{"id":1539,"date":"2017-11-09T08:36:19","date_gmt":"2017-11-09T08:36:19","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/?p=1539"},"modified":"2017-12-06T00:48:59","modified_gmt":"2017-12-06T00:48:59","slug":"need-better-evidence-humanitarian-disasters-heres","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/11\/09\/need-better-evidence-humanitarian-disasters-heres\/","title":{"rendered":"We need better evidence in humanitarian disasters: here\u2019s why"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p><i><span style=\"font-weight: 400\">Humanitarian aid<\/span><\/i><span style=\"font-weight: 400\"> is the help provided in response to <\/span><i><span style=\"font-weight: 400\">humanitarian<\/span><\/i><span style=\"font-weight: 400\">\u00a0disasters. The objectives of <\/span><i><span style=\"font-weight: 400\">humanitarian aid<\/span><\/i><span style=\"font-weight: 400\"> are to save lives, alleviate suffering, and maintain human dignity. Therefore, it makes sense, well it does to me, that to achieve these objectives there is a need for better evidence. And here\u2019s why.\u00a0 \u00a0<\/span><\/p>\n<p style=\"text-align: right\">Carl Heneghan<\/p>\n<p><span style=\"font-weight: 400\"><a href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2017\/06\/Carl-Heneghan.png\"><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-1324 alignleft\" src=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2017\/06\/Carl-Heneghan-150x150.png\" alt=\"\" width=\"150\" height=\"150\" \/><\/a>First, a blog post this week by <\/span><a href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/11\/07\/ebm-library-systematic-reviews-support-humanitarian-medicine\/\"><span style=\"font-weight: 400\">Kamal Mahtani <\/span><\/a><span style=\"font-weight: 400\">discussed how systematic review evidence had influenced humanitarian aid. Evidence from such reviews is essential to inform interventions designed to save lives. In this blog, Mahtani reported on a <\/span><a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/14651858.CD004794.pub3\/full\"><span style=\"font-weight: 400\">Cochrane review<\/span><\/a><span style=\"font-weight: 400\"> that looked at interventions designed improve water quality and therefore prevents diarrhoea. \u00a0Evidence suggests solar water disinfection can reduce the risk of diarrhoea by a third. Not bad for an intervention that involves a plastic bottle and a bit of newspaper.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Evidence from systematic reviews can also prevent waste of resources. \u00a0A <\/span><a href=\"http:\/\/www.evidenceaid.org\/mental-health-disasters-and-what-not-to-do\/\"><span style=\"font-weight: 400\">Blog post by Claire Allen<\/span><\/a><span style=\"font-weight: 400\">, from Evidence Aid, highlights that \u2018there is no evidence that short-term interventions such as psychological debriefing or \u2018trauma counselling\u2019 for all are a good idea.\u2019 \u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Fifteen years ago, a <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/12241834\"><span style=\"font-weight: 400\">Lancet meta-analysis<\/span><\/a><span style=\"font-weight: 400\">, reported single session debriefing after psychological trauma did not improve natural recovery from psychological trauma. A result that was further backed up by a <\/span><a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/14651858.CD000560\/abstract;jsessionid=A52F6232772EB44DD4FF421E8784D30C.f04t04\"><span style=\"font-weight: 400\">Cochrane \u00a0Review<\/span><\/a><span style=\"font-weight: 400\">, which reported psychological debriefing is either equivalent to, or worse than, control or educational interventions in preventing or reducing the severity of psychological problems post trauma. Not all interventions are therefore as effective as we\u2019d like to think. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Second, there is a clear need to speed up the publication of research and provide better access to data in public health emergencies. \u00a0In 2015, we published A World Health organisation consultation on <\/span><a href=\"http:\/\/www.who.int\/medicines\/ebola-treatment\/background_briefing_on_data_results_sharing_during_phes.pdf?ua=1\"><span style=\"font-weight: 400\">Data and Results Sharing During Public Health Emergencies<\/span><\/a><span style=\"font-weight: 400\">. The Ebola outbreak showed there were problems with rapidly sharing data and results to identify the causative agent, predict spread, define diagnostic criteria, and assess treatments to contain further spread.<\/span><\/p>\n<p><span style=\"font-weight: 400\">While multiple barriers were identified to sharing data there was no simple, immediate solution that could fix the problem. Solutions included simplifying regulatory frameworks, developing formal data sharing platforms, improving journal publications and new publishing models such as pre-print servers and post-publication peer review, and a realignment of academic reward structures to incentivise data sharing.<\/span><\/p>\n<p><span style=\"font-weight: 400\">My third, and final reason, is the real need to improve the quality of evidence on the ground to better target resources in the short, medium and long-term. <\/span><\/p>\n<p><span style=\"font-weight: 400\">As an example, six months after the 2013 Haiti earthquake, \u00a0<\/span><a href=\"http:\/\/www.cnn.com\/2013\/10\/09\/world\/americas\/haiti-un-cholera-lawsuit\/\"><span style=\"font-weight: 400\">1.5 million<\/span><\/a><span style=\"font-weight: 400\"> were still homeless. A lack of sanitation the led to<\/span><a href=\"http:\/\/edition.cnn.com\/2013\/10\/09\/world\/americas\/haiti-un-cholera-lawsuit\/\"> <span style=\"font-weight: 400\">a cholera epidemic<\/span><\/a><span style=\"font-weight: 400\"> &#8211; 650,000 people were infected, and 8,300 died. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Given there have been <\/span><a href=\"https:\/\/www.theguardian.com\/commentisfree\/2010\/dec\/28\/haiti-cholera-earthquake-aid-agencies-failure\"><span style=\"font-weight: 400\">criticisms of aid agencies<\/span><\/a><span style=\"font-weight: 400\"> use of resources then we need better evidence to target scarce aid to treat the urgent needs in crises but also prevent the long-term consequences. The<\/span><a href=\"http:\/\/www.ghdinitiative.org\/ghd\/gns\/about-us\/about-ghd.html\"> <span style=\"font-weight: 400\">Good Humanitarian Donorship<\/span><\/a><span style=\"font-weight: 400\"> (GHD) initiative identified as essential the sharing of evidence produced and lessons learnt. The Lancet also recently called for the <\/span>improvement of evidence for health in humanitarian crises,<span style=\"font-weight: 400\"> citing an estimated 172 million people are currently affected by armed conflict.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Optimising evidence for <\/span><a href=\"http:\/\/journals.plos.org\/plosmedicine\/article?id=10.1371\/journal.pmed.1001632\"><span style=\"font-weight: 400\">disasters will not be easy<\/span><\/a><span style=\"font-weight: 400\">; will require a paradigm shift in decision making in humanitarian disasters and public health emergencies<\/span><\/p>\n<p><span style=\"font-weight: 400\">Spending on humanitarian aid is at record levels, In the last ten years, nearly 1.6 billion people worldwide were affected by disasters. The case for better evidence is compelling: \u00a0we need targeted, accessible evidence published promptly to alleviate suffering, save lives and maintain human dignity in humanitarian crises. <\/span><\/p>\n<hr \/>\n<p>Carl Heneghan is<a href=\"http:\/\/www.phc.ox.ac.uk\/team\/researchers\/carl-heneghan\">\u00a0Professor of EBM<\/a> at the University of Oxford,<a href=\"http:\/\/www.cebm.net\/\">\u00a0Director of CEBM<\/a> and Editor in Chief of BMJ EBM<\/p>\n<p><em>Follow on twitter <a href=\"https:\/\/twitter.com\/carlheneghan?lang=en\">@carlheneghan<\/a><\/em><\/p>\n<p><b>Competing interests<\/b><\/p>\n<p>Carl has received expenses and fees for his media work including BBC Inside Health. He holds grant funding from the NIHR, the NIHR School of Primary Care Research, The Wellcome Trust and the WHO. He has also received income from the publication of a series of toolkit books published by Blackwells. CEBM jointly runs the <a title=\"\" href=\"http:\/\/evidencelive.org\/\">EvidenceLive<\/a> Conference with the BMJ and the <a title=\"\" href=\"http:\/\/www.preventingoverdiagnosis.net\/\">Overdiagnosis Conference<\/a> with some international partners which are based on a\u00a0 non-profit model and is also a CEBM is a partner\u00a0with <a href=\"http:\/\/www.evidenceaid.org\/\">Evidence Aid<\/a>.<\/p>\n<p>&nbsp;<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; Humanitarian aid is the help provided in response to humanitarian\u00a0disasters. The objectives of humanitarian aid are to save lives, alleviate suffering, and maintain human dignity. Therefore, it makes sense, well it does to me, that to achieve these objectives there is a need for better evidence. And here\u2019s why.\u00a0 \u00a0 Carl Heneghan First, a [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/11\/09\/need-better-evidence-humanitarian-disasters-heres\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":1533,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14374],"tags":[],"class_list":["post-1539","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-carl-heneghan"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>We need better evidence in humanitarian disasters: here\u2019s why - BMJ EBM Spotlight<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/11\/09\/need-better-evidence-humanitarian-disasters-heres\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"We need better evidence in humanitarian disasters: here\u2019s why - BMJ EBM Spotlight\" \/>\n<meta property=\"og:description\" content=\"&nbsp; Humanitarian aid is the help provided in response to humanitarian\u00a0disasters. 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The objectives of humanitarian aid are to save lives, alleviate suffering, and maintain human dignity. Therefore, it makes sense, well it does to me, that to achieve these objectives there is a need for better evidence. And here\u2019s why.\u00a0 \u00a0 Carl Heneghan First, a [...]Read More...","og_url":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/11\/09\/need-better-evidence-humanitarian-disasters-heres\/","og_site_name":"BMJ EBM Spotlight","article_published_time":"2017-11-09T08:36:19+00:00","article_modified_time":"2017-12-06T00:48:59+00:00","og_image":[{"width":380,"height":250,"url":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2017\/11\/HEW-Logo-with-image-925X405-DRAFT01-20170620-e1507551033489.png","type":"image\/png"}],"author":"BMJ","twitter_card":"summary_large_image","twitter_misc":{"Written by":"BMJ","Estimated reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/11\/09\/need-better-evidence-humanitarian-disasters-heres\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/11\/09\/need-better-evidence-humanitarian-disasters-heres\/"},"author":{"name":"BMJ","@id":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe"},"headline":"We need better evidence in humanitarian disasters: here\u2019s why","datePublished":"2017-11-09T08:36:19+00:00","dateModified":"2017-12-06T00:48:59+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/11\/09\/need-better-evidence-humanitarian-disasters-heres\/"},"wordCount":699,"publisher":{"@id":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/#organization"},"image":{"@id":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/11\/09\/need-better-evidence-humanitarian-disasters-heres\/#primaryimage"},"thumbnailUrl":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2017\/11\/HEW-Logo-with-image-925X405-DRAFT01-20170620-e1507551033489.png","articleSection":["Carl Heneghan"],"inLanguage":"en-GB"},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/11\/09\/need-better-evidence-humanitarian-disasters-heres\/","url":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/11\/09\/need-better-evidence-humanitarian-disasters-heres\/","name":"We need better evidence in humanitarian disasters: here\u2019s why - 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