Dr Rasha Al-Lamee visited the Australian Centre for Health Service Innovation (AusHSI) at Queensland University of Technology (QUT) for two weeks in August supported by an Institute of Health and Biomedical Innovation Visiting Researcher Grant. Dr Al-Lamee is an academic interventional cardiologist at the National Heart and Lung Institute and Imperial College NHS Trust based at Hammersmith Hospital in London. During her time in Brisbane Dr Al-Lamee delivered a series of lectures and met with numerous clinicians, scientists and researchers at QUT and across local health services. It is hoped that her visit will form the foundation for long-term collaborative links between QUT the National Heart and Lung Institute.
Dr Al-Lamee is best known as the architect and principle investigator of the ORBITA trial; the first ever double blind placebo controlled trial or percutaneous coronary intervention (‘angioplasty’) in patients with angina due to severe single vessel coronary artery disease, undertaken over four decades since the first procedures were performed.
ORBITA showed that the treatment effect of stenting, when compared to guideline recommended medical therapy, was considerably less than had been expected based on prior unblinded comparisons and did not reach statistical significance. The ORBITA results were surprising, shocked the cardiology community and have attracted multiple editorials in the medical literature and extensive coverage in mainstream media. The ensuing debate goes on this week, almost two years after publication of the trial, as the European Society of Cardiology released new clinical guidelines for the management of stable coronary artery disease at its annual congress in Paris.
The ORBITA results are important for the practice of cardiology but also provide valuable lessons for those involved across the spectrum of health and medical research. Health service research is all about bringing the best quality and value to the healthcare that we deliver. AusHSI partners with health services at multiple levels to achieve this goal. To do this we need to generate new evidence, embrace new technology and to implement all of these things in clinically meaningful and sustainable ways. But it’s equally important to continue to question those things that we have already been doing for a long time, things that might seem based on unshakeable logic, and things that we have maybe taken for granted. Dr Al-Lamee’s work exemplifies all of these things.
For those who were not able to attend any of Dr Al-Lamee’s lectures her outstanding keynote address at AusHSI is available online at
http://www.aushsi.org.au/news_events/videos/
Prof Will Parsonage is the Clinical Director of AusHSI and a Senior Staff Cardiologist at RBWH.