#TRIALSYM15

The original purpose of this blog was as an entirely personal, reflective project. In the last few weeks (not that the blog has a history before this) it has become a forum for my reflections on events I have attended of a general medical innovation bent -the AMEE Hackathon and a CCIO meeting.  And now it is the turn of the inaugural Clinical Trials Methodology Symposium of the HRB’s brand new Trials Methodology Research Network. I only attended day 1 of this event which is a pity. The hashtag #trialsym15 is being used on Twitter so proceedings can be followed there. I won’t try and summarise proceedings here as it would be a little too much “he said… she said…” but give some reflective thoughts, especially following on from my prior posts.

As a full time clinician with an aspirational interest in research (ie a desire to take part in it that is often foiled) I find the concept of a network very appealing, and having an interest in conceptual issues in mental health and illness the methodology element is also fascinating.   It is rather invidious to select highlights; one was Sir Iain Chalmers , a founder of the Cochrane Collaboration (the logo of which incorporates a metaanalysis performed by an Irish doctor, Patricia Crowley ) who in a fascinating talk showed how, contrary to what is often taught, the randomised controlled trial did not emerge in 1948 from statistical theory but from a much longer history of clinical researchers engaging in fair trials of treatment.

Another was NUI Galway’s John Newell who gave the most engaging talk by a statistician I have ever heard

(his NUIG bio photo is also pleasingly Action Man-y)  john_newell

Newell gave a really honest and inspirational talk on translational statistics, and conveying statistical concepts to non-statistician audiences. I also learned about an egregious misuse of statistics by no less a moral authority than Fintan O’Toole … in a rather self-righteous article decrying the misuse of statistics. “The most entertaining talk I ever heard by a statistician” probably sounds like a set-up for a joke, but actually statisticians in my experience tend to be a wry lot. Newell’s talk really was the most entertaining talk I ever heard by a statistician.

I also enjoyed the total absence of the words “transform” or “revolutionise.” This was a particularly evident absence in Prof Craig Ramsay’s  witty, optimistic-yet-realistic presentation on  implementation science or knowledge transfer or (insert current description of this field here) . I had to pop out for a call towards the end (see the passing comment on not having time to do research above!) and, lurking at the door afterwards, was interested to hear him discuss developing research teams integrated into clinical settings. This chimed with some of my thoughts on the technology-health interface discussed towards the end of my Glasgow Hackathon post

The dynamic between technology and healthcare (and technology and education) is becoming one of the themes of these blog posts. My Glasgow experience made me wonder if the dynamic is, almost irretrievably, biased towards the tech being in the driving seat. I was more reassured by the CCIO meeting and even more impressed today by the amount of thought going into methodology by the likes of Prof Ramsay and the COMET Initiative .

Another highlight was Prof Peter Sandercock’s at times harrowing account of the travails of the International Stroke Trial and an illustration of the downside of social media and healthcare’s interaction. A questioner asked him about his current thoughts on pharma and drug trials. To paraphrase his reply, he said that he worried less about pharma influence, which is now highly scrutinised and regulated, than the medical device industry, which is not to anything like the same degree.

This got me thinking again about the deification of tech, or rather a certain kind of tech. Big Pharma is now a regular movie villain, whereas medical devices are Good Tech and therefore only criticised by fogeys. As it happened, during the day I came across a blog post by my  friend Phil Lawton  which, in dealing with the recent move of the Web Summit from Dublin, captured many of my own thoughts not only about the uncritical adoration of tech, but also about Dublin itself – especially as a Dublin native now happily domiciled a long long way away in Tipperary.

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