Alex Jadad

Last updated
Alejandro (Alex) Jadad
Alex Jadad in 2023.png
Born (1963-08-09) August 9, 1963 (age 61)
Medellin, Colombia
NationalityCanadian and Colombian
Alma mater Pontificia Universidad Javeriana; University of Oxford
Known for Jadad Scale; Evidence-based medicine; Systematic reviews; Clinical trials; Bias; eHealth innovation; Collaborative decision-making; Computational Management
SpouseMartha Garcia (m. 1988)
Children2 (Alia and Tamen Jadad-Garcia)
Scientific career
FieldsFuture of Health and Medicine; Jadad Scale; Evidence-based medicine; Systematic reviews; Clinical trials; Bias detection and reduction; Pain relief; End-of-life care; Artificial intelligence; Machine learning; Medical innovation; Computational Management; Human-machine collaboration
Institutions University of Oxford; McMaster University; University Health Network; University of Toronto
Doctoral advisor Henry McQuay
Other academic advisors David Sackett; Iain Chalmers; Murray Enkin

Alejandro R. Jadad Bechara (Alex Jadad; born August 9, 1963) is a Canadian-Colombian physician-scientist, clinical epidemiologist, and public health scholar. His work focuses on evidence-based medicine, networks of trust, simulation scenarios, digital health, end-of-life care and human-machine collaboration. [1] [2] He is also known as the developer of the Jadad Scale, the first validated tool to assess the methodological quality of clinical trials, [3] and the Founder of the Centre for Global eHealth Innovation (now the Centre for Digital Therapeutics) in Toronto, [4] a simulator of the future of healthcare and medicine.

Contents

In 2021, he became member of the global Public Health Leadership Coalition, [5] a group assembled by the World Federation of Public Health Associations [6] from members of over 130 national and international public health organizations, to propose evidence-informed options with which to tackle existential threats in the 21st century. [7]

Early life and education

Born in Medellín, Colombia, Jadad earned a Doctor of Medicine degree from Xavierian Pontifical University in Bogotá in 1986, specializing in anesthesiology in 1990. In the early 1980s, while a medical student, he conducted studies on the jargon, the chemical composition and the clinical implications of an emerging drug of abuse, called 'basuco', later known as "crack" cocaine. [8]

In 1990, he became a Clinical Research Fellow at the Oxford Pain Relief Unit (Now the Oxford Pain Management Centre) of the Nuffield Department of Anaesthetics, University of Oxford, United Kingdom. In 1992, he enrolled as a doctoral student in Balliol College, the oldest school in the University of Oxford, where he received in 1994 the degree of Doctor of Philosophy (DPhil) in Clinical Medicine. His doctoral thesis, entitled "Meta-analysis of Controlled Trials on Pain Relief", [9] contributed to the development of methods for analyzing big data, identifying and synthesizing health information, and influenced the formation of the Cochrane Collaboration. He has also received honorary doctorates from St. Xavier University in Canada (Laws, 2016) and the Open University of Catalonia in Spain (Arts, 2018), for his contributions to health and innovation.

Areas of interest

Pain relief

During his time at Oxford, Jadad conducted clinical research on multiple analgesic modalities, and demonstrated that neuropathic pain ("pain in numb areas due to nerve damage") could be relieved by opioids. [10]

As part of his doctoral work, he led the creation of the largest database of clinical trials in pain relief, developing new methods to optimize searches of the US National Library of Medicine, complementing them with manual screening of over 1.3 million pages of scholarly journals since 1948 to 1990. This resulted in the compilation of over 8,000 citations of clinical trials on pain relief, and new statistical techniques for the combination of their results, which provided the foundations for the Cochrane Pain, Palliative Care and Supportive Care (PaPaS) Collaborative Review Group. [11]

He was also one of the inaugural members of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT), an international collaborative effort to develop consensus reviews and recommendations for improving the design, execution, and interpretation of clinical trials of treatments for pain. [12]

Evidence-based decision-making

Jadad's doctoral thesis also included the development of the Jadad scale, the first validated tool to assess the methodological quality of clinical trials in the world. As of November 2024, it had been cited more than 25,000 times in the biomedical literature, being used to identify systematic differences among studies of the same healthcare interventions in more than 10,000 reviews of research in virtually all areas in the healthcare sector. [3]

In 1995, he joined McMaster University in Canada. During this period, he was Director of the Health Information Research Unit; [13] Co-director of the Canadian Cochrane Centre and Network, [14] Associate Medical Director of the Program in Evidence-based on Cancer Care Ontario, [15] and the Founding Director of the McMaster Evidence-based Practice Center [16] (the first of its kind funded by the US government overseas), and Professor in the Department of Clinical Epidemiology and Biostatistics. [17]

In 1998, Jadad authored the book with which the British Medical Journal celebrated the 50th anniversary of modern clinical trials. [18] A new edition, co-written with Murray Enkin, was published in 2007. [19]

Supportive, palliative and end-of-life care

In 2000, Jadad joined the University of Toronto as Professor in the Faculty of Medicine, and Inaugural Rose Family Chair in Supportive Care (a post he held until 2010), conducting research on the concepts of health and end-of-life care, innovations aimed at supporting individuals with chronic or terminal illnesses, conditions associated with a "good death" and the perspectives of healthcare staff perspectives on end-of-life care. [20] [21] [22]

In 2013, he co-authored the World Innovation Summit for Health's report 'Dying Healed: Transforming End-Of-Life Care through Innovation', and effort led by Sir Thomas Hughes-Hallett, designed to promote best national practices and a global agenda for optimal care at the end of life. [23]

Digital health

In 2000, he also became the Founding Director of the Program in eHealth Innovation [24] and Professor in the Department of Anesthesia in the Faculty of Medicine, and in the Institute for Health Policy, Management and Evaluation at the University of Toronto. In this capacity, he led the creation of the Centre for Global eHealth Innovation, [24] (now, The Centre for Digital Therapeutics), a simulator of the future, to study and optimize the use of the information and communication technologies (ICTs) before their introduction into the health system. To support this work, in 2002, Jadad was awarded the Canada Research Chair in eHealth Innovation (Tier 1), which he held until 2015. During this period, he led some of the earliest key studies on the language of digital health; patterns of Internet use among health professionals and patients; ways to improve people's ability to evaluate the quality of online health information; the effect of virtual communities on health; new approaches to use online tools to promote evidence-based decision-making in healthcare; and new ways of using digital tools to respond to major threats to public health (e.g., obesity, complex chronic diseases and pandemics); while anticipating and assessing the risk of harm associated with digital technologies, including wearable devices. [25] [26] [27]

Global collaborative efforts

The meaning of ‘health’

In 2008, Jadad led a global conversation about the meaning of health through the British Medical Journal. [28] This effort included contributions from experts in 52 countries, and resulted the conceptualization of health as 'the ability to adapt and manage' the physical, mental or social challenges faced by individuals or communities throughout life. [29] In 2018, such efforts led to the description of an integrated network of services that enabled 88.6% and 93.1% of its users to experience positive levels of self-reported health and well-being, while ranking first when compared with the performance of the health systems of the 36 countries that are members of the Organization for Economic Cooperation and Development (OECD). Trust among payers, service-providing institutions, professionals and users of health services was the key to achieving these results with only 25% of the average expenditure across the OECD. [30]

Complex chronic disease management

In 2010, he was the Editor-in-Chief of When people live with multiple chronic diseases: A collaborative approach to an emerging global challenge, a book co-created globally using digital technologies. [31] The same year, he chaired and convened the Global People-Centred eHealth Innovation Forum in the European Ministerial Conference. [32]

Jadad also conducted research showing that only 2% of clinical trial reports published in top journals included patients with multiple chronic diseases explicitly, [33] limiting the clinical value of research evidence in this area, and motivating calls for study designs aligned with the needs of the group that is responsible for most of the expenditures in the healthcare system. [34]

Public health leadership

From 2016 to 2019, he was Director of the Institute for Global Health Equity and Innovation, in the Dalla Lana School of Public Health, University of Toronto, a tenure that followed the Global Summit 'Creating a Pandemic of Health', an international event that he co-hosted. [35]

In 2019, he became a member of the Council of the Wise, a group of 43 experts in eight different areas charged by the government of Colombia to produce recommendations about the future of the country in the following 25 years. [36]

In 2021, he was selected as one of the members of the Public Health Leadership Coalition, a group assembled by the World Federation of Public Health Associations to foster evidence-informed decisions about the COVID-19 pandemic and other major existential health threats.

In 2024, he co-chaired the health track of the World Design Policy Conference in San Diego, California, bringing together experts from around the world to imagine and identify the building blocks of a trust-based, positive-sum, scalable and resilient health system for all in the 21st century.

Selected publications

Scholarly articles

Books

References

  1. Vanchieri C (1998). "Cancer Researcher's Odyssey Benefits Many Patients". JNCI: Journal of the National Cancer Institute. 90 (3): 184–186. doi:10.1093/jnci/90.3.184. PMID   9462671.
  2. Wiseman H (July 27, 2017). "Dr Alex Jadad is on a world-wide mission to achieve a pandemic of health, happiness and love".
  3. 1 2 "Google Scholar".
  4. "The Centre for Digital Therapeutics". The Centre for Digital Therapeutics.
  5. "Public Health Leadership Coalition". World Federation of Public Health Associations. 2021.
  6. "World Federation of Public Health Associations". World Federation of Public Health Associations.
  7. "Public Health Leadership Coalition: A Call to Action". December 20, 2021.
  8. Caro Barreto DA (2016). La definición del adicto: las aproximaciones científicas al consumo de drogas - Bogotá, 1960-2000 (The definition of the addict: scientific approach to drug consumption - Bogota, 1960-2000) (PDF). Bogota, Colombia: Facultad de Historia, Universidad Javeriana (Faculty of History, Xavierian University).
  9. Jadad-Bechara, Alejandro Ricardo (1994). Meta-analysis of Randomised Clinical Trials in Pain Relief. Oxford, United Kingdom: University of Oxford.
  10. Duarte, N.; Pedraza, J.; Santos, M. (2023). Analgesic treatment in non-cancer chronic pain. School of Health of the Polytechnic Institute of Porto, Portugal. pp. 26–27. ISBN   978-989-9045-29-3.
  11. Wiffen P (2003). "The Cochrane Pain, Palliative and Supportive Care Group: scope and challenges". Palliative Medicine. 17 (3): 232–4. doi:10.1191/0269216303pm839xx. PMID   14694926.
  12. "IMMPACT: Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials". Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials.
  13. http://hiru.mcmaster.ca/hiru/ Health Information Research Unit
  14. http://ccnc.cochrane.org/ Canadian Cochrane Network and Center
  15. Program in Evidence-Based Care (PEBC) (Program in Evidence-based Care of Cancer Care Ontario)
  16. http://www.fhs.mcmaster.ca/ceb/acts/epc.htm McMaster Evidence-based Practice Center
  17. http://fhs.mcmaster.ca/ceb/ Department of Clinical Epidemiology & Biostatistics
  18. Vader JP (1998). "Randomised Controlled Trials: A User's Guide". BMJ. 317 (7167): 1258. doi:10.1136/bmj.317.7167.1258. PMC   1114182 . PMID   9794885.
  19. Howick J (2008). "Rethinking randomized controlled trials". CMAJ. 179 (11): 1178. doi:10.1503/cmaj.081675. PMC   2582776 .
  20. Gurnani MV; Agarwal A (2014). "Healthy Lives for All, Until the Last Breath". University of Toronto Medical Journal. 92 (1): 20–24.
  21. Wagstaff A (2006). "Betting on e-collaboration" (PDF). Cancer World (September–October): 59–62.
  22. McInerney M (September 8, 2017). "Some big questions about life and death: challenging "conveyer belt" of Western medicine and wishing for a loving end". Croakey Health Media.
  23. Hughes-Hallett, T; Murray, S; Cleary, J; Grant, L; Harding, R; Jadad, A; Steedman, M; Taylor, K (2013). Dying Healed: Transforming End-Of-Life Care through Innovation. World Innovation Summit for Health.
  24. 1 2 "EHealth Innovation".
  25. Catto S (October 25, 2000). "Feel Under the Weather in Canada? Log on for an Electronic House Call". New York Times.
  26. Lewis A (August 2007). "An innovator in global healthcare and human well-being". Floreat Domus. Balliol College, University of Oxford.
  27. Schroeder S; Schmid S; Martin A; Buhić-Bergner A; Linden M; Vögele C; Bischoff C; Schmädeke S; Adam M; Dreher C; Bencetic D. (2013). "On living a long, healthy, and happy life, full of love, and with no regrets, until our last breath". Verhaltenstherapie. 23 (4): 287–9.
  28. Jadad, A (December 10, 2008). "A global conversation on defining health: Alex Jadad and Laura O'Grady".
  29. Godlee F (2011). "What is health?" (PDF). BMJ. 343: d4817.
  30. Maranda F (2019). "Achieving World- Class Health Outcomes on a Shoestring". Dalla Lana School of Public Health, University of Toronto.
  31. Smith R (June 4, 2010). "The rise and rise of "polypathology"". The BMJ Blog.
  32. Novillo-Ortiz, D; Jadad, A, eds. (2011). The Global People-Centered eHealth Innovation Forum. London: BMJ Group.
  33. Aggarwal, P.; Woolford, S.J.; Patel, H.P. (2020). "Multi-morbidity and polypharmacy in older people: challenges and opportunities for clinical practice". Geriatrics. 5 (4): 85. doi: 10.3390/geriatrics5040085 . PMC   7709573 . PMID   33126470.
  34. Aubert, C.E.; Kerr, E.A.; Klamerusm, M.L.; Hofer, T.P.; Wei, M.Y. (2021). "Focus and features of prescribing indications spanning multiple chronic conditions in older adults: A narrative review". Journal of Multimorbidity and Comorbidity. 11:26335565211012876.
  35. Smith E (2014). "Creating a Pandemic of Health: global conference gathers experts at U of T".
  36. Colombia: On the path to a knowledge-based society (PDF). Bogota, Colombia: Government of Colombia. 2020. ISBN   978-9585135222.
  37. Jadad, A.R.; Jadad-Garcia, T. (2023). Healthy No Matter What: How Humans are Wired to Adapt. New York: Crown/Penguin Random House. ISBN   9780593240823.