The Centre for Evidence-Based Medicine (CEBM), based in the Nuffield Department of Primary Care Health Sciences at the
University of Oxford
, mottoeng = The Lord is my light
, established =
, endowment = £6.1 billion (including colleges) (2019)
, budget = £2.145 billion (2019–20)
, chancellor ...
, is an academic-led centre dedicated to the practice, teaching, and dissemination of high quality evidence-based medicine 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
Paul Philip Glasziou (born 21 May 1954) is an Australian academic physician known for his research in evidence-based medicine. He is Professor of Evidence-Based Medicine at Bond University, where he is also Director of the Faculty of Health Sc ...
. 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. The Graduate School includes a MSc in Evidence-Based Health Care and a
DPhil
A Doctor of Philosophy (PhD, Ph.D., or DPhil; Latin: or ') is the most common degree at the highest academic level awarded following a course of study. PhDs are awarded for programs across the whole breadth of academic fields. Because it is ...
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
Jeremy Howick is a Canadian-born, British residing clinical epidemiologist and philosopher of science. He researches evidence-based medicine, clinical empathy and the philosophy of medicine, including the use of placebos in clinical practice and ...
and
Iain Chalmers
Sir Iain Geoffrey Chalmers (born 3 June 1943) is a British health services researcher, one of the founders of the Cochrane Collaboration,evidence-based medicine. The conference is organised in collaboration with the British Medical Journal. 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
A hierarchy of evidence (or levels of evidence) is a heuristic used to rank the relative strength of results obtained from scientific research. There is broad agreement on the relative strength of large-scale, epidemiological studies. More than 8 ...
homogeneity
Homogeneity and heterogeneity are concepts often used in the sciences and statistics relating to the Uniformity (chemistry), uniformity of a Chemical substance, substance or organism. A material or image that is homogeneous is uniform in compos ...
) 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, 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
Oseltamivir, sold under the brand name Tamiflu, is an antiviral medication used to treat and prevent influenza A and influenza B, viruses that cause the flu. Many medical organizations recommend it in people who have complications or are at hi ...
, despite the systematic review claiming to find no evidence for the effectiveness of it.
Sports products
A systematic review conducted in 2012 discovered a 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''. 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 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, is a medication that is used as an anticoagulant (blood thinner). It is commonly used to prevent blood clots such as deep vein thrombosis and pulmonary embolism, and to prevent st ...
) 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
Thrombosis (from Ancient Greek "clotting") is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel (a vein or an artery) is injured, the body uses platelets (thro ...
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 transmissible directly from one person to another. NCDs include Parkinson's disease, autoimmune diseases, strokes, most heart diseases, most cancers, diabetes, chronic kidney disease, ...
.
AllTrials
The centre is one of the co-founders of the AllTrials 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
A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entities, such as states, counties and cities, often also operate a health department of their ow ...
on
antimicrobial resistance
Antimicrobial resistance (AMR) occurs when microbes evolve mechanisms that protect them from the effects of antimicrobials. All classes of microbes can evolve resistance. Fungi evolve antifungal resistance. Viruses evolve antiviral resistance. P ...
diagnostics, which highlighted the considerable number of new diagnostic technologies in development to underpin rational prescribing of antibiotics.
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:
*
Ben Goldacre
Ben Michael Goldacre (born 20 May 1974) is a British physician, academic and science writer. He is the first Bennett Professor of Evidence-Based Medicine and director of the Bennett Institute for Applied Data Science at the University of Oxford ...
, Senior clinical
Research fellow
A research fellow is an academic research position at a university or a similar research institution, usually for academic staff or faculty members. A research fellow may act either as an independent investigator or under the supervision of a pr ...
*
Iain Chalmers
Sir Iain Geoffrey Chalmers (born 3 June 1943) is a British health services researcher, one of the founders of the Cochrane Collaboration,Muir Gray
Sir John Armstrong Muir Gray is a British physician, who has held senior positions in screening, public health, information management. and value in healthcare. He is currently the Chief Knowledge Officer for EXi, a digital health therapeu ...
* Professor Rod Jackson,
University of Auckland
, mottoeng = By natural ability and hard work
, established = 1883; years ago
, endowment = NZD $293 million (31 December 2021)
, budget = NZD $1.281 billion (31 December 2021)
, chancellor = Cecilia Tarrant
, vice_chancellor = Dawn F ...