Dr Ian Douglas
MRC methodology research fellow at the London School of Hygiene and Tropical Medicine.
Dr Ian Douglas is an MRC fellow who uses patient data to develop new ways of investigating the safety of drugs and uses his experience in industry and the regulatory sector to inform his work.
“It’s a slightly unconventional career path,” says Ian. “I spent eight years out of academia and came back, which was not as easy as it could be. But it’s been invaluable. I have an unusually broad understanding of how [drug development] works,” he says.
Ian completed a BSc and PhD in physiology at the University of Manchester and then spent three years assessing the safety of drugs at the Medicines and Healthcare products Regulatory Agency (MHRA) after deciding that a life at the bench was not for him.
He then spent five years researching drug safety for the pharmaceutical company GlaxoSmithKline, looking at both drugs in development and those that had already been approved. An MSc in epidemiology at the London School of Hygiene and Tropical Medicine (LSHTM) was a gateway back into academia.
His varied perspective on the drug development and approval process has been integral to his research at LSHTM. Ian uses resources such as the General Practice Research Database (GPRD) — one of the largest databases of its kind in the world — to access anonymous information about the health of people visiting their GP. “[Resources such as the database] are a fantastic way of making use of the wealth of information that’s already out there. We often worry about patients having issues with data being used but I think often it’s the other way around — they wonder why you’re not making better use of it if it’s going to benefit them,” he says.
One way to find out whether a drug is causing an effect — beneficial or harmful — is to use these patient records to look at how often a potential side effect, for example, crops up in a group of patients who are taking a drug compared with a group that isn’t. But this approach is difficult because differences found between the two groups could be down to the differences between the people, and not an effect of the drug.
Accounting for these differences between people is problematic, so to unpick some of these issues, Ian is working with ‘case only’ methods. Instead of comparing patients taking a drug with ‘control’ patients who aren’t, patients act as their own controls, with researchers comparing their health while they are taking a drug with times when they are not. This removes many of the problems inherent in comparing people but the technique has its own complexities, so Ian is trying to iron these out so that this kind of case only method can be used more widely.
It’s important to Ian that he applies methodologies to genuine questions about drug effects as he develops them. “The way that I do methodological research is to apply it to look at data and answer questions. Unless someone actually takes a new method and makes it work in real life then only half of the methodological advance has been made,” he says.
And sometimes the answers might lead to clinical trials. For example, Ian is hoping to be involved in a trial of whether treating pneumonia with cholesterol-lowering statins will reduce deaths, after he discovered that people who happened to be taking statins when they contracted pneumonia were less likely to die. Ian continues to collaborate with industry, spending one day a week working with drug companies designing studies to answer specific questions about the safety of particular drugs. He also collaborates with the MHRA and institutions such as the Open University. His eventual plan is to establish himself as an independent researcher. “In lots of ways this is my absolute dream job. There’s nothing about it that I dislike. I felt fantastically fortunate to get this fellowship,” he says.
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Published December 2011