ILS conference in Leiden the Netherlands

source leidenuniv.edu

I am back in the Netherlands this week. I’ve got some meetings planned, catching up with former colleagues, meeting some new people interested in working together on new projects I am starting up in Berlin, and of course I am meeting some friends along the way. But there is one more reason for me to go to the Netherlands this week: I was invited to the Interaction between legal systems conference. This international conference is organized by the Law faculty in Leiden and is focused on how different legal  systems interact, but also how legal systems interact with other fields of research and areas of expertise (e.g. psychology, statistics and epidemiology). More information on the conference can be found here.

But what am I doing there? I am going to talk about my interdisciplinary project on how civil law, and especially liability cases, relate to causal inference in epidemiology. This project, together with ILS conference organiser PWdH, is one of my pet projects in which we compare the concepts behind causal inference in both clinical epidemiology as well as legal systems. Both systems rely on the condicio sine qua non principle, where the idea is that the consequence of a cause would not have happened if the cause would not have been present. This idea is of course known as the counter factual theory in epidemiology, and is related to the potential outcomes approach. But this is only the start, as there are several problems and challenges that come up: although epidemiology has recognized the idea of multi causality for some time (think component causes), legal systems have only been working with  this  only for a couple of years and with some hesitance. A way to use this in liability claims is to use proportional liability, where the claim should be proportional to the number of factors the defendant is responsible for.  Sounds cool, but how to get to a fair division? How to interpret evidence? And can we use population measures like the population attributable fraction to substantiate a ruling on individual level?

I am invited to talk about this project, bust mostly and to tell the story of interdisciplinary research. It goes without saying that working on something so far from your own comfort zone brings along a lot of challenges and problems. For example since you can only oversee the quality and relevance of part of the project, you have might have the feeling that what you are working on is kind of useless (really, is this interesting?). But on the other hand, the questions that came up during this project also provided me with some insight into the concepts of epidemiology. Explaining why the things in your field are as they are will confront you will inconsistencies in your field and in your own thinking. I noticed that this project learned me a lot about the things I thought I understood, and that is for me the true added value of interdisciplinary research.

 – update jan 26: I uploaded a pdf version of the presentation, which can be found here (pdf)
– update march 17:I visited Leiden again, now on the invitation of the dept of criminal law to talk about the concept of multi causality. We decided that we might need to braoden this into a dutch publication, with e viewpoint from both tort law and criminal law. Interesting!

The professor as an entrepeneur

picture: onderzoeksredactie.nl

Today, I’ve read a long read from the onderzoekdsredactie, which is a Dutch initiative for high quality research journalism. In this article they present their results from their research into the conflicts of interest of profs in the Netherlands. They were very thorough: they published a summary in article from, but also made sure that all methodological choices, the questionnaire they used, the results etc are all available for further scrutiny of the reader. It is a shame though that the complete dataset is not available for further analyses (what characteristics make that some prof do not disclose their COI?)

The results are, although unpleasant to realise, not new. At least not to me. I can imagine that for most people the idea of prof with COI is indeed a rarity, but working in academia I’ve seen numbers of cases to know that this is not the case. The article that I’ve read was thorough in their analyses: it is not only because profs just want to get rich, but this concept of the prof as an entrepreneur is even supported by the Dutch government. Recent changes in the funding structure of research makes that ‘valorisation’, spinn-offs and collaboration with industry partners are promoted. this is all to further enlarge the ‘societal impact’ of science. These changes mightinded enforce such a thing, but I think that the academic freedom that researchers have should never be the victim.

CSB Virchow stipend

Are you a young researcher? Want to learn epidemiology? In Berlin? By doing a research project on stroke? Then boy, have I got news for you. The Center for stroke research has made funds available for young scientist to visit Berlin and work on a epidemiological project. From the website strokecenter.de

The Center for Stroke research Berlin (CSB) started the CSB – Virchow Stipend to encourage young stroke researchers to broaden or deepen their knowledge of epidemiology in the field of cerebrovascular disease through the execution of an epidemiological project. The stipend is aimed to stimulate (inter)national collaborations and therefore applicants are encouraged to collaborate with a CSB researcher on a joint project that can be executed during the stay in Berlin.

The stipend allows the awardee to travel to Berlin to work at the CSB for up to 3 months. The stipend covers all costs related to this visit with a maximum of € 4000 (€ 1000 for travel and 3 × € 1000 for accommodation).

Enthusiastic? Apply now for the first round (deadline is 12.12) or perhaps wait for the next call! Please find more information here.

New article published – but did I deserve it?

One of these dots is me standing on a platform waiting for my train! Source: GNCnet.nl

This website is to keep track of all things that sound ‘sciency’, and so all the papers that I contributed end up here with a short description. Normally this means that I am one of the authors and I know well ahead of time that an article will be published online or in print. Today, however, I got a little surprise: I got notice that I am a co-author on a paper (pdf) which I knew was coming, but I didn’t know that I was a co-author. And my amazement grew even more the moment that I discovered that I was placed as the last author, a place reserved for senior authorship in most medical journals.

However , there is a catch… I had to share my ‘last authorship’ position with 3186 others, an unprecedented number!

You might have guessed that this is not just a normal paper and that there is something weird going on here. Well weird is not the right word. Unusual is the word I would like to use since this paper is an example of something that I hope will happen more often! Citizen scientists. A citizen scientist is where ordinary people without any background or training can help in a scientific experiment of some sorts by helping just a little to obtain the data after some minimal instruction. This is wonderfully explained by this project, the iSpex project, where I contributed not as an epidemiologist, but as a citizen scientist. If you want to know more, just read what I have written  previously on this blog in the post ‘measuring aerosols with your iPhone’.

So the researcher who initiated the iSpex project have now analysed their data and submitted the results to the journal Geophysical research letters, and as a bonus made all contributing citizen scientist co-author. Cool!

Now lets get back to the question stated in the title… Did I deserve an authorship on this paper? Basically no: none of the 3187 citizen scientist do not fulfil the criteria of authorship that I am used to (i.e. ICMJE), nor fulfil the criteria of the journal itself. I am no exception. However, I do believe that it is quite clear for any reader what the role of these citizen scientist was in this project. So this new form of a authorship, i.e. ‘gift authorship to a group of citizen scientists’ is a cool way to keep the public engaged to science. A job well done!

New publication “Graphical presentation of confounding in directed acyclic graphs”

source: wikimedia.org

A new publication became available, again an ‘educational’. However, this time the topic is new. It is about the application of directed acyclic graphs, a technique widely used in different areas of science. Ranging from computer science, mathematics, psychology, economics and epidemiology, this specific type of graphs has shown to be useful to describe the underlying causal structure of mechanisms of interest. This comes in very handy, since it can help to determine the sources of confounding for a specific epidemiological research question.

But, isn’t that what epidemiologist do all the time? What is new about these graphs, except for the fancy concepts as colliders, edges, and backdoor paths? Well, the idea behind DAGs are not new, there have been diagrams in epidemiology since years, but each epidemiologist has his own specific ways to draw the different relationship between various variables factors. Did you ever got stuck in a discussion about if something is a confounder or not? If you don’t get it resolved by talking, you might want to draw out the your point of view in a diagram, only to see that your colleagues is used to a different way of drawing epidemiological diagrams. DAGs resolve this. There is a clear set on rules that each DAG should comply with and if they do, they provides a clear overview of the sources of confounding and identify the minimal set of variables to account for all confounding present.

So that’s it… DAGs are a nifty method to talk the same idiom while discussing the causal questions you want to resolve. The only thing that you and your colleague now can fight over is the validity of the assumptions made by the DAG you just drew. And that is called good science!

The paper, with first author MMS, appeared in the methodology series of the journal Nephrology Dialysis and Transplantation, can be found here in pdf, and also on my mendeley account.

New publication in NTVG: Mendelian randomisation

Together with HdH and AvHV I wrote an article for the Dutch NTVG on Mendelian Randomisation in the Methodology series, which was published online today. This is not the first time; I wrote in the NTVG before for this up-to-date series (not 1 but 2 papers on crossover design) but I also wrote on Mendelian Randomisation before. In fact that was one of the first ‘ educationals’ I ever wrote. The weird thing is that I never formally applied mendelian randomisation analyses in a paper. I did apply the underlying reasoning in a paper, but no two-stage-least-squares analyses or similar. Does this bother me? Only a bit, but I think this just shows the limited value of formal Mendelian Randomsation studies: you need a lot of power and untestable assumptions which greatly reduces the applicability of this method in practice. however, the underlying reasoning is a good insight in the origin, and effects of confounding (and perhaps even others forms of bias) in epidemiological studies.Thats why I love Mendelian Randomisation; it is just another tool in the epidemiolgists toolbox.

The NTVG paper can be found here on their website (here in pdf) and also on my mendeley account.

Quackery conference kicked out of LUMC

So I got a newsarticle in my RSS reader from the Dutch society against quackery describing the story how a quack conference was banned from the lecture halls from the LUMC. This is an interesting item, because it shows what happens when there are non scientific groups working in an academic environment. With that I mean that the guys from the Boerhaave committee, which is the LUMCs own conference bureau, can be approached by anyone to organise a conference. But a conference ‘organised by the LUMC’, held in the LUMC lecture halls has a different feel to it then just some guys who booked a room in a hotel somewhere. It feels like the content is sanctioned by the LUMC. Academia and academics must be aware of their status and not just lend their name(s) to anyone, even if you can earn an honest buck or two. This important understanding of the role of academia in society will become ever more important with valorisation and industry-academia partnerships.

Now I know that there are safeguards in place to prevent this from happening with the Boerhaave committee and apparently this kind of works, since the guys from the Society for Scientific Exploration (SSE) are no longer welcome in the Halls of the LUMC. Although I did not study the scientific validity of ‘biophotons’ completely, what I have been reading is not pretty.

Full disclaimer: I am a member of Dutch the society against quackery, I am an employee of the LUMC and I have worked with the Boerhaave committee in the organisation of the WEON.

Moving to Berlin!

After about 8 years learning and working in Leiden at the LUMC, it is time for something new. I’ve got a new job as the head of the ‘Clinical Epidemiology and Health Services Research in Stroke’ unit at the Center for Stroke research in Berlin (CSB, http://www.schlaganfallcentrum.de). This a very exciting opportunity for me: working with new colleagues on new projects, learning more about stroke research and strengthen the epidemiological studies that are executed at the CSB. I am looking forward to work with these brilliant and creative minds especially the guys from the CEHRIS team.

With moving to Berlin I will have to leave Leiden, which do regret. Not only because of the great research, but also because of the students and co-workers. Fortunately, I think that this new chapter in my academic life will provide ample opportunity to start new collaborations between Berlin and Leiden.

“BKO”

Today I got a letter stating that I have fulfilled all requirements for my BKO certificate. “BKO” is the Dutch acronym of the University Teaching Qualification certificate. It is the cornerstone of a nationwide effort to ensure that all teachers at the university have a basic understanding of everything related to teaching. Or, as is stated at the website of the Leiden University

Good teaching is of critical importance to the University. Good teaching is a skill in itself and it is one that you must develop and maintain. Only then can the University offer the quality that students deserve. The Dutch universities therefore introduced the University Teaching Qualification (UTQ) in 2008. The UTQ is a mark of quality for lecturers who have thus proven that they have mastered the craft. It is a basis from which they can further develop their skills. Show what you can do!

 

Although it is a bit of a hassle to do all courses and assignments, I believe that ensuring a basic teaching quality for university teachers is in principle a good thing… But is “BKO” enough? Only time will tell.

Honours Class ‘academic entrepeneurship’

Yesterday I was part of the Honours Class ‘academic entrepeneurship’, organised by the Leiden University in the ‘Living Lab’ | center for innovation. Together with 15 students we discussed how a scientist should be aware of the contect he is working in. From their website

 

Als wetenschapper communiceer je met veel uiteenlopende groepen: mede-wetenschappers, maar ook ‘het brede publiek’: je wilt hen informeren over jouw onderzoeksresultaten, en het is belangrijk dat je duidelijk maakt waarom jouw onderzoek belangrijk is. Verschillende vaardigheden zijn dan van belang: schrijven, presenteren, omgaan met ‘de media’ etc. Met sommige van deze vaardigheden zul je kennis maken in een (gast)college, met andere, zoals schrijven, ga je zelf aan de slag.

Om onderzoek te doen, is geld nodig en de hedendaagse wetenschapper moet daarom ook  ‘academisch ondernemerschap’ ontwikkelen: subsidies aanvragen en budgetteren zijn daarbij belangrijk.

My contribution was that the surrounding of a scientist also influences his actions and choices. We discussed the concept of scientific integrity and how integer behaviour might (or might not) be dependent on the context. In the end the students have to think how they can or might even should be aware of the threats to their scientific independence they might encounter while doing their research… I am curious what their answers are going to be!

preconference workshop ‘crash course peer review’ cancelled

I worked together with some partners on a new workshop for young epidemiologist. The title says it all: WEON preconference workshop ‘crash course peer review’.

Unfortunately, we had to cancel the workshop because the number of participants was to low to justify the effort of not only myself, but especially all the other teachers. I think it is a pity that we had to cancel, but by cancelling we still have a fresh start whenever we want to try again in a different format.

Whilst preparing this workshop I noticed that peer review, or a better term would be refereeing, is not popular. It is seen as a task that task up to much time, with too much political consequences and little reward etc. New initiatives like Pubmed commons and other post publication peer review systems are regarded by some as answers to some of these problems. But what is the future of refereeing, when young epidemiologist are not intrinsically motivated to contribute time and effort to the publication process? Only time will tell.

For those who are still interested in this crash course, please contact me via email.

 

Research in the media

Research in the media. It is however not my own research, but these two newspaper articles are related to my research.The first article (pdf) is on the role of helmets for scooters. This is linked to the publication on the risks related to motorised two-wheel vehicle crashes. (cick here for the pubmed entry)
1

The second article from the same edition of the NRC is related to the topic of my thesis. It is about the role of FXII in thrombosis, based on a publication by Thomas Renne et al in Science translational medicine. Antibodies against FXII downregulate the pathological thrombogenenis during extracorporeal circulation. These antibodies might be used in the prevention of clots during heart-lung surgery, but might also be applied in the prevention of thrombosis, both arterial and venous. Click here (pdf) for the NRC newspaper article, and here for the original research by Renne et al.

2

New article: the intrinsic coagulation proteins and the risk of arterial thrombosis

I got good news today! A manuscript on the role of the intrinsic coagulation factors in the causal mechanisms leading to myocardial infarction and ischaemic stroke has been accepted for publication by the JTH. It took sometime, but in the end I’m very glad that this paper was published in the JTH because its readership is both clinical as well as biomedical: just the place where I feel most at home.

The basic message? These factors do contribute to ischaemic risk, but not to the risk of myocardial infarction. This is mostly the case for coagulation factor XI, which is a nice finding, because it could be a new target for anti-thrombotic therapies.

The article is now in print and will be made available soon. In the mean time, you can refer to my thesis, in which this research was also described.

Retraction Watch – blog on retractions of scientific articles

I’ve been a fond reader of retraction watch for over a year now. It is quite interesting to read the reports of how science corrects their own mistakes. Sometimes it is just plain old fraud, such as the case of Stapel, but also other Dutch researchers. But sometimes the stories behind the retractions show that there are also ‘legitimate mistakes’ that lead to such a retraction, for example this retraction from Genes and Development in which “it’s quite clear there isn’t even a whiff of misconduct or fraud”. Please check out the Retraction Watch blog or read an interview with one of its founders  which appeared in the de Volkskrant.

On being a scientist – second meeting planned

After our first pilot of our workshop ‘on being a scientist’ it is time for the second installment. The date has been set (feb 19th), and the location remains unchanged. Slight changes to the programme though! Afterall, whats the use of a pilot if you don’t learn from it. The main program remains the same, as you can see below:

  • Introduction
  • A short history of scientific misconduct, the case of the Netherlands
  • From Fishy to fraud – a discussion about the grey area
  • PhD candidates: a special case?
  • Closing remarks

Hope to see you there!

credit and accountability: new authorship rules by ICMJE

The international consortium of medical journal editors (ICMJE) have issued a new version of their recommadations.The most important change is the addition of a fourth aspect to the list of authorship criteria. According to their motivation , this addition was inspired by cases of scientific misconduct investigation in which authors denied responsibility (e.g. “I didn’t participate in that part of the study or in writing that part of the paper; ask someone else”). According to the ICMJE, authorship requires:

1 | Substantial contributions to: the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND

2 | Drafting the work or revising it critically for important intellectual content; AND

3 |Final approval of the version to be published; AND

4 | Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved

To my opinion, this addition is a good way to help researchers think about their role in the writing process: am I involved enough to justify an authorship?

However, denying responsibility of a case of scientific misconduct is in my book not the same as being responsible of the misconduct. This addition could lead to the situation where such a denial equals scientific misconduct. Isn’t that a bit to harsh? Also, the fourth criterion reflects your actions in a situation in the future, not the work that has already been done as is the case is criteria 1-3.  It is possible to compare your actions of the past to the criteria, but this is more problematic for the future. For example, a researcher might be willing, but unable to help in an investigation (e.g. change of lab). This might lead to several problems in the future, especially for young scientist who often change research groups. To make this fourth criterion work, the idea of the fourth criterion should lie in the willingness to help, the act of helping itself.

New publication: LTTE in the American Journal of Epidemiology

12.coverAt the department of Clinical Epidemiology of the LUMC we have a continuous course/journal in which we read epi-literature and books in a nice little group. The group, called Capita Selecta, has a nice website which can be found here. sometime ago we’ve read an article that proposed to include dormant Mendelian Randomisation studies in RCT, to figure out the causal pathways of a treatment for chronic diseases. This could be most helpful when there is a discrepancy between the expected effect and the observed effect. During the discussion of this article we did not agree with the authors for several reasons. We, AGCB/IP/myself, decided to write a LTTE with these points. The journal was nice enough to publish our concerns, together with a response by the authors of the original article. The PDF can be found via the links below which will take you to the website of the American Journal of Epidemiology. The PDF of our LTTE can also be found at my mendeley profile.

original article
letter to the editor
response by the author

The pharmaceutical industry, both good AND bad

As said, I spoke at the “Gezondheidszorg in Vogelvlucht” symposium, organised by the Leidse Co-raad for all students doing their clinical rotations on the topic of the role of the pharmaceutical industry in medicine.

Previously I told you that I wondered what kind of presentation it would be. During the preparation the story became clear to me… there is no way to choose between good or bad… they are both. How come? There are some serious problems in the way medicine is organised how it comes to new decisions on treatments. Missing data from trials indeed hamper the way doctors can decide what treatment to give and which not. So, I did talk about the book Bad Pharma and our Bad Pharma Symposium. But this was not all. Science has taken a beating lately, for example in the Economist article from October. And while preparing this talk I learned that Science and pharmaceutcal companies can learn a lot from each other. 

During the presentation I used two books: Bad Pharma, which can be bought everywhere, or borrowed from the Walaeus Library of the LUMC, and Arrowsmith, a great coming of age novel by Sinclair Lewis, about a young scientist doctor who is struggling with the questions young doctors/scientist all encounter. I will write a longer post on that novel somewhat later, but in the mean time you can download the free e-book here

A pdf from my lecture can be downloaded here: Big Pharma co raad symposium  2013 (pdf)

Bad Pharma 2013 – a great succes

bad pharma skype

300 students reading one book, summarising it contents and discussing three propositions in order to grasp the essence of the book. This might sound a bit boring perhaps…But what if it Goldacres book Bad Pharma, you only have to read 30 pages and still get the content of the complete book, and get to Skype with the author? Great fun!

And we weren’t the only who had fun: Ben Goldacre addressed 300 students, all with critical questions, and apparently he enjoyed the whole debate:

We also invited AV, a spokesperson of NEFARMA an organisation who represents most pharmaceutical companies in the Netherlands. With him we discussed whether the AllTrials campaign was a waste of time and money. Also, BB  a reporter from the Mare, who has knowledge on conflict of interest of professors joined in on the discussion whether professors should declare their COI before each lecture. All in all, it was a great day in which some of the students were shocked by the message of Ben Goldacre, whereas other students were not impressed and doubted whether there view is too one-sided… The debate still continues!

Bad Pharma Symposium on the front page of Mare

Mare 2013 11 28 Bad Pharma  - front pageThis week, the Mare decided to run a story on Bad Pharma book by Ben Goldacre and our related symposium. The author, BB did an outstanding job in describing the argument Goldacre brings forward in his book. As you might know, we are organising a symposium for our 300 students that are following our course “academic and scientific training”, because I believe that doctors should learn about their field that they will graduate in once they have graduated. A quote from me in the Mare (in Dutch)

Dokter zijn gaat verder dan alleen het behandelen van één patiënt. Onze beroepsgroep heeft een bijzondere positie in de samenleving; mensen leggen letterlijk hun leven in je handen. Naast je arts-patiëntrelatie heb je ook te maken met de wetenschap, beleidsmakers en de farmaceutische industrie. Aankomende artsen moeten daarvan bewust worden en goed op de hoogte zijn van de ontwikkelingen in hun veld. Dit boek sloeg de spijker op zijn kop.

one little error slipped in… I am not a doctor and therefore it is officially not ‘onze beroepsgroep’ but i think people will grasp the point that I try to make. The complete article can be read here.

The pharmaceutical industry, a blessing in disguise?

I will speak at the “Gezondheidszorg in Vogelvlucht” symposium, organised by the Leidse Co-raad for all students doing their clinical rotations on the topic of the role of the pharmaceutical industry in medicine. Although I do not have any experience with working with commercial partners, I do have an opinion on such collaborations. The stories that were published before on this website might give you a hint: The Diane-35 story (part 1, 2 and 3) and the “Bad Pharma” the book by Ben Goldacre.

However, in the preparation of the course that started today I keep on wondering whether it’s all that bad. I guess it’s not. Sure, there is a lot to change in the way new medications find their way to their patients. Also, I believe that at some level commercial interest should not be the driving force of medicine. But there are lessons to learn from pharmaceutical companies: their R&D departments are highly effective and come up with great stuff. Also, companies like these have adopted strict protocols which might be used as a template to order the flow of data in academia to minimise sloppy science! These thoughts will keep me busy for the next couple of days while i prepare for my talk. To be continued!

Academic and scientific training about to start

After 7 months of preparation the new and improved version of the second year course ‘Academic and Scientific Training’ is about to start. Tomorrow, 300 students will come together for two weeks to learn the how and why of clinical epidemiology. We emphasize on testing new treatments in RCT, and how doctors should critically appraise the articles that describe these studies.

Together with AvHV, JS and others we were able to secure funding to buy 400 copies of the book “Bad Pharma” (click for more background) In order to organise a ‘Bad Pharma Symposium’. In this symposium, all students will read the whole book, do some research on three topics which will be debated in the final debate. This will take a lot of commitment of all students, but what to think of the 40+ Teaching Assistants that we need for this course!

All in all, it’s time to start!

On being a scientist – first pilot was a succes

Last week we had our first pilot of our workshop ‘on being a scientist’. When I first wrote about this I was talking about a LUMC workshop, but we’ve got an upgrade: the workshop is now targeted at PhD candidates from all over the university. This way ll participants can learn from the dfiferences and similarities between areas of research. Exciting stuff!

We started last week with a small group of 12 PhD candidates from all over the university. This pilot included candidates from law, physics, psychology, medicine and the campus The Hague were all present. Also present were TdC as a co-organiser and KS as our guest.

Although the formal evaluation forms have not been processed I guess we can establish that the pilot was succesful and with that I mean that the pilot showed that we are on the right track: of course some of the content needs to be changed, but the general flow of the workshop was great. The same goes for the participants and the location.

Below a short programme

  • Introduction
  • A short history of scientific misconduct, the case of the Netherlands
  • From Fishy to fraud – a discussion about the grey area
  • PhD candidates: a special case?
  • Closing remarks

The guys from the human resource department who are responsible for the general eduction programme of all PhD who start at the Leiden University have decided that this workshop is a great way to get this topic to the attention of young researchers. The first thought is to take this workshop as a compulsory part of the eduction programme. To cater to all the 400 new PhD students the university has, we need more scientist from all over the university who can teach this course. This means we need to work on the reproducibillity of the course. with more generic examples and a clear descrition of the reason why some parts are included etc. But if we succeed, I believe that this workshop is a great way to let PhD candidates talk and think about this subject matter, which hopefully will be of help in their scientific career.

journalclub: change in program

The articles that need to be read for the journalclub meeting #7 and #8 are switched! See below for an update.

7 5-nov Ovaska MT, Madanat R, Huotari K, et al. Risk Factors for Deep Surgical Site Infection. 2013;348–353.
8 12-nov Hernán M a., Hernández-Díaz S, Robins JM. A Structural Approach to Selection Bias. Epidemiology. 2004;15(5):615–625.

How science goes wrong? we’re improving!

econ

Fraud, shoddy and sloppy science, conflicts of interest… Who said a science career is boring? When I write on these topics I sometimes have the feeling that I am doing science more harm than good; am I doing science a favor by showing its weaknesses and caveats? The answer still remains yes, for I believe that we need problems need to be identified before you can act on them. This is also the theme of this post: What is all being done on these topics in the last couple of days. A point by point list:

  • AllTrials: The AllTrials initiative which I support is going into its next round.Pharmaceutical companies are opening up (LEO, GSK), there are hearings in brussels and the debate in Medical journals (especially the BMJ, as one of the founders of AllTrials) is going on. Great stuff!
  • PubMed commons (a commenting system in PubMed, as a new post publication peer review) got online. It’s still a trial, but boy this is cool. I love its punchline: “A forum for scientific discourse”.
  • We organised a try out of our ‘on being a scientist’ workshop on which i wrote earlier this post. IN this post i say that is if going to be a LUMC workshop, but this changed to a workshop for all starting PhD students from the university Leiden, thus including all faculties. I am truly exciting and it our first run in november works out, this workshop might even become part of the official PhD education program of the university Leiden. The economist published a coverstory on How science goes wrong. It tells how science, peer review, statistical false positives etc work. It is a good read, especially when you are interested in science as a social process. Some remarks can be made: it’s not all that bad because scientist tend to be familiar with how the system works… the system might not be perfect, but it is at the moment the best we can do… luckily there are ways to get better, ways that are also discussed in the article.It is good that the economist and other media shares these concerns, because now this might up to build to critical mass to really change some of the weak points in the system. I thought about using the graph published next to the paper, but once I discovered the animated version of the graph i fell in love. See for yourself below. (PS false positives: another reason why not only to rely on statistical testing!)
  •  – edit: i changed the title of the pot… the first title was a bit pretentious –

Continue reading “How science goes wrong? we’re improving!”

Diane 35 and thrombosis risk – Zembla broadcast

The oral contraceptive pill ‘Diane 35- was’ in the news again. I wrote about the diane-35 pill on this website before, even twice,  when there was a broadcast of the radio show Argos.

The first time I wrote:

[…] this is a bit strange: there is nothing new about the information that third and fourth generation oral contraceptives have an increased risk of thrombosis compared to the risk conveyed by second generation oral contraceptives. Because the desired effects of the older and newer generation pills are similar (not getting pregnant, preventing or curing acne) there is limited, if any, reason to prescribe the newest and more expensive pills. See also the recent comment by Helmerhorst and Rosendaal in the BMJ. However, still 160.000+ (Diane 35) 500.000 (third generation) women take these newer pills. […]

Those words also fit the broadcast of the TV show Zembla last week. Zembla has a reputation to be ‘activist reporters’ and some of the broadcast is not to my taste. It is however good to see that Zembla tried to figure out how it is possible that Diane-35, which is not registered as an anti-conception pill, still gets prescribed as such. However, the broadcast leaves me unsatisfied for it does not provide answers, or even get to talk to everybody they wanted to? (Why did they reporters did not proceed to work on their WOB? a missed change!)

As in the previous two blog posts on this topic, I feel like these story are important but they also need to have the proper amount of nuance. Therefore, also this time I conclude with saying that the absolute risk of thrombosis in young women (both venous and arterial) is very low, even when using oral contraceptives. But all unnecessary risk without any benefit that can be avoided should be avoided. As always, consult your GP if you have any questions.

Diederik stapel on TEDx Maastricht BrainTrain

I am a frequent reader of the retraction watch blog. Today they’ve put up a video from a TEDx event called, TEDxbraintrain. From their website:

“TEDx BrainTrain is a side event of TEDx Maastricht and is organised in collaboration with Dutch Railways and the SocialCoupé. In the intercity train between Maastricht and Amsterdam Central Station, inspiring talks by interesting speakers will be held in the same way as the main TEDx Maastricht event in the theatre at the Vrijthof”

Interestingly, one of the speakers is Diederick Stapel, a former clinical social psychology researcher with so far 54 retracted publications. The speech is quite similar to his book, which i’ve read out of interest in his part of the story: it sounds nice, but I don’t really understand what the message is. What struck me most is the part where he describes why he “invented research data and blew up his career as a scientist”:

“I became detached from myself (…) I lost my passion and desires… my personal goals became less important than my professional goals, and my professional goals completely overtook me”

This sounds weird to me…is good research practice not a ‘professional goal’? I am lost with this guy…

Edit: on the LUMC PhD-day, a day long PhD fun organised by the VAO, I will give an interactive workshop (together with TdC) on scientific integrity to the PhD students of the LUMC. This workshop is titles “How NOT to become the next Diederick Stapel”. Lesson 1: don’t think that inventing research data to get published is the right way to adhere to your professional goals!

Nacht van Kunst en Kennis

On the 14th of september (a saturday) the Nacht van Kunst en Kennis will be organised in Leiden. During this festival, the differences and similarities between arts and science will be explored on several locations. A great initiative, which might just increase the public awareness of the necessity of interest free research.The program is quite interesting with inspiring scientist and great artists!

I will also be helping out during this festival night: I will host the section that is organised by science cafe leiden. This organisation tries to bridge the presumed gap between science and the lay person. We will be discussing several themes which are still subject to change… currently we are thinking along the lines of bounderies… Where is the line between just the right amount and to much. More information on this special section can be found here

Journal club 2013: application form is now available

Just like the last 2 years I will organise a journal club together with RAvA. Students of the LUMC who want to participate please use this form to apply. Since there is only a limited number of places available, application does not guarantee participation.

During this journal club students will learn how to read and be critical of articles that describe clinical research: from crossover trials to nested case-control studies. We will read the good, the bad and the ugly. And off course, some methodology will also be present!

The level of knowledge needed to participate is high: students in doubt of their knowledge and experience  in clinical research should note this in the application form.

Scientific fraud on TV – improvisation program

onderzoeksfraude de vloerop

I find the several Dutch examples of scientific fraud and misconduct quite intriguing and  I consider this topic to be one of my ‘projects’. I believe that these examples from the past learn us how the exactly the scientific community works. Different books, documentaries and reports have been published on this topic (such as the books from Frank van Kolfschoten, the  weird apology-in-book-format from Diederik Stapel, the nice documentary on Buck, and the comprehensive reports from the KNAW such as the Schuyt report), and since last friday we can add an episode of the Dutch program “de vloer op” a TV program in which Dutch top actors improvise scenes which are only described in one little sentence.

For this scene, two actors are placed in an empty university dining hall, and the junior scientist is about to confront the senior prof with his suspicion of scientific fraud. The result can be seen here (unfortunately the video cannot be embedded on this wordpress.com website)

PS if you like “de vloer op” please consider to support this great program because the government support for HUMAN is not guaranteed. please visit their special website.

WEON 2014

twitter logo

The WEON is the annual meeting of the VVE, the Dutch Epidemiological Society. The whole conference is held in English though, given that each more and more non Dutch also attend. These might be working here in the Netherlands, but we also have visitors from abroad. Last year, the WEON was organised in Utrecht with a couple of organisation from Utrecht and surroundings. The conference was a great succes with great preconferecence workshops and great plenary speakers, as I wrote before on the causality blog.

But now onto next year, when the WEON will be held in Leiden! Before you start with anything, you need to start with a motto and logo. Since the focusgroup “causality” is also based in Leiden the motto and the logo are off course linked to causal inference! Currently, we are working hard on the basic program. And specifically, I’m working on a special preconference workshop that is targeted at young epidemiologist. I got some ideas, but if you have any suggestions, please join the conversation via @WEON2014!

 

ERA-EDTA CME course – “interpretation and presentation of study results”

During “conference season” I visited several conferences: ISTH, eurostroke, WEON, NVTH,  UK-CIM and the ERA-EDTA. During all conferences I got the opportunity to present my own research, except for during the ERA-EDTA. For this conference I was asked to teach in a CME course on how to perform and interpret a clinical research project. The program:

– Setting up your study: study questions and study designs
Vianda Stel, Amsterdam, the Netherlands

– Threats to validity of study findings: bias and confounding
Kitty Jager, Amsterdam, the Netherlands

– Prognosis vs aetiology
Friedo Dekker, Leiden, the Netherlands

– Interpretation and presentation of study results
Bob Siegerink, Leiden, the Netherlands

Since this is a conference on kidney diseases, the examples that I use are from that field. Although not necessarily my field, I believe that the talk can be of interest for anybody who is at the start of their research career. Please click the picture below to see the talk (slides + audio)

click here for audio and slides

Bad Pharma Symposium

I just got word that we got funding from an external to buy 400 copies of Bad Pharma to use as instruction material in our redesigned course on academic and scientific education. The book touches upon the role of  the pharmaceutical industry in the design, execution, presentation and dissemination of results of clinical trials. The author, Ben Goldacre, identifies several problems and brings forth several solutions. But are these all correct?

We will use this basic question as the basis for a complete symposium on this topic: are the problems identified by Goldacre the real problems, or just cherry picked examples from the past? And are the solutions that he provides real solution that could work? And can we think of any other way to improve the care of our patients in the future?

I had this idea a long time ago when i first read this book. It touches upon a matter that is discussed in the old version of this course for a couple of years. Even more so: during this course students are asked to grade the quality of trials and the subsequent reference to this publication. The results show that the quality is often low, even in high impact journals, and that the references do not always justify the claims made in medical advertisements. These results have been published in several publications and are even cited in the book.

It was quite a hassle to get a ‘normal’ book into the curriculum of our medical center. Most people liked the idea of reading a book and organising a symposium, but a lot of people told me that it was impossible to do so. A “normal” book could not be placed on the mandatory reading list, and just buying electronic or hard copy  versions is just way to expensive. luckily, with help from the Walaeus Library of the LUMC and prof FMH we were able to obtain external funding. And no, its not funded by ‘big pharma’, but a small fund that subsidises small but nice projects that make the world a bit smarter.

Measuring aerosols with your smartphone

Today I participated in crowdsourced science: Measuring aerosols with my smartphone. Thousands of measurements in one day, all about the air quality in the Netherlands. The nice thing about this project is that laypeople are the researchers: everybody that ordered a free gadget for their iPhone is a researcher on this great sunny day. How the measurements work? See for yourself!

More on this project can be seen on their website ispex.nl. This project was made possible with funds fron the Dutch lung foundation and the Academische Jaarprijs. So is it time to think of a big epi project in which crowd sourced data can be used?

New publication in NTVG: patient crossover studies

Recently another paper became available online. Although accepted couple of months before and not yet in print, the paper on patient crossover studies can now be read and downloaded from the NTVG website. This paper, with first author REJR,  is a continuation on the paper on crossover trials on which I’ve blogged earlier. Together, these articles provide a comprehensive overview of the possibilities to use a study subject as its own control.

Eurostroke 2013

Today, I write from the Eurostroke conference. This conference is a yearly conference for stroke physicians and researchers to share knowledge, both existing and new. I always liked the idea of combining research and education in a conference.

There are about 3500 delegates, as can be seen from the panorama photo I just took during the plenary clinical trials session. Although most of these topics are not directly of interest fr my own research, I enjoyed seeing how these PI share their work, which sometimes is a real impressive feat.
Image ESCI gotta run to my poster session, where I will present the poster below. If I referred you to this site to download the electronic version of the poster, you can click the link below.

 Poster eurostroke 2013 Siegerink et al P255

New course started today: Scientific education

Today, the course scientific education started. This course, a regular 2nd year course in the LUMC curriculum, runs for three weeks and is organised by AvHV and myself. This is the last year this course will be given in this form, and we are working hard to modify the course to make it fit in the new curriculum. This means that this year we have a opportunity to test some of my our ideas. One of these things is a non compulsory journalclub, in which we’re going to read one article with all students at the same time. I’m curious how may students really would like to train their scientific skills, outside of the curriculum.

Also, we are preparing a new full day interactive assignment and sympium, which is centered around the book Bad Pharma of author Ben Goldacre. I hope to fine some students that are wiling to help me in this development of this part of the new course. Exciting stuff!

– edit 30/5 : the course just finished and 320 students took their exam friday 24th. Although i do like students, I hope I won’t have to see them again for that will mean that they failed the course.