Paul Garner | |
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| Born | 25 August 1955 |
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| Known for | Evidence-based medicine |
Paul Garner is a British epidemiologist and public health professional, known for his work in systematic reviews and evidence-informed policy. He is currently an Emeritus Professor, Evidence Synthesis in Global Health, at the Liverpool School of Tropical Medicine. [1] Previously he was a member of the WHO malaria treatment guidelines group from 2004-18.
Paul Garner attended Spalding Grammar School in Lincolnshire, England, and he went on to study medicine at University College London and University College Hospital Medical School. He qualified as a medical doctor with a MB BS in 1979. He gained an MD from the University of London in 1990.
Garner worked in Papua New Guinea, and from 1982 to 1984 he ran the Aitape Health Center in West Sepik Province, a 100-bed hospital with a catchment area of 200,000 people. From 1984 to 1988 he worked as a researcher at the Papua New Guinea Institute of Medical Research branch in Madang. [2]
Between 2004 and 2022, he was a full time Professor of Evidence Synthesis at the Liverpool School of Tropical Medicine (LSTM) and the Director of the Center for Evidence Synthesis in Global Health. He is now an emeritus professor at LSTM. He has also been an honorary research fellow at St. George's University School of Medicine, Grenada since 1997, and honorary Professor at the University of Stellenbosch since 2013. He has also directed a series of UK Government research and development programmes in evidence synthesis related to problems of the tropics and low- and middle-income countries, the most recent being READ-It from 2018 to 2024. He is a Fellow of the Faculty of Public Health. [1]
In 1992, Paul Garner played a key role in the development of the Cochrane Collaboration after its founding. He led the Cochrane Infectious Diseases Group, whose reviews have helped underpin policy changes across the world.
Garner directly contributed to change in the formulation of oral rehydration solution and global policies related to its use in treatment of diarrheal diseases. At the time the World Health Organization (WHO) used a 311mOsm/L solution as the standard and Garner's systematic review clearly showed that lower osmolarity of 240mOsm/L is more effective. [3] [4] [5]
Garner worked closely with the WHO in the development of malaria treatment guidelines from 2004 to 2018, organizing evidence synthesis for the three editions in 2006, 2010, and 2015. He played a key role in the introduction of Artemisinin-based combination treatments for malaria around the world. [6]
His systematic reviews have also challenged global dogmas, including Directly Observed Therapy for tuberculosis, [7] and routine de-worming of soil transmitted helminths in schoolchildren living in endemic areas in middle- and low-income countries. [8]
Drawing from personal experience, Garner worked to highlight the occurrence of the post-COVID-19 syndrome and health concerns related to it. [9] [10] He advocated that the involvement of communities of people who have recovered from post-viral illnesses would be helpful in management and treatment approaches. Over time, Garner rejected the notion of a purely biomedical cause of his own post-COVID illness and attributed his full recovery to psychological training including techniques of meditation and visualisation. [11] His statements created huge controversy among post-COVID and ME/CFS activist groups, resulting in Garner receiving death threats while others thanked him for opening a path to recovery for them. [12]
Malaria is a mosquito-borne infectious disease that affects vertebrates. Human malaria causes symptoms that typically include fever, fatigue, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. Symptoms usually begin 10 to 15 days after being bitten by an infected Anopheles mosquito. If not properly treated, people may have recurrences of the disease months later. In those who have recently survived an infection, reinfection usually causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria.
Diarrhea, also spelled diarrhoea or diarrhœa, is the condition of having at least three loose, liquid, or watery bowel movements in a day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin with loss of the normal stretchiness of the skin and irritable behaviour. This can progress to decreased urination, loss of skin color, a fast heart rate, and a decrease in responsiveness as it becomes more severe. Loose but non-watery stools in babies who are exclusively breastfed, however, are normal.
Pharyngitis is inflammation of the back of the throat, known as the pharynx. It typically results in a sore throat and fever. Other symptoms may include a runny nose, cough, headache, difficulty swallowing, swollen lymph nodes, and a hoarse voice. Symptoms usually last 3–5 days, but can be longer depending on cause. Complications can include sinusitis and acute otitis media. Pharyngitis is a type of upper respiratory tract infection.
Cochrane is a British international charitable organisation formed to synthesize medical research findings to facilitate evidence-based choices about health interventions involving health professionals, patients and policy makers. It includes 53 review groups that are based at research institutions worldwide. Cochrane has over 37,000 volunteer experts from around the world.
Sore throat, also known as throat pain, is pain or irritation of the throat. Usually, causes of sore throat include:
Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities, gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened deposits (tartar) not removed by routine cleaning. Those with dentures and natural teeth may supplement their cleaning with a denture cleaner.
Artemisinin and its semisynthetic derivatives are a group of drugs used in the treatment of malaria due to Plasmodium falciparum. It was discovered in 1972 by Tu Youyou, who shared the 2015 Nobel Prize in Physiology or Medicine for her discovery. Artemisinin-based combination therapies (ACTs) are now standard treatment worldwide for P. falciparum malaria as well as malaria due to other species of Plasmodium. Artemisinin is extracted from the plant Artemisia annua an herb employed in Chinese traditional medicine. A precursor compound can be produced using a genetically engineered yeast, which is much more efficient than using the plant.
Oseltamivir, sold under the brand name Tamiflu, is an antiviral medication used to treat and prevent influenza A and influenza B, viruses that cause the flu. Many medical organizations recommend it in people who have complications or are at high risk of complications within 48 hours of first symptoms of infection. They recommend it to prevent infection in those at high risk, but not the general population. The Centers for Disease Control and Prevention (CDC) recommends that clinicians use their discretion to treat those at lower risk who present within 48 hours of first symptoms of infection. It is taken by mouth, either as a pill or liquid.
Ivermectin is an antiparasitic drug. After its discovery in 1975, its first uses were in veterinary medicine to prevent and treat heartworm and acariasis. Approved for human use in 1987, it is used to treat infestations including head lice, scabies, river blindness (onchocerciasis), strongyloidiasis, trichuriasis, ascariasis and lymphatic filariasis. It works through many mechanisms to kill the targeted parasites, and can be taken by mouth, or applied to the skin for external infestations. It belongs to the avermectin family of medications.
Artemether is a medication used for the treatment of malaria. The injectable form is specifically used for severe malaria rather than quinine. In adults, it may not be as effective as artesunate. It is given by injection in a muscle. It is also available by mouth in combination with lumefantrine, known as artemether/lumefantrine.
Artesunate (AS) is a medication used to treat malaria. The intravenous form is preferred to quinine for severe malaria. Often it is used as part of combination therapy, such as artesunate plus mefloquine. It is not used for the prevention of malaria. Artesunate can be given by injection into a vein, injection into a muscle, by mouth, and by rectum.
Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. Oral rehydration therapy can also be given by a nasogastric tube. Therapy can include the use of zinc supplements to reduce the duration of diarrhea in infants and children under the age of 5. Use of oral rehydration therapy has been estimated to decrease the risk of death from diarrhea by up to 93%.
A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on the topic, then analyzes, describes, critically appraises and summarizes interpretations into a refined evidence-based conclusion. For example, a systematic review of randomized controlled trials is a way of summarizing and implementing evidence-based medicine.
Sir Iain Geoffrey Chalmers is a British health services researcher, one of the founders of the Cochrane Collaboration, and coordinator of the James Lind Initiative, which includes the James Lind Library and James Lind Alliance.
Dihydroartemisinin is a drug used to treat malaria. Dihydroartemisinin is the active metabolite of all artemisinin compounds and is also available as a drug in itself. It is a semi-synthetic derivative of artemisinin and is widely used as an intermediate in the preparation of other artemisinin-derived antimalarial drugs. It is sold commercially in combination with piperaquine and has been shown to be equivalent to artemether/lumefantrine.
Peter Christian Gøtzsche is a Danish physician, medical researcher, and former leader of the Nordic Cochrane Center at Rigshospitalet in Copenhagen, Denmark. He is a co-founder of the Cochrane Collaboration and has written numerous reviews for the organization. His membership in Cochrane was terminated by its Governing Board of Trustees on 25 September 2018. During the COVID-19 pandemic, Gøtzsche was criticised for spreading disinformation about COVID-19 vaccines.
Migraine may be treated either prophylactically (preventive) or abortively (rescue) for acute attacks. Migraine is an complex condition; there are various preventive treatments which disrupt different links in the chain of events that occur during a migraine attack. Rescue treatments also target and disrupt different processes occurring during migraine.
The Centre for Evidence-Based Medicine (CEBM), based in the Nuffield Department of Primary Care Health Sciences at the University of Oxford, is an academic-led centre dedicated to the practice, teaching, and dissemination of high quality evidence-based medicine to improve healthcare in everyday clinical practice. CEBM was founded by David Sackett in 1995. It was subsequently directed by Brian Haynes and Paul Glasziou. Since 2010 it has been led by Professor Carl Heneghan, a clinical epidemiologist and general practitioner.
Cochrane Eyes and Vision (CEV) is a collaboration of researchers and healthcare professionals who prepare systematic reviews to study interventions pertaining to the treatment of eye disease and visual impairment. Though many of the systematic reviews focus on common eye diseases, reviews have been prepared for varied eye topics, including screening prevention and rarer eye diseases.
Elizabeth Jean Carleton Hay-Smith is a New Zealand academic, and is a full professor at the University of Otago in Wellington, specialising in research on non-surgical treatments for pelvic organ prolapse and bladder problems.
| Authority control databases: Academics |
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