Zheln on World EBHC Day 2021

Zhelnov P. Zheln on World EBHC Day 2021. Zheln. 2021 Oct 20;Suppl:s31e2. URI: https://zheln.com/summary/2021/10/20/suppl/.

Short Intro to Zheln

First of all, I would like to welcome you at the Zheln website once again. As Zheln has been on hiatus since exactly December 30, 2020, due to a lack of funding, nothing new has happened since then. So I am not going to be repetitive and just throwing in some links to the previous materials that fairly describe what was happening on Zheln while it was active:

• For the latest account of Zheln, see The 30th Anniversary Summary Post.
• The Running Out of Funds summary post—the activity interruption announcement. You can read there that I was planning to keep uploading records, but I was unable to do that too. I am really sorry.
• You can find links to all the reviews included in Zheln and selected for appraisal so far in the same Running Out of Funds summary post. Alternatively, you can directly search for appraisals or browse appraisals by AMA specialty.

Why World EBHC Day?

World Evidence-Based Healthcare Day is a global initiative launched in 2020. The topic for the 2021 campaign is the so-called infodemic and any ways/experiences of tackling it. I applied for Zheln to become an Evidence Ambassador for the #WorldEBHCday campaign, and this request was proudly honored.

Evidence Ambassadors are supposed to provide insight on or resources for managing the (mis/dis)information overload and raise awareness about any ongoing counter-measures. Honestly, I believe there is essentially one path to raising quality of public health information: to improve quality of the information outgoing from the sources most trusted by the target communities. Alternatively, one could introduce another trusted source. If you look at it, the model is no different from the model for improving quality of any other good or service on the market. As summarized in the seminal book on customer development, The Startup Owner’s Manual by Steve Blank and Bob Dorf, a new business (or an evidence initiative, in our case) can simply enter an existing market, resegment one, or create a new one. For evidence initiatives, it could mean identifying and influencing the information sources their communities primarily rely on or introducing new ones while making sure to divert attention of the communities.

But What Exactly Are We Going to Do?

I was very delighted to read a recent post in BMJ Evid Based Med by Kari Tikkinen and Gordon Guyatt about how we should probably put less focus on critical appraisal skills when teaching health care practitioners and talk more about applying point-of-care resources, such as UpToDate or Medscape, as well as lower-level evidence syntheses like systematic reviews. In fact, this has turned out to be the most viable option given limited time capacity and research methodology training of people who deliver health care services every day. Then we, as evidence advocates, should put more resources into keeping these websites and mobile apps updated and readily available and ensuring quality of this information. It is not enough to ensure that this information exists­—we should also ensure it is placed where everyone is likely to retrieve it from. This also goes for health information for general audiences, but implementation seems much more complicated in the latter case.

To wrap up, I think we need a single, most popular resource that every health practitioner would go to and easily retrieve the most recent and carefully examined health information for their needs; ideally it should be routinely available at some static place so that practitioners could plan their continuous medical education activities in advance. Ideally, also, the same resource should have a general audiences section, recognized as the top information provider for public health media. Arguably, there is no such resource today.

Cochrane was viewed as something of this sort by many, but it seems clear to me now that its capacity is not enough these days. Cochrane cannot do everything. Also, we already have wonderful point-of-care resources mentioned earlier, but they are too narrative in general and do not incorporate living evidence syntheses. Among the latter, however, we have the Trip database, L·OVE by Epistemonikos, Health Evidence, and mind-blowing COVID-19 resources such as COVID-NMA, COVID-19 LNMA, and COVID19 Recommendations and Gateway to Contextualization, to name a few. But despite this variety of options (or rather, probably in part due to it), in my opinion, the problem still stands: we have no single best resource, no one-stop-shop option. Whether we like it or not, people love it when they can find something at the same place at all times­—people like to form habits.

So What Are We Going to Do, For Crying Out Loud!?

Zheln is going to continue exploring options for putting it all together. Zheln is definitely not dead, but it could take other forms in the future. I am absolutely not worried about the brand—I am only worried about bringing my above-mentioned vision into reality (if it is shared by the community, that is). The more I think about it, the more it seems to me that the logical next step is to perform a scoping review of existing platforms for ‘universal living overview of health-related’ information (both practitioner- and lay-oriented) and their relative success. To be even more specific, I am currently looking for PhD opportunities so that I could fund my work and collaborate with professionals in the field more easily. It would be really cool to actually contact the above-mentioned parties and do business with them.

Thank You for Being Here, and Happy World Evidence-Based Healthcare Day! 🎉

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