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Medical statistician: an oxymoron? Balancing teaching and research: reflections over 30 years

Medical statistician: an oxymoron? Balancing teaching and research: reflections over 30 years. Mike Campbell University of Sheffield. Review of talk. Experience over >30 years How to balance research/consulting/teaching How the balance has changed Speaker not a good role model. Oxymoron.

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Medical statistician: an oxymoron? Balancing teaching and research: reflections over 30 years

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  1. Medical statistician: an oxymoron?Balancing teaching and research:reflections over 30 years Mike Campbell University of Sheffield Teachers of Medical Statistics- Manchester 2012

  2. Review of talk • Experience over >30 years • How to balance research/consulting/teaching • How the balance has changed • Speaker not a good role model Teachers of Medical Statistics- Manchester 2012

  3. Oxymoron ‘Putting together words which seem to contradict each other’: Examples: Bitter-sweet, Airline food, American Beer, Microsoft Works, Random Order, unbiased opinion , Military Intelligence Teachers of Medical Statistics- Manchester 2012

  4. A bit of history…. ‘The past is a different country – they do things differently there.’ L.P. Hartley – The Go Between The past helps you understand why you are where you are, now (MJC) Teachers of Medical Statistics- Manchester 2012

  5. Computing in the ‘70s and ‘80s DIY: Programs Fortran, Algol Packages: ‘Batch mode’ SPSS BMDP – SPSS-PC 1989 Language: Genstat Interactive: Glim, Minitab Commodore Pet/Apple (1978), Basic IBM PC 1981, BBC Computer 1981 Specially written stats packages for BBC Computer Teachers of Medical Statistics- Manchester 2012

  6. Developments in computing Now All packages run on a PC ‘R’ Manuals for packages run to 15 volumes Technology for teaching eg OHP=> Powerpoint Web2.0 - information available - MOLE Much easier to analyse data (calculators on phones) Remote voting etc Teachers of Medical Statistics- Manchester 2012

  7. Burwalls 1985 Teachers of Medical Statistics- Manchester 2012

  8. Early important books and papers Armitage P (1971) Statistical methods in medical research Nelder JA and Wedderburn RWM (1972) Generalized linear models JRSSA Cox DR (1972) Regression models and life tables JRSSB Breslow NE (1984) Extra-Poisson variation in log-linear models. Appl Stat Bland M and Altman (1986)Method of agreement Lancet Teachers of Medical Statistics- Manchester 2012

  9. New techniques that have had a big effect on the practice of medical statistics Bootstrap (Efron 1979 JASA) (extension of Fisher’s permutation methods) Random effects (Laird and Ware, 1982 Biometrics) Ordinal models (McCullagh, 1980 JRSSB) Multi-level models (Goldstein , 1987) Teachers of Medical Statistics- Manchester 2012

  10. Techniques no longer used ANOVA Probit analysis Discriminant analysis Teachers of Medical Statistics- Manchester 2012

  11. Other developments New journals Statistics in Medicine (1981) Biostatistics (2001) Pharmaceutical Statistics (2002) New Societies Statisticians in the Pharmaceutical Industry (1977) International Society of Clinical Biostatistics (1980) Teachers of Medical Statistics- Manchester 2012

  12. Changes in emphasis in medical statistics • Estimation not P-values Modelling not testing • ‘ EBM’ In particular more on binary data Eg Relative risk, number needed to treat • Bayesian methods (now feasible) • Latent variables (propensity scores, SEM etc) • Many papers in the literature now use methods which are difficult to understand (and validate) – because software available • Makes finding current examples from the literature for teaching more difficult Teachers of Medical Statistics- Manchester 2012

  13. What has stayed the same • Demand for teaching medical statistics (In fact much more demand than in the past) • Content of courses (see next slide) • Communicating statistics to doctors Teachers of Medical Statistics- Manchester 2012

  14. Standard courses Teachers of Medical Statistics- Manchester 2012

  15. Communication with doctors • Important skill • Doctors get less statistics in their courses than earlier (at least in Sheffield) • Statisticians no longer the ‘high-priests’ of technology- doctors can do it themselves • Often simple statistics will still suffice (eg summary measures, Matthews et al 1990) Teachers of Medical Statistics- Manchester 2012

  16. Evolution of the job 1982 Possible to ‘know’ most of medical stats 2012 Specialization Journals becoming more mathematical An applied statistician can learn more from newsletters of software packages than from journals Teachers of Medical Statistics- Manchester 2012

  17. Balancing act IMHO being a medical statistician in a medical school is both very rewarding and very demanding Rewarding ‘Get to play in everyone’s sandpit’ (Tukey) In general given respect as a professional Demanding Seen as a technician – promotion and being given positions of responsibility can be difficult (despite being on large numbers of papers and numerous grants) Not seen as an independent researcher – glass wall between medics and others Not seen as ‘serious’ by Statistics departments (jack of all trades etc) Teachers of Medical Statistics- Manchester 2012

  18. Solutions • Know your own worth • Don’t spread yourself too thin • Have one small area of statistical expertise to talk about at stats conferences, to give some professional standing • Do what you enjoy! Teachers of Medical Statistics- Manchester 2012

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