Alejandro R. Jadad Bechara
|Alejandro (Alex) Jadad Bechara|
August 9, 1963 |
|Nationality||Colombian - Canadian|
|Institutions||University of Toronto
University Health Network
|Known for||Collaboration, Innovation, Evidence-based Medicine, Global Health, Salutogenesis, eHealth, Pain Relief, Supportive and Palliative Care, End of Life, Death, Happiness, Well-being, Love, Suffering Elimination|
Alejandro (Alex) Jadad (born August 9, 1963, in Medellín, Colombia) is a physician, educator, researcher, entrepreneur and public advocate, whose mission is to enable people to live full, healthy and happy lives until their last breath, through innovative global collaborative efforts enabled by information and communication technologies (ICTs). His overarching goal is to promote a pandemic of health, happiness and love.
Dr. Jadad is currently the Founder of the Centre for Global eHealth Innovation (and its Chief Innovator from 2009 to 2012) at the University of Toronto and University Health Network, where he is a full professor, staff physician and holder of the Canada Research Chair in eHealth Innovation.
Born in Medellin, and educated in his native Colombia, he obtained his medical degree in 1986 from Javeriana University in Bogota. While still a teenaged medical student, he collected the largest data set on jargon, chemical composition and clinical implications of cocaine base (crack) abuse in Colombia, becoming an internationally sought after speaker. Before completing his residence in anesthesiology at Javeriana University, he co-authored his first book, Neuroanesthesia and Neurosurgical Critical Care with Dr. Mario Ruiz, a leading Colombian anesthesiologist affiliated with Santa Fe de Bogota Foundation. This was the first textbook in this area ever published in Spanish.
In 1988, he married Martha Lucia Garcia, a biochemist from Javeriana University, with whom he had two daughters, Alia and Tamen. In 1989, he received a British Council Scholarship that enabled him to become a Research Fellow at the Oxford Pain Relief Unit, Nuffield Department of Anaesthetics, University of Oxford. In 1992, he received an Overseas Research Student Award from the Committee of Vice-Chancellors and Principals of the Universities of the United Kingdom for work on the opioid responsiveness of neuropathic pain, and became a doctoral student at Balliol College, University of Oxford. In 1994, he received a Doctor of Philosophy degree in Clinical Medicine after completing a thesis entitled Meta-analysis of randomised clinical trials in pain relief, becoming one of the first physicians in the world with a doctorate on knowledge synthesis, under the supervision of Henry J. McQuay, Professor in Pain Relief, University of Oxford, and the co-supervision of Iain Chalmers, then Director of the UK Cochrane Centre, Oxford. His examiners were Drs. David Sackett, then Oxford Professor of Evidence-based Medicine and Adrian Grant, Director of the Health Services Research Unit at the University of Aberdeen. His thesis involved the development of new tools to distill high-quality health-related information, new methods to build specialized bibliographic databases to support health-related decisions, and the validation of the most widely used tool to assess the quality of clinical trials in the world: the Jadad scale.
The Jadad Scale
The Jadad scale appears to produce robust and valid results in an increasing number of empirical studies. The scale includes three items that are directly related to bias reduction: randomization; blinding; description of withdrawals and drop outs. These are presented as questions to elicit ‘yes’ or ‘no’ answers and produces scores from 0 to 5. A trial could be judged as having poor quality if it is awarded 2 points or fewer. Studies that obtain 2 or fewer points have been shown to produce treatment effects which are 35% larger, on average, than those produced by trials with 3 or more points. Although some concerns have been expressed about the inter-observer reliability of the assessments, the scale has been cited over 7,000 times in the biomedical literature and has been used successfully to identify systematic differences in over 1,000 reviews of trials in many areas of health care.
Life in Canada
While at Oxford, in the early 1990s, Dr. Jadad met Dr. Murray Enkin who had recently co-authored his opus Effective Care in Pregnancy and Childbirth (regarded as one of the 100 most influential books in health services and policy of all times) with Drs. Iain Chalmers and Marc Keirse. Dr. Enkin persuaded Dr. Jadad to continue his research at McMaster University, in Canada, where he stayed from 1995 until 1999. During this period, he was Chief of the Health Information Research Unit; Co-Director of the Canadian Cochrane Network and Centre; Associate Medical Director of the Program in Evidence-based Care of Cancer Care Ontario; Founding Director of the McMaster Evidence-based Practice Centre (the first of its kind funded by the US government in a foreign country); and Professor in the Department of Clinical Epidemiology & Biostatistics.
In 2000, Dr. Jadad moved to Toronto, as the Rose Family Chair in Supportive Care (held until 2010); Director of the Program in eHealth Innovation and Professor in the Departments of Health Policy, Management and Evaluation (now an Institute); and Anesthesia. During the following 5 years, he led the creation of the Centre for Global eHealth Innovation, a simulator of the future of the health system, to study and optimize the use of ICTs before their introduction into the health system. The construction of the Centre was supported by the Canada Foundation for Innovation and the University Health Network, where it is located. During the same time, he led the development of virtual clinical tools to transform the encounter between patients and health professionals, and new ways to use ICTs to respond to major public health threats (e.g., poverty, inequity, obesity, complex chronic diseases) and to enable the public (particularly young people) to shape the health system and society.
In 2002, Dr. Jadad was named the Canada Research Chair in eHealth Innovation (Tier 1). In 2008, he initiated the People, Health equity and Innovation (PHI) Group, in Toronto, to explore ways to level the playing field for disadvantaged groups in society through the innovative use of information and communication technologies.
In the late 1990s, Dr. Jadad was the founding Chair of the Consumer Health Informatics Working Group of the International and the American Medical Informatics Association. In 1998, his best-selling book Randomised Controlled Trials was published and launched by the British Medical Journal as part of the 50th anniversary of clinical trials in health care. A new edition, co-written with Dr. Murray Enkin, was published in 2007.
In the early 2000s, in close collaboration with Dr. Julio Lorca from Spain, Dr. Jadad was instrumental in the creation of the Spanish eHealth Network and the development of Revista eSalud, the leading journal and portal in the Hispanic world focused on eHealth. In 2004, he received the Canadian-Latin American Achievement Award in recognition for his contributions to the relationships between Canada and the Hispanic world.
From 2006 to 2010, Dr. Jadad was the Founding Chair of the Board of Directors of the Institute for Innovation on Human Wellbeing, in Malaga, Spain, an effort funded by the Andalusian Government and the European Union, to support innovative projects to promote optimal levels of quality of life for all, worldwide.
In 2007, he was invited by the British Medical Journal to write an essay highlighting the role of computers as one of the 15 most important breakthroughs in medicine since 1840, when the journal was published for the first time, as part of a commemorative issue marking the journal’s transformational efforts at the dawn of the 21st century.
Dr. Jadad advised the World Health Organization as a member of its Global Observatory for eHealth’s Strategic Advisory Group of Experts (SAGE).
In 2010, he chaired and convened the Global People-centred eHealth Innovation Forum during the European Ministerial eHealth Conference, and the International Forum¨"Youth-led Innovation and Entrepreneurship" in Brussels and Extremadura, two events designed to promote collaborative efforts among leading groups interested in optimizing human wellbeing through the innovative use of ICTs. In late 2010, he co-chaired the First International Summit on Human-centred and Family-focused eHealth in China, becoming the Chair of the International Advisory Committee on eHealth of the Beijing Institute of Technology.
The meaning of "health"
In 2008, the year of the 60th anniversary of the World Health Organization, Dr. Jadad (with Dr. Laura O'Grady) led a global conversation about the meaning of health, worldwide, supported by the British Medical Journal. This effort was followed by a meeting in The Hague in 2009, supported by the Netherlands Organisation for Health Research and Development, during which a new reconceptualization was created and proposed, based on the ability of individuals or communities "to adapt and self-manage" in the face of physical, mental or social challenges. This new approach, which was published by the British Medical Journal in 2011, is being embraced by large organizations worldwide, and guided the Luxembourg Health Summit in 2012.
The Maimonides Project
The Maimonides project is a public-private effort designed to transform daily life through products, services, processes and models that put the needs of people and communities at their core, powered by the collective effort of an international group of top policy makers, health professionals, academics, funders, corporate groups and community organizations committed to joint radical ‘glocal’ innovative efforts. Participants in the project funnel the best innovations from around the world to key local environments, to develop new models for the way in which humans will live and sustain themselves in the 21st century, which could be disseminated globally.
Specifically, this global collaborative effort seeks to facilitate:
- Links between bold innovators and top decision makers who are facing complex issues that could not be addressed with locally available resources,
- The identification of successful and failed large-scale health reform efforts from around the world,
- The creation of future scenarios based on the best available evidence and innovations available,
- The transformation of key regions in different parts of the world into networked ‘Living Laboratories’ or 'ecosystems for social innovation',
- Systematic testing, refinement and implementation of the scenarios in real-world controlled environments within each of the Living Labs, and
- The use of powerful technological resources to translate successes obtained in the controlled environments into viable large-scale efforts.
Several projects are focusing on the optimization of services to meet the challenges created and faced by people living with two or more chronic conditions (also known as complex chronic conditions or polypathology). These cases, which already represent at least two thirds of people over the age of 65 years and one quarter of the population of patients in hospitals, are consuming the largest amounts of health resources, while rendering traditional clinical services, funding models and institutions obsolete. A key resource for this work is OPIMEC a global observatory of innovative practices for complex chronic disease management, which Dr. Jadad coordinates with support from the Andalusian Ministry of Health and the Andalusian School of Public Health in Spain.
- Medical education, professional practice and drug abuse among physicians [Educacion medica, ejercicio profesional y consumo de drogas entre medicos] Javeriana University Press, Bogota, 1988
- The neurosurgical patient: anesthetic and intensive care [El paciente neuro-quirurgico: manejo anestesico y de cuidados intensivos (with Mario Ruiz Pelaez)] Copilito Press, 1989
- Randomised Controlled Trials: A user's guide. London: BMJ Publishing Group, 1998
- Randomized Controlled Trials: Questions, Answers and Musings. Oxford: Blackwell Publishing, 2007 (with Murray W. Enkin)]
- Unlearning: incomplete musings on the game of life and the illusions that keep us playing. Foresight Links Press, 2008 [ISBN 978-0-557-01508-5]
- When people live with multiple chronic diseases: a global collaborative challenge [this is a live, interactive, co-created book, available in English and Spanish, on paper and online, which is open to contributions by any person interested in this topic, anywhere in the world]
Sample of Articles
Awards and recognition
1992-1994 Overseas Research Student Award, Committee of Vice-Chancellors and Principals of the Universities of the United Kingdom
1997-2002 National Health Research Scholar Award - National Health Research and Development Program, Canada
1998 Canada’s Top 40 Under 40 Award (awarded in April 1999)
1999 Jose Maria Cordoba Science and Technology Medal, Government of Cordoba, Colombia
1999-2004 Premier’s Research Excellence Award, Ontario Ministry of Energy, Science and Technology
2000- Inaugural Rose Family Chair in Supportive Care
2000 Spinoza Professor, Academic Medical Centre and Faculty of Medicine, University of Amsterdam
2001 New Pioneers Award in Science and Technology [Presented by Skills for Change, Canada]
2003 American Academy of Pain Medicine/Pfizer Visiting Professorship Award, Johns Hopkins University
2004 Canadian Latin American Achievement Award for the most important contribution to Latin American-Canadian relations by a Hispanic person
2005 One of the Best of the Best, as selected by fellow Top 40 Under 40 in Canada, in the category of Health and Science
2006 Chief Scientist Lecturer Award, Health Canada
2007 Chief Scientist's Distinguished Speaker Award, Health Canada
2007 One of the 10 most influential Hispanics in Canada
2007 Fellow, Canadian Academy of Health Sciences
2008 Order of the Congress, Colombia
2012 Pioneer for Change, Canada
- http://abanico.ca/Revista-Abanico-Te-identifica/Nuestra-Esencia/Entrevista-con-Alejandro-Jadad.html (in Spanish)