Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Weight loss interventions for adults who are obese on mortality and morbidity: What’s the evidence?

394 views

Published on

Health Evidence™ hosted a 60 minute webinar examining the effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease and cancer. Follow this link to access to the audio recording for this webinar: https://youtu.be/olF1bvaofXE

Dr. Alison Avenell, Clinical Chair in Health Services Research, and Sam (Chenhan) Ma, from the Health Services Research Unit at the University of Aberdeen presented an overview of findings from their latest systematic review and meta-analysis:


Ma C, Avenell A, Bolland M, Hudson J, Stewart F, Robertson C, et al. (2017). Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease, and cancer: Systematic review and meta-analysis. BMJ, 359, j4849.


Adults with obesity have an increased risk of premature mortality, cardiovascular disease, some cancers, type 2 diabetes, and many other diseases. This review assesses whether weight loss intervention for adults with obesity affect all cause, cardiovascular, and cancer mortality, cardiovascular disease, cancer, and body weight. Fifty-four randomized controlled trials (RCTs) with 30,206 participants were identified in the review. High quality evidence showed that weight loss interventions decrease all cause mortality, with six fewer deaths per 1000 participants. Moderate quality evidence showed an effect on cardiovascular mortality, and very low quality evidence showed an effect on cancer mortality. Weight reducing diets, usually low in fat and saturated fat, with or without exercise advice or programmes, may reduce premature all cause mortality in adults with obesity.

Published in: Education
  • Here's How YOU Can Stake Out Your Personal Claim In Our EIGHT MILLION DOLLAR GOLDMINE... ♣♣♣ https://tinyurl.com/vd3y33w
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Eat THIS �prickly flower to crush food cravings ●●● http://t.cn/AirVsfPx
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • 21748 Women, 374,701lbs lost - This Changes EVERYTHING! ➤➤ http://ishbv.com/poundinc/pdf
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • My doc said he couldn't give me all the details�� ????? "Just keep an eye out for this 'Flavor-Pairing' transformation system�� ??" Since he said that, I started seeing it everywhere ???? - I thought, maybe it's time for me to try it. BUT since this doesn't work for everybody, you can't just start immediately. In fact, you need to take a short but strangely insightful quiz before you can get started. Well, aren't I glad I followed my gut instinct and gave it a shot! Speaking of guts�� I can't believe the changes I'm seeing and neither can my husband! I'd never even heard of carb-pairing or wine-timing, but I'm so glad I did it! I guess a little faith can go a long way. Click below to see if you're "ICE Type 1" like me. ◆◆◆ http://ishbv.com/poundinc/pdf
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • top 10 ways to reduce tummy without exercise ★★★ http://t.cn/AiugoW6M
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Weight loss interventions for adults who are obese on mortality and morbidity: What’s the evidence?

  1. 1. Welcome! Effect of weight loss interventions for adults who are obese on mortality and morbidity: What’s the evidence? You will be placed on hold until the webinar begins. The webinar will begin shortly, please remain on the line.
  2. 2. Poll Questions: Consent • Participation in the webinar poll questions is voluntary • Names are not recorded and persons will not be identified in any way • Participation in the anonymous polling questions is accepted as an indication of your consent to participate Benefits: • Results inform improvement of the current and future webinars • Enable engagement; stimulate discussion. This session is intended for professional development. Some data may be used for program evaluation and research purposes (e.g., exploring opinion change) • Results may also be used to inform the production of systematic reviews and overviews Risks: None beyond day-to-day living
  3. 3. After Today • The PowerPoint presentation and audio recording will be made available • These resources are available at: – PowerPoint: http://www.slideshare.net/HealthEvidence – Audio Recording: https://www.youtube.com/user/healthevidence /videos 3
  4. 4. What’s the evidence? Ma C, Avenell A, Bolland M, Hudson J, Stewart F, Robertson C, et al. (2017). Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease, and cancer: Systematic review and meta-analysis. BMJ, 359, j4849. https://healthevidence.org/view- article.aspx?a=effects-weight-loss- interventions-adults-obese-mortality- cardiovascular-disease-32978
  5. 5. • Use CHAT to post comments / questions during the webinar – ‘Send’ questions to All (not privately to ‘Host’) • Connection issues – Recommend using a wired Internet connection (vs. wireless) • WebEx 24/7 help line – 1-866-229-3239 Participant Side Panel in WebEx Housekeeping
  6. 6. Housekeeping (cont’d) • Audio – Listen through your speakers – Go to ‘Communicate > Audio Broadcast’ • WebEx 24/7 help line – 1-866-229-3239
  7. 7. Poll Question #1 How many people are watching today’s session with you? A. Just me B. 2-3 C. 4-5 D. 6-10 E. >10
  8. 8. Students: Sarah Neil-Sztramko (Postdoctoral fellow) Emily Belita (PhD candidate) Patricia Burnett (PhD candidate) Grace Thomas Research Assistant Rawan Farran Research Assistant Kristin Read Research Coordinator Heather Husson Administrative Director The Health Evidence™ Team Maureen Dobbins Scientific Director Olivia Marquez Research Coordinator Maureen Dobbins Scientific Director Claire Howarth Research Coordinator Kate Turner Research Assistant Emily Sully Research Assistant
  9. 9. What is www.healthevidence.org? Evidence Decision Making inform
  10. 10. Why use www.healthevidence.org? 1. Saves you time 2. Relevant & current evidence 3. Transparent process 4. Supports for EIDM available 5. Easy to use
  11. 11. A Model for Evidence- Informed Decision Making National Collaborating Centre for Methods and Tools. (revised 2012). A Model for Evidence-Informed Decision-Making in Public Health (Fact Sheet). [http://www.nccmt.ca/pubs/FactSheet_EIDM_EN_WEB.pdf]
  12. 12. Stages in the process of Evidence-Informed Public Health National Collaborating Centre for Methods and Tools. Evidence-Informed Public Health. [http://www.nccmt.ca/eiph/index-eng.html]
  13. 13. Poll Question #2 Have you heard of PICO(S) before? A. Yes B. No
  14. 14. Searchable Questions Think “PICOS” 1.Population (situation) 2.Intervention (exposure) 3.Comparison (other group) 4.Outcomes 5.Setting
  15. 15. How often do you use systematic reviews to inform a program/services? A. Always B. Often C. Sometimes D. Never E. I don’t know what a systematic review is is Poll Question #3
  16. 16. Dr. Alison Avenell MD, MSc, BSc, Clinical Chair in Health Services Research, Health Services Research Unit, University of Aberdeen Sam Ma Foundation Year 2 Doctor, University of Aberdeen
  17. 17. Effects of Weight Loss Interventions in Adults with Obesity on Mortality, Cardiovascular Disease and Cancer A Systematic Review and Meta- analysis of Long-term RCTs BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4849 Chenhan Ma, Alison Avenell, Jemma Hudson, Fiona Stewart, Clare Robertson, Pawana Sharma, Cynthia Fraser, and Graeme MacLennan, Health Services Research Unit, University of Aberdeen, UK Mark Bolland, Department of Medicine, University of Auckland, New Zealand
  18. 18. Disclosures None to declare. The Health Services Research Unit is funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorate.
  19. 19. Background Obesity = BMI≥30kg/m2 • At least 650 million adults with obesity worldwide (WHO, 2016) • in addition to 381 million children with overweight or obesity under 18 (WHO, 2016). • In Canada, 1 in 4 obese adults (increased from 13.8% to 26.4% between 1978 to 2014). • In UK, 26% adult men and 27% adult women are obese (Health Survey in England 2016), more are overweight. World Health Organisation [Internet]. Obesity and overweight. Available from: http://www.who.int/mediacentre/factsheets/fs311/en/ Health Survey in England, 2016. Available from: https://files.digital.nhs.uk/publication/m/6/hse2016-adult-obe.pdf
  20. 20. Worldwide projected rates of obesity OECD. Obesity Update 2017. Organisation for Economic Co-operation and Development. Available at: https://www.oecd.org/els/health-systems/Obesity-Update-2017.pdf
  21. 21. Scottish Data (Scottish Government) Condition 2003 2030 Total cases Total cases attributable to obesity (%) Total cases Total cases attributable to obesity (%) Predicted increase due to obesity Hypertension 1,351,185 488,496 (36%) 1,730,561 867,872 (50%) 379,376 Angina Pectoris 249,909 40,151 (16%) 281,091 71,333 (25%) 31,182 Type 2 diabetes 139,881 87,216 (62%) 207,615 154,950 (75%) 67,734 Myocardial infarction 133,869 27,111 (20%) 154,924 48,166 (31%) 21,055 Stroke 92,252 6,174 (7%) 97,047 10,969 (11%) 4,795 Increased prevalence of diseases associated with predicted increases in obesity levels, 2030 assuming no effective obesity prevention (Source: Preventing Overweight and Obesity in Scotland, Gov.scot, http://www.gov.scot/Publications/2010/02/17140721/14 )
  22. 22. Obesity and Diseases
  23. 23. However… • Is deliberate weight loss able to reduce premature mortality, CVD and cancers? • For any BMI in 18.5-24.9 (normal),25-29.9 (overweight), 30-34.9 (obesity I), ≥35 (obesity II+) (Flegal 2013)? • For any age group? • … Obesity paradox Flegal 2013, JAMA. 2013;309(1):71-82.
  24. 24. Global BMI Mortality Collaboration The Global BMJ Mortality Collaboration. Body-mass index and-all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet 2016 July 13 http://dx.doi.org/10.1016/S0140- 6736(16)30175-1 Figure 2 Association of body-mass index with all-cause mortality, by baseline age group The HR per 5 kg/m2 higher body-mass index (BMI) and its 95% CI are calculated only for BMI more than 25·0 kg/m2. Analyses restricted to never-smokers without pre-existing chronic disease, and excluding the first 5 years of follow-up, and include data from all geographical regions. The reference category is shown with the arrow and is 22·5–<25·0 kg/m2. CIs are from floating variance estimates (reflecting independent variability within each category, including the reference category). Areas of squares are proportional to the information content. Analyses by baseline age and the three main geographical regions are in the appendix (p 38). HR=hazard ratio.
  25. 25. The Global BMJ Mortality Collaboration. Body-mass index and-all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet 2016 July 13 http://dx.doi.org/10.1016/S0140- 6736(16)30175-1 Figure 3 Association of body-mass index with all-cause mortality, by sex The HR per 5 kg/m2 higher body-mass index (BMI) and its 95% CI are calculated only for BMI more than 25·0 kg/m2. Analyses restricted to never-smokers without pre-existing chronic disease, excluding the first 5 years of follow-up, and include data from all geographical regions. The reference category is shown with the arrow and is 22·5–<25·0 kg/m2. CIs are from floating variance estimates (reflecting independent variability within each category, including reference). Areas of squares are proportional to the information content. Analyses by sex and the three main geographical regions (east Asia, Europe, and North America) are in the appendix (p 39). HR=hazard ratio.
  26. 26. The Global BMJ Mortality Collaboration. Body-mass index and-all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet 2016 July 13 http://dx.doi.org/10.1016/S0140- 6736(16)30175-1 Figure 4 Association of body-mass index with mortality, by major underlying cause The HR per 5 kg/m2 higher body-mass index (BMI) and its 95% CI are calculated only for BMI more than 25·0 kg/m2. Analyses restricted to never-smokers without pre-existing chronic disease, excluding the first 5 years of follow-up, and include data from all geographical regions. The reference category is shown with the arrow and is 22·5–<25·0 kg/m2. CIs are from floating variance estimates (reflecting independent variability within each category, including reference). Areas of squares are proportional to the information content. Analyses of cause-specific mortality by three geographical regions (east Asia, Europe, and North America) are in the appendix (pp 41, 42).
  27. 27. Systematic Review of RCT Evidence Kritchevsky 2015 review of 15 RCTs (overweight and obese)- • Weight loss vs non-weight loss: RR 0.85 (0.73, 1.00) • Few studies, not investigated CVD, cancer Kritchevsky SB, et al. (2015) Intentional Weight Loss and All- Cause Mortality: A Meta- Analysis of Randomized Clinical Trials. PLoS ONE 10(3): e0121993.
  28. 28. Methods Question: Do dietary (+/-exercise) weight loss interventions compared to no intervention or control affect the risk of mortality, cardiovascular or cancer outcomes in obese adults? Primary Outcomes: • All-cause mortality • Cardiovascular Mortality • Cancer Mortality Secondary Outcomes: • Participants with any Cardiovascular Events • Participants with Cancer Events • Weight Change
  29. 29. Subgroup Analysis Pre-specified Subgroup analyses – these were performed for • Effects of Age (<60,≥60), • Gender (M, F, Both), • BMI (<35, ≥35), • Type 2 DM (No/Other, IGT/IFG, Yes), • Physical Activity (No, Yes-advice only, Yes-facility provided), • Ethnicity (Mixed, Caucasian, Black, Asian (post-hoc))
  30. 30. Sensitivity Analysis • Sensitivity analysis – these were performed for • Effects of Risk of Bias for Allocation Concealment (indication of study quality/intervention effect) (Low risk, Unclear/High Risk), • % participant follow-up (<80%, ≥80%) • CVD Outcomes using JACC definitions (Fatal, Non-fatal, Fatal and Non-fatal) JACC = Journal of American College of Cardiologists Hicks KA, et al. 2014 ACC/AHA Key data elements and definitions for cardiovascular endpoint events in clinical trials. J Am Coll Cardiol 2015; 66(4): 403-469. Available from: http://ac.els-cdn.com/S0735109714074841/1-s2.0- S0735109714074841-main.pdf?_tid=27df2800-8c76-11e5-b1b6- 00000aab0f27&acdnat=1447687660_73fa495cdf0a1e0f4443e826101b30d7
  31. 31. Flowchart of Review Process 1174 RCTs reports identified in Obesity Database 1174 RCT reports screened fulltext 5595 Abstracts identified in Online Database Medline/Embase Screen 5595 Abstracts screened 4 Abstract papers + 89 RCTs with review outcomes - Reviewed in- depth Excluded Abstracts: 5591 due to non- RCT, <12mo duration, BMI<30 or duplicated. Excluded RCT reports: 1088 due to <12mo duration, non-dietary interventions, no review outcomes or duplicates. Excluded: BMI<30 (9) BMI<25 Asian (1) No suitable interventions (17) Unsuitable RCT design (4) Unclear/unsuitable outcomes (9) No outcomes (3) Duplicates (1) 48 studies included in qualitative and quantitative syntheses Obesity Database Inclusion Criteria: • Randomised Controlled Trials ≥1yr duration • Adults ≥ 18yrs old • Obesity (BMI≥30kg/m2, Asian BMI≥25kg/m2) • Dietary Intervention • +/- Exercise, Behavioural Exclusion Criteria: • Pregnancy, Lactation
  32. 32. Results Characteristics of Included Studies: Participants: 30 206 obese adults participants in 54 RCTs • Co-morbidities included: DM type 2, hypertension, osteoarthritis, post-cancer treatment, psychiatric illness • Length of Follow-up: 1yr-12.7yrs • Location: USA, Europe, Australia, Asia
  33. 33. Weight loss on All-cause Mortality (34 RCTs) Figure 1. All-cause Mortality (Weight Loss Intervention vs Control) Overall: Weight Loss Intervention vs Control All-cause mortality RR (95% CI) – 0.82 (0.71, 0.95) 18% relative risk reduction, 6 fewer deaths per 1000 population Weight Loss Weight Loss
  34. 34. Weight loss on Cardiovascular Mortality (8 RCTs) Figure 2. Cardiovascular Mortality CVD Mortality (Weight Loss vs Control): RR (95% CI) 0.93 (0.67, 1.31)
  35. 35. Weight loss on Cancer Mortality (8 RCTs) Figure 3. Cancer Mortality Cancer Mortality (Weight Loss vs Control) RR (95% CI) 0.58 (0.30, 1.11) Weight Loss
  36. 36. Weight loss on Participants with Cardiovascular Events (24 RCTs) Figure 4. Any cardiovascular event Any CVD Event (Weight Loss vs Control) RR (95% CI) 0.93 (0.83, 1.04)Weight Loss Weight Loss
  37. 37. Weight Loss on Participants with Cardiovascular Events (JACC/AHA) (17 RCTs) Figure 4.1 Cardiovascular events (JACC/AHA defined) Cardiovascular Events (JACC/AHA defined) (Weight loss vs Control) RR (0.95% CI) 0.95 (0.84, 1.08)
  38. 38. Weight loss on Participants with Cancer Events (19 RCTs) Figure 5. Cancer Events Cancer Event (Weight Loss vs Control) RR (95% CI) 0.92 (0.63, 1.36) Weight Loss
  39. 39. Weight loss Intervention on Weight changes at 1 year (44 RCTs) Figure 6. Weight Change in kg – at 1 year Weight change in kg (at 1 year) (Weight Loss vs Control) Mean Difference (95% CI) -3.42 (-4.09, -2.75) Weight Loss
  40. 40. Weight Loss Intervention on Weight change at 2yr (20 RCTs) Weight Change in kg (2yr) (Weight Loss vs Control) Mean Difference (95% CI) -2.51 (-3.42, -1.60) Figure 7. Weight change at 2yr FU Weight Loss Weight Loss
  41. 41. Weight Loss Intervention on Weight Change at 3 or more yrs (8 RCTs) Weight change in kg (3 or more yrs) (Weight Loss vs Control) MD (95% CI) -2.56 (-3.50, -1.62) Figure 8. Weight change at 3 or more yrs FU Weight Loss
  42. 42. Asian Studies Summary Outcome Outcome or Subgroup No. of RCTs Intervention (Events / N Randomised) Control (Events / N Randomised) Statistical Method Effect Estimate Hetero geneity I2 Test for Significance of Overall Effect: Z value, (p-value) 1.58 All-cause Mortality 38 326 / 12197 385 / 11392 RR (95% CI) 0.84 [0.73, 0.97] I² = 0% Z = 2.44 (P = 0.01) 1.59 Cancer Mortality 9 16 / 1700 21 / 1415 RR (95% CI) 0.65 [0.34, 1.23] I² = 0% Z = 1.32 (P = 0.19) 1.60 Cardiovascular Mortality 10 68 / 5053 70 / 5064 RR (95% CI) 0.95 [0.68, 1.32] I² = 0% Z = 0.31 (P = 0.75) 1.61 Cancer Event 20 56 / 3669 50 / 3157 RR (95% CI) 0.96 [0.65, 1.40] I² = 0% Z = 0.23 (P = 0.82) 1.62 Any Cardiovascular Event 26 522 / 8334 560 / 7869 RR (95% CI) 0.94 [0.84, 1.06] I² = 0% Z = 1.00 (P = 0.32) 1.63 Weight Change in kg 52 0 / 13328 0 / 11895 Mean Difference (95% CI) -2.72 [-3.19, - 2.25] I² = 86% Z = 11.36 (P < 0.00001) Figure: Outcomes with Asian RCTs having Obesity defined as BMI≥25
  43. 43. Subgroup and Sensitivity Analyses • Non-diabetics/non-IGT had lower risks of CVD events compared to diabetics when following weight loss interventions (p=0.04) • Reduction in CVD event incidence in Caucasians when following weight loss interventions vs other ethnic groups (p=0.02) and including Asian RCTs (p=0.01) • *IGT = impaired glucose tolerance
  44. 44. Further results • Additional Bayesian meta-analyses (due to rare events) consistent with above results • Consistent effects for age, BMI over and under 35, with and without physical activity
  45. 45. Discussion • Weight reducing dietary interventions reduces risk ratio for premature all-cause mortality by 18%, 6 fewer deaths per 1000 participants • Appears consistent irrespective of age and BMIs above 30 • Predominantly low fat/saturated fat weight reducing diets • Evidence for reduction in CVD events in Caucasians/non- diabetics on weight reducing diets, but likely related to many tests for subgroup differences
  46. 46. Discussion Limitations of study 1) Few data for other outcomes - Fewer trials with data, reporting of adverse events in RCTs (CONSORT statement) 2) Lack of power in subgroup/sensitivity analysis - Role of individual participant data meta-analysis - Specific studies on other types of diets/patient groups CONSORT Extension for Harms, Ann Intern Med. 2004;141:781-788 .
  47. 47. Acknowledgements • We’d like to thank the 16 RCT authors whom provided additional data/clarifications to assist with this study. • All the HSRU staff for their support and time.
  48. 48. Protocol Prospero registration: CRD42016033217 http://www.crd.york.ac.uk/PROSPERO/display_record.as p?ID=CRD42016033217
  49. 49. References • World Health Organisation [Internet]. International; 2015. Obesity and overweight; [cited 2015 Aug 23]; [about 3 screen]. Available from: http://www.who.int/mediacentre/factsheets/fs311/en/ • Bancej C, Jayabalasingham B, Wall RW et al. Trends and projections of obesity among Canadians. Health Promot Chronic Dis Prev Can. 2015 Sep; 35(7): 109–112. • National Institute for Health and Care Excellence. Obesity. Identification, assessment and management of overweight and obesity in children, young people and adults [Internet]. UK: National Institute for Health and Care Excellence; 2014 [cited 2015 Aug 23]. Available from: http://www.nice.org.uk/guidance/cg189/evidence/obesity-update-full-guideline-193342429 • Lavie CJ, McAuley PA, Church TS, Milani RV, Blair SN. Obesity and cardiovascular diseases. Implications regarding fitness, fatness, and severity in the obesity paradox. J Am Coll Cardiol [Internet]. 2014 [cited 2015 Aug 17]. 63(14): 1345-1354. Available from: http://dx.doi.org/10.1016/j.jacc.2014.01.022 • Kritchevsky SB, Beavers KM, Miller ME, Shea MK, Houston DK, Kitzman DW et al. Intentional weight loss and all-cause mortality: a meta-analysis of randomised clinical trials. PLoS ONE [Internet]. 2015 [cited 2015 Aug 17]; 10(3): e0121993.doi:10.1371/journal.pone.0121993 Available from: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0121993 • Wing RR, Bolin P, Brancati FL, Bray GA, Clark JM, Coday M et al. Cardiovascular effects of intensive lifestyle intervention in Type 2 diabetes. N Engl J Med [Internet]. 2013 [cited 2015 Sep 5];369:145-54. Available from: http://www.nejm.org/doi/pdf/10.1056/NEJMoa1212914. • Hicks KA, Tcheng JE, Bozkurt B, Chaitman BR, Cutlip DE, Farb A et al. ACC AHA Clinical data standards. 2014 ACC/AHA Key data elements and definitions for cardiovascular endpoint events in clinical trials. J Am Coll Cardiol 2015 [cited 2015 Oct 11]; 66(4): 403-469. Available from: http://ac.els- cdn.com/S0735109714074841/1-s2.0-S0735109714074841-main.pdf?_tid=27df2800-8c76-11e5-b1b6- 00000aab0f27&acdnat=1447687660_73fa495cdf0a1e0f4443e826101b30d7 • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration • Avenell A, Broom J, Brown TJ, Poobalan A, Aucott L, Stearns SC et al. Systematic review of the long-term effects and economic consequences of treatments for obesity and implications for health improvement. Health Technol Assess 2004; 8(21): 1-458. • Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analysis. BMJ 2003;327:557–60.
  50. 50. Poll Question #4 The information presented today was helpful A. Strongly agree B. Agree C. Neutral D. Disagree E. Strongly disagree
  51. 51. What can I do now? Visit the website; a repository of over 5,000+ quality-rated systematic reviews related to the effectiveness of public health interventions. Health Evidence™ is FREE to use. Register to receive monthly tailored registry updates AND monthly newsletter to keep you up to date on upcoming events and public health news. Tell your colleagues about Health Evidence™: helping you use best evidence to inform public health practice, program planning, and policy decisions! Follow us @HealthEvidence on Twitter and receive daily public health review- related Tweets, receive information about our monthly webinars, as well as announcements and events relevant to public health. Encourage your organization to use Health Evidence™ to search for and apply quality-rated review level evidence to inform program planning and policy decisions. Contact us to suggest topics or provide feedback. info@healthevidence.org
  52. 52. Poll Question #5 What are your next steps? [Check all that apply] A. Access the full text systematic review B. Access the quality assessment for the review on www.healthevidence.org C. Consider using the evidence D. Tell a colleague about the evidence
  53. 53. Your Feedback is Important Please take a few minutes to share your thoughts on today’s webinar. Your comments and suggestions help to improve the resources we offer and plan future webinars. The short survey is available at: https://surveys.mcmaster.ca/limesurvey/index.p hp/727876?lang=en
  54. 54. Thank you! Contact us: info@healthevidence.org For a copy of the presentation please visit: http://www.healthevidence.org/webinars.aspx

×