Short Symposia*

Monday 1 October 2012, 11:00-12:30

Simultaneous Sessions:

1. The relevance of Cochrane for people with impairments and how to engage with them

This symposium will challenge the Cochrane Collaboration to be more inclusive of the disability sector by highlighting areas of relevance to people with impairments. We have invited people with three different perspectives to speak on this issue. They will focus on ways that evidence could make a significant difference for people with impairments, with a view to improving engagement between this sector and the Cochrane Collaboration. Recommendations about future ongoing engagement will be made, using the United Nations Convention on the Rights of Persons with disabilities as a framework. There will be time for discussion with the panel at the end.

Chairs: Judi Strid and Catherine McIlwain

Martin Sullivan: "Different ways of thinking about disability"

Dr Martin Sullivan is a Senior Lecturer in Rehabilitation for the School of Health & Social Services at Massey University in Palmerston North.

Rachel Noble: "Challenging Cochrane contributors to include the international convention in their work"

Rachel Noble is the CEO of the Disabled Peoples Assembly, an independent voice for all people with disabilities in New Zealand.

Minnie Baragwanath: "Cochrane and the Be Accessible Lens"

Minnie Baragwanath is CEO of the Be. Institute, an independent social enterprise backed by the Auckland Council, Auckland District Health Board and the Auckland University of Technology.

Questions and discussion with panel

2. Preventing Overdiagnosis: Challenges and opportunities for the Cochrane Collaboration

This symposium brings together speakers with an interest in the problem of overdiagnosis. The aim is to discuss how the Cochrane Collaboration might improve processes of disease-definition, and help prevent overdiagnosis. An engaging discussion with the panel and all attendees will follow.

Chairs: Andrew Grey and Lisa Bero

Ray Moynihan: "Overdiagnosis and disease-definitions: challenges and opportunities for the Cochrane Collaboration"

Ray Moynihan is an author and Senior Research Fellow at Bond University, Australia, undertaking a PhD on Overdiagnosis. 

Jenny Doust: "Overdiagnosis: challenges and opportunities for guideline committees and funding bodies in using Cochrane reviews"

Professor Jenny Doust is based at the Center for Research in Evidence-Based Practice at Bond University in Australia.

Anna Noel-Storr: “Scoping the evidence-base: risk of overdiagnosis in dementia”

Anna Noel-Storr is the Trials Search Coordinator, Cochrane Dementia and Cognitive Improvement Group, Nuffield Dept. of Medicine, Oxford University.

Questions and discussion with panel

3. Bridging the divide: Cochrane and HTA's

This session is aiming to bridge the divide between what Cochrane does and what Health Technology Assessment does. We know there are differences. But can we work more closely together? We have a panel of mostly international experts in health technology and Cochrane to discuss the issue and to find some common ground.

Chair: Anne Lethaby and Erin Holmes

Jean Slutsky: “HTA in the USA”

Jean R. Slutsky is the Director of the Center for Outcomes and Evidence (COE), Agency for Healthcare Research and Quality (AHRQ) of the U.S. Department of Health and Human Services, United States.

Jeremy Grimshaw: “Next step in reducing the divide”

Jeremy Grimshaw is a Senior Scientist in Clinical Epidemiology, Ottawa Hospital Research Institute, Professor, Department of Medicine, University of Ottawa and Director, Canadian Cochrane Centre and Co-ordinating editor of the Cochrane Effective Practice and Organisation of Care (EPOC) group and current Co-Chair of the Steering Group of the Cochrane Collaboration.

Janet Hiller: “Is it a divide or is it duplication?”

Janet Hiller chairs the Stoma Product Advisory Panel for Australia which uses HTA to advise the minister about subsidised access to stoma products and is a member of the Protocol Advisory SubCommittee of MSAC. She was the founder-director of Adelaide Health Technology Assessment.

Finn Børlum Kristensen: “HTA in Europe”

Finn Børlum Kristensen, MD, PhD, is Chairman of the Executive Committee, European Network for HTA (EUnetHTA) and Director of the Coordinating Secretariat of EUnetHTA, Danish Health and Medicines Authority, Denmark.

Ray Kirk: “New Zealand HTA projects – Could Cochrane help?”

Associate Professor Ray Kirk is the Director, Health Sciences Centre; and Health Information Management Convenor; and Co-Director Health Services Assessment Collaboration (HSAC) at the University of Canterbury.

Questions and discussion with panel

Tuesday 2 October 2012, 11:00-12:30

Simultaneous Sessions:

4.  Evidence into action

This session will showcase some local examples in getting evidence into action in New Zealand. New Zealanders suffer from many chronic conditions common in developed countries and there are some novel strategies to get evidence into action.

Chairs: Jenny Doust and Andrew Jull

Vanessa Selak: “Killing heart disease: the polypill trial”

Vanessa Selak is a Public Health Physician in the National Institute of Health Innovation at the School of Population Health. She is one of the Investigators in New Zealand arm of the polypill trial. She has an interest in cardiovascular disease.

Bruce Arroll: "Gout no laughing matter! Gout publicity campaign"

Bruce Arroll is a Professor in the Department of General Practice and Primary Health Care at the University of Auckland. He is a graduate from the University of Auckland and spent a year at McMaster University in Hamilton Ontario 1981-2. Having attended the meeting that established the Australasian Cochrane Centre. He is part of the Cochrane Primary Care Field (Shared with Auckland, Nijmegen and Dublin) which developed the PEARLs (Practical  evidence about real life situations) which are minimalistic summaries of Cochrane reviews aimed at primary care clinicians.

Anna Fay: "Saving millions! School Nurses and standing orders"

Anna Poutu Fay is a descendant of Te Hapu o Tuwhakairiora and Te Iwi o Ngati Porou, Indigenous Māori of Aotearoa New Zealand on her mother's lineage and Irish, Scottish and English descent on her North American father's lineage. She was born in Washington DC and grew up in Auckland. In 2008, Anna completed a Bachelor of Health Sciences at The University of Auckland. She was then the first Māori student to undertake the Bachelor of Health Sciences (Honours) degree, graduating in 2011. Her Honours research was titled: Hauora Hākakatanga Tamawahine Māori: What Young Māori Women want in a school-based sexual health service.
Anna has published in the Journal of Primary Health Care and has worked as a health researcher on a diversity of projects within The University of Auckland’s School of Population Health. She is currently a PhD candidate in the Te Kupenga Hauora Māori department at The University of Auckland.

Student Nurses – Manisha Singh, Gemma Veale, Auckland University School of Nursing: “Summer nights! Preventing pregnancy & STDs in high schools”

Manisha Singh, Gemma Veale are final year nursing students at the School of Nursing University of Auckland. They conducted a review of the literature on sexuality issues in high school students in response to a spike in the rate of pregnancy at a local high school. They have developed an intervention based on their review.

Questions and discussion with panel

5. Can evidence reduce health inequalities?

This session will focus on the challenge of reducing health inequalities. New Zealand has been struggling with this issue for many years. The question is can using evidence reduce health inequalities. We have a panel of international and local experts to talk about different approaches.

Chairs: Sue Crengle and Dale Bramley

Jennifer O'Neill: “The Campbell and Cochrane Equity Group – what is it about? Will it help?”

Jennifer has a BSc in Health Sciences from Brock University and an MSc in Population and Public Health (Global Health) from Simon Fraser University. Jennifer worked with the Royal College of Physicians and Surgeons of Canada and the National Aboriginal Health Organization before joining the Equity Methods Group. Her research interests include knowledge translation, systematic review methods, and health equity.

Moira McLeod & Miriam Te Hira Scanlan: “How evidence has been used to reduce inequalities in mammography screening”

Moira McLeod was the Programme Manager for the BreastScreen Waitemata Northland (BSWN) BreastScreen Aotearoa programme from February 2006 to July 2012. BreastScreen Waitemata Northland is a partnership between Waitemata DHB and Northland DHB and was the first fully digital BreastScreen Aotearoa programme established in New Zealand. Moira is completing her final paper for her Post Grad Diploma in Public Health and left Waitemata DHB to manage the national Universal Newborn Hearing Screening and Early Intervention Programme and is based at the Ministry of Health Penrose.

Miriam Te Hira-Scanlan is of Te Rarawa and Ngati Kuri descent, a member of Ngakau Atawhai Roopu, Maori Womens Welfare League. She is the Community Whanau Support Coordinator for BreastScreen Waitemata Northland (BSWN) and as part of her role supports wahine to screening and assessments. Miriam works closely with the local Maori community and marae to promote breast screening. Miriam is a WBHB scholarship recipient completing her Graduate Diploma in Not For Profit Management. 

Tim Jelleyman: “Improving immunisation rates”

Dr Tim Jelleyman is a Community and General Paediatrician working in the Waitemata district.  His training included primary care, general paediatrics and community child health.  He has particular interests in population health and in how health care systems might better address disparities in health. His current work includes direct clinical work, health care integration and strategic planning.

Vanessa Selak: “Representative recruitment in RCTs”

Vanessa Selak is a Public Health Physician in the National Institute of Health Innovation at the School of Population Health. She is one of the Investigators in New Zealand arm of the polypill trial. She has an interest in cardiovascular disease.

Questions and discussion with panel

6. Evidence into practice

During this session there will be three presentations on implementing evidence or guidelines into practice.

The first presentation will focus on the Best Practice Advocacy Centre experience of implementing evidence through focused educational messages and electronic decision support tools.

The second presentation will explain the development and implementation of care pathways in general practice in the Canterbury District Health Board. The pathway development has been a collective development between primary and secondary care either based on current evidence or best practice.

The third presentation will demonstrate how PHARMAC (the national drug purchasing agency for New Zealand) implements evidence into a national drug purchasing framework.

Chairs: Ashley Bloomfield and Murray Tilyard

Murray Tilyard: “Implementing guideline’s and evidence into General Practice, the BPAC experience”

Professor Tilyard graduated in medicine in 1980 from the University of Otago and became a fellow of the Royal New Zealand College of General Practitioners in 1996. He is currently the Elaine Gurr Professor of General Practice, at the Dunedin School of Medicine, University of Otago.

Murray leads bpacnz an independent, not for profit organisation whose role is to deliver educational and continuing professional development programmes to medical practitioners and other health professional groups throughout New Zealand.

He is also Executive Director of BPAC Inc, a not for profit organisation that has developed a decision support tool for general practice, and is the CEO of the New Zealand Formulary Limited Partnership, which has been contracted by the Ministry of Health to develop and maintain a National MedicinesFormulary for New Zealand.

In addition, Professor Tilyard works in his own private practice and is a member of the Otago Hospice Community Board.

Graham McGeoch: “Development and implementation of care pathways in General Practice, the Canterbury experience”

Dr Graham McGeoch is a general practitioner and Clinical Director of the Hyperbaric Medicine Unit, Christchurch Hospital.  He works with Planning and Funding, Canterbury DHB, on the Canterbury Initiative which works at the interface between primary care and hospital care.  

One of the results is HealthPathways which contains; 418 Clinical Pathways, 120 Resources and 66 Referral to Services Pages.

Current versions of HealthPathways are; West Coast, Canterbury, South Canterbury, Nelson Marlborough, Hutt Valley, Hunter and New England New South Wales and South Island Regional (Inter-hospital and Secondary to Tertiary pathways).

Each pathway contains an agreed way of working between general practice, other community services and hospital clinicians with detailed local information on assessment, management, referral, private options, patient information and further reading.  Dr McGeoch will discuss the advantages and pitfalls of this way of working which delivers evidence-based clinical information in a practical form for use during patient consultations. 

PeterMoodie: “Implementing evidence into drug purchasing at a national level, the PHARMAC experience”

Peter Moodie is the Medical Director of the New Zealand Pharmaceutical Management Agency, PHARMAC.  He has a particular interest in the management of high cost medicines and led the team which developed and implemented the electronic special authority process in New Zealand.  This project resulted in the online access to an authorisation facility for high-cost medicines with a response time of 17 seconds.  Over 50% of New Zealand medical practitioners now use the system.

Peter has a background in primary care and still continues to practice on a part-time basis at the Karori Medical Centre.  The Karori Medical Centre installed a fully electronic case notes, prescribing, accounting and recall system 1984.  With the advent of scanning for incoming correspondence, the practice has been paperless since about 1990.

Peter has continued to have an interest in the development of primary care interconnectivity.

Questions and discussion with panel

Wednesday 3 October 2012, 11:00-12:30

Simultaneous Sessions:

7. From reviews to recommendations: working with the World Health Organization

This session is a first for the Collaboration. In 2011, we were accepted as a non-governmental organization in official relations with the World Health Organization (WHO), the public health arm of the United Nations, establishing formalised communication between our two organizations. The opportunities for our contributors to influence the way research evidence is created and used by WHO are significant. Can we realise them? What other opportunities does this relationship provide?

Chairs: Prathap Tharyan and Davina Ghersi

Lisa Bero: “What is an NGO in official relations with WHO?"

Lisa Bero is Professor at the Department of Clinical Pharmacy, and Faculty member at Institute for Health Policy Studies; University of California, San Francisco, USA. She is also Director of the San Francisco branch of the US Cochrane Center. Lisa led the Collaboration’s bid to enter official relations with WHO.

Toby Lasserson: “Supporting reviews for WHO guidelines on vitamin A supplementation: a case study”

Toby Lasserson is a Senior Editor of The Cochrane Library at the Cochrane Editorial Unit, London, UK.

Elizabeth Waters: “Challenges and Rewards of producing reviews that are relevant to WHO”

Professor Elizabeth Waters is the Jack Brockhoff Chair of Public Health, and Director of the Brockhoff Child Health and Wellbeing Program; University of Melbourne, Australia. She is also Co-ordinating Editor of the Cochrane Public Health Review Group.

Susan L. Norris: “Changes and opportunities at WHO”

Susan L. Norris, MD MPH MSc is Guidelines Review Committee Secretariat, WHO Press, World Health Organization. Susan supports the WHO Guideline Review Committee, as well as develops committee processes and related training. She has extensive experience with GRADE, guideline development and research on conflicts of interest.

Questions and discussion with panel

8. Achieving a Smoke-free NZ by 2025:  What is the evidence-base?

New Zealand has led the world in seeking to be a “smoke free nation” by 2025. But is there evidence that the strategies being put in place or promoted by advocacy groups to reach the goal are effective? Or is it all about politics? 

Our local speakers have expertise and experience in clinical practice, clinical trials, community interventions, Cochrane reviews, clinical guidelines and tobacco control policy development, and will provide a range of local perspectives on this topic.

Chairs: Chris Bullen and Phillippa Poole

Chris Bullen: Introduction to topic and speakers

Associate Professor Chris Bullen is a public health physician with broad and extensive  experience in the health sector. He is Director of the National Institute for Health Innovation and Co-Director of the HRC-funded Tobacco Control Research Turanga Programme at the University of Auckland. His research is focussed primarily on tobacco control and smoking cessation interventions. He has co-authored four Cochrane reviews.

Marewa Glover: “What is the evidence that interventions with communities and population groups can make a contribution to the 2025 goal?”

Co-Director of the Tūranga (New Zealand’s only research centre dedicated to tobacco control), Dr Marewa Glover (Ngā Puhi) is a long-standing member of the tobacco control sector. She has experience at a policy level, in health promotion and cessation programme design and has an extensive research portfolio looking at tobacco control and the effects of smoking. In addition, Dr Glover also developed and convenes New Zealand’s first post-graduate paper on Tobacco Control.

Bruce Arroll: “What evidence is there that primary care can contribute to achievement of the 2025 goal?”

Bruce Arroll is a Professor in the Department of General Practice and Primary Health Care at the University of Auckland. He is a graduate from the University of Auckland and spent a year at McMaster University in Hamilton Ontario 1981-2. Having attended the meeting that established the Australasian Cochrane Centre. He is part of the Cochrane Primary Care Field (Shared with Auckland, Nijmegen and Dublin) which developed the PEARLs (Practical  evidence about real life situations) which are minimalistic summaries of Cochrane reviews aimed at primary care clinicians.

Prof Richard Edwards: “What evidence is there for ‘upstream‘ policies to achieve the 2025 goal?”

Richard Edwards trained in medicine and public health in the UK. He came to the University of Otago, Wellington in November 2005, was appointed Head of Department of Public Health and Professor of Public Health in August 2009. He is Director of ASPIRE 2025 - a research collaboration from the University of Otago, Massey University, Tala Pasifika and Whakauae Research Services carrying out research to help achieve a smokefree New Zealand by 2025. 

His research interests focus mainly on tobacco use epidemiology and control, where he has had a particular interest in policy-orientated research such as into smoke-free policies and legislation, plain packaging and point of sale displays. More recently, he has been involved with research orientated towards developing ‘endgame’ ideas and informing policies and strategies to achieve a Tupeka Kore (tobacco free) Aotearoa.

Discussant: Alistair Woodward: “Have we sufficient evidence to achieve the goal? What additional evidence is needed?”

Alistair Woodward is Head of the School of Population Health at the University of Auckland. He graduated in medicine from the University of Adelaide, worked in hospitals and in general practice in Australia and England, and undertook his training in public health medicine in the UK. He wrote his PhD on passive smoking and child health, and has been involved for more than 25 years in the science and practice of tobacco control. Amongst other topics, he has written on the effectiveness of smoke-free interventions, the burden of disease attributable to tobacco, the prevalence of smoking in the Pacific, and smoking in prisons.

Questions and discussion with panel

Closure: Chris Bullen

*Subject to change