Alejandro R. Jadad Bechara
|Alejandro R. Jadad Bechara|
August 9, 1963 |
|Institutions||University of Toronto
University Health Network
|Known for||Jadad Scale|
Alejandro Jadad Bechara (born August 9, 1963) is a Colombian Canadian physician.
Jadad is the Founder of the Centre for Global eHealth Innovation at the University of Toronto and University Health Network, where he is also professor, staff physician, and current Canada Research Chair in eHealth Innovation.
Born in Medellin, Colombia, he obtained his medical degree in 1986 from Pontifical Xavierian University in Bogota. 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 anaesthesiology at Pontifical Xavierian University, he co-authored his first book, Neuroanesthesia and Neurosurgical Critical Care with Dr. Mario Ruiz, a Colombian anaesthesiologist affiliated with Santa Fe de Bogota Foundation. This was the first textbook in this field published in Spanish.
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 specialised 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 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.
- 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]