A pioneer of evidencebased medicine
McMaster doctor’s belief in importance of clinical trials led to shift in patient care
Dr. David Sackett was considered the father of evidence-based medicine and was credited with putting McMaster University on the map for it.
Evidence-based medicine integrates the best research data with clinical expertise and patient values. The goal is to use the best evidence to give patients the best possible care.
“Until evidence-based medicine, we were functioning from pure observation (in treating patients),” said Dr. John Kelton, McMaster’s dean of health sciences. “He made very important changes to how we think about health care.”
Sackett died on Wednesday at the age of 80, from cancer.
In1967, at age 32, he established the world’s first department of clinical epidemiology at the still-new McMaster medical school and created a training program in health research methods. He went on to win the Canada Gairdner Wightman Award for outstanding leadership in medicine, was named an officer of the Order of Canada and was inducted into the Canadian Medical Hall of Fame.
Kelton read Sackett’s research papers long before coming to McMaster, while living in the U.S. He likens the experience to that of someone hearing the Beatles or the Rolling Stones for the first time.
“His writings were so unique and curious. I started contacting people at McMaster to learn more and to let me come here,” Kelton said.
Sackett’s belief in evidence-based treatment led to the benchmark of using clinical trials to prove a treatment was effective, Kelton explained. “Now to get a drug approved, you have to prove it works.”
Dr. Gord Guyatt, a specialist in internal medicine and a professor of clinical epidemiology and biostatistics at McMaster, said Sackett’s work ensured patients were getting the right treatment.
Sackett was instrumental in running randomized trials. Through them he established, for example, that taking Aspirin reduces the risk of stroke in people who’ve had minor strokes, Guyatt said.
“His influence led McMaster, despite being a relatively small university, to maintain its pre-eminence worldwide as the institute providing more leadership (in evidence-based medicine) than anywhere else.”
In addition to benchmark studies on the benefits of Aspirin, Sackett’s research teams showed the value of surgically removing arterial plaque, developed new ways to treat high blood pressure and demonstrated the effectiveness of nurse practitioners.
Doctors now routinely recommend daily doses of Aspirin for many patients who have had a stroke or heart attack or who face even a relatively low risk of one in the next decade.
Sackett was the author or co-author of 10 books, including EvidenceBased Medicine and Clinical Epidemiology: A Basic Science for Clinical Medicine. He remained at McMaster for 26 years and served as physician in chief of medicine and head of the division of general internal medicine at Chedoke Hospital, also in Hamilton.
In 1994, he left to establish the Centre for Evidence-Based Medicine as a professor at the University of Oxford in England. He retired from clinical practice in1999 and returned to Canada.
Sackett was born on Nov. 17, 1934, in Chicago. Bedridden for months as a child with polio, he recovered and exercised to develop into an accomplished runner. He also became a voracious reader and, he said, the youngest member of the Society for the Preservation and Encouragement of Barber Shop Quartets Singing in America (also known as the Barbershop Harmony Society).
Teachers and friends convinced him that he could better understand physiology by becoming a physician. He received his medical degree from the University of Illinois college of medicine and a master of science degree from the Harvard School of Public Health before being recruited by the U.S. Public Health Service and sent to the Chronic Disease Research Institute in Buffalo.
Sackett, who lived in Markdale, Ont., is survived by his wife, the former Barbara Bennett; four sons, David, Charles, Andrew and Robert; eight grandchildren; and a brother, Jim.
He said in an oral history that he was most proud of “the brilliant young people I taught and mentored” and of his “ability to translate, demystify, explain, promote and popularize research methods.” With files from the New York Times
Dr. David Sackett’s research showed the benefits of Aspirin in reducing the risk of stroke. But he was most proud of his role as a teacher.