Student spotlight: finding the way out of an Evidence-Based Health Care maze

Working as a GP trying to help patients, I always had the desire to improve the quality of care for “my” patients and maybe also those of others. Therefore, getting the chance to study the master course of “Evidence-based Healthcare” in Oxford was an utmost valuable experience for me.

During the modules on this programme, I had the opportunity to get a deeper insight into how evidence for improving health care is generated. The modules about Statistics were especially valuable for me. Richard Stevens and Jenny Hirst explained Essential Medical Statistics and Meta-analysis so passionately and unbelievable graphically. I remember feeling like not seeing the wood for the trees when looking at Forest Plots when starting to learn about Medical Statistics. This first impression changed completely as I gained confidence in interpreting research data. In the end, I liked calculating my own meta-analysis and creating my personal figures. I enjoyed entering a completely new world of statistical computing.

Beyond the factual input, it was amazing to meet so many interesting people from all over the world and to have the opportunity for innumerable engaging conversations. Those hours talking with other students were inspiring and I would even say I was able to find friends.

In my daily clinical practice, I had a lot of contact to people using minimally and non-invasive devices to monitor their blood sugar levels. Those devices are a great benefit for people with diabetes as they can monitor nearly continuously without the need to perform “bloody measurements” several times per day. However, I was irritated by how convinced people were about the reliability of those devices. Many people were taking uncertain risks because they had the impression devices’ alarm function would always warn them of life-threatening low glucose values. Looking at the advertisement of manufacturers, I could understand how people could get to that impression. But was this actually supported by scientific data? The topic for my dissertation was there – I was going to investigate how accurately minimally and non-invasive glucose monitoring devices were able to detect hypoglycaemia.

Working on the dissertation was the most challenging part of my studies. On the one hand, it was a great pleasure to bring the knowledge I could gain in the modules before into action. I remember enjoying being able to focus on a question in detail, to be so happy to find more and more studies contributing to my results, and to enter a completely new world of computer coding and statistics. On the other hand, the time was quite demanding and I remember nightmares of juggling with numbers and desperately searching for a way to escape out of the “R” software maze. In the end, I was proud of being able to finish the project and having contributed to the field of Evidence-based Healthcare.

Looking at the results of my dissertation, minimally and non-invasive devices are less reliable in detecting hypoglycaemic episodes than many had the impression they would.

For me, it was highly important to make people using those devices aware of this limitation. Therefore, I wanted to share my results with others. To write an article out of my analyses was nearly as labour-intensive as the whole dissertation. I had to overwork the project quite a bit to be able to submit the first version of the article to a journal. I was very disappointed when the manuscript got rejected at first. However, after getting back on my feet I could value the useful feedback I had received. I overworked the article again and then in the third round, it was accepted (https://rdcu.be/ctLKo). To be finally able to hold the publication in my hand, to have the chance to present the work at the annual meeting of the Society of Academic Primary care and a popular radio show was a great reward for the work. Now I am looking forward to another honour - returning to Oxford for Graduation.

In my daily life working as a GP and working as an academic at the Department of Primary Care at the University of Marburg, Germany, the knowledge and insights I have gained in Oxford keep being a source of inspiration to me.

The complete article on the accuracy of hypoglycaemia detection can be found here: https://rdcu.be/ctLKo

I sincerely want to thank my supervisor Tim Holt for his great support and Aya Kuwabara for being the best second reviewer I could ask for.