Medicine

Where Patients and Statistics Intersect

The new doctoral program Clinical Science at UZH helps strengthen clinical research in Switzerland. We spoke with Roxane D. Staiger, one of the program’s first candidates.

Adrian Ritter

Roxane D. Staiger
Roxane D. Staiger
Postdoctoral researcher Roxane D. Staiger is investigating fundamental questions on benchmarking in surgery. (Photo: Adrian Ritter)

 

It’s a perfect setup for Roxane D. Staiger: One month per semester, she works as a resident physician with the patients in the Department of Surgery and Transplantation at UniversityHospital Zurich. The rest of her time she spends engulfed in research. Roxane D. Staiger is among the first to take part in the doctoral program Clinical Science, which was newly created in 2016, at the Faculty of Medicine of the University of Zurich.

The PhD program offers structured education in medical research methods such as biostatistics and epidemiology. During the three-year program, its candidates also perform in-depth clinical research in the field of medicine – involving healthy persons, or inpatients and outpatients who are ill. One of the requirements for admission to the program is a Master's degree in a field such as medicine, biomedicine, biology, or psychology. The program starts every semester and currently counts 14 candidates.

Practical questions

After studying medicine and obtaining her individual doctorate at the Faculty of Medicine (Dr. med.), Roxane D. Staiger initially knew that she wanted to do clinical rather than research work. She thus spent seven years as a resident physician and attending physician at a number of hospitals, and continued her education to become a medical specialist for surgery. However, she kept coming across the same type of questions in her day-to-day work: Why is it that some patients experience more complications after an operation than others? How could their treatment be further improved? “It was clear to me that these kinds of questions can only be answered through research,” says Staiger.

When she heard about the new doctoral program Clinical Science, she jumped at the opportunity and applied: “I was keen on being able to contribute toward improving the quality of health care through my own research.” And so, Roxane D. Staiger changed her workplace in early 2016, from GZO Spital Wetzikon to the Department of Surgery and Transplantation at UniversityHospital Zurich.

Roxane D. Staiger with her peers.
Roxane D. Staiger with her peers.
Flanked by two renowned scholars: Roxane D. Staiger with Milo Puhan (left) und Pierre-Alain Clavien. (Photo: Adrian Ritter)

Benchmarking in surgery

Staiger’s doctoral research focuses on benchmarking in surgery. Her goal is to reduce complications after an operation and thus increase the patients’ quality of life. Pierre-Alain Clavien, Director of the Department of Surgery and Transplantation, and his team have been working on recording and categorizing postoperative complications for many years. The resulting Clavien-Dindo classification is now being used all over the world. To allow researchers to compare complications on a global scale, the Comprehensive Complication Index was developed in a further step. This index has also become a key element of benchmarking in surgery.

Pierre-Alain Clavien’s benchmarking team have already drawn up three international benchmarks – in the areas of liver surgery, liver transplants, and minimally invasive surgery of the esophagus. Roxane D. Staiger is a member of this benchmarking team. For her PhD thesis, she has focused her investigations on some of the fundamental questions – how can benchmarking be applied?  When does benchmarking make sense? What is its added value? The current focus of her research is on the link between postoperative complications and health care costs.

Double supervision

In her current work, Roxane D. Staiger alternates between attending to patients and using statistics programs – where clinical experience intersects with research methodology. This means that the postdoctoral researcher also has two supervisors: Pierre-Alain Clavien as well as Professor Milo Puhan, Director of the Epidemiology, Biostatistics and Prevention Institute at UZH. “Being supported by two such distinguished researchers is a great privilege. Their different scientific backgrounds complement each other perfectly, and I benefit from this very much,” says Staiger.

At the same time, she also benefits from her own long-standing experience performing clinical work: “I have first-hand experience with complications after operations from my daily work in hospitals. It’s this kind of experience that enables me to assess which type of study design is suitable for the patients and hospital staff. This way I can plan studies that are close to daily practice and thus high-quality right from the beginning.”

Support from politics

“Physicians are highly qualified to perform clinical research thanks to their practical experience working with patients. This is why we would like to attract even more medical professionals to the Clinical Science doctoral program,” explains Malcolm Kohler, Director of the Department of Pulmonology at UniversityHospital Zurich, who also heads up the commission of the Clinical Science doctoral program.

The necessity for more clinical research is well recognized in the political arena, too. The Federal Office of Public Health is doing its part in strengthening clinical research through a road map. Roxane D. Staiger doesn’t rule out going back to focusing on clinical work in a few years’ time; however, she would want to include research work in any such step and would also like to pass on her knowledge to younger medical professionals working in hospitals.

Doktoratsstufe der Medizinischen Fakultät

In addition to the Clinical Science program, the studies at doctoral level at the Faculty of Medicine include three other degree programs: The individual doctoral program (Dr. med.), the doctoral program Biomedical Ethics and Law  (Dr. sc. Med.), and the joint MD/PhD program (Dr. sc. nat.). The doctoral programs Clinical Science, Biomedical Ethics and Law, and the MD/PhD program are part of the Life Science Zurich Graduate School.

Adrian Ritter, Editor UZH News.

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