Abstract
Kazan hosted Russia’s second International Conference QiQUM 2015 on Cochrane evidence for health policy, which was entirely independent of the pharmaceutical or other health industry, bringing together 259 participants from 11 countries and 13 regions of the Russian Federation. The Conference was greeted and endorsed by world leaders in Evidence-based medicine, health and pharmaceutical information, policy and regulation, and the World Health Organization. Participants discussed the professional and social problems arising from biased health information, unethical pharmaceutical promotion, misleading reporting of clinical trials with consequent flaws in health care delivery and the role of Cochrane evidence for informed decisions and better health. The first in history Cochrane workshop, facilitated jointly by experts from Cochrane and the WHO, with 40 participants from Kazakhstan, Kyrgyzstan, Tajikistan and Russia introduced the concept of Cochrane systematic review and the Use of Cochrane evidence in WHO policy setting. Websites document conference materials and provide interface for future collaboration: http://kpfu.ru/biology-medicine/struktura-instituta/kafedry/kfikf/konferenciya/mezhdunarodnaya-konferenciya-39dokazatelnaya.html and http://russia.cochrane.org/news/international-conference.
Keywords
The international Conference “Evidence-based medicine: achievements and barriers (QiQUM 2015 – Quality Information for Quality Use of Medicines 2015)” was held in Kazan, the capital of the Republic of Tatarstan at the Kazan (Volga Region) Federal University on the 7-8th of December 2015.
The Conference QiQUM 2015 celebrated the official launch of Cochrane Russia and became the first in history Cochrane event which was organised in the Russian Federation.
Cochrane Russia, as the Russian branch of the Nordic Cochrane Centre, with Coordinating Centre at the Kazan Federal University, has been established in August 2015, building on the work of the Affiliated Centre in Tatarstan of the Nordic Cochrane Centre, based at the Department of Basic and Clinical Pharmacology of the Institute of Fundamental Medicine and Biology.
The International Conference “Evidence-based medicine: achievements and barriers (QiQUM 2015)” was held under the auspices of the rector of Kazan Federal University, professor Ilshat R. Gafurov.
Financial support for the Conference was provided by the Kazan Federal University, the A.E. Arbuzov Institute of Organic and Physical Chemistry (Russian Science Foundation), Wiley Publishing House, the World Health Organization, and the Cochrane Collaboration.
Co-organizers of the conference were: Cochrane working group, Kazan Federal University, AE Arbuzov Institute of Organic and Physical Chemistry of Kazan Scientific, Center of the Russian Academy of Sciences, Russian Science Foundation, Kazan State Medical University, Kazan National Research Technological University, The Tatarstan Academy of Sciences, The All-Russian Association of Clinical Pharmacologists, The All-Russian Society of Organization of Health-care, Public health, The Association of Medical Societies for Quality (ASMOK), The International Association of Clinical Pharmacologists and Pharmacists, Eurasian Academy of Medical Sciences, Russian Scientific Society of Pharmacologists.
The Russian Ministry of Health endorsed the conference and encouraged participation by health authorities as well as health educators from across the Russian Federation. The conference gathered 259 experts from 11 countries (Great Britain, Denmark, Switzerland, USA, Moldova, Kyrgyzstan, Kazakhstan, Tajikistan, Vietnam, Uzbekistan, Zambia) and 13 Russian regions, including representatives leading experts in the field of evidence-based medicine in Russia, post-Soviet Independent conutires (NIS countries) and foreign countries.
International support and expertise were provided by the invited speakers from the Cochrane Collaboration and the World Health Organization, Department of Essential Medicines and the WHO European office.
The scientific community of Russia and NIS countries (Kazakhstan, Kyrgyzstan, Tajikistan, Uzbekistan) were represented by members of the teaching departments, research labs, heads of medical organizations and professional societies and associations; employees of government agencies of the Republic of Tatarstan and other Russian regions, including Ministry of Health of the Republic of Tatarstan, Territorial Compulsory Medical Insurance Fund of the Republic of Tatarstan, territorial authority of Roszdravnadzor in the Astrakhan region and others.
The opening ceremony of the conference was started with a welcoming speech of the rector of the Kazan Federal University, Professor I.R. Gafurov, followed by official greetings from the assistant to the President of the Tatarstan Republic, Leila R. Fazleeva, and the Chairman of the Tatarstan State Council Committee on Social Policy Svetlana M. Zakharova. They highlighted the importance of the discussed issues and took the opportunity to wish success to the conference and Cochrane collaboration developemnt in Tatarstan and Russia.
International leaders in the field of evidence-based medicine, pharmaceutical policy and rational use of medicines forwarded their greetings to the Conference participants and endorsements of the Conference QiQUM 2015:
Peter C. Gøtzsche, the Director of the Nordic Cochrane Centre, co-founder of Cochrane Collaboration (Denmark);
Hans V. Hogerzeil, Professor of Global Health and the Right to Health, Groningen University, the Netherlands, ex-Director, Department of Essential Medicines and Pharmaceutical Policies, World Health Organization (Geneva, Switzerland);
Joel Lexchin,, Professor of the School of Health Policy and Management (Faculty of Health, York University, Toronto, Canada);
David B. Menkes, Associate Professor of Psychiatry, Waikato Clinical School, Faculty of Medical and Health Sciences, University of Auckland; consultant liaison psychiatrist (New Zealand);
Barbara Mintzes, Senior Lecturer of the Charles Perkins Centre and Faculty of Pharmacy of the University of Sydney (Australia);
Andrew Herxheimer, clinical pharmacologist, founding Editor of the Drug and Therapeutics Bulletin, co-founder and honorary member of the British Cochrane Centre (UK), WHO consultant; Extraordinary professor of Clinical Pharmacology at the University of Groningen, Co-convenor of the Cochrane Adverse Effects Methods Group;
Kees de Joncheere, Director, Department of Essential Medicines and Health Products World Health Organization, Geneva.
The Editor of the International Journal of Risk and Safety in Medicine, Professor C.J. van Boxtel and the publisher IOS Press provided support by publishing a special Journal issue with contributions from the QiQUM 2015 Conference participants (Amsterdam, the Netherlands).
The scientific program included plenaries and parallel sessions with the participation of international leaders in the field of evidence-based medicine and the Cochrane collaboration, representatives of the World Health Organization, the independent International Society of Drug Bulletins, professional health associations, as well as leading Russian scientists - specialists in evidence-based medicine. As David B. Menkes pointed out “the organisers’ ambitious scope is warranted by the challenges we face in ensuring that drug information is accessible, high-quality, and unbiased. This is a truly international issue which manifests in clinical, academic, and administrative settings around the world”.
The Cochrane Chief Executive Officer Mark G. Wilson (Cochrane Central Executive, London, UK) in his plenary lecture presented the vision and mission of Cochrane, strategy and perspectives for development of this unique international organization that provides worldwide trusted evidence for informed decision-making in health care in order to improve global health – trusted evidence, informed decisions for better health. Mark G. Wilson showed how greatly has increased the demand for evidence-based information by russians with the establishment of Cochrane Russia, and that the Russian speaking community became the sixth among non-english audiences in using Cochrane evidence. The Cochrane Russia Director, Professor Liliya E. Ziganshina, presented the plenary report about problems and perspectives of Cochrane Russia development. She also spoke about the success of large-scale priority project of Russian translations of Cochrane evidence.
Co-director Cochrane Switzerland, Erik von Elm, spoke about the use of Cochrane evidence to develop interventions for public health and health care. To illustrate his idea, he presented demonstrative examples showing how the implementation of Cochrane evidence has led to global health success for the problems of alcohol consumption, smoking, healthy eating and physical activity.
Principles of evidence-based medicine for the prevention of non-communicable diseases were highlighted in the plenary report of Professor Oleg S. Medvedev, the Head of the Department of Pharmacology of the Faculty of Fundamental Medicine of the Moscow State University.
Director of Institute for Health Policy Analysis, Director of Eurasian Medical Education Program (a program for continuing medical education for Russian physicians in partnership with the American College of Physicians), Professor Edward J. Burger (Washington, USA) spoke about the importance of evidence in health and the heritage of Archie Leman Cochrane first hand, having known him personally.
The Chairman of the Board of the Association of Medical Societies for Quality, the executive secretary of the All-Russian Society of Organization of Health-care and Public Health, Guzel E. Ulumbekova spoke about the possibilities of solving national health care problems.
Guillaume Dedet (Copenhagen, Denmark) presented the strategy of the WHO European Office for the use of evidence in Europe as a basis for shaping health and drug policy and for the development of health technology assessment (HTA). Branca Mrljes (Wiley Publishing House, Oxford, UK) in her report made a brief introduction to the Cochrane Library - the single most reliable source of evidence on the efficacy and safety of interventions in health care.
The Deputy Director of the Nordic Cochrane Center, Karsten Juhl Jørgensen (Copenhagen, Denmark) presented the best Danish experience in the development of national clinical guidelines based on evidence. He spoke about the role of Cochrane in this process, the development of this process and lessons learned.
Lyudmila A. Doronina, head of the management department of protection of the rights of insured citizens of the Republic of Tatarstan of the Tatarstan Fund of the Obligatory health (Medical) Insurance (TFOMI - TFOMS), gave a speech about the use of evidence-based medicine in health care quality assessment in the system of obligatory health insurance (OHI).
Natalia A. Chebotarenko, the head of the Coalition for Rational and Safe Use of Medicines, (Chisinau, Moldova) presented the experience of developing of the national drug formulary based on independent sources of drug information. The Associate Professor of the Department of Basic and Clinical Pharmacology, Veronica N. Khaziakhmetova spoke about the experience of introducing and implementing of Cochrane evidence-based principles in graduate (Masters) programs of a classical university, postgraduate education of physicians and healthcare practice of the Republic of Tatarstan and the Russian Federation.
The final chord of the plenary was the plenary report, presented by an experienced author of numerous Cochrane systematic reviews, Lorenzo Moya, from the Department of Essential Medicines and Health Products of the World Health Organization (Geneva, Switzerland). Lorenzo Moya described the WHO Model List of Essential medicines and the use of evidence to determine which medicines are better than others.
At the afternoon parallel Conference sessions the following issues were scrupulously discussed: the problems of quality in health care delivery, the role of Cochrane evidence in informed decision making in health care, the role of Cochrane evidence in clinical guideline development and in pharmaceutical regulation. Special attention was given to the issues of the rational use of medicines on the basis of solid evidence, to the problems of flooding of medical academic world with misleading information about the efficacy and safety of interventions, diagnostic procedures, methods and tests, organizational solutions in healthcare. A thorough discussion concerning the problem of conflict of interest in health care delivery and public health was opened.
The poster session created the most active interest of conference participants. The contributions, which provided some examples of how people solve the above discussed problems in the different geographical areas of Russia at health care institutions of various levels, as well as in medical and pharmaceutical education, attracted great attention and were thoroughly discussed.
As a result of the conference the participants expressed their unanimous understanding that solution of the problems, raised by the Conferenece, directly depends on rigorous research evidence of the total value of health technologies and medicines.
It has been highlighted that the prime need is to actively and widely disseminate Cochrane gold standard evidence among health professionals and population communities as a whole.
Within the framework of the QiQUM 2015 Conference, the first Cochrane workshop was held on 8 December 2015. It was organized and conducted by the staff of the Nordic Cochrane Centre (Karsten Juhl Jørgensen, Deputy Director of the Nordic Cochrane Centre, Denmark), Cochrane Switzerland (Erik von Elm, Co-director Cochrane Switzerland), the World Health Organization (Lorenzo Moya, Switzerland) and the WHO European Office (Guillaume Dedet, Denmark) and the Department of Basic and Clinical pharmacology of the Kazan Ffederal University (L. E. Ziganshina, the Head of the Department of Basic and Clinical pharmacology, Director of Cochrane Russia).
The Cochrane workshop was attended by 40 young and accomplished scholars from Kazakhstan, Kyrgyzstan, Tajikistan and Russia (Kazan, Moscow, St. Petersburg, Chelyabinsk, Saratov). Organizers and participants of the workshop discussed the methodology of developing of Cochrane systematic reviews, the way to interpret the results of clinical trials and the use of evidence-based data in clinical practice; new computer technologies which allow optimizing the work with clinical research evidence in the development of Cochrane systematic reviews were presented to participants.
On the same day, December the 8th 2015, at the Parliament of the Republic of Tatarstan, the meeting of the members of the Commission of the State Council of the Republic of Tatarstan on monitoring implementation of governmental programs in health sector with the participants of the International Conference “Evidence-based medicine: achievements and barriers (QiQUM 2015)” took place.
At this meeting the development strategy of Cochrane Russia (the Russian branch of the Nordic Cochrane Centre) was discussed. The meeting was opened by the Deputy Chairman of State Council Committee on Social Policy, Tatiana Voropaeva. She presented the main directions and recent novations in the social sphere of the Tatarstan Republic, as well as measures, which need to be taken to improve the health care system. The QiQUM 2015 Conference participants, representatives of Moldova, Kyrgyzstan and Kazakhstan also participated in the meetings.
Lorenzo Moya, representating of the World Health Organization, Department of Essential Medicines, noted that there is a lot of conflicting information about medicines in the world. Some medicines are indeed really helpful, others maybe widely advertised and publicized without any benefit to health. Research is needed to assess their actual benefits and harms, which needs to be based of Cochrane methodology.
In conclusion, the Deputy Director of the Nordic Cochrane Centre, Karsten Juhl Jørgensen, expressed his forward looking to a long and fruitful collaborative work.
The Conference organizers thank all speakers and participants who made the QiQUM2015 happen and ensured its success and impact on the development of Evidence-based thinking and approaches in on-going health reform in Russia and the NIS countries.
Proceedings of the International Conference “Evidence-based medicine: achievements and barriers (QiQUM 2015 December 7-8, 2015)” have been published in a special issue of the International Journal of Risk and Safety in Medicine (International Journal of Risk & Safety in Medicine,Volume 27, issue s1) and are freely available Open Access at: http://content.iospress.com/journals/international-journal-of-risk-and-safety-in-medicine/27/s1?start=0.
The Conference materials, including translation of presentations from International invited speakers, Conference endorsements and their translations into Russian, are available at Cochrane Russia website and at the Conference website:
http://kpfu.ru/biology-medicine/struktura-instituta/kafedry/kfikf/konferenciya/mezhdunarodnaya-konferenciya-39dokazatelnaya.html and http://russia.cochrane.org/news/international-conference
The websites provide interface for future communication and collaborative efforts of like-minded people to face the challenges ahead.
Footnotes
Acknowledgments
We would like to thank Ludivine Vernay for her help with translating into English of the Russian language conference report for this paper during her 4-months internship with Cochrane Russia at the Kazan Federal University.