Dr. David Sackett, a giant among giants (1934-2015).

On his first day of medical school, Philip Devereaux learned from a tutor that his academic advisor was Dr. David Sackett. “Who is he?” Devereaux recalls asking. The tutor told him that Sackett was a famous clinical epidemiologist. But Devereaux had no interest in clinical epidemiology; he planned on returning home to Cape Breton and being a “real” doctor. “My first thought was: how am I going to get rid of this guy and get a real advisor?” said Devereaux. Then he met Sackett. And like so many other young physicians and researchers, his life was soon set on a whole new path. “He opened up my eyes to a world I didn’t even know existed,” said Devereaux, now an assistant professor in the department of clinical epidemiology and biostatistics at McMaster University, a department founded by Sackett in 1967. “He was a giant among giants.” Sackett, a pioneer in clinical epidemiology, died at age 80 on May 13. His influence on the practice of medicine around the world was profound. He changed the way people thought about clinical trials, systematic reviews, medical education, research methods to evaluate new treatments, mentoring clinician-scientists and more. “If I could use only one word, it would be ‘transforming.’ We are practising medicine differently today because of Dave,” said Dr. Holger Schünemann, chair of the department of clinical epidemiology and biostatistics at McMaster, in describing Sackett’s work. “He took a multidisciplinary approach in focusing on research designs, on how research is synthesized, how research is presented and how people are educated in using research at the bedside.” Sackett is perhaps best known as the driving force behind evidence-based medicine. The best patient care is based on the best scientific evidence, he taught, and not on tradition, expert opinion, conventional wisdom or wishful thinking. “There have always been great professors who ask tough questions about if something is in the scientific literature, but Dave and his colleagues put this on another scale,” said Dr. John Dirks, president and scientific director of the Gairdner Foundation, which awarded Sackett the Canada Gairdner Wightman Award in 2009. “Because of their advocacy and their example, they made [evidence-based medicine] a real foundation stone for clinical practice at large. It influenced government decision-making and public policy. The dividends were remarkable.” According to Devereaux, the unique thing about Sackett was that, unlike many pioneers in health, he changed more than just one field of medicine. “He influenced nursing. He influenced pediatrics. He influenced surgery, psychiatry — across the board,” said Devereaux. “He had such a profound influence on modern medicine, and it’s a sad, sad loss.” Like Devereaux, Dr. Peter Tugwell can clearly remember the first time he met Sackett — down to the minute, actually. It was July 1, 1975, 12:01 pm. Tugwell, who was planning to go on to practise rheumatology in British Columbia, had just arrived at McMaster University to take clinical exams and looked lost on his way to lunch. Sackett was behind him and struck up a conversation. In short order, Sackett had another mentee, and another medical career was redirected. “He persuaded me to give up the lotus land of British Columbia for the excitement of academic medicine at McMaster,” said Tugwell, now a senior scientist in the clinical epidemiology program at the Ottawa Hospital Research Institute. Sackett is lauded for setting up Canada’s first department of clinical epidemiology and biostatistics at McMaster, but according to Tugwell he also deserves praise for discouraging the creation of another department. “He persuaded McMaster not to have an independent department of public health, because he was committed to the idea that epidemiology and the principles of epidemiology should be pervasive through every department, and you shouldn’t be able to say that it is the responsibility of the department of public health.” This was not a conventional approach, which is not surprising in the least given the source of the idea, according to Tugwell. “He was always thinking outside the box. He had the most amazing way of reconceptualizing complex problems, which is one of the marks of genius, which I think he is.” It was not only his intellect, however, that attracted people to Sackett. That was but one of many traits that made him popular among those he took under his wing. “He was a wonderful mentor in terms of being a superb role model and in terms of critical thinking and kindness and skepticism and dedication and hard work and commitment, and he was great at bringing young people together and helping them work Dr. David Sackett, a giant among giants (1934–2015)