User:Cheneghan/Centre for evidence-based medicine

The Oxford Centre for Evidence-Based Medicine (CEBM) aims to develop, teach and promote evidence-based health care through conferences, workshops and EBM tools so that all health care professionals can maintain the highest standards of medical practice and research. They provide support and resources to doctors, clinicians, teachers and others interested in learning about Evidence Based Medicine (EBM), The Centre is currently directed by Professor Carl Heneghan. Previous directors include Professor Dave Sackett, Professor Martin Dawes, and Professor Paul Glasziou. Over 1000 healthcare professionals from all over the world have trained with the CEBM either in Oxford or through a growing Outreach Programme.

History of the Oxford CEBM
In 1995 Sir Muir Gray invited Dave Sackett to Oxford to found the Oxford CEBM. The original centre was funded by the National Health Service Research & Development. The initial remit was two fold: to promote the teaching and practice of evidence-based healthcare throughout the UK, and to effect the creation of formal graduate education in the conduct of randomised trials and systematic reviews. Professor Sackett retired from EBM research in 2000

Research Areas
Research at the Oxford CEBM focuses on developing and implementing evidence that leads to patient benefit. These include:

1. Diagnosis

2. The Philosophy of Medicine

3. Systematic reviews

4. Anticoagulation

5. Placebo research

6. Self monitoring

7. Emergency admissions

Teaching and Training in EBM
The Oxford CEBM delivers training in critical appraisal, randomized controlled trial methods, systematic review methods as well as EBM workshops and postgraduate degrees. They have also developed a variety of teaching resources and books have been developed by the Centre. .

Oxford CEBM Levels of Evidence
Most of the evidence ranking schemes grade evidence for therapy and prevention, but not for diagnostic tests, prognostic markers, or harm. The Oxford CEBM Levels of Evidence addresses this issue and provides 'Levels' of evidence for claims about prognosis, diagnosis, treatment benefits, treatment harms, and screening. The original CEBM Levels was first released in September 2000 for Evidence-Based On Call to make the process of finding evidence feasible and its results explicit. In 2011 the Oxford CEBM Levels were redesigned by international team including Jeremy Howick, Sir Iain Chalmers, Paul Glasziou (chair), Trish Greenhalgh, Carl Heneghan, Alessandro Liberati, Ivan Moschetti, Bob Phillips, and Hazel Thornton (and help from Olive Goddard and Mary Hodgkinson) re-designed the Oxford CEBM Levels to make it more understandable and to take into account recent developments in evidence ranking schemes. The Oxford CEBM Levels of Evidence have been used by patients, clinicians and also to develop clinical guidelines including recommendations for the optimal use of phototherapy and topical therapy in psoriasis and guidelines for the use of the BCLC staging system for diagnosing and monitoring hepatocellular carcinoma in Canada.

Oxford CEBM controversy in the press
A number of centre activities are widely disseminated to affect change. These include: 1. The overstated benefits of sports drink.

2. Exposing current regulations on medical devices as insufficient (The hip replacement fiasco 3. Exposing the potential harm done by claims about sports products that lack evidence in The Truth About Sports Products 4. Potential harms caused by publication bias Tamiflu. 5. Calling for the registration, reporting and publishing of all trials through the AllTrials Campaign 6. Tamiflu: Millions wasted on flu drug, claims major report 7. Orphan drug costs prove ‘prohibitive’ 8. The need to publish negative results (the AllTrials campaign).