New ways to engage with research

#SolentConf1711th July 2017

André TomlinThe Mental Elf@Mental_Elf

I want your feedback NOW!

Keep up to date, connect with experts & manage your CPD

EvidenceBased

PracticeWhy aren’t we doing it?

“The scandal of poor medical research: We need less research, better research, and research done for the right reasons.”

Doug AltmanBMJ, 1994

Are we practicing EBM?Somewhat

– Still can’t get evidence when we need it

– Steadily increasing volume of it

– Increasing workload and burden of service reorganisation

– Less time to do it– Increasing variation in

practice, use of unproven treatments

Can we fix the evidence?Evidence is (still) written for

researchers, not practitioners or patients

• About half of it doesn’t get published

• About half of what’s left is biased

• A goodly amount of it remains locked away behind paywallsand on disparate platforms

• There remains a critical appraisal skills gap

“The application of what we know already will have a bigger impact on health and disease than any drug or technology likely to be introduced in the next decade.”

@MuirGray

The opportunityBlogs and social media can reach parts other media cannot reach• Sharing critical appraisal skills• Putting evidence in context• Search-friendly• Open access• Pushed content• New learning opportunities• Constructive engagement

between researchers, professionals and health service users

We have the technology

As health professionals, it’s the time, skill, confidence

and motivation we lack

We need new ways to engage with research evidence

Why use social media?Keeping up to date

Following publications, organisations and individuals. Side-stepping traditional media.

Networking

Forming relationships & engaging in a conversation with these people.

Promoting evidence

Putting reliable evidence into the ring with the ‘click bait’ and ‘infotainment’.

Be sociable AND safe

• Remember your professional guidance• Social media is not all the same• Be yourself to build relationships,

networks & skills• Don’t tweet back in anger!

Avoid filter bubbles &echo chambers

Read research critically• Acknowledge uncertainty• If you don’t know, say so! @CASPUK• Healthy skeptics not anti-science• Our elf blogs highlight the strengths and

limitations of research• BUT also provide the constructive ‘so what?’

commentary: how should this new evidence change our practice?

Mindfulness: digital case study

• PREVENT RCT• Published in The Lancet, 21/04/15• Significant findings• Impact on clinical practice?

Who needs to know?• People with recurrent depression & their carers• Health & social care professionals

– GPs– Mental health professionals– Mindfulness practitioners

• Commissioners• Policy makers• Researchers• App developers

What the paper concludes

“We found no evidence that MBCT-TS is superior to maintenance antidepressant treatment for the prevention of depressive relapse in individuals at risk for depressive relapse or recurrence.”

Important!• Well conducted and well reported RCT• A non-inferiority trial, not an equivalence trial• No usual care or attention control group• Quite specific population, may limit

applicability– At high risk of depressive relapse or recurrence – Currently taking antidepressants – Predominantly white and female– Open to stopping their drug therapy and starting

a group psychosocial treatment

Media headlines

Conclusion of our blog

“This RCT does not establish equivalence between mindfulness-based cognitive therapy (MBCT) and antidepressants for recurrent depression, but it does show MBCT in a positive light for preventing depression.”

I fell into an avalanche, it covered up my soul

5 seconds• Blog title, Tweet

30 seconds• Teaser, Tweet with Infographic,

Abstract

3 minutes• Blog, Video

30-60 minutes• Full-text, Podcast, Webinar,

Tweet chat

The blog: evidence-based summary, implications for practice/policy/research

The social media stuff:Extensive dissemination and democratic conversation.

Plus #WeCATS critical appraisal training

The podcast: interview with lead researcher, detailed discussion of

mindfulness practice and mindfulness-based interventions.

The webinar: live streamed EBMH hangout supported by Twitter

BLOG• >12,000 unique visits• >3m30s per visit

PODCAST• >2,500 downloads

WEBINAR• >900 views

SOCIAL MEDIA• 15 initial tweets

– 130k impressions– 6k total

engagement• Tweet chat:

– 72 people– 500 tweets– 5m reach

Digital engagement opens doors!

BLOGSOCIAL MEDIA

PODCAST LIVE EVENTS

Digital dissemination of research

Mental Health Question Time

• Public discussions• Live streamed & tweeted #MHQT• Bringing together the public, patients, professionals and

researchers• UCL Psychiatry, Lancet Psychiatry & Mental Elf• Most recent event: Women’s Mental Health,

July 2017 elfi.sh/mhqt-4

#BeyondTheRoom

Democratic conversationBuzz, Reach, Impact, Legacy

Elf ethos• Low barrier to entry• Incentivise learning• Audit trail for CPD• Gamification

• Evidence-based• Coproduced• Expert critical appraisal• Implications for practice

Atkinson LZ et al Implementing tools to support evidence-based practice: a survey and brief intervention study of the National Elf Service across Oxford Health NHS Foundation Trust. EBMH 2017;20:41-45.

It’s not enough just to give people evidence

Engaging with research means:Context, Discussion, Action

Elfy acknowledgements