Plenary Session 1: Equity Matters: Cochrane’s Next Frontier

Tuesday 22 October 2019, 09:00-10:30

To open the first Plenary of the Colloquium, short welcomes will be given by various speakers, including
Karla Soares-Weiser, Cochrane’s Editor-in-Chief.

Cochrane has prioritized health equity as part of its new content strategy for all Cochrane reviews because health is inextricably linked with social determinants of health.  At the heart of this strategy, we recognize that averages may obscure differences in health outcomes across diverse populations that can worsen or perpetuate health inequities. In this session, we will look at the imperative for evidence on equity from decision-makers, how Cochrane is responding to these needs and the rewards and challenges of using these methods in reviews.

Peter Tugwell

Dr. Peter Tugwell (OC, LRCP, MRCS, MD, MSc, FRCPS, FRCP [UK], FCAHS) is Professor of Medicine and Epidemiology & Community Medicine at the University of Ottawa and is a practicing rheumatologist at the Ottawa Hospital. In 2001, he became Director for the Centre for Global Health at the University of Ottawa. He has built a research program and multidisciplinary team around his Canada Research Chair in Health Equity. Dr. Tugwell was Founding Director of the International Clinical Epidemiology Network Training Centre at McMaster University [1982-91] and currently serves as Secretary General to INCLEN's North American group (CanUSAClen). Dr. Tugwell is co-director of a WHO Collaborating Centre for Knowledge Translation & Health Technology Assessment in Equity. Dr. Tugwell is Coordinating Editor of the Cochrane Musculoskeletal Review Group and is Founding Co-convenor of the Cochrane Health Equity Field/Campbell Equity Methods Group and serves on the Steering Committee of the Campbell Collaboration.

Beibei Yuan

Dr. Beibei Yuan (MD, PhD) is an Associate Professor in Peking University China Center for Health Development Studies. She got her PhD in management from Shandong University in 2011, and worked in Peking University and Karolinska Institutet as postdoctoral fellow from 2011-2013. She continued research on evidence-based method in the areas of health system and policies, including development of appropriate methodology on evidence synthesis, conducting of systematic reviews on specific health system and policy research topics, like strategies for expanding health insurance coverage, payment methods evaluation, interventions to reduce inequalities in maternal health, and the equity consequences of health policies. She also has experience teaching courses related to systematic review or evidence synthesis. Her research interests also include incentives and motivation of health workers in primary health facilities, and the integration reform of primary healthcare system. She is a governance member of Emerging Voices for Global Health, expert member of WHO Alliance Health Systems Research Synthesis Advisory Group, expert member of China Delegation for World Health Assembly on the areas of WHO financing and Universal Health Coverage, and the committee member of China Young Scholars Federation of Health Management Researches.

Jeanette Vega

Dr. Jeanette Vega (MD, MPH, PhD) is the Chief Medical and Innovation Officer at Red de Salud UC-Christus, the main private health provider in Chile. She has over 20 years of experience in international health. Her areas of expertise include social determinants of healthy, health equity and health systems. She is the former Director of FONASA, the National Chilean Public Health Insurance Agency, as part of President Bachelet´s government, between 2014 and March 2018 and former Vice Minister of health, between 2008 and 2010. She has served as as Managing Director of Health at the Rockefeller Foundation between 2011 and 2014. Previously she was a Director at the World Health Organization in Geneva, where she led the equity in health agenda, and the Commission on Social Determinants of Health Secretariat, established in March 2005 to support countries and global health partners in addressing the social factors leading to ill health and health inequities. 

Session Co-Chairs: Tamara Lotfi and Lawrence Mbuagbaw

Dr. Tamara Lotfi (MD, MPH) is the Coordinator of the Global Evidence Synthesis Initiative (GESI) Secretariat at the American University of Beirut (AUB) and a Research Associate at the Faculty of Medicine at AUB, Lebanon.  She received her Medical Doctor degree from Université Saint Joseph, Lebanon (2013) and her Master’s in Public Health concentrating in Epidemiology & Biostatistics (2016) at AUB. Within GESI, Tamara works towards enhancing the capacity in Low & Middle Income Countries in conducting and using Evidence Synthesis (ES) through online and face-to-face trainings, joint applications for funding and enhancing the representation of LMIC centres in discussions on and methods for ES. 

Dr. Lawrence Mbuagbaw (MD, MPH, PhD) is a Research Methods Consultant and assistant professor in the Department of Health Research Methods, Evidence and Impact, McMaster University. His research interests are study design, infectious diseases, mother and child health, mHealth, health systems strengthening, health equity and the intersection of these fields.

Session coordinated by Vivian Welch.

Plenary Session 2: Stakeholder Diversity

Wednesday 23 October 2019, 09:00-10:30

Considering the important role Cochrane plays in providing high-quality evidence that serves a variety of stakeholders, this plenary will provide an opportunity for the Cochrane community to hear from representatives of various groups, including policy makers, clinicians, and civil society and consumers. Speakers will address how Cochrane evidence serves their group, and discuss diversity within their group.

Rodrigo A. Salinas

Dr. Rodrigo A. Salinas is a Physician, Neurologist, and Senior Lecturer of Clinical Neurology at the Faculty of Medicine of the University of Chile. He has a Master of Science in Evidence Based Health Care (University of Oxford) and a Master of Health Economics (University of York). He is a member of the Prioritization Committee for Rare Diseases of the Ministry of Health of Chile and is the former Director of the Medicines Regulatory Agency of Chile.

Cristian Herrera

Dr. Cristian A. Herrera is Chilean. He holds an MD from Pontificia Universidad Católica de Chile (UC), an MBA from Universidad de Chile, and an MSc Public Policy and Administration from the London School of Economics and Political Science. In 2010-2011 he worked as primary care physician and advisor in the Department of Primary Healthcare of the Municipality of Santiago, and was member of the Health Experts Committee of the Chilean Association of Municipalities. Since 2012, he has worked as associate researcher at the Department of Public Health of UC. Between 2014 and early 2016 was advisor to the Minister of Health of Chile. Between 2016 and early 2018, Dr Herrera was Head of the Division of Health Planning of the Ministry of Health of Chile and also took the position of Acting Vice-Minister of Public Health several times. Since 2018, he has been a health policy analyst in the Health Division of the Organisation for Economic Cooperation and Development (OECD).

Síle Lane

Síle Lane is Head of International Campaigns and Policy with Sense About Science, the independent charity that campaigns around use and misuse of evidence in public life. Síle leads all Sense about Science's current campaigns which include AllTrials, the global movement for clinical trial transparency and Ask for Evidence, a public campaign to help people request for themselves the evidence behind news stories, marketing claims and policies. Síle was one of the original founders of the AllTrials campaign, alongside Ben Goldacre, growing it from a simple petition to a high profile, worldwide campaign. Síle also oversees Sense about Science's EU office, which calls for EU citizens, researchers and the European parliament to scrutinise and share evidence behind European policymaking. Síle has run public-led events in parliaments in Westminster, the European parliament in Brussels and the Oireachtas in Dublin to remind elected officials that evidence matters to the public. Prior to joining Sense about Science in 2009, Síle was a post-doctoral researcher at Imperial College London working on stem cells and regenerative medicine. 

Session Co-Chairs: Holger J. Shünemann and Eva Madrid

Holger J. Schünemann, M.D., M.Sc., Ph.D., FRCPC, is Chair of the Department of Health Research Methods, Evidence, and Impact at McMaster University. He is a Professor of Clinical Epidemiology and Medicine at McMaster, and Director of Cochrane Canada and the McMaster GRADE Centre. His scientific work focuses on evidence synthesis, quality of life research and the presentation and development of health care recommendations spanning clinical medicine to public health. 

Eva Madrid, M.D., Ph.D., is a full Professor of Research Methodology and Evidence-Based Medicine at the School of Medicine at the Universidad de Valparaíso, Chile. She is the current president of the Bioethics Board at the Chilean National Agency of Science and Technology (CONICYT).  She received her MD degree (1984) at the Universidad de Chile, and received her doctorate degree from the School of Medicine in Granada, Spain. During her postdoctoral fellowship at Harvard School of Public Health, she studied and worked in Clinical Epidemiology and Research Methodology. She is part of the board of directors of Cochrane Chile and the Head of the Associate Centre at the Universidad de Valparaiso. 

Session coordinated by Eva Madrid. 

Plenary Session 3: Embracing Methodological Diversity

Thursday 24 October 2019, 09:00-10:30

As with primary research, systematic reviews ask questions from a variety of epistemological, ideological, and theoretical standpoints. This diversity reflects the different ways in which people ask and answer questions, and the numerous perspectives they have about those questions. Therefore, reviews may differ from each other in many ways along a number of dimensions such as their approach (and epistemology), their structure, and the way in which they are conceptualised. Cochrane has developed and consolidated methods that are primarily related to reviews of the effects of interventions and diagnostic test accuracy. However, a number of other areas relevant to decision maker questions have had different degrees of methodological development within and/or outside Cochrane. Some of these areas are: 

• Qualitative research and qualitative evidence synthesis. The potential contribution of qualitative evidence to decision-making is well established and a synthesis of such evidence (qualitative evidence synthesis) can add value by providing decision-makers with evidence to improve understanding of intervention complexity, contextual variation, implementation, and stakeholder preferences and experiences. However, there are a number of available methods that seems to require a wide range of expertise to be implemented and the selection of which of them should be used to answer a specific review question can be challenging.
• Rapid reviews. These reviews have become prominent in the context of urgent decision-making processes in order to answer the time-sensitive needs of policymakers (and other decision makers). Although the concept is not novel, it remains a poorly understood and as yet ill-defined set of diverse methodologies supported by a paucity of published, available scientific literature. Additionally, there is tension between a timely response and ensuring that the scientific imperative of methodological rigour is satisfied.

Speakers will reflect on the relevance of these diverse review methodologies/types for different stakeholders, and how Cochrane is currently addressing the challenge of incorporating and developing these review methods. The new Cochrane Handbook for Systematic Reviews of Interventions will also be launched during this plenary session.

Lisa Anne Bero

Lisa A. Bero, PhD is an expert in examining how science can be influenced and translated into clinical practice and health policy.  She directs the Evidence, Policy and Influence Collaborative Research Program at the Charles Perkins Centre, with Research nodes in Bias, Evidence Synthesis and Pharmaceutical Policy.  Professor Bero is Chair of Medicines Use and Health Outcomes, Faculty of Medicine and Health, School of Pharmacy, The University of Sydney.  She was Co-Chair, Cochrane Governing Board from 2014-2018 and is currently Senior Editor, Cochrane Public Health and Health Systems Network.  She has developed and validated methods for assessing bias in the design, conduct and dissemination of research on pharmaceuticals, tobacco, chemicals, and complex public health interventions.  Prof. Bero has also conducted analyses to examine the dissemination and policy implications of research evidence.  Her international activities include member and chair of the World Health Organization (WHO) Essential Medicines Committee and Cochrane Collaboration liaison to WHO.  Prof. Bero serves on several committees related to conflicts of interest, evidence and decisions, such as the Institute of Medicine Committee on Conflict of Interest in Medical Research, Education and Practice and the National Academy of Science Committee to review the Environmental Protection Agency Integrated Risk Information System Process. 

Jorge Barreto

Jorge Barreto, PhD, is a researcher at the Oswaldo Cruz Foundation (Fiocruz), focusing on Evidence-informed Policy-making (EIPM) and Health Systems Research (HSR). He has more than 15 years management and research experience in HSR and EIPM fields and implemented the first EVIPNet Brazil workgroup at local level. He was the Special Secretary for Science and Technology of the National Council of Municipal Health Secretaries of Brazil and led the Knowledge Management for Science and Technology coordination and the EVIPNet Brazil at the Brazilian Ministry of Health. Today he participates in several projects related to knowledge translation platforms to make the decision making process more transparent, systematic and balanced.

Adrienne Stevens

Adrienne Stevens, PhD, is Co-Convenor of the Cochrane Rapid Reviews Methods Group and Clinical Research Manager with the Knowledge Synthesis Group at the Ottawa Hospital Research Institute, Canada. She provides scientific leadership and guidance in relation to knowledge synthesis research, including systematic and rapid reviews, to serve the needs of various end users. Her doctoral work focused on rapid reviews and reporting, and her broader research interests lie in knowledge synthesis, research reporting, and clinical practice guideline development. She received a PhD in Epidemiology from the University of Split, Croatia.

Jane Noyes

Jane Noyes, D.Phil., MSc., is Professor of Health and Social Services Research and Child Health in the School of Health Sciences, Bangor University, UK. Jane is Co-Lead of the Wales National Centre for Population Health & Wellbeing Research and the Wales Kidney Research Unit. She is the former Co-Chair and now member of the Cochrane Methods Executive, Member of the Cochrane Scientific Committee,  Lead Convenor of the Cochrane Qualitative and Implementation Methods Group, Honorary Visiting Professor in Child Health at University College Dublin, and Editor of the Journal of Advanced Nursing. She is a methodologist, systematic reviewer and primary researcher with a particular interest in complex social interventions. Jane is one of the founder members of the group that developed GRADE CERQual to assess the confidence in findings of synthesised qualitative research.

Session Co-Chairs: Ella Flemyng and Ignacio Neumann

Ella Flemyng is the Methods Implementation Coordinator in Cochrane, part of the Editorial and Methods Department. Ella project manages, or is involved in, the methods implementation projects highlighted in Content Strategy and is working on developing how methods are implemented in Cochrane so that authors and editors have the resources and support they need to use the new methods or review types. She also coordinates other methods-related activities in Cochrane, including Handbook and MECIR development, and works with the Methods Executive and Methods Groups on developing the methods community in Cochrane more generally.

Session coordinated by Tomás Pantoja.

Closing Plenary

Friday, October 25, 09:00-10:30

Conversation with Governing Board

The Use of Evidence in Health Decision-Making: Public Policy in Latin America (in Spanish)

A panel of policy makers from the Latin American region will discuss the use of evidence in health policy and decision making in their countries and contexts. Participants will reflect on how evidence, and Cochrane evidence in particular, is used in making health policy and priority setting.

This panel discussion will be in Spanish, with simultaneous translation provided in English. 

Panelists include:

Dalia Xochitl Sandoval López

Dra. Sandoval is the Subdirector of the National Institute of Health of El Salvador. 

Jaime José Mañalich Muxi

Dr. Mañalich is the current Minister of Health of Chile. 

Cristian Herrera

Dr. Cristian Herrera is a Health Policy Analyst in the Health Division of the Organisation for Economic Cooperation and Development (OECD).

Conversation Chair: Rodrigo Salinas

Dr. Rodrigo Salinas is the first Chilean author of a Cochrane systematic review. Ex-Director of the Public Health Institute (pharmaceutical regulatory agency in Chile), he has held multiple public positions related to health policy decision-making.  

Session coordinated by Cochrane Chile and Cochrane CET.

Cochrane Lecture: The unbearable lightness of the Cochrane Collaboration

Friday 25 October 2019, 11:00-12:00

"Was it better to be with Tereza or to remain alone? There is no means of testing which decision is better, because there is no basis for comparison." -Milan Kundera

The Cochrane Collaboration has a diversity of choices - including decisions about our mission, principles, goals, and organisation. Like Tomáš in The Unbearable Lightness of Being, we have no basis for comparison. Assessing our choices depends on imagining what might have happened had alternative decisions been made. What might have happened had the Cochrane Collaboration made different choices, and what might happen in the future if we make different choices now?

Andy Oxman

Andy Oxman is a researcher in the Centre for Informed Health Choices at the Norwegian Institute of Public Health. His research over the past three decades has focused on ways of helping people make informed choices about healthcare. He has helped to develop and evaluate ways to make research evidence more accessible and understandable, ways to enable people to assess health claims and make informed choices, and implementation strategies. His current research focuses primarily on developing and evaluating learning resources to enable people to assess claims about effects. He is particularly interested in resources for children and for people in low-income countries.