Starting a research group: some thoughts for a new paper

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It has been 18 months since I started in Berlin to start at the CSB to take over the lead of the clinical epidemiology research group. Recently, the ISTH early career taskforce  have contacted me whether I would be willing to write something about my experiences over the last 18 months as a rookie group leader. The idea is that these experiences, combined with a couple of other papers on similar useful topics for early career researchers, will be published in JTH.

I was a bit reluctant at first, as I believe that how people handle new situations that one encounters as a new group leader is quite dependent on personality and the individual circumstances. But then again, the new situations that i encountered might be more generalizable to other people. So I decided to go ahead and focus more on the description of the new situations I found myself in while trying to keep the personal experiences limited and only for illustrations only.

While writing, I have discerned that there are basically 4 new things about my new situations that I would have loved to realise a bit earlier.

  1. A new research group is never without context; get to know the academic landscape of your research group as this is where you find people for new collaboration etc
  2. You either start a new research group from scratch, or your inherit a research group; be aware that both have very different consequences and require different approaches.
  3. Try to find training and mentoring to help you cope with your new roles that group leaders have; it is not only the role of group leader that you need to get adjusted to. HR manager, accountant, mentor, researcher, project initiator, project manager, consultant are just a couple of roles that I also need to fulfill on a regular basis.
  4. New projects; it is tempting to put all your power, attention time and money behind a project. but sometimes new projects fail. Perhaps start a couple of small side projects as a contingency?

As said, the stuff I describe in the paper might be very specific for my situation and as such not likely to be applicable for everyone. Nonetheless, I hope that reading the paper might help other young researchers to help them prepare for the transition from post-doc to group leader. I will report back when the paper is finished and available online.

 

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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)

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!

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.

Diane 35 and thrombosis risk – Argos broadcast part II

Last week I wrote a post after hearing the radio broadcast of Argos. They concluded that broadcast with the promise to discuss how it is possibe that a more expensive, just as effective medicine which has more side effects still can be prescribed (in large numbers) in the Netherlands.

So I’ve listen with great interest the second part of the story, which can be heard on the Argos website. They journalists did a good job by covering all sides of the story , and they provide insight in the differences between ‘advertisement’ and ‘providing information’. What if information that is provided is only one sided? Does that count as advertisement? and if you want to play a nice game during the broadcast, ‘spot the logical fallacy’ is good suggestion… Gems!

In case you are wondering: the absolute risk of thrombosis in young women is low, even when using oral contraceptives. But I still believe that all unnecessary added risk without any benefit that can be avoided should be avoided by you in dialogue with your GP!

Diane 35 and thrombosis risk – Argos broadcast

The oral contraceptive pill – especially the Diane 35- was in the news again. However, 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. Since thrombosis risk might be highest in the first few months, it is unclear whether these women all should switch to the safer second generation oral contraceptives. But for women who get their first prescription, a second generation oral contraceptive the best way to go (also according the Dutch GP guidelines).

A lot of the research on this topic has been executed by my colleagues from both the MEGA study and the RATIO study. Want to learn more about the pill controversy, please listen this episode of Argos, a Dutch radio programme.

In case you are wondering: the absolute risk of thrombosis in young women is low, even when using a newer generation oral contraceptives. But all added risk that can be avoided should be avoided by you in dialogue with your GP!