• By Michael Little
  • Posted on Tuesday 24th February, 2009

Impressive - but where's the ground control?

I have spent the beginning of the week as Steve Aos’s chaperon, a most agreeable task. His hectic schedule, typically American, is partly my responsibility so I feel the least I can do is help him get from A to B.Cost-benefit analysis on prevention programs has got itself a bad reputation. Good but small studies undertaken many years ago are the basis for claims that a single dollar (it is gener…

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  • By Nick Axford
  • Posted on Tuesday 03rd February, 2009

"I was paying too much attention to the literature."

Humility was the keynote of the closing presentation from Roy Cameron, from the Center for Behavioral Research and Program Evaluation at the University of Waterloo, Canada.A few years previously he was faced with this conundrum: policy makers in Canada were not using his research findings on proven programs to tackle tobacco misuse, yet rates of smoking were falling. He concluded that I was paying…

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  • By Nick Axford
  • Posted on Tuesday 03rd February, 2009

Implementation researchers wanted for new science

If implementation research is to take off as a new science, its going to need a new generation of implementation researchers. What training do those researchers need? A lot, judging by a think-tank session on Training the next generation of implementation researchers, chaired by Enola Proctor from Washington University.The challenges are daunting. The theory of implementation science is debated an…

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  • By Nick Axford
  • Posted on Tuesday 03rd February, 2009

Have we been forgetting to learn from what we do?

Drug reps may not have the best reputation, but they may have something to teach us in terms of learning about translating research into practice.Who is using is using the latest behavioral science change research in hospitals? asked Jim Yong Kim of Harvard Medical School. Not doctors, not nurses, not health care managers drug reps.Drug reps, he explained, carefully record the nature of their int…

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  • By Nick Axford
  • Posted on Monday 02nd February, 2009

Take it from "the Michael" they want to deliver

Progress often demands shacking up with some unlikely bedfellows. At least thats the view of Jim Yong Kim, formerly of the World Health Organization, who extolled the virtues of involving Harvard strategy guru Michael Porter in helping him understand health care delivery systems.Such was Porters influence on the Harvard medical students he taught that a worried Dean of the Medical School called Ki…

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  • By Nick Axford
  • Posted on Monday 02nd February, 2009

Cash can be a catalyst for big change

As is often the case, financial imperatives focus the mind and act as a catalyst for change.Here, Jim Yong Kim from Harvard Medical School encouraged delegates to think about the cost of heath and public services and to ask themselves whether that money was being spent optimally.The implication was that it is not, and that a better understanding of how effective interventions can best be delivered…

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  • By Nick Axford
  • Posted on Monday 02nd February, 2009

Might Dubyas bacon be saved by the Three Ones?

Just a week after Barack Obama's inauguration, and at a conference only a short metro ride from the White House and Capitol Hill, it is hardly surprising that optimism about the new US Presidency fills the air. At least one presenter ended their talk with a slide showing Obama with a speech bubble declaring Yes, we can!, to the delight of delegates.Less expected was the claim by Jim Yong Kim, Prof…

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  • By Nick Axford
  • Posted on Monday 02nd February, 2009

Introducing a new science of the third D (for Delivery)

Grants by the Bill Gates Foundation have traditionally focused on so-called technologies in health care for example, new vaccines for HIV/AIDS. Recently, however, it has reorganized itself so that in addition to departments for Discovery (basic scientific research) and Development (developing and testing new technologies based on that research) there is a new one for Delivery, which studies how b…

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  • By Nick Axford
  • Posted on Wednesday 01st October, 2008

When a black diamond represents a lifeline

What's in a logo? The Cochrane Collaboration is well-known for its systematic reviews in healthcare. Perhaps less well-known is the story behind The Cochrane Collaboration logo. Lawrence Sherman, Director of the Jerry Lee Centre for Experimental Criminology at the University of Cambridge, explained how it shows a systematic review of data from seven RCTs comparing one health care treatment with a…

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  • By Nick Axford
  • Posted on Wednesday 01st October, 2008

Just too random – or perhaps not random enough

When is a randomized controlled trial not a randomized controlled trial? The question arises from a presentation by Martin Bland from the University of York on a method of allocation designed to ensure a good balance between treatment and control groups in terms of key variables. The technique was used in a study involving 13 schools in Northern Ireland that varied in terms of size, geography (urb…

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  • By Nick Axford
  • Posted on Wednesday 01st October, 2008

Putting trials to the Consort quality test

It’s recognized that randomized controlled trials tend to find smaller effects than other evaluation methods. Now there’s the intriguing suggestion that the reporting of methodological quality in RCTs has an impact on trial outcomes. This has been established in health but lately it’s been studied in criminal justice by Glyn Hallam and Amanda Perry from the University of York's Centre for Cr…

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  • By Nick Axford
  • Posted on Wednesday 01st October, 2008

We say we're systematic – but what's the system?

Simple enough: policy makers want to know what works and systematic reviews are supposed to tell them. The reality is more complicated, however, as Mark Newman from the EPPI-Centre at the Institute for Education, London, demonstrated.One of the problems is that there is no agreed formula for deciding how many studies, of what quality, are needed to claim that a particular type of intervention is e…

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  • By Nick Axford
  • Posted on Wednesday 01st October, 2008

We're just learning to walk; better not to stand alone

A radical note to end the conference: forget your standalone RCT, just publish the updated meta-analysis. Or, less provocatively, place the meta-analysis center-stage in the study publication and include the RCT results later or publish them on the internet.Alex Sutton, a medical statistician from the University of Leicester, argued that greater attention should be paid to previous research, notab…

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  • By Nick Axford
  • Posted on Wednesday 01st October, 2008

Yorks conference ends with hopes of win-win

“Children crushed by school test stress.” Such headlines are horribly familiar. It turns out, however, that the volume of test data now routinely collected on pupils in UK schools could have an unexpected benefit: it is now easy to conduct natural experiments on school-based interventions because the data is there just waiting to be exploited.Without defending the current testing system per se…

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  • By Nick Axford
  • Posted on Wednesday 01st October, 2008

Only 0.2! – we should be dancing

How big an impact does a service need to have before it should be declared a success story? Peter Tymms reported on a study of a school-based peer tutoring program which identified an effect size of 0.2. He expressed disappointment with this: according to Cohen's accepted rule of thumb, it was small.However, Robert Slavin, from the University of York's Institute for Effective Education, argued tha…

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