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Collaboration in qualitative research: The Qualitative Health Research Symposium 2017

13 Feb, 17 | by Hemali Bedi

Hemali Bedi

I was very pleased to attend the 3rd Qualitative Health Research Symposium that was held in London, UK, on Tuesday 7th February 2017. Hosted by the UCL Qualitative Health Research Network, the focus of the symposium was enhancing engagement, co-production and collaborative meaning-making in qualitative health research. Abstracts from the symposium will be published by BMJ Open in early March.

After opening remarks from the UCL President & Provost Professor, Michael Arthur, this year’s symposium began with a number of insightful presentations that explored interdisciplinary collaboration within qualitative research. Case studies were presented by researchers from all over the world, including Argentina, Denmark and Tanzania.

Following this, a number of breakout sessions focused on new developments in qualitative research, such as the use of novel visual methods to support participant engagement, multi-sectoral collaborations in research on human-environmental health and the changing nature of healthcare organisations and how we study them.

The potential benefits of using novel visual methods to support participant engagement in qualitative research

One of the many highlights of the day was the keynote address from Professor Jonathon Tritter. He spoke about the various tensions, challenges and opportunities of patient and public involvement in qualitative research. Professor Tritter highlighted the significant differences between patient and public involvement and concluded that collaboration should be based on the recognition of these differences.

Professor Jonathan Tritter’s concluding thoughts: Who should be involved in research and what gets in the way?

Next, the poster presentations were delivered. There were a great number of interesting and thought provoking posters on display throughout the symposium. The key research themes were: culture, creativity and innovation in research, health services and systems, making research accessible to marginalised and vulnerable groups and theorising and reflecting on collaboration. Roman Kislov and Fiona Fox were voted the winners for their research titled “Enabling collaborative health research: a qualitative longitudinal study of a large-scale co-production programme” and “Insiders and Outsiders: the experience of co-researchers exploring autism in a Somali community” respectively.

The afternoon session further reaffirmed the need for interdisciplinary research teams to consist of both qualitative and quantitative researchers, as well as other health care professionals, stakeholders and policy makers. The audience was captivated by the panel discussion which followed.

Roberto Abadie spoke about the role of the broker in mixed-methods collaboration

We would like to thank all of the speakers and participants for sharing their insights and we look forward to attending the next symposium.

Top 10 Most Read: Antidepressant use during pregnancy, medical graduates’ preparedness for practice and E-therapies for stress, anxiety and depression

3 Feb, 17 | by Ed Sucksmith

January sees 5 new entries into the top 10 most read articles. At number 4 is a cohort study by Anick Bérard and colleagues investigating the association between first-trimester exposure to antidepressants and the risk of major congenital malformations in 18,487 depressed/anxious women from Quebec, Canada. Results indicate that antidepressants increase the risk of a wide range of organ-specific malformations. At number 6 is a systematic review and meta-analysis by Tea Reljic and colleagues suggesting that, in terminally ill patients, active treatment targeted at underlying disease does not have a demonstrable impact on overall survival compared to palliative care.

Also making its way into the top ten is a rapid review of the literature examining the preparedness of UK graduates for practice as junior doctors. Whilst the review indicates that junior doctors are well prepared in a number of different areas of practice, some problem areas are identified including safe and legal prescribing, multidisciplinary team-working, handovers, breaking bad news to patients, learning needs and reflective practice.

Other new entries this month include a systematic review of life expectancy among individuals with non-cancer chronic disease and a survey of web and smartphone apps used and recommended for stress, anxiety or depression by the National Health Service in England. Fenton et al.’s systematic review of dietary acid load, alkaline water and cancer moves up four positions to become January’s most read article.

 

Rank Author(s) Title
1 Fenton et al. Systematic review of the association between dietary acid load, alkaline water and cancer
2 Ravnskov et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review
3 Boulton et al. How much sugar is hidden in drinks marketed to children? A survey of fruit juices, juice drinks and smoothies
4 Bérard et al. Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort
5 Murdoch  et al. Selling falsehoods? A cross-sectional study of Canadian naturopathy, homeopathy, chiropractic and acupuncture clinic website claims relating to allergy and asthma
6 Reljic et al. Treatment targeted at underlying disease versus palliative care in terminally ill patients: a systematic review
7 Hole et al. How long do patients with chronic disease expect to live? A systematic review of the literature
8 Bennion et al. E-therapies in England for stress, anxiety or depression: what is being used in the NHS? A survey of mental health services
9 Monrouxe et al. How prepared are UK medical graduates for practice? A rapid review of the literature 2009–2014
10 Steele et al. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study

Most read figures are based on pdf downloads and full text views. Abstract views are excluded.

Top 10 Most Read: The Male-Female Gap in Alcohol Use, requests for genital cosmetic surgery and opposition to standardised tobacco packaging in the UK.

8 Nov, 16 | by Ed Sucksmith

alcohol-492871_960_720

October sees six new entries make it into our top ten most read articles. In at number 2 is a systematic review investigating birth cohort changes in male-to-female ratios in indicators of alcohol use and related harms. The authors concluded that the male–female gap in alcohol use was closing over time, with women now drinking almost as much as men. At number 3 is a survey of GPs’ knowledge, attitudes and practice regarding female genital cosmetic surgery in Australia. The study found high rates of women contacting their GP about genital normality concerns, with those requesting female genital cosmetic surgery frequently having a suspected or diagnosed psychological problem.

Other new entries include a documentary analysis of opponents to standardised packaging in the UK by Dr Jenny Hatchard and colleagues from the University of Bath and Aston University. The authors found that opposition to standardised packaging was primarily undertaken by third parties with financial relationships to major tobacco manufacturers, whilst a lack of transparency regarding these links created a misleading impression of diverse and widespread opposition.

Ravnskov et al.’s systematic review on the associations between low-density-lipoprotein cholesterol and mortality remains in first place for a fifth month in a row.

 

Rank Author(s) Title
1 Ravnskov et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review
2 Slade et al. Birth cohort trends in the global epidemiology of alcohol use and alcohol-related harms in men and women: systematic review and metaregression
3 Simonis et al. Female genital cosmetic surgery: a cross-sectional survey exploring knowledge, attitude and practice of general practitioners
4 Fenton et al. Systematic review of the association between dietary acid load, alkaline water and cancer
5 Power et al. Multimethod study of a large-scale programme to improve patient safety using a harm-free care approach
6 Nazar et al. New transfer of care initiative of electronic referral from hospital to community pharmacy in England: a formative service evaluation
7 Hatchard et al. Standardised tobacco packaging: a health policy case study of corporate conflict expansion and adaptation
8 Pound et al. What do young people think about their school-based sex and relationship education? A qualitative synthesis of young people’s views and experiences
9 Dean et al. Community-based Rehabilitation Training after stroke: protocol of a pilot randomised controlled trial (ReTrain)
10 Johnson et al. Early real-world evidence of persistence on oral anticoagulants for stroke prevention in non-valvular atrial fibrillation: a cohort study in UK primary care

Most read articles in September: young people’s views on school sex education, gender equity in academic medicine and improving patient safety

7 Oct, 16 | by Hemali Bedi

cellular-1352613_1920September’s most read list sees several new entries as well as some popular non-movers. This month’s top spot still belongs to Ravnskov et al and their systematic review on the associations between low-density-lipoprotein cholesterol and mortality in the elderly. Pound et al come in at number three with a qualitative synthesis of young people’s views and experiences of school sex and relationship education (SRE). They concluded that SRE should be delivered by experts who maintain clear boundaries with students and taught using a ‘sex-positive’ approach – one that aims for young people to enjoy their sexuality in a way that is safe, consensual and healthy.

Other new entries this month include Caffrey et al, who performed a multimethod, qualitative study investigating how a gender equity programme, Athena SWAN, could be enabled and whether  interactions between the programme and the context it is implemented into might produce unintended consequences.

At number ten is a multimethod study by Power et al, looking at whether a large-scale two-phase quality improvement programme achieved its aim to improve patient safety using a harm-free care approach.

See below for a full round up of September’s top 10 most read articles.

Rank Author(s) Title
1 Ravnskov et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review
2 Ferrer et al. Comparative study analysing women’s childbirth satisfaction and obstetric outcomes across two different models of maternity care
3 Pound et al. What do young people think about their school-based sex and relationship education? A qualitative synthesis of young people’s views and experiences
4 Caffrey et al. Gender equity programmes in academic medicine: a realist evaluation approach to Athena SWAN processes
5 Teschke et al. Bicycling injury hospitalisation rates in Canadian jurisdictions: analyses examining associations with helmet legislation and mode share
6 Quigley et al. Association between home birth and breast feeding outcomes: a cross-sectional study in 28,125 mother–infant pairs from Ireland and the UK
7 Pradhan et al. Nutrition interventions for children aged less than 5 years following natural disasters: a systematic review
8 Ma’som et al Attitudes and factors affecting acceptability of self-administered cervicovaginal sampling for human papillomavirus (HPV) genotyping as an alternative to Pap testing among multiethnic Malaysian women
9 Assiri et al Investigating the epidemiology of medication errors and error-related adverse drug events (ADEs) in primary care, ambulatory care and home settings: a systematic review protocol
10 Power et al. Multimethod study of a large-scale programme to improve patient safety using a harm-free care approach

Most read figures are based on pdf downloads and full text views. Abstract views are excluded.

BMJ Open to publish abstracts for the UCL Qualitative Health Research Network symposium

9 Sep, 16 | by aaldcroft

On the Tuesday 7th February 2017, the UCL Qualitative Health Research Network will be hosting their third symposium entitled ‘Engagement, Co-production, and Collaborative Meaning-Making: Collaboration in Qualitative Health Research’, supported by The Wellcome Trust.

Held within the Institute of Child Health, 30 Guildford Street, London, the Network invite all those with an interest in qualitative health research, from policy makers to the general public, to come along and engage in presentations, workshops and discussions on the theme of collaboration.

Abstracts can be submitted up until the closing date of 26th September 2016, with successful submissions published in BMJ Open shortly after the symposium. The call for abstracts and details on of the submission process are available here.

Registration will open in November 2016 but please check the website or follow the QHRN on Twitter to keep up to date on key dates and plans.

Complimentary therapies, well-being and consultants as victims of bullying: Most read articles in July.

11 Aug, 16 | by Fay Pearson

 Tired Doc

July’s top 10 most read papers sees two studies taking into account doctors’ points of view. The first, by Bourne et al., takes a closer look at look at which aspects of the complaints process they find the most stressful. The second, by Shabazz et al., uses a survey of Royal College of Obstetricians and Gynaecologists to explore how significant numbers of consultants in the UK are victims of bullying.

We also have a study by Linton et al., that systematically reviews self-report measures for assessing well-being, and a randomised controlled trial by Levett et al., that concludes that the use of complementary therapies during birth can significantly reduce usage of epidurals and cesarean sections.

Rank Author(s) Title
1  Ravnskov et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review
2 Levett, et al. Complementary therapies for labour and birth study: a randomised controlled trial of antenatal integrative medicine for pain management in labour
3 Eleftheriou et al. Does attractiveness influence condom use intentions in heterosexual men? An experimental study
4 Bourne et al. Doctors’ experiences and their perception of the most stressful aspects of complaints processes in the UK: an analysis of qualitative survey data
5 Teschke et al. Bicycling injury hospitalisation rates in Canadian jurisdictions: analyses examining associations with helmet legislation and mode share
6 Kristensen et al. The effect of statins on average survival in randomised trials, an analysis of end point postponement
7 Shabazz,et al. Consultants as victims of bullying and undermining: a survey of Royal College of Obstetricians and Gynaecologists consultant experiences
8 Oudin et al. Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents
9 Tsubokura et al. Estimated association between dwelling soil contamination and internal radiation contamination levels after the 2011 Fukushima Daiichi nuclear accident in Japan
10 Linton et al. Review of 99 self-report measures for assessing well-being in adults: exploring dimensions of well-being and developments over time

BMJ Open works with Publons to give credit for peer review

1 Aug, 16 | by aaldcroft

Publons

We’re pleased to announce that BMJ Open has partnered with Publons to help reviewers gain credit for their work.

Publons is a free service for reviewers, which enables them to gain public recognition for the reviews they complete. To take advantage of this service, you will first need to create a profile on Publons. When you submit your review via ScholarOne you will then be asked whether you would like to be credited for your review on Publons. Selecting ‘yes’ means that your review details will automatically be exported.

ORCID integration

In addition, Publons has partnered with ORCID so that reviewers can opt to have their verified review history automatically added to their ORCID profile.

Follow the steps below to make use of this service:

  1. Register for an ORCID profile (if you haven’t already).
  2. Sign in to Publons.
  3. Click on your profile picture in the top right-hand corner and select ‘Settings’.
  4. Under the ‘Reviews’ tab, click on the box ‘Authorise Publons to add reviews to ORCID’. Complete the relevant fields and click ‘Authorise’.
  5. Under the ‘Emails’ tab on the Publons site, add and verify any email addresses you have used for past peer review work.

Top 10 Most Read: Cholesterol and mortality in the elderly, chronic pain in the UK and smokers’ quitting attempts

8 Jul, 16 | by Ed Sucksmith

cigarettes-1221102_960_720

Several new entries make it into our top 10 Most Read list this month. In first place is a systematic review on the associations between low-density-lipoprotein cholesterol and mortality in the elderly. Further down the list is an analysis of Italian medical societies’ websites to examine conflicts of interest between professional medical societies and industry. Other new entries this month include an investigation into the relationship between air pollution and child and adolescent mental health by researchers from Umeå University in Sweden. Using a cohort of over half a million individuals under 18 years of age, the authors found that neighbourhood air pollution concentration is associated with dispensed medications for certain psychiatric disorders. At number 6 is a systematic review and meta-analysis of the prevalence of chronic pain in the UK. The authors conclude that chronic pain affects between one-third and one-half of the population of the UK, corresponding to just under 28 million adults. Lastly, making it in at number 9 is a study by Chaiton and colleagues on smokers’ quitting behaviour. The authors found that it may take as much as 30 or more attempts before a smoker quits successfully.

 

Rank Author(s) Title
1 Ravnskov et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review
2 Eleftheriou et al. Does attractiveness influence condom use intentions in heterosexual men? An experimental study
3 Oudin et al. Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents
4 Fabbri et al. Conflict of interest between professional medical societies and industry: a cross-sectional study of Italian medical societies’ websites
5 Kristensen et al. The effect of statins on average survival in randomised trials, an analysis of end point postponement
6 Fayaz et al. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies
7 Teschke et al. Bicycling injury hospitalisation rates in Canadian jurisdictions: analyses examining associations with helmet legislation and mode share
8 Thomas et al. When procedures meet practice in community pharmacies: qualitative insights from pharmacists and pharmacy support staff
9 Chaiton et al. Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers
10 Fenton et al. Systematic review of the association between dietary acid load, alkaline water and cancer

Most read figures are based on pdf downloads and full text views. Abstract views are excluded.

International Clinical Trials Day

19 May, 16 | by aaldcroft

By Sir George Chalmers, c 1720-1791 - [1], Public Domain, https://commons.wikimedia.org/w/index.php?curid=32922810

Today is Clinical Trials Day. Celebrated around the world on or near May 20, Clinical Trials Day commemorates the date when, in 1747, James Lind started the first clinical trial to test citrus fruits as a treatment for scurvy.

This year’s campaign from the NIHR is OK To Ask, which encourages patients and carers to inquire about research opportunities that could be available. We here at BMJ Open support initiatives for patient involvement in research and decision-making and hope that, in making our content freely available online, we help make research more familiar and accessible to the public, including patients, for whom the research is ultimately intended.

While James Lind’s basic principle for the trial remains, the scale, sophistication, and problems surrounding modern trials are evolving rapidly. The importance of registering drugs and publishing all trial results is recognised, but adherence remains unsatisfactory. The notion of what constitutes an intervention is also changing, with text messaging and educational methods now being studied using the same framework as drugs.

BMJ Open will continue efforts to improve the quality of reporting trials, emphasizing the importance of publishing null and negative results and study protocols. The clinical trial is certainly worthy of celebration, along with improvement.

What is ‘overdiagnosis’? Public meanings and misconceptions

28 Apr, 16 | by Ed Sucksmith

overdiagnosis pic 1

A recent study published in BMJ Open found less than 3% of the British public could define the meaning of overdiagnosis correctly. We talk to lead author Dr Alex Ghanouni about his research.

Stories about the ‘overdiagnosis’ of medical conditions regularly make the headlines. “GPs to trial new tests for asthma amid concerns about overdiagnosis” reported The Guardian in February, whilst in March The Telegraph declared “ADHD is vastly overdiagnosed and many children are just immature”. But what is meant by the term overdiagnosis and is it correctly understood? Some stories equate overdiagnosis with the proliferation of misdiagnoses or so-called ‘false-positives’ where a diagnostic test wrongly indicates that you have a medical condition. These meanings, however, are considered inaccurate by medical experts. They instead define it somewhat counter intuitively as the diagnosis of a disease which would never have become clinically apparent in a person’s lifetime. In other words, the disease is real but it does not cause the patient any harm, whether or not it has been identified through a medical test.

A research group led by Dr Jo Waller from University College London set out to assess the British public’s awareness and understanding of overdiagnosis. Why did Dr Waller and colleagues pursue this particular topic? “Our interest in overdiagnosis came primarily via the debate around its significance in breast cancer screening” explains Dr Alex Ghanouni, a member of the research team. Screening tests for breast cancer may lead to the identification of tumours that would not have presented clinically in the absence of the screening test. Overdiagnosis is therefore a significant concern because it could result in patients receiving unnecessary treatments as well as needless stress and anxiety that arise from receiving a diagnosis. “Knowing that the public often has only limited knowledge about the intricacies of screening tests, we speculated that the term has not reached public awareness, despite intense professional debate. We thought it important to assess this since it would limit people’s ability to consider it when deciding whether to take up a screening invitation.

Dr Waller’s team surveyed 390 adults from the UK aged 50-70 years of age. The survey asked participants if they had seen or heard of overdiagnosis and, if they had, to explain what the term meant. Results revealed that just 3 in 10 participants had encountered the term before, whilst less than 3% of all participants surveyed provided responses that were consistent with the accepted definition. A number of common misconceptions were identified, including equating overdiagnosis with both ‘misdiagnosis’ and ‘false-positive diagnosis’.

The study’s findings attracted a large audience when they were published in March. Were the authors surprised by the level of attention that their study received? “We were surprised in some respects”, says Dr Ghanouni, “In previous studies, we have found that overdiagnosis is something that few people understand intuitively and so we had some expectation that this would make the study less accessible to the general public. On the other hand, we were aware throughout the study that we were researching a topic where there were many strong views among medics and academics and so we did expect a degree of attention, at least among people working in related fields.

The survey results replicated previous studies that found low public knowledge of overdiagnosis in the UK and elsewhere. Dr Ghanouni and colleagues plan to further develop their research in this area. “This is an area of research that we are keen to take further and have in fact just had a paper published on a follow-up topic, namely, of information about overdiagnosis in breast screening that the public can read on the most prominent UK and Australian health websites. Some of our findings were quite striking; for example, we found that a markedly higher proportion of websites included relevant information compared to the last study to review information on the web, in 2002. This might indicate that the topic will gradually become something that more people know about.”

 

More on Overdiagnosis

For further information about overdiagnosis please see The BMJ’s ‘Too Much Medicine’ campaign, which aims to highlight and contribute to the evidence base on overdiagnosis and overtreatment. This includes a recent digital theme issue on overdiagnosis. The BMJ is also a partner in the upcoming Preventing Overdiagnosis conference that will be taking place on 20 – 22 September 2016 in Barcelona, Spain.