Dave Sackett, a professor emeritus at McMaster University in Hamilton, has been awarded the prestigious Gairdner Wightman Award, which is given to a Canadian who has demonstrated outstanding leadership in medicine. He received his award last night at a gala event in Toronto.
Dr. Sackett is a pioneer in the field of clinical epidemiology and evidence-based medicine, which aim to teach health professionals how to separate good research from bad and apply it to the individual needs of their patients. He is also a world expert on the design and implementation of clinical trials.
In 1967, at age 32, he established the department of clinical epidemiology and biostatistics at the newly-created McMaster medical school, then went on to do hundreds of clinical trials, some of which had massive implications, such as the research that showed the benefits of Aspirin for preventing heart attacks and strokes.
At age 49, Dr. Sackett took up clinical practice, becoming physician-in-chief of Chedoke-McMaster Hospitals. In 1994, he turned to academia, as founding director of the Centre for Evidence-Based Medicine at Oxford University. Five years later, Dr. Sackett retired from clinical practice and founded the Trout Research & Education Centre in Markdale, Ont., where he reads, researches, writes and teaches about randomized clinical trials.
Dr. Sackett sat down with Globe and Mail reporter André Picard to discuss his contribution to medicine.
You are the dean of "clinical epidemiology." Does that concept, from many decades ago, still matter?
Well, it was the forerunner of evidence-based medicine in that it was from clinical epidemiology that we developed these quite straightforward tactics and methods for looking at an article and determining if it was likely to be true.
You are the dean of “clinical epidemiology.” Does that concept, from many decades ago, still matter?
Well, it was the forerunner of evidence-based medicine in that it was from clinical epidemiology that we developed these quite straightforward tactics and methods for looking at an article and determining if it was likely to be true. It was the outgrowth of the Cuban missile crisis. I was a bench researcher in Chicago when [Soviet premier Nikita] Khrushchev put the missiles in Cuba. I was pulled from the lab and put into military service. It was the public-health service rather than the navy so I had to start learning epidemiology and biostatistics. In public health, you study epidemics, large populations and so on. I thought, wouldn’t it be interesting, perhaps useful, if I took those methods from public health sciences and tried to apply them to individual patients? I needed to name it something so I called it clinical epidemiology and started a unit in Buffalo. The folks at McMaster University found out about it and asked me to come up and help start the medical school.
You are a pioneer in evidence-based medicine. This is a major issue for health professionals, but does it matter to the public?
I think it matters to the public because it represents bringing together for clinicians the three crucial elements that patients are going to benefit from in interacting with health professionals:
1) We have much better evidence of what works and what doesn’t work, what is risky and what is beneficial, than we ever had before;
2) We’re much better than we ever were before at getting that information into a form that can be accessed quickly by clinicians and the public and;
3) The essential piece in terms of the public perspective: We now have better ways of bringing patient desires, expectations and what they deserve into that equation.
So it’s a combination of the evidence, the clinical expertise and the patient’s views that come together. It was difficult to do it before so we decided to stick a new name on it – evidence-based medicine.
In the age of the Internet is it easier to get that information and, if so, are we making better use of the information?
