There is no mistaking Dr. Reed Siemieniuk’s passion for improving health care.
As early as high school, when he was entering data and making photocopies for studies at an HIV clinic in Calgary, Alberta, he saw how one doctor’s research could have an immediate impact on the patients in the community he was serving.
Now a physician himself at McMaster University in Hamilton, Ontario, he has always been struck by how little certainty there is in medicine and dismayed by how often clinical guidelines fall short. When clinicians decide to prescribe a drug or order a procedure, they turn to recommendations that can often be out of date, out of touch with real-life practicalities, or out of ethical bounds due to conflicts of interest.
“There’s a huge gap in time where the evidence is out there about what we should be doing but practice hasn’t changed,” Siemieniuk said.
His solution — and his just-defended doctoral dissertation project — is to publish trustworthy guidance for physicians within three to four months after a potentially practice-changing study comes out. The idea is not only to cut the years it might take influential professional societies to meet and craft guidance, but also to include insights from patients and allied health professionals on the subject — not just doctors.
In partnership with the BMJ, Siemienuk launched BMJ Rapid Recommendations to disseminate the latest high-quality meta-analyses of research on a topic of pressing importance.
“There’s a huge gap in time where the evidence is out there about what we should be doing but practice hasn’t changed.”
One questioned the routine use of oxygen for people who had suffered heart attacks after a study showed some patients were more likely to die of a second heart attack. Another looked at arthroscopy for knee pain from osteoarthritis — the most common orthopedic procedure in North America — and found it did more harm than good.
“The way I can contribute is to try to answer some of these questions,” he said. “And we can base it on the best science.”
— Elizabeth Cooney