“What’s the evidence for that?”
Brian Haynes, ’69 BSc, ’71 MD, was the student at medical school constantly seeking proof behind the theories and practices being taught in class.
Instructors at the U of A were fairly diplomatic in their responses. Things were less polite at the University of Toronto, where Haynes completed his residency. “Some of them would actually get mad,” he laughs.
But what Haynes didn’t get was answers.
“I knew something wasn’t quite right but I didn’t know how to fix it," he says. So he started looking for a way to learn more about research methods.
That journey began during Haynes’s medical internship at Toronto General Hospital in the early ’70s after a fortuitous meeting with Dave Sackett, widely regarded as the father of evidence-based medicine and one of Haynes’s mentors.
Haynes followed Sackett to McMaster University, where he earned a master’s and PhD while developing expertise as a health-care researcher. Then Haynes, now a professor emeritus at McMaster, went on to create sophisticated digital systems that put medical research at the fingertips of physicians around the world.
Information avalanche
Not every clinical trial is a good one — but how to tell them apart? Sackett and Haynes began teaching doctors how to critically appraise medical literature, a program that was a good first step — but not a solution. “Even if we taught everybody how to appraise evidence when it’s published, they wouldn’t have time to do it,” he says. That’s why, in 1987, he founded McMaster’s Health Information Research Unit and, within it, a “refinery” to assess published information about health.
Knowledge refinery
“About one article in 50 is worthwhile paying attention to,” Haynes says. The McMaster Health Knowledge Refinery mines for scientifically sound material in the avalanche of medical literature, a labour-intensive process now aided by artificial intelligence. The resulting “nuggets” are screened by a network of clinician experts and rated based on scientific soundness, medical relevance and innovation. The end product is a newsfeed of groundbreaking research that is shared with about 240,000 people as well as publishing services around the world.
I believe that Dr. Haynes is a medical hero. He has had a broad and profound impact on patient care, research and training in Canada and internationally.
Sharon Straus, Toronto doctor and director of the U of T knowledge translation program
Future challenge
Even getting the best research into the right hands isn’t enough, Haynes says. A doctor who sees patients might recall reading about a new treatment “but they don’t know how to spell it. They can’t remember the correct doses of it.” The future challenge of evidence-based medicine, he says, is figuring out how to speed up the adoption of innovative treatments in the doctor’s office.
Paradigm shifter
Robert Hayward, a health information expert and professor in the Faculty of Medicine & Dentistry, says Haynes’s work has defined the field of evidence-based informatics. “Truly extraordinary is his ability to design and conduct high-quality studies exploring the roots of common information problems, then build information services that redress the problems,” Hayward notes. “These have become gold standards in informatics.”
Go Deeper
More about Brian Haynes, recipient of a 2022 Distinguished Alumni Award.
An early go-getter
At 13, the sports-loving Calgarian became a door-to-door salesman hawking a tasty treat: the potato-based “Spudnut” doughnuts.
Say uncle
Haynes’s decision to give medical school a try was influenced by an uncle who was a doctor and role model. “I didn’t think I actually had the right stuff to be a physician,” he says. “But I tested it out and it worked out alright.”
Student of the ’60s
Haynes recalls the decade as a remarkable period where anything seemed possible. “[There was] a sense that youth had a better way to do things than the old people,” he says. Plus, “a fair amount of rambunctiousness and craziness.”
Start your search engine
Haynes developed Clinical Queries in the late 1990s, search filters that allow doctors to find relevant articles in medical databases. His work even changed how abstracts are written.
Freudian slip
A psychiatrist lecturing about Freud’s theories gave a refreshingly honest answer to Haynes’s famous “evidence” question. As Haynes recalls, the psychiatrist answered: “I was told to give this lecture by the head of the department, who’s a Freudian. But I don’t think that there’s any evidence that these theories are correct.”
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