Profile: Dr Liam Smeeth
Dr Liam Smeeth from the Non-communicable Disease Epidemiology Unit talks about his career and research
"I trained in medicine and worked for a number of years as a hospital doctor. I then moved into general practice (primary care) where I became interested in the evidence for the clinical decisions I was making. I wasn’t alone; the concept of “evidence-based medicine” was becoming increasingly popular at the time. This led me to an interest in epidemiology which I see as the basic science underpinning clinical medicine and public health. Fortunately I obtained a fellowship from the UK National Health Service to undertake the MSc Epidemiology at the School. I had a wonderful time. My interest in epidemiology grew and grew – the more I learnt, the more I realised there was to learn. Diseases and their determinants change and new tools and methods become available, opening up possibilities to do better research. I am supported by a Clinician Scientist Fellowship from the Medical Research Council which allows me to research while continuing clinical work as a doctor.
In terms of research, I see myself as being in the middle of a triangle formed by three areas: basic biomedical science, clinical medicine and public health. Hopefully I can contribute by pulling together strands from these areas to take ideas forward. One of my major interests is in making better use of routinely collected clinical data for research. Computers are increasingly used to record clinical information, and the resulting data offer amazing opportunities to undertake research. We have used such data to answer a range of questions, particularly about the beneficial and harmful effects of drugs. This research includes methodological aspects such as utilising novel study designs and strategies for dealing with missing data.
Particularly in sub-Saharan Africa, communicable diseases such as malaria and HIV/AIDS remain major threats to health. However, in many middle and low-income countries, non-communicable diseases such as cardiovascular disease are emerging as major causes of morbidity and mortality. Increased research in this area has been identified as a priority for the School. The determinants of non-communicable diseases in low income countries may differ from the determinants in richer countries, yet the majority of research to date has been undertaken in higher income, developed settings."
I am an editor for the Cochrane Collaboration, an international organisation that aims to provide the most reliable up-to-date information about health interventions. I have become interested in the potential contribution genetic epidemiology can make to our knowledge of the underlying causes of disease. One strand of this work is to apply the approach used by the Cochrane Collaboration for health interventions to cardiovascular genetics, by undertaking systematic reviews of genetic association studies. A priority must be to ensure that advances in genetics and basic science are translated into research of direct relevance to human health. This is particularly important for people in low income countries who suffer the greatest burden of disease and hence have the most to gain.
