Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Saturday, November 21, 2015

Top Mind Prevails

"I spent many, many days in the dunce's corner. I think the teachers thought I was a challenge sent by the devil ... They were not themselves particularly educated about learning disabilities."
"....I have no understanding of grammar and I can only spell words I can visualize."
"Systematic reviews are part of the DNA of providing best practice guidelines, and that impacts the care we give to patients. That's why it's so important that they're done right and reported correctly."
Dr. David Moher, senior scientist, The Ottawa Hospital
Research relevance: About 40,000 clinical trials are ongoing at any one time, globally. They represent the most valid medical research, but also the most costly. The potential bias inherent in reported RCTs can severely overstate the effect of any intervention, such as a new treatment for malaria. Programs built on a foundation of faulty data cause suffering and waste money.
Systematic reviews are key means of accessing evidence in the ever-changing environment of healthcare. They provide a synthesis of available evidence and support strong decision-making. Those that are reported with low quality are likely to induce varying degrees of bias, thus distorting the estimates of the effectiveness (and harms) of interventions. Accurate and complete reporting of systematic reviews provides readers with a transparent record of the processes involved in a review's conduct, clarifies possible sources of bias, and allows the reader to make an informed judgment of the value and relevance of the evidence University Research Chair in Systematic Reviews
Dr. David Moher, of the Ottawa Hospital, is one of the most influential medical scientists in the world. Bruno Schlumberger file photo / Ottawa Citizen
Dr. Moher is a hugely unusual individual. He has had to struggle throughout his life with a kind of mental roadblock which has made it extremely difficult for him, as a man with a scientific mind to perform the most basic of communication pursuits; deciphering language patterns; in other words to do what most of us take for granted: reading. Some people with dyslexia tend to attempt reading and writing from right to left, so what could be more frustrating than having to cope with a mind that reacts in its own inimitable way?

Yet this is a man who has excelled in the world of medical science as an expert in the systematic review of medical studies, and one of the world's most influential scientific minds. So influential that as a clinical epidemiologist, one who has written and published over 500 research papers, many of those papers and their findings have been referenced over 25,000 times by other scientists. That is a rate indicating the trust placed in this man's unusual and precise mind to make sense of what others cannot.

He is placed among the top one percent of the world's most highly cited researchers. And yet dyslexia remains a challenge for Dr. Moher. Imagine, from childhood forward facing the never-ending roadblock of a mind that perceives and reacts differently than the norm. When we communicate it is in a certain manner, readily accessible to everyone. Almost everyone; anyone who cannot readily access communication is at a tremendous disadvantage. A small boy's trust in himself, an older student's morale, and an adult's determination to succeed despite clear adversity.

In Dr. Moher's case, his disadvantages were overcome by the sheer quality of his mind insisting that he persevere and find ways to go forward and to rise about his disability. As far as he is concerned it was for him a combination of inquisitiveness (the first mark of a scientific mind), perseverance and good fortune. The luck was represented by the encouragement he received working as a research assistant for an epidemiologist who saw his potential, urging him to apply for graduate school, poor marks be damned.

As a clinical epidemiologist whose scientific papers are of vital importance to the world of medical science and practise, he is also a University of Ottawa research chair and Director of Clinical Research, CHEO (Children's Hospital of Eastern Ontario) Research Institute. He is set to be awarded with a career achievement award in recognition of his contributions to medical science. "Instead of reading ten articles about the effectiveness of a drug or a device, why not read one study that aggregates those ten studies?", he asks, and this is precisely what he does.

Over 70 systematic reviews covering a broad range of subjects from cancer to diabetes, stroke to HIV and Ebola, along with a widely heralded systematic review of systematic reviews concluding that the quality of studies varies dramatically have led to advances in health care. These systematic reviews give physicians a summary of current evidence relating to the diagnosis and treatment of specific diseases with the reviews identifying the clinical studies on a given topic, analyzing the data contained in them, then synthesizing their findings.

Dr. Moyer developed reporting guidelines and a 25-point checklist in use by clinical trials researchers around the world, which came out of his analyzing thousands of clinical trials and identifying common shortcomings. His guidelines ensure that those research results are relevant and of use in a manner advancing medical science's efficiency and effectiveness. This is a man who struggled to become a health-sciences pioneer.

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