{"id":45742,"date":"2019-09-25T14:56:24","date_gmt":"2019-09-25T13:56:24","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=45742"},"modified":"2019-09-25T20:27:52","modified_gmt":"2019-09-25T19:27:52","slug":"marialena-trivella-the-albus-dumbledore-of-the-medical-research-world-what-would-doug-altman-think","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/09\/25\/marialena-trivella-the-albus-dumbledore-of-the-medical-research-world-what-would-doug-altman-think\/","title":{"rendered":"Marialena Trivella: The Albus Dumbledore of the medical research world\u2014what would Doug Altman think?"},"content":{"rendered":"<p class=\"standfirst\"><i>A year on from his death, Marialena Trivella remembers Doug Altman and his lasting legacy on medical research, his colleagues, and friends<\/i><br \/>\n<!--more--><\/p>\n<p><span style=\"font-weight: 400\"><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/09\/Doug_MHT-only.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-45743\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/09\/Doug_MHT-only-231x300.jpg\" alt=\"\" width=\"231\" height=\"300\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/09\/Doug_MHT-only-231x300.jpg 231w, https:\/\/blogs.bmj.com\/bmj\/files\/2019\/09\/Doug_MHT-only.jpg 333w\" sizes=\"auto, (max-width: 231px) 100vw, 231px\" \/><\/a>It is just over a year since <\/span><a href=\"https:\/\/www.bmj.com\/content\/361\/bmj.k2588\"><span style=\"font-weight: 400\">Doug Altman died<\/span><\/a><span style=\"font-weight: 400\">. Is a year a long time? It is all relative of course, but it feels a long time without <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/06\/08\/jeffrey-aronson-when-i-use-a-word-the-geniousness-of-doug-altman\/\"><span style=\"font-weight: 400\">Doug\u2019s presence<\/span><\/a><span style=\"font-weight: 400\">. A recent <\/span><a href=\"https:\/\/www.bmj.com\/content\/365\/bmj.l2320\"><span style=\"font-weight: 400\">analysis paper<\/span><\/a><span style=\"font-weight: 400\"> may well be his last publication in <\/span><i><span style=\"font-weight: 400\">The BMJ<\/span><\/i><span style=\"font-weight: 400\">. [1] It was published a year after his death. Fittingly, the paper highlights problems with the design and analysis of research in a specific medical area. Doug\u2019s talent in astutely probing research methods was one of his best known attributes.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Doug was the \u201cgo to\u201d person for big and small questions. He was deeply knowledgeable and forward thinking, and he welcomed queries and visits from colleagues and collaborators seeking advice, guidance, or just a sounding board for discussing challenging methodological explorations or invitations to pioneering initiatives. He took great pleasure in sharing his expertise with humour and passion, and he had a unique insight into usual and unusual problems (statistical or not). He was an excellent communicator, inspiring teacher and collaborator, humble in nature but generous in spirit; a rare gem of a human being and a true friend. Personally, I feel blessed and inspired to have known him as a colleague and friend for the best part of 20 years.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Almost every person who knew him used the sentence \u201cI\u2019ll just have a quick word\/email with Doug\u201d at least once, if not multiple times. After June 2018, this was quickly replaced by \u201cWhat would Doug think?\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">The value that people attached to his professional opinion is a notable legacy in itself. But perhaps a legacy of much greater value is that those inspired by Doug can now give an answer to these questions with a degree of certainty, and follow his footsteps by abiding by similar principles.<\/span><\/p>\n<p><span style=\"font-weight: 400\">It is difficult to explain the huge loss of Doug to people outside the area of medical research. During a vain attempt with colleagues to best describe the spirit of Doug, the fictional headmaster Albus Dumbledore from the Harry Potter series was brought into the conversation. Call it a <a href=\"https:\/\/en.wikipedia.org\/wiki\/Magic_in_Harry_Potter#Transfiguration\">transfiguration spell<\/a> if you must, but suddenly the penny dropped and my interlocutor<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">although not a dedicated Harry Potter fan himself<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">immediately understood exactly who Doug was; he was the \u201cAlbus Dumbledore of the medical research world\u201d, with many of the character\u2019s qualities, and rightfully being treated with the same awe and affection as the fictional headmaster. Amazingly, and amusingly, you could take many references to the fictitious white haired wizard and apply them directly to the real white haired professor.<\/span><\/p>\n<p><span style=\"font-weight: 400\">According to JK Rowling, author of the Harry Potter series, <\/span><a href=\"https:\/\/en.wikipedia.org\/wiki\/Albus_Dumbledore\"><span style=\"font-weight: 400\">Dumbledore<\/span><\/a><span style=\"font-weight: 400\"> (briefly) &#8220;knows pretty much everything\u201d, \u201che has always had to be the one who knew, and one who had the burden of knowing\u201d, and \u201che is a genius, a very kind and wise man\u201d. [2] People like Doug may be portrayed well as fictional characters, but don\u2019t come about very often in real life. That is why his legacy lives on and will guide generations of researchers in performing their magic in research in medicine.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">So, what would Doug think now, a year on?<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">He would still roll his eyes in despair at the sight of a badly designed and reported research paper while applauding each additional journal choosing to adopt conduct and reporting guidelines and adequate statistical reviewing;<\/span><\/li>\n<li style=\"font-weight: 400\">He would still put patient benefit above all other goals, and would not hesitate to launch an intellectual war on unethical practices, inadequate research, and non-reproducible findings, that could ultimately compromise patient benefit;<\/li>\n<li style=\"font-weight: 400\">He would still work tirelessly towards minimising research waste, <a style=\"background-color: #ffffff;font-size: 1rem\" href=\"https:\/\/www.bmj.com\/content\/308\/6924\/283\">staying true to his motto<\/a><span style=\"font-weight: 400\">, as true today as it was in 1994: \u201cWe need less research, better research, and research done for the right reasons\u201d; [3]<\/span><\/li>\n<li style=\"font-weight: 400\">He would still approach matters from all logical corners, using common sense and detailed knowledge, to address concerns such as \u201c<a style=\"background-color: #ffffff;font-size: 1rem\" href=\"http:\/\/miror-ejd.eu\/2018\/03\/20\/interview-with-professor-doug-altman\/\">the continuing dominance of statistical significance as a mark of truth, which is nonsense<\/a><span style=\"font-weight: 400\">\u201d; [4]<\/span><\/li>\n<li style=\"font-weight: 400\">He would still look for catchy acronyms for a study because \u201cyou can\u2019t do good research without a good acronym\u201d; [5]<\/li>\n<li style=\"font-weight: 400\">He would still invest in building solid, warm, and fruitful relationships<span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">friendships even\u2014with his collaborators. In his words \u201cthe best project results come from collaboration meetings where there is friendship, humour, and laughter\u201d; [5]\u00a0 <\/span><a style=\"background-color: #ffffff;font-size: 1rem\" href=\"https:\/\/www.tripod-statement.org\/\">TRIPOD<\/a><span style=\"font-weight: 400\"> being one such example; [6]<\/span><\/li>\n<li style=\"font-weight: 400\">He would still be hugely observant of, amused by, and inspired by seemingly unconnected little things and remarks from people alien to his field, because their approach could resonate with a methodological question grappling his mind;<\/li>\n<li style=\"font-weight: 400\">He would still welcome academic dialogue to resolve or enhance methodological issues and would be kind and informative even when criticising other people\u2019s work as his belief was that \u201cyou must stand up if you see something wrong but remember to be especially kind and constructive when criticising other people\u2019s work\u201d; [5]<\/li>\n<li style=\"font-weight: 400\">He would still be surrounded by seemingly untidy piles of paper to the untrained eye in all things \u2018Doug\u2019, but which were to him valuable printouts of interesting articles often annotated with hand-written comments (sometimes summarised as \u2018Good stuff\u2019, or \u2018Nonsense\u2019), organised in past, current, and future projects ideas for questions needing an answer;<\/li>\n<li style=\"font-weight: 400\">He would still welcome anyone knocking on his office door for a chat, whether scientific or not, he would appreciate a good joke, he would especially enjoy a good cartoon or news of his favourite sport teams, and would be proud to share some of his, almost professional quality, photographs from his extensive travels;<\/li>\n<li style=\"font-weight: 400\">He would still use humour: When he knew the end was near, just a day or two before his death, he finalised a list for trusted colleagues, with information on where important files are and his wishes on what to do with certain piles of paper. For one big unsorted pile of paper he simply wrote \u2018Good luck\u2019!<\/li>\n<li style=\"font-weight: 400\">Remarkably, he would still be genuinely surprised by people praising his extraordinary brilliance.<\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Doug channelled the exasperation he felt strongly about <\/span><i><span style=\"font-weight: 400\">the scandal of poor medical research<\/span><\/i><span style=\"font-weight: 400\"> into positive, remedial action. [3] Through a mixture of pleasure and duty, he tirelessly and almost single-handedly forced change in the way we do research in medicine, [7,8] and established long lasting and beneficial foundations for the future of the field: the <\/span><a href=\"http:\/\/www.consort-statement.org\/consort-2010\"><span style=\"font-weight: 400\">CONSORT<\/span><\/a><span style=\"font-weight: 400\">(Consolidated Standards of Reporting Trials) guidelines, the <\/span><a href=\"http:\/\/www.equator-network.org\/\"><span style=\"font-weight: 400\">EQUATOR<\/span><\/a><span style=\"font-weight: 400\"> (Enhancing the Quality and Transparency of Health Research) Network, and some <\/span><a href=\"https:\/\/methods.cochrane.org\/news\/memoriam-doug-altman\"><span style=\"font-weight: 400\">Cochrane Methods Groups<\/span><\/a><span style=\"font-weight: 400\">, [9,10,11] just a few of many examples.<\/span><\/p>\n<p><span style=\"font-weight: 400\"><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/09\/Long-hair.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-45745 alignright\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/09\/Long-hair-291x300.jpg\" alt=\"\" width=\"196\" height=\"192\" \/><\/a>I am guessing that Doug would be initially surprised, possibly mildly horrified, but ultimately humbly amused to find himself referred to as the \u201cAlbus Dumbledore of medical research\u201d (even more amused by the thought that he too, had longish<\/span><span style=\"font-weight: 400\">\u2060\u2014<\/span><span style=\"font-weight: 400\">albeit not white<\/span><span style=\"font-weight: 400\">\u2060\u2014<\/span><span style=\"font-weight: 400\">hair in his younger days) and possibly resonate with the headmaster\u2019s wise words: \u201cI have been hoping for this piece of evidence for a very long time. It confirms the theory on which I have been working, it tells me that I am right, and also how very far there is still to go\u2026\u201d [12]<\/span><\/p>\n<p><span style=\"font-weight: 400\">There is no greater legacy than his colleagues, friends, and collaborators being able to answer with confidence the question \u2018what would Doug think?\u2019, and follow his ethos.<\/span><\/p>\n<p><strong>Acknowledgement<\/strong>: <em>Many thanks to Sue Altman for reading the piece and a photo of Doug.\u00a0<\/em><\/p>\n<p>&nbsp;<\/p>\n<p><b><i><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/09\/MHT2_new1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-45744\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/09\/MHT2_new1-289x300.jpg\" alt=\"\" width=\"157\" height=\"157\" \/><\/a>Marialena Trivella <\/i><\/b><i><span style=\"font-weight: 400\">is senior researcher at the Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford.<\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400\"><br \/>\n<\/span><\/i><em><b>Competing interests: <\/b><span style=\"font-weight: 400\">None declared<\/span><\/em><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><b>References:<\/b><\/p>\n<ol>\n<li><span style=\"font-weight: 400\">Trivella M, Stanworth SJ, Brunskill S, Dutton P, Altman DG. Can we be certain that storage duration of transfused red blood cells does not affect patient outcomes? BMJ (Clinical research ed) 2019; 365: l2320<\/span><\/li>\n<li><span style=\"font-weight: 400\">Wikipedia: <\/span><a href=\"https:\/\/en.wikipedia.org\/wiki\/Albus_Dumbledore\"><span style=\"font-weight: 400\">https:\/\/en.wikipedia.org\/wiki\/Albus_Dumbledore<\/span><\/a><\/li>\n<li><span style=\"font-weight: 400\">Altman DG. The scandal of poor medical research. BMJ (Clinical research ed) 1994; 308(6924): 283-4<\/span><\/li>\n<li><span style=\"font-weight: 400\">MiRoR interview with D. Altman: <\/span><a href=\"http:\/\/miror-ejd.eu\/2018\/03\/20\/interview-with-professor-doug-altman\/\"><span style=\"font-weight: 400\">http:\/\/miror-ejd.eu\/2018\/03\/20\/interview-with-professor-doug-altman\/<\/span><\/a><\/li>\n<li><span style=\"font-weight: 400\">Personal communication. Verbatim, some of the words of advice from Doug Altman to many of us who worked or collaborated with him. Recorded and remembered fondly.<\/span><\/li>\n<li><span style=\"font-weight: 400\">The TRIPOD statement: <\/span><a href=\"https:\/\/www.tripod-statement.org\/\"><span style=\"font-weight: 400\">https:\/\/www.tripod-statement.org\/<\/span><\/a><\/li>\n<li><span style=\"font-weight: 400\">Professor Douglas Altman. BMJ 2009;339:b5542. doi: 10.1136\/bmj.b5542<\/span><\/li>\n<li><span style=\"font-weight: 400\">BMJ Group Lifetime Achievement Award. BMJ 2010;340:c242. doi: 10.1136\/bmj.c242<\/span><\/li>\n<li><span style=\"font-weight: 400\">The CONSORT statement: <\/span><a href=\"http:\/\/www.consort-statement.org\/consort-2010\"><span style=\"font-weight: 400\">http:\/\/www.consort-statement.org\/consort-2010<\/span><\/a><\/li>\n<li><span style=\"font-weight: 400\">The EQUATOR Network: <\/span><a href=\"http:\/\/www.equator-network.org\/\"><span style=\"font-weight: 400\">http:\/\/www.equator-network.org\/<\/span><\/a><\/li>\n<li><span style=\"font-weight: 400\">Cochrane, in memoriam: <\/span><a href=\"https:\/\/methods.cochrane.org\/news\/memoriam-doug-altman\"><span style=\"font-weight: 400\">https:\/\/methods.cochrane.org\/news\/memoriam-doug-altman<\/span><\/a><\/li>\n<li><span style=\"font-weight: 400\">Rowling J. Harry Potter and the half-blood prince. Bloomsbury Publishing; 2015, Chapter: Horcruxes; p.415.\u00a0<\/span><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>A year on from his death, Marialena Trivella remembers Doug Altman and his lasting legacy on medical research, his colleagues, and friends [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/09\/25\/marialena-trivella-the-albus-dumbledore-of-the-medical-research-world-what-would-doug-altman-think\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":45087,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-45742","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Marialena Trivella: The Albus Dumbledore of the medical research world\u2014what would Doug Altman think? 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