Models for developing capacity: inside or out?

Gabriel Rada (@radagabriel)radagabriel@epistemonikos.orgEvidence-based Health Care Program, Pontificia Universidad Católica de ChileEpistemonikos Foundation (@epistemonikos)Santiago, Chile

Late ‘90s

Evidence-based Health Care ProgramPontificia Universidad Católica de Chile

Ordered by question?

• The traditional approach

• Ontologies

What’snext?

Our first 4 Cochrane reviews

Title to ProtocolProtocol to ReviewPublished review/up-to-dateUpdate needed

Barriers

Academic contracts for teachingNo protected times

Underpaid Need to make a living with clinicalpractice

Very few national research grants

Difficulties to assemble review teams

We need more capacity

Title to ProtocolProtocol to ReviewPublished review/up-to-dateUpdate needed

What are we going to do with the Chilean PhDs?

EVOLUTION

Homo medicus

Ho·mome·di·cusnoun \ˌhō-(ˌ)mō-ˈmē-di-kus/

: eminence-based doctor. Read a paper once and didn’t like it.

Homo evidence

Ho·mo e·vi·dencenoun \ˌhō-(ˌ)mō-ˈē-vi-dēns/

: evidence-based doctor. Makesresearch-informed decisions, and thinks research is useful butcomplicated

Homo synthesis

Ho·mo syn·the·sisnoun \ˌhō-(ˌ)mo- sin-ˈtē-sis-/

: a mutation of the homo evidencethat sparkled interest in synthesising research in order tohelp others.

Ho·mo Co·chra·nenoun \ˌhō-(ˌ)mō-ˈcō-krēn, especially British /

: the species of human that are able tocomplete a high quality Cochrane review ontime

BUILD +++ CAPACITY IN-HOUSE

Homo medicus

Homo evidence

TEACHING EBMCHANGING CURRICULUM DISSEMINATING EVIDENCEADVOCATING FOR EVIDENCE

TEACHING EVIDENCE SYNTHESISSTRUCTURED SUMMARIESRAPID REVIEWS

Homo evidence

Homo synthesis

Cochrane output

Key messages

• Conducting reviews requires more than a fewpeople that have the capacity

• There are no shortcuts to build capacity inside if there is no research infrastructure, resources and tradition

• Generating the appropriate environment for those returning from their training abroad is key to succeed

MANY THANKS