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Cochrane Symposium 2014 – #CE3U

Posted on July 22, 2014 by Alice Buchan

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Symposium group photo

On the 23rd and 24th of April, many of the UK’s Cochranites descended on the Renold Building in Manchester for the Cochrane UK & Ireland Annual Symposium. As a Students 4 Best Evidence Pioneer – I was awarded a stipend by the UK Cochrane Centre to attend the Symposium. In addition to standing by the Students 4 Best Evidence banner and chatting to anyone who was interested, I attended the workshops and plenary sessions. I also live-tweeted my first conference, which was great fun! It turns out being that person who scribbles furiously through university lectures translates well into typing quickly… I found the talks extremely thought provoking, and I’ve just jotted down a few of the things from the Cochrane symposium that have stayed with me over the past few weeks. Although these are the things that have changed how I think about evidence and medicine, the best bit was being in a gathering of like-minded people, many of whom I didn’t think I’d meet in real life.

#CE3Udevelop

First up were the developmental workshops, which were great opportunities to discuss and brainstorm in small groups. I attended one by the COMET initiative – which was enlightening as I hadn’t come across the idea of core outcome sets before. It does make sense to use the same set of core outcomes in all new RCTs for consistency (easier to systematically review) but also to make sure that every trial covers all the outcomes most important to patients and clinicians.

The second workshop I attended was about patient and stakeholder involvement in Cochrane reviews. In this, I encountered a Cochranite whom I first met by chance a year ago, not long before I became involved in Students 4 Best Evidence. Patient and stakeholder involvement in reviews is something I think is really important, as these are the people your review is likely to impact on the most. Patients may also rank different outcomes more highly than clinicians.

Plenaries – #CE3Useful, #CE3Usable, #CE3Used and #CE3UBrand

The plenary sessions were interesting, insightful, and left me with lots to think about – and helped me to look at some of the issues in evidence-based healthcare in a new and different way.

  • Health economics – not something I thought I had any interest in before the talk by Karl Claxton, but the concept of quantifying the harm caused by treatment uncertainties was intriguing. The idea that there was a probability of an adverse effect, and that by closing the uncertainty you reduce the probability of that harm occurring and could potentially saves lives does make the case for more and better evidence. The opposite side of the same coin is that by quantifying it in this way, you can see the point at which enrolling people in trials causes more harm than you would prevent by resolving the uncertainty – e.g. the harm to people in the placebo arm of a trial of a treatment where there isn’t much uncertainty. Whilst it can’t all be boiled down to numbers, it’s important to remember that more research is not always needed, and that there is the possibility that even the best designed trial could do more harm than good. (Below is the video of Karl’s plenary, his talk starts 40 min into the video.)

  • Shared decision-making is something I first came across whilst following the 2013 Colloquium through the YouTube videos of the plenary sessions. Much like evidence-based medicine, it seems blindingly obvious. Meanwhile in the real world, it’s not that simple. Al Mulley’s talk was entertaining, but also brought home the importance of patient preferences: “Preference misdiagnosis can be as bad as disease misdiagnosis – in both cases you get the wrong treatment”. (Al’s plenary starts 40 min into the video below.)

Overall, attending the Cochrane symposium conference was a great opportunity to learn more about the current concepts in evidence-based healthcare and evidence synthesis. It was great to finally meet some of the people involved in S4BE with the S4BE stipend.

If you would like to watch all the plenaries from the Symposium, click here.

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Alice Buchan

I'm Alice, a fifth year medical student at the University of Oxford. I did my 'intercalated year' focusing on immunology. At the moment, my particular interests are in immunology, reproductive biology, and obstetrics. View more posts from Alice

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