Muir Gray
* Professor Rod Jackson
University of Auckland
The University of Auckland (; Māori: ''Waipapa Taumata Rau'') is a public research university based in Auckland, New Zealand. The institution was established in 1883 as a constituent college of the University of New Zealand. Initially loc ...
References
{{coord missing, Oxfordshire
1995 establishments in England
Educational institutions established in 1995
Research institutes of the University of Oxford
Evidence-Based Medicine
Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. It means integrating individual clinical expertise with the best available exte ...
Medical and health organisations based in England
English medical research
Evidence-based medicine