American-Canadian physician
David Lawrence Sackett
OC
FRSC
(November 17, 1934 ? May 13, 2015) was an
American-Canadian
physician
and a pioneer in
evidence-based medicine
.
[1]
[2]
He is known as one of the fathers of
Evidence-Based Medicine
. He founded the first department of
clinical epidemiology
in Canada at
McMaster University
, and the
Oxford Centre for Evidence-Based Medicine
.
[3]
He is well known for his textbooks
Clinical Epidemiology
and
Evidence-Based Medicine
.
One of his more famous quotes is: "Half of what you learn in medical school is dead wrong."
Education
[
edit
]
Sackett obtained his medical degree at the
University of Illinois
, and a
Master of Science
in
Epidemiology
from
Harvard University
.
Career
[
edit
]
David Sackett made seminal contributions to the science of health care and the teaching and practice of medicine. He did so through vision (about how to improve health care through research), innovation (in research methods for health care and education of researchers and clinicians), and engendering collegiality and collaboration.
Among his more important
randomized clinical trials
, and in collaboration with colleagues around the world, he was a Principal Investigator in the trials that showed, for the first time anywhere, the life-saving benefits of
aspirin
for patients with threatened stroke and threatened heart attack, that surgically repairing the "hardened" arteries of patients with threatened stroke (carotid endarterectomy) prevented both stroke and death, and the ability of nurse practitioners to provide effective, high-quality primary care. In addition, his "debunking" trials showed the futility of traditional health education in helping hypertensive patients take their medicine, and that a popular "bypass" operation for stroke-prone individuals did more harm than good.
He repeated his residency in medicine some 20 years after first training because, although a professor in medical school, he 'wasn't a good enough doctor.'"
[4]
His contributions to research methodology included ways to detect and reduce bias in clinical research, and ways to design, conduct, and report randomized clinical trials.
David Sackett is widely regarded as one of 3 "fathers" of modern clinical epidemiology (along with
Archie Cochrane
of the UK and
Alvan Feinstein
of the USA). Clinical epidemiology is a research discipline based on the methods of epidemiology (and other scientific pursuits, notably biostatistics, the behavioral sciences, and
health economics
), applied to understanding the nature of health care problems and, especially, their management. Thus, it is a bridging discipline, linking research to clinical practice. Typical topics include the cause, diagnosis, course (prognosis, clinical prediction), prevention, treatment, and amelioration of health disorders, and the improvement and cost-effectiveness of health services.
Sackett was the founding chair of the first department of Clinical Epidemiology and Biostatistics in the world at McMaster University in Hamilton, Ontario, in 1967, and extensively contributed to the development of research methods through his books and published articles, as well as through education and lectures at McMaster and around the world. Notably, he turned clinical research into a scientifically sound and practical, multidisciplinary "team sport" and has changed for the better the quality of health care research and clinical practice.
In the late 1970s, Sackett began to popularize the use of clinical epidemiologic principles in the practice of medicine and other health care disciplines, working with his former students, Brian Haynes, Peter Tugwell,
Gordon Guyatt
and eventually many other clinician scientists at McMaster University and around the world. Initially termed "critical appraisal of the medical literature", to help practitioners keep up with scientific advances in health care, this became "evidence-based medicine". Evidence-Based Medicine: An Oral History documents some of the highlights of the role that he and others played in the evolution of EBM. Sackett led the writing of seminal articles on clinical disagreement and how to read clinical journals books, beginning in 1980 in the Canadian Medical Association Journal, followed by seminal books, beginning in 1985 with Clinical Epidemiology: A Basic Science for Clinical Medicine.
In 1994, Sackett accepted an invitation from (later, Sir) Muir Gray of the UK National Health Service to start the first Centre for Evidence-Based Medicine in Britain, as Professor of Clinical Epidemiology, Nuffield Department of Clinical Medicine, University of Oxford.
Clinically, Sackett practiced as a general internist and was appointed Physician-in-Chief of Medicine at the Chedoke-McMaster Hospital in Hamilton Ontario in 1986, then Head of the Division of General Internal Medicine in 1988. In Oxford, he practiced as Honorary NHS Consultant in General Medicine.
Retired from clinical practice in 1999, he returned to Canada and created the Trout Research & Education Centre, where he read, researched, wrote and taught about randomized clinical trials. He also authored, with Sharon Straus, the definitive guide about mentorship for clinician scientists.
[5]
Along the way, he has published 10 books, chapters for about 50 others, and about 300 papers in medical and scientific journals. He died on May 13, 2015
[6]
in
Markdale, Ontario
.
[7]
Honours
[
edit
]
David Sackett won many awards, honorary degrees and accolades for his research, teaching and writing. Notably, in 1992, he was made a Fellow of the
Royal Society of Canada
. In 2000, he was inducted into the Canadian Medical Hall of Fame.[5] In 2001, he was appointed Officer of the Order of Canada.[4] In 2009, he was awarded the
Gairdner Foundation
Wightman Award
.[6] He was awarded honorary doctorates from the University of Bern, Switzerland, and
McMaster University
, Canada, and appointed as Honorary Professor of Clinical Epidemiology, at the West China University of Medical Sciences, and Adjunct Professor of the University of Ottawa, Canada.
Selected publications
[
edit
]
- David L Sackett: Interview in 2014 and 2015. Haynes RB (editor). 2015.
https://fhs.mcmaster.ca/ceb/docs/David_L_Sackett_Interview_in_2014_2015.pdf
- Sackett DL, Haynes RB (editors). Compliance with Therapeutic Regimens. Baltimore: Johns Hopkins University Press, 1976.
- Haynes RB, Taylor DW, Sackett DL. Compliance in Health Care. Baltimore: Johns Hopkins University Press, 1979.
ISBN
0-8018-2162-2
.
- Sackett DL (1979). "Bias in analytic research".
J Chronic Dis
.
32
(1?2): 51?63.
doi
:
10.1016/0021-9681(79)90012-2
.
PMID
447779
.
- "Clinical disagreement I: how often it occurs, and why".
Can Med Assoc J
.
23
(499): 504. 1980.
- "Clinical disagreement II: how to avoid it and learn from one's mistakes".
Can Med Assoc J
.
123
(613): 617. 1980.
- "How to read clinical journals: I. Why to read them and how to start reading them critically".
Can Med Assoc J
.
124
(555): 558. 1981.
- Laupacis A, Sackett DL, Roberts RS (June 1988). "An assessment of clinically useful measures of the consequences of treatment".
N. Engl. J. Med
.
318
(26): 1728?33.
doi
:
10.1056/NEJM198806303182605
.
PMID
3374545
.
{{
cite journal
}}
: CS1 maint: multiple names: authors list (
link
)
- Sackett DL (February 1986). "Rules of evidence and clinical recommendations on the use of antithrombotic agents".
Chest
.
89
(2): 2S?3S.
doi
:
10.1378/chest.89.2_supplement.2s
.
PMID
3943408
.
- Sackett DL, Haynes RB, Tugwell P. Clinical epidemiology: a basic science for clinical medicine, First edition. Boston: Little, Brown, 1985.
ISBN
0-316-76595-3
.
- North American Symptomatic Carotid Endarterectomy Trial Collaborators; Barnett HJM; Taylor, D. W.; Haynes, R. B.; Sackett, D. L.; Peerless, S. J.; Ferguson, G. G.; Fox, A. J.; Rankin, R. N.; Hachinski, V. C.; Wiebers, D. O.; Eliasziw, M. (1991).
"Beneficial effect of carotid endarterectomy in symptomatic patients with high grade carotid stenosis"
.
N Engl J Med
.
325
(7): 445?53.
doi
:
10.1056/nejm199108153250701
.
PMID
1852179
.
- Guyatt GH, Sackett DL, Cook DJ (December 1993). "Users' guides to the medical literature. II. How to use an article about therapy or prevention. A. Are the results of the study valid? Evidence-Based Medicine Working Group".
JAMA
.
270
(21): 2598?601.
doi
:
10.1001/jama.1993.03510210084032
.
PMID
8230645
.
{{
cite journal
}}
: CS1 maint: multiple names: authors list (
link
)
- Guyatt GH, Sackett DL, Cook DJ (January 1994). "Users' guides to the medical literature. II. How to use an article about therapy or prevention. B. What were the results and will they help me in caring for my patients? Evidence-Based Medicine Working Group".
JAMA
.
271
(1): 59?63.
doi
:
10.1001/jama.271.1.59
.
PMID
8258890
.
{{
cite journal
}}
: CS1 maint: multiple names: authors list (
link
)
- Jaeschke R, Guyatt G, Sackett DL (February 1994). "Users' guides to the medical literature. III. How to use an article about a diagnostic test. A. Are the results of the study valid? Evidence-Based Medicine Working Group".
JAMA
.
271
(5): 389?91.
doi
:
10.1001/jama.1994.03510290071040
.
PMID
8283589
.
{{
cite journal
}}
: CS1 maint: multiple names: authors list (
link
)
- Jaeschke R, Guyatt GH, Sackett DL (March 1994). "Users' guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? The Evidence-Based Medicine Working Group".
JAMA
.
271
(9): 703?7.
doi
:
10.1001/jama.271.9.703
.
PMID
8309035
.
{{
cite journal
}}
: CS1 maint: multiple names: authors list (
link
)
- Cook RJ, Sackett DL (February 1995).
"The number needed to treat: a clinically useful measure of treatment effect"
.
BMJ
.
310
(6977): 452?4.
doi
:
10.1136/bmj.310.6977.452
.
PMC
2548824
.
PMID
7873954
.
- Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS (January 1996).
"Evidence based medicine: what it is and what it isn't"
.
BMJ
.
312
(7023): 71?2.
doi
:
10.1136/bmj.312.7023.71
.
PMC
2349778
.
PMID
8555924
.
{{
cite journal
}}
: CS1 maint: multiple names: authors list (
link
)
- Barnett HJ, Taylor DW, Eliasziw M; et al. (November 1998).
"Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators"
.
N. Engl. J. Med
.
339
(20): 1415?25.
doi
:
10.1056/NEJM199811123392002
.
PMID
9811916
.
{{
cite journal
}}
: CS1 maint: multiple names: authors list (
link
)
- Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-based medicine: how to practice and teach EBM, 2nd ed. Edinburgh & New York: Churchill Livingstone, 2000.
ISBN
0-443-06240-4
.
- Haynes RB, Sackett DL, Guyatt GH, Tugwell P. Clinical epidemiology: how to do clinical practice research, 3rd edition. Philadelphia: Lippincott, Williams and Wilkins, 2006.
ISBN
0-7817-4524-1
.
- Straus SE, Sackett DL, Mentorship in Academic Medicine. John Wiley & Sons, 2014. Print
ISBN
9781118446027
doi
:
10.1002/9781118446065
See also
[
edit
]
References
[
edit
]
- ^
White B (2004). "Making evidence-based medicine doable in everyday practice".
Fam Pract Manag
.
11
(2): 51?8.
PMID
15011482
.
Free Full Text
Archived
2009-05-10 at the
Wayback Machine
.
- ^
Evidence-Based Medicine Working Group (1992). "Evidence-based medicine. A new approach to teaching the practice of medicine".
JAMA
.
268
(17): 2420?5.
doi
:
10.1001/JAMA.1992.03490170092032
.
PMID
1404801
.
- ^
"Home - CEBM"
.
CEBM
.
Archived
from the original on 2022-06-24
. Retrieved
2007-02-10
.
- ^
Smith, Richard (23 May 2015).
"Obituaries: David Sackett"
(PDF)
.
The British Medical Journal
.
350
(8009): 26.
doi
:
10.1136/bmj.h2639
.
S2CID
220087622
.
Archived
(PDF)
from the original on 29 May 2021
. Retrieved
29 May
2020
.
- ^
Straus SE, Sackett DL, Mentorship in Academic Medicine. John Wiley & Sons, 2014. Print
ISBN
9781118446027
doi 10.1002/9781118446065
- ^
Belluz, Julia
(May 15, 2015).
"David Sackett, the father of evidence-based medicine, dies at 80"
.
Vox
.
Archived
from the original on November 7, 2017
. Retrieved
February 26,
2018
.
- ^
Roberts, Sam (2015-05-19).
"Dr. David Sackett, Who Proved Aspirin Helps Prevent Heart Attacks, Dies at 80 (Published 2015)"
.
The New York Times
.
ISSN
0362-4331
.
Archived
from the original on 2020-10-20
. Retrieved
2020-10-16
.
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