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Evidence-informed Decision Making in the Era of COVID-19

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In partnership with the Community Health Nurses’ Initiatives Group (CHNIG), this webinar will provide an overview of Evidence-Informed Decision Making (EIDM) processes and apply those processes to the rapidly expanding COVID-19 literature. Learn how to think critically about headlines and find high-quality evidence you can trust.

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Evidence-informed Decision Making in the Era of COVID-19

  1. 1. November 25, 2020Emily Clark, MSc Emily Belita, RN, PhD Evidence-informed Decision Making in the Era of COVID-19
  2. 2. Presenter Emily Clark, MSc National Collaborating Centre for Methods and Tools
  3. 3. Housekeeping • We are testing a new webinar platform • Connection issues • We recommend using a wired Internet Connection • If you are experiencing technical issues please send a private message to admin • Use chat to post questions and/or comments throughout the webinar • Post your questions in the public chat box • Send questions about technical difficulties in a private chat to admin • Polling
  4. 4. After Today After the webinar, access the recording (in English) at www.youtube.com/nccmt and slides in English and French at www.slideshare.net/NCCMT/presentations.
  5. 5. 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
  6. 6. Poll Question 2 Have you visited the National Collaborating Centre for Methods and Tools’ website or used its resources before? A) Yes B) No
  7. 7. Poll Question 3 If you stated YES on the previous question, how many times have you used the NCCMT’s resources? A) Once B) 2-3 times C) 4-10 times D) 10+ times
  8. 8. Today’s Presentation Welcome, CHNIG members! • What are the NCCMT and the NCCPH? • What is evidence-informed public health (EIPH) • How has our approach to EIPH changed during the COVID-19 pandemic? • Overview of EIPH with COVID-19 lessons learned
  9. 9. National Collaborating Centre for Methods and Tools • Our vision: Stronger public health, driven by the best-available evidence, to improve the health and well-being of every person living in Canada. • We encourage and scale evidence-informed decision-making in health care organizations in Canada. We achieve this by providing high-quality resources, real-world training and practical mentorship that evolves with, and responds to, the ever-changing needs of public health.
  10. 10. What is Evidence-Informed Public Health? The process of distilling and disseminating the best available evidence from research, context and experience, and using that evidence to inform and improve public health practice, programs and policy. 11
  11. 11. What is Evidence-Informed Public Health? • The process of distilling and disseminating the best available evidence from research, context and experience • Using that evidence to inform and improve public health practice, programs and policy.
  12. 12. Decision making models 13 Opinion-based Ask question Make Decision Find Evidence Ask question Find Evidence Make Decision Evidence-based
  13. 13. Why Evidence-Informed Decision Making?
  14. 14. Why Evidence-Informed Decision Making? 15 • Reduce harms • Improve outcomes • Improve satisfaction • Maximize resources
  15. 15. What is Evidence? 16
  16. 16. 7-Steps of Evidence-informed Decision Making 17
  17. 17. Evidence during the COVID-19 pandemic • Explosion of research articles • New COVID-19-specific databases • Most up-to-date evidence often pre-print articles • How can you find and use evidence that you can trust?
  18. 18. NCCMT’s COVID-19 response • Pivoted from capacity building and training to evidence production • Urgent need for high-quality, synthesized evidence • Rapid Review Repository • Database of ongoing and completed rapid reviews from across Canada • Rapid Evidence Service • Rapid reviews completed by NCCMT • What have we learned about applying EIPH in a COVID-19 world?
  19. 19. Defining a focused research question • Research questions should be: • Focused • Actionable 20
  20. 20. 21 Health Evidence™ Developing an Efficient Search Strategy Using PICO http://www.healthevidence.or g/practice-tools.aspx#PT2
  21. 21. Defining a focused research question • COVID-19 considerations • When? Early pandemic, 2nd wave • Where? Applicable to context 22
  22. 22. Efficient searching • Where should you start your search? • How can you optimize your search? 23
  23. 23. Systematic Reviews • High level of synthesized evidence on a given topic • Systematic, transparent methods • Meta-analysis: combines results of multiple studies 24 Study 1: 139 participants No effect Study 2: 389 participants No effect Study 3: 521 participants No effect Systematic review and meta- analysis: 1049 participants Effect + + 
  24. 24. 25 Example: Search for “built environment” and “mental health” Summaries TRIP 3 Syntheses Health Evidence™ 34 Studies PubMed 194 Google Scholar 60 600 Google 4 330 000 (DiCenso et al., 2009; Haynes et al. 2005; Robeson et al., 2010) 6S Pyramid
  25. 25. Health Evidence™ Repository • Almost 6000 quality-rated systematic reviews evaluating the effectiveness of public health interventions 26
  26. 26. 27 Enter Search terms Use filters and/or
  27. 27. 28 • Sign up for free • Stay up-to- date with reviews relevant to topics you care about Health Evidence™ Evidence Service
  28. 28. COVID-19 Databases • Synthesized Evidence • LitCovid (Pubmed) • WHO* • L*OVE (Epistemonikos) • UNCOVER (Oxford)* • NCCMT* • McMaster Health Forum* • Single studies • LitCovid • WHO* • MMWR (CDC)* • MedRxiv pre-print server* Warning: Not all peer-reviewed
  29. 29. Can you be confident in the findings? Guidelines: AGREE II • http://www.agreetrust.org/resource-centre/agree-ii/ Systematic Reviews: Health Evidence™ Quality Appraisal Tool Critical Appraisal Skills Programme: Checklists • http://www.casp-uk.net/ • CASP offers free, downloadable checklists for: 30 • Randomised Controlled Trials • Systematic Reviews • Cohort Studies • Case-Control Studies • Qualitative Studies • Economic Evaluations • Diagnostic Studies • Clinical Prediction Rules Appraising for quality
  30. 30. Online Learning Modules • Interactive, problem-based • Free to access 31
  31. 31. Bringing it all together • Synthesis step critical for communicating evidence • Creating briefing notes to inform decision- makers Health Evidence™ Briefing Note: Decisions, Rationale Rationale and Key FindingsSummary http://www.healthevidence.org/practice- tools.aspx#PT6 • Rapid review guidebook: https://www.nccmt.ca/tools/rapid-review-guidebook
  32. 32. Understanding Research Evidence Video Series
  33. 33. Weighing findings by quality of evidence • Include quality in summary of findings • Present limitations of evidence and knowledge gaps • NCCMT uses Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate overall certainty of the findings • How likely are the findings to change with more evidence?
  34. 34. • Effective communication from public health leaders critical for COVID-19 response • How can we best communicate with public? 35 Rapid Review: Risk Communication
  35. 35. Key Points • Messaging should be clear, repeated, action-oriented and by a trusted leader. Certainty of evidence is moderate (GRADE). • Trust can be built by addressing uncertainty, acknowledging change and previous errors. Certain of evidence is low (GRADE) and may change as more data becomes available. • Communication should be tailored to audience in message and medium. Certainty of evidence is moderate (GRADE). • Positively framed messages emphasizing collective may be more effective. Certain of evidence is low (GRADE) and may change as more data becomes available. 36
  36. 36. Overview of Evidence • Majority of evidence from non-COVID-19 literature (e.g., previous epidemics, vaccinations, smoking), and may be less relevant in social media-driven world • Studies of COVID-19-specific messaging so far limited to analyzing spread of info via social media. • Characteristics of a trusted leader is not defined. 37
  37. 37. Registry of Methods and Tools • Searchable database of KT resources • Summaries and links 200+ resources • Categorized by: • Method/tool • KT and related activity • EIPH step 38
  38. 38. 39
  39. 39. Explore NCCMT’s Rapid Reviews • Check out nccmt.ca/covid-19/covid-19-rapid- evidence-service • 26 reviews and growing • Living review: Role of children in COVID-19 transmission • Sign up for email alerts for new or updated reviews 40
  40. 40. Getting Started: Assess your learning needs • SkillsAssessmentTool • 20 multiple choice questions • Personalized report
  41. 41. Getting Started • Connect via our newsletter, Twitter or Facebook • Check out a Rapid Review • Try the Skills Assessment • Try an Online Learning Module • Look up a relevant topic on Health Evidence™ 42
  42. 42. Questions?
  43. 43. Share your story! • Are you using EIDM in your practice? We want to hear about it! • Email us: nccmt@mcmaster.ca • Need support for EIDM? Contact us for help! • Email us: nccmt@mcmaster.ca • We typically respond within 24 business hours 44
  44. 44. Webinar Feedback Your responses will be kept anonymous. Please indicate your level of agreement with the following 1. Participating in the webinar increased my knowledge and understanding of evidence-informed decision making. Strongly agree Agree Undecided Disagree Strongly Disagree
  45. 45. Webinar Feedback Your responses will be kept anonymous. Please indicate your level of agreement with the following: 2. I will use the information from today’s webinar in my own practice. Strongly agree Agree Undecided Disagree Strongly Disagree
  46. 46. Webinar Feedback Your responses will be kept anonymous. 3. Which of the following statements apply to your experience with the webinar today (check all that apply): □ The webinar was relevant to me and my public health practice □ The webinar was effectively facilitated □ The webinar had opportunities to participate □ The webinar was easy to follow along □ The webinar met my expectations
  47. 47. Webinar Feedback Your responses will be kept anonymous. 4. Can we contact you in the future to discuss how the NCCMT can improve its webinar series? □ Yes □ No
  48. 48. Webinars from the NCCMT Learn more about our webinars: http://www.nccmt.ca/capacity-development/webinars 49
  49. 49. For more information: NCCMT website: www.nccmt.ca Contact: nccmt@mcmaster.ca
  • HannahTagore

    Dec. 22, 2020

In partnership with the Community Health Nurses’ Initiatives Group (CHNIG), this webinar will provide an overview of Evidence-Informed Decision Making (EIDM) processes and apply those processes to the rapidly expanding COVID-19 literature. Learn how to think critically about headlines and find high-quality evidence you can trust.

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