Dr. Dean Fergusson’s research is shedding light on the many unanswered questions in health care

July 25, 2007

As an undergraduate student studying public policy, Dean Fergusson was always interested in the big unanswered questions: Why are we doing this? Does it really make a difference? Could we be doing it better? It quickly became clear that some of the biggest unanswered questions could be found in health care, a field in which knowledge accumulated over centuries mixes with the medical breakthroughs announced in the news every day. In this rapidly changing environment, it can be difficult to determine which treatments are truly best for patients, but if you can figure it out, the impact can be substantial.

“Coming out of my masters in health administration at the University of Ottawa, my first opportunity in health research was with Dr. Andreas Laupacis at the Loeb Research Institute. Dr. Laupacis received funding to undertake a large multi-study initiative examining blood transfusion practices and it turned out that there were many interventions and drugs being used without having been rigorously tested. At the most basic level, we really didn’t even have good evidence for when to transfuse, how much to transfuse, and what treatments were effective at reducing transfusions,” said Dr. Fergusson. “It was clear that if we could answer these questions, we could impact the lives of many patients undergoing surgery,” he added.

Dr. Fergusson continued to ask these questions as he pursued his PhD in Epidemiology and Biostatistics with Dr. Stanley Shapiro at McGill and Dr. Paul Hébert at the University of Ottawa. Today, he is a Scientist in the Clinical Epidemiology Program at the Ottawa Hospital Research Institute at The Ottawa Hospital, an Associate Professor of Medicine at the University of Ottawa and an epidemiologist at the University of Ottawa Centre for Transfusion Research.

Dr. Fergusson’s many studies on blood transfusion have revealed important practice-changing findings. One study involving premature babies revealed that reducing the number of white blood cells before transfusion could substantially reduce the frequency of serious complications such as chronic lung injury, inflammation of the bowel and internal bleeding in the head. Another study, a systematic review of previous research, showed that a drug called aprotinin was effective in reducing the number of transfusions needed during cardiac surgery. Interestingly, this study also revealed that this conclusion could have been reached many years ago, and further studies conducted since then were largely redundant. In fact, the widespread continuation of randomized studies of aprotinin put patients at risk because only half of the people enrolled in these studies would receive the drug. This analysis generated debate around the world and prompted journals such as The Lancet to change their guidelines for publishing clinical research studies.

While continuing his research in transfusion medicine, Dr. Fergusson has also taken a major role in clinical research studies involving antidepressants, kidney disease, lung disease and other topics.

Dr. Fergusson is also the Director of the newly created Clinical Epidemiology Methods Centre. The mission of the Methods Centre is to enhance and enable world-class clinical research at The Ottawa Hospital and OHRI.

“Effective clinical research requires collaboration among physicians, methodologists, statisticians, data managers and other experts,” he explained. “The Methods Centre will make sure that when someone has a great idea for a clinical trial, they can get all the expertise and support they need all in one place.”

For more information, see Dr. Fergusson’s online profile or click on the links throughout this story.