Kay Dickersin '73 on how consumers can change public health care
If you’ve ever wondered how it was that biomedical scientists concluded that exercise programs such as tai chi can actually help prevent falls in the elderly, or that cranberry juice really does treat urinary tract infections in women, you can credit people like Dr. Kay Dickersin ’73. For almost two decades, Dickersin has been at the center of the evidence-based health care movement, which emphasizes using up-to-date evidence in health care decision-making; she was one of the 70 founding members of The Cochrane Collaboration, an international public health organization that compiles information from high-quality research studies across the globe. Now spanning at least 22,000 contributing members from more than 100 countries, members of the Collaboration synthesize the available knowledge on everything from the effectiveness of certain prescription drugs to using yoga to treat depression. Their goal is to help health care providers, policy makers, and patients make well-informed decisions by publishing and regularly updating their findings online in The Cochrane Library, which Dickersin describes as a “one-stop shop for accurate information about the effects of health care interventions.” She is also the director of the U.S. Cochrane Center, where she educates the public on how to access and, more important, understand the information the Collaboration produces.
It is critical to give consumers the tools needed to understand the basics of research and to make informed decisions about health care, Dickersin says, because “the way we’re actually going to change practice is through consumers having a voice.” Through the U.S. Cochrane Center, Dickersin helps coordinate Consumers United for Evidence-Based Healthcare, a coalition of consumer organizations that want to learn more about the science and language of research and contribute to it. A 23-year breast cancer survivor, she has also been an active participant in the National Breast Cancer Coalition (NBCC), whose leadership included fellow Bennington alumnae Pat Barr ’71. Dickersin developed the original curriculum for NBCC’s Project LEAD, a science training course for breast cancer activists. Dickersin continues to teach in the program, which celebrates its 15th anniversary this year.
Dickersin’s story begins at Bennington. Although she had always been interested in math, her all-girls high school gave her little exposure to the sciences and few opportunities to pursue it. She planned instead to study art. But her advisor, a physics faculty member, encouraged her to try out a few science classes. After spending her second year Field Work Term as a lab assistant at Harvard Medical School, she fell in love. “I had my eyes opened about the world of science. […] I loved the lab and was ready for a big change,” Dickersin says. She took a year off school to work in a laboratory, completed a master’s degree in cell biology, and later followed her passion to Johns Hopkins University, where she received her PhD in epidemiology and where she now serves as a professor and the director of the Center for Clinical Trials.
In addition to her work with the Cochrane Collaboration and as a professor and public health educator, Dickersin keeps busy with her research on publication bias, a phenomenon in which more than half of all research studies conducted are never published because they did not yield their intended results. Because so much of our health care decision-making relies on the information we receive from researchers, Dickersin and her colleagues recognized the potentially devastating ramifications of publication bias. It took them more than two decades of work, but Congress and journal editors now insist on registration of all clinical trials at their initiation, and Dickersin hopes that researchers will soon be required to report their full findings to the public as well. In this way, knowledge about what works and what doesn’t work in health care will never be lost again, and research will not have to be repeated unnecessarily.