Hear Ranin Soliman's experiences during her recently completed DPhil in EBHC about generating evidence to improve childhood cancer health outcomes and resource use in Egypt

"Just as different locks need different keys to unlock them, different problems need different solutions to address them." In my DPhil thesis, I developed a context-specific conceptual framework of evidence synthesis from a global health perspective using real-world data and addressing the implementation gaps in resource-limited settings, generating relevant and applicable evidence to the local context.

- Ranin Soliman

Ranin’s DPhil thesis presented a context-specific conceptual framework of evidence synthesis to improve the survival outcomes and resource use for children with cancer in Egypt through generating three types of evidence: (1) real-world evidence from the Children’s Cancer Hospital Egypt – 57357; (2) systematic evidence from the literature; and (3) qualitative evidence based on experts’ opinions from the local context. Her DPhil work addresses evidence synthesis from a global health perspective using real-world data and addressing the implementation gaps in resource-limited settings, generating evidence relevant and applicable to the local context. Ranin’s DPhil work presents evidence-based recommendations to improve childhood cancer health outcomes, resource allocation, and managing costs effectively with implications for policymaking, clinical practice, and future research in Egypt.

Here she shares with us her experience of the DPhil and its impact on her current work and her future plans:

Tell me about yourself; what is your current work and where did you study previously?

I am currently working as the Head of the Health Economics and Value Unit at the Children’s Cancer Hospital Egypt – 57357. I graduated from the Faculty of Pharmacy at Cairo University in Egypt, then I joined the clinical research department at 57357 Hospital, where I conducted clinical studies to improve the survival outcomes of children with cancer and reduce chemotherapy-related toxicities. During that time, I pursued my Master’s degree in Health Informatics at Walden University in the US, and became a certified professional in healthcare quality. During my work in clinical research I was passionate about analysing patients’ data to determine patterns and trends in health outcomes, and make improvements in care delivery accordingly.  

Why did you choose Oxford for your DPhil and what helped you make that decision?

I learnt about the DPhil in Evidence-based Healthcare (EBHC) programme at the University of Oxford by pure chance. I was attending a conference about value-based healthcare in Oxford, during which I was introduced to Professor Sir Muir Gray who had organised the conference and he advised me to check out the DPhil in Evidence-Based Health Care programme. The moment I found out about the DPhil in EBHC  I became instantly excited to join it and realised that it was exactly what I had been looking for. After that I returned to Egypt, completed my DPhil application, was then shortlisted for an interview and got accepted onto the programme on my first attempt. For me, it was like everything fell into place perfectly.

And why evidence-based healthcare in particular?

I was very interested to learn more about evidence-based health care and discover what evidence-based medicine is, so that I could apply these concepts to help improve the health outcomes of children with cancer at my hospital in Egypt. I wanted to help promote evidence-based clinical decision-making and policy-making at 57357 Hospital and apply evidence-based practice that is relevant to our context and our patients in Egypt.

What has your experience of the DPhil been?

It has been such an amazing learning experience.  I did not expect I would learn so much and acquire so many research skills during my DPhil journey. My journey started with learning about conducting quantitative statistical analysis using R and STATA softwares, after which, I conducted all the statistical analyses in my DPhil research work using R software. I also attended several training courses throughout my DPhil to develop my skills in systematic reviews, evidence-based practice, qualitative research methods, decision modelling health economic evaluation, and putting knowledge into action.

Gaining the necessary knowledge and research skills was essential to carrying out the different research studies in my thesis and generating high-quality evidence combining: (1) real-world evidence using real-world data from Children’s Cancer Hospital Egypt (CCHE) through conducting three retrospective cohort studies to identify key priority areas from the local context; (2) systematic evidence from the literature through conducting a systematic review study to synthesise the best currently available evidence about a local priority area; and (3) qualitative evidence through conducting a qualitative interview study with clinicians at CCHE to identify the implementation gaps and translate evidence into practice.

Throughout the five years of my DPhil, I published six articles from my thesis in international peer-reviewed journals, and presented my research findings at several international conferences including EBM Live at the University of Oxford. 

What was your experience of academic support/supervision?

I am grateful for my amazing supervisors for all their support and guidance throughout my DPhil journey. I thank Professor Carl Heneghan for his mentorship and intellectual guidance throughout my DPhil. He has opened up new horizons of thinking for me that I did not know existed, and has encouraged me to reach my full potential. I truly appreciate the fact that he believed in me and gave me the space to develop and articulate my critical thinking skills, which enabled me to develop the conceptual framework underpinning my DPhil thesis and to become an independent researcher under his supervision and guidance. I thank Dr Jason Oke for always being there for me and providing technical guidance on the statistical analyses conducted in my thesis. He provided insightful answers to all of my statistical analysis queries, and helped me through when my Cox model was not fitting properly. I thank Dr Anne-Marie Boylan who supervised the qualitative component in the last chapter of my thesis. She has helped me realise the importance of understanding the research context, clinicians’ concepts and beliefs, to help translate the generated evidence into practice. It has been my absolute pleasure and inspiration to have worked with them all.

 What have you enjoyed, what surprised you and have there been any barriers for you or things that could be improved?

I enjoyed spending my time here in Oxford as I fell in love with Oxford at first sight and will truly miss spending time in this inspiring and wonderful city. I really enjoyed my discussions with my supervisors and all our online and in-person meetings throughout the years. I always learned something new from them every time we met to discuss my research work. I enjoyed attending the courses and communicating with other students and various people from the department where we shared common research and personal interests. Another thing I really enjoyed was acting as the student representative for the DPhil in EBHC programme over two years, and working with Jamie Hartmann-Boyce, the director of the DPhil programme. She has supported me to create the Evidence Resonates initiative which connects EBHC DPhil students, enabling them to communicate their research work addressing diverse health problems and healthcare disciplines around the world, with an evidence-based approach that resonates with many research areas and methods. Working on this initiative and writing several blogs about how evidence resonates with different research methodologies and different stakeholders (policymakers, clinicians, patients, and the public) was one of the most interesting experiences that I had here in Oxford.

What surprised me? The COVID–19 pandemic surprised me and was a barrier at times, as there were travel restrictions and I could not go to Oxford to meet with my supervisors in person for around a year and a half. I felt that was the biggest barrier during my DPhil. Then another surprise happened and I became pregnant with twins, which was a nice surprise, but quite challenging as well, as I had a very difficult pregnancy and got COVID–19 during my pregnancy. After having the babies I suspended my DPhil for maternity leave for one academic term. Then I returned to my normal research work and studies. During these challenging times my supervisors were very understanding and supportive and truly cared about my well-being. Also, Jamie was so kind and supportive and provided helpful advice to get through these times (managing my DPhil studies and the baby twins). They all made me feel at ease and became like family to me over time.

When you were able to come here, how did you find Oxford as a place to study and stay?

From my very first visit to Oxford I had the impression that I had stepped into some sort of fairy-tale; a vibrant city bursting with a passion for knowledge, eagerness to learn, and a sense of authenticity.  I really enjoyed my visits and found it an inspiring place to study and stay. 

So, what are your plans now for the future?

Having completed my DPhil in EBHC, I hope to translate the evidence I generated during my DPhil into evidence-based practice and policy-making to improve the health outcomes of children with cancer in Egypt, with optimal resource use and managing costs effectively. Besides this, I am eager to spread the knowledge and skills I have gained over the years in evidence-based healthcare to my country, Egypt, emphasising the importance of generating real-world evidence, systematic evidence from literature, and qualitative evidence based on experts’ opinions. Furthermore, I am hoping to support evidence-based policymaking and decision-making in key health priority areas in Egypt, through capacity building, generating relevant research evidence, and translating evidence into practice. 

What would your advice be to students considering studying a DPhil in EBHC at Oxford?

For those thinking about applying for a DPhil in EBHC at the University of Oxford, I would strongly advise them to choose a research topic that they are truly passionate about, and willing to dedicate several years of their lives to working on. This is because studying for a part-time research-based DPhil at Oxford requires a lot of hard work and effort, alongside other job responsibilities and family/personal commitments. I would also advise them to enjoy it while it lasts. It is once-in-a-lifetime experience and they should make the most of it.