David Sackett, RIP

On May 13, David Sackett died. He was inarguably the Father of evidence-based medicine, and his work has transformed the practice of healthcare in incalculable ways. He began his work by establishing the first Department of Clinical Epidemiology and Biostatistics in Canada, at McMaster University. McMaster is now renowned as the epicenter of evidence-based care, and we have sent many of our faculty there to take their week-long course in how to teach evidence-based care.

According to the website devoted to the Sackett Symposium, Dr. Sackett was best known for work in three areas: research methods for applied testing of healthcare innovations; use of those methods to evaluate the scientific validity and clinical utility of medical interventions; and education of healthcare clinicians in the use and application of best evidence in practice.

The work at our college has been transformed by his work. We use his approach in what we do- we ask questions, acquire information, appraise that information, apply it, and assess it to determine whether it is working. That cycle repeats itself as time goes on and as our patient either does or does not respond to what we do. What he did, more than anyone before or after, was show how to use research literature and combine it with clinical expertise to benefit the patient, always respecting the patient’s own values. We say this as a mantra now, but it was a seismic shift in how medicine was practiced.

And he acknowledged the evidence-based medicine was not static; it needed to evolve, and it has. He was funny, bold, and at times profane, not afraid to use a select swear word where it was appropriate to make his point. The Users’ Guide to the Medical Literature is based on the series of papers Sackett and others wrote in the 1980s; that book is now in its 3^rd edition, and it helps inform Dr. Mike Haneline’s excellent text “Evidence-Based Chiropractic Practice.”

And he was much of the opinion that once you become seen as an expert, you need to stop and do something else. He did, regularly; He shifted from epidemiology, to compliance and then to writing about clinical trials. Once he became good at something, he stopped and moved to a new area.

We owe him a huge debt, which we repay every day when we use the tools he brought to our attention. He will be missed.