Having an Impact in a Multi-Having an Impact in a Multi-Disciplinary SettingDisciplinary Setting

Janice Derr, Ph.D.Janice Derr, Ph.D.

I am speaking as a private citizen and not as an official FDA representative. The statements I am about to make reflect my personal opinions and are not necessarily

supported or endorsed by FDA.

Having an ImpactHaving an Impact

For Statisticians, Methodologists, Epidemiologists, …For Statisticians, Methodologists, Epidemiologists, …

What Does “Having an Impact” Mean?What Does “Having an Impact” Mean?

Typical ChallengesTypical Challenges

Practical ApproachesPractical Approaches

Having an Impact Having an Impact Tale #1Tale #1

An investigator came to my office asking for sample size requirements

I could never get a clear picture of the overall situation

She put my questions aside, all she wanted was “the number”

After I finally coughed up a number for her she never got back to me

I admit I did not try very hard to follow up with her either

My impression is that the number was too large

Having an Impact Having an Impact Tale #2Tale #2

I was working as a biostatistician for a large grant

The primary analyses specified in our grant were not significant

In the exploratory analyses, the intervention effects were significant

The investigator asked me to help draft a manuscript based only on the exploratory results

I explained the difference between exploratory analyses and confirmatory analyses

After a long series of discussions, I finally persuaded her and we agreed to report both the primary analysis results and the exploratory analysis results.

What Does “Having an Impact” Mean?What Does “Having an Impact” Mean?

Promoting good statistical practicesPromoting good statistical practices

Promoting statistical thinkingPromoting statistical thinking

Contributing to the goals of the organization Contributing to the goals of the organization

Contributing to the development of research Contributing to the development of research methodology methodology

Other ideas?Other ideas?

Tale #1: Lack of Involvement Limits ImpactTale #1: Lack of Involvement Limits Impact

The statistician:The statistician:

Encountered resistance to her questions Encountered resistance to her questions (why?)(why?)

Provided an answer that probably didn’t Provided an answer that probably didn’t satisfy anybodysatisfy anybody

Tale #2: Involved Statistician Has an ImpactTale #2: Involved Statistician Has an Impact

The statistician:The statistician:

Supported the overall research objectivesSupported the overall research objectives

Explained his concerns and consequences Explained his concerns and consequences in the context of the study conclusionsin the context of the study conclusions

Suggested an alternative approachSuggested an alternative approach

Maintained a collaborative relationship with Maintained a collaborative relationship with the teamthe team

What does it take for a statistician to have What does it take for a statistician to have an impact in a multi-disiplinary setting?an impact in a multi-disiplinary setting?

Statistical ExpertiseStatistical Expertise

Non-Statistical Non-Statistical SkillsSkills

Vision of Broad Vision of Broad RoleRole

ImpactImpactInvolvementInvolvement

Challenges to Having an ImpactChallenges to Having an Impact

They didn’t appreciate all of my hard work on their problem.

They didn’t understand how my work addresses their questions.

Clients from this field seem to think they can just ignore the statistical evidence and make arbitrary decisions.

Her solutions don’t look very realistic..

We don’t understand the report or the relevance of her input.

Statisticians don’t give us answers that we can use. We’ll just make a decision based on what we’ve always done in the past.

Statistician Client

Challenges to Having an ImpactChallenges to Having an Impact

1.1. Role of the statistician Role of the statistician

2.2. Communication skillsCommunication skills

3.3. Strategic issuesStrategic issues

Challenge #1: Challenge #1: Role of the StatisticianRole of the Statistician

Narrow Narrow

BroadBroad““Helping clients think through their scientific goals, working out Helping clients think through their scientific goals, working out details of study design and implementation, and figuring out how details of study design and implementation, and figuring out how to display and interpret results are major tasks. In fact, refining to display and interpret results are major tasks. In fact, refining a good idea for a research study into concrete specific aims and a good idea for a research study into concrete specific aims and study design is one of the most challenging parts of doing study design is one of the most challenging parts of doing research, and something with which an experienced statistician research, and something with which an experienced statistician can be a great help.”can be a great help.” Kevin Cain, Kevin Cain, The Statistical ConsultantThe Statistical Consultant, Fall, 2006, Fall, 2006

Practical ApproachesPractical Approaches

Graduate student education in Graduate student education in statistics/methodology needs to include full statistics/methodology needs to include full involvement in actual projectsinvolvement in actual projects

Practicing statisticians: Evaluate the level of your Practicing statisticians: Evaluate the level of your involvement in projectsinvolvement in projects

Challenge #2: Communication SkillsChallenge #2: Communication Skills

Client’s problem

Client’s solution

Statistical model

Statistical solution

Asking Good

Questions

Talking About

Statistics

Practical Approach: Improve Your SkillsPractical Approach: Improve Your Skills

1. “So, what is your target population?”

3. “Well, you mentioned this forty thousand. Now is that undergraduate students on their own or is it graduates and undergraduates?”

5. “OK, so are you able to get a random probability sample of this target population?”

2. “Uh, you mean the people we want to find out about?”

4. “Well, it’s graduates and undergraduates...”

6.“A what?”

Use Closed Probes for Specific InformationUse Closed Probes for Specific Information

How many nursing homes are in the database?How many nursing homes are in the database?

Can you conduct interviews in person instead of Can you conduct interviews in person instead of over the phone?over the phone?

Did each surgeon evaluate the records of all 202 Did each surgeon evaluate the records of all 202 patients for risk of complications?patients for risk of complications?

Can you obtain a matching set of records for Can you obtain a matching set of records for patients who did not use antidepressants?patients who did not use antidepressants?

Use Open Probes for General InformationUse Open Probes for General Information

Why do you need a seven-year reference period for Why do you need a seven-year reference period for recalling product purchases?recalling product purchases?

How does a surgeon express the risk of How does a surgeon express the risk of complications in the abdominal aneurism surgery?complications in the abdominal aneurism surgery?

How would clinicians view each of the outcomes How would clinicians view each of the outcomes related to incontinence in the nursing home related to incontinence in the nursing home patients?patients?

What other factors might influence a patient’s insulin What other factors might influence a patient’s insulin dosage over the 14-year reference period?dosage over the 14-year reference period?

Use Concrete Paraphrase To Confirm Use Concrete Paraphrase To Confirm Your UnderstandingYour Understanding

My understanding is that …My understanding is that …

as a diabetic patient ages he tends to use a larger dose of as a diabetic patient ages he tends to use a larger dose of insulin.insulin.

we could develop a plan to conduct an in-person interview we could develop a plan to conduct an in-person interview with fewer subjects but with a greater response rate.with fewer subjects but with a greater response rate.

clinicians view the use of a catheter as a separate outcome clinicians view the use of a catheter as a separate outcome not related to incontinence.not related to incontinence.

the computer program was developed independently of the the computer program was developed independently of the surgeons who evaluated the patients’ records.surgeons who evaluated the patients’ records.

GGEENNEERRAALL

SSPPEECCIIFFIICC

REQUEST FORINFORMATION

OPEN QUESTION

CONCRETE PARAPHRASE

CLOSED PROBE

CONCRETE PARAPHRASE

SSPPEECCIIFFIICC

GGEENNEERRAALL

CLOSED PROBE

CONCRETE PARAPHRASE

REQUEST FORINFORMATION

CONCRETEPARAPHRASE

OPEN QUESTION

Asking Good QuestionsAsking Good Questions

Talking About StatisticsTalking About Statistics

Video examples of good and poor communication skills

Talking About StatisticsTalking About Statistics

Be prepared to communicate statistical information in Be prepared to communicate statistical information in a variety of different waysa variety of different ways

Be attuned to your client to pick up clues about Be attuned to your client to pick up clues about his/her learning preferences (visual, auditory, his/her learning preferences (visual, auditory, kinesthetic)kinesthetic)

Adapt your discussion accordingly, on the spot!Adapt your discussion accordingly, on the spot!

Challenge #3: Strategic IssuesChallenge #3: Strategic Issues

Clients not aware of benefits of collaborationClients not aware of benefits of collaboration

Lack of previous collaborative experiencesLack of previous collaborative experiences

Client discipline does not have a tradition of Client discipline does not have a tradition of involving statisticiansinvolving statisticians

Institutional barriersInstitutional barriers

Limited resourcesLimited resources

Position of statistician in the organizationPosition of statistician in the organization

Practical ApproachesPractical Approaches

Provide talks, short courses to clientsProvide talks, short courses to clients

Invite clients and statisticians to discuss common Invite clients and statisticians to discuss common methodological concernsmethodological concerns

Identify clients who can serve as role models to their Identify clients who can serve as role models to their colleagues for collaboration and innovationcolleagues for collaboration and innovation

Discuss with clients how to minimize institutional Discuss with clients how to minimize institutional barriersbarriers

Having an Impact in a Multi-Disciplinary Having an Impact in a Multi-Disciplinary SettingSetting

““In my opinion, statisticians can help facilitate effective In my opinion, statisticians can help facilitate effective collaborative relationships with clinical researchers by being collaborative relationships with clinical researchers by being proactive in being included in research teams from the proactive in being included in research teams from the inceptions of projects. In all situations, asking the questions inceptions of projects. In all situations, asking the questions needed to gain a clear understanding of the research and needed to gain a clear understanding of the research and related clinical issues should be considered a prerequisite to related clinical issues should be considered a prerequisite to providing assistance. … providing assistance. …

Collaborative relationships could be further enhanced by Collaborative relationships could be further enhanced by training statisticians in consultative approaches and methods training statisticians in consultative approaches and methods along with real-world practice providing consultation in a along with real-world practice providing consultation in a variety of settings. ”variety of settings. ” Janet Powell, Janet Powell, The Statistical ConsultantThe Statistical Consultant, Fall, 2006, Fall, 2006