Mackenzie Lectures


The Mackenzie Lectures are held annually in honour of Sir James Mackenzie, a pioneer in research in general practice and the safe use of medicines.

The 11th Mackenzie Lecture

As part of Dundee Grand Rounds the Division of Population Health Sciences & HIC are hosting the 11th Mackenzie Lecture:

Professor David Henry will deliver this year's lecture:

'Distributed networks of person-level linked health data: their role in the rapid quantification of drug-related harms'

When: Thursday 26 May 2016 1 pm

Where: The Gannochy Trust Lecture Theatre, level 7, Ninewells

For more information see event leaflet

 

The 10th Mackenzie Lecture

As part of the Dundee Grand Rounds series, and hosted with the Division of Population Health Sciences, the 10th Mackenzie Lecture 'When an entire country is a cohort' was delivered by Professor Mads Melbye (MD, DMSc).  The Lecture took place on 28th May 2015 at 1pm in the Gannochy Trust Lecture Theatre on Level 7 of Ninewells Hospital.  

A video of the Lecture can be viewed on the Dundee Grand Rounds archive page.

Professor Mads Melbye

The 9th Mackenzie Lecture

Last year's Lecture 'Genomic Medicine - time for translation', was given by Professor Mark Caulfield, and co-hosted by HIC Services and the Division of Population Health Sciences on 15th May 2014 at 1pm, also as part of the Dundee Grand Rounds series.  The Lecture took place in the Gannochy Trust Lecture Theatre.

HIC Services also held an informal event on the morning of 15th May.  

A video of the Lecture can be viewed on the Dundee Grand Rounds archive page.

Professor Mark Caulfield

The 8th Mackenzie Lecture

The 2013 Lecture, hosted by the Health Informatics Centre and the Division of Population Health Sciences working in collaboration with SHIP, TASC, NHS Tayside and NHS Fife, was given by Professor George Davey Smith, "The Limits of Personalised Medicine: Epidemiological Reflections" in Lecture Theatre 3 at the Dalhousie Building (on the University of Dundee Main Campus).  A copy of the slides is available on the right of this page.

Professor George Davey Smith

The 7th Mackenzie Lecture

Professor Trisha Greenhalgh (OBE, Co-Director of the Global Health, Policy and Innovation Unit at Barts and the London School of Medicine and Dentistry, London, UK) delivered the Lecture, 'Why National eHealth Programs Need Dead Philosophers: Wittgensteinian Reflections on Policymakers' Reluctance to Learn from History'.

Policymakers seeking to introduce national eHealth programs would be advised to study comparable examples from elsewhere. England’s £13 billion National Programme for IT (NPfIT) ran from 2003 to 2010; it is now being described as the world’s largest failed IT system. Was the NPfIT world-leading in its vision, scope and technical sophistication – or was it monolithic, inflexible, resource-hungry and over-governed? Perhaps it was both.

Of the many lessons from this colossal natural experiment, one stands out. National eHealth programs unfold as they do partly because no-one fully understands what is going on. They fail when this lack of understanding becomes mission-critical. Detailed analyses of the fortunes of these programs, narrativized (as in-depth case studies) to illuminate the contextualized talk and action (“language games”) of multiple stakeholders, offer unique and important insights. Such accounts set the stage for productive debate around the complex, interdependent social practices of which eHealth programs consist.

The complexity of contemporary healthcare combined with the multiple stakeholders in large technology initiatives means that national eHealth programs require considerably more thinking through than has sometimes occurred. We need fewer grand plans and more learning communities

The Lecture, hosted by the Health Informatics Centre and the Division of Population Health Sciences working in collaboration with TASC, NHS Tayside and NHS Fife, was held in Lecture Theatre 1 at the Dalhousie Building on Tuesday 15th May 2012.  We were delighted that nearly 120 people from across Scotland were able to join us for the Lecture and the feedback was very positive.

Professor Trisha Greenhalgh

The 6th Mackenzie Lecture

Dr John Halamka MD delivered the Lecture 'Connecting Patients, Providers, and Payers' a discussion of how $27 billion will be spent to improve the quality, safety and efficiency of Healthcare in the US through strategic implementation of information technology, which was chaired by Mr Derek Feeley, the then Acting Director-General Health and Social Care and Chief Executive of NHS in Scotland.  This Lecture was held on 26th of May 2011 in Lecture Theatre 4 at the Dalhousie Building on the University of Dundee's Main Campus.

The morning session was of interest to those working in health research in the East of Scotland as talks from the TAyside medical Science Centre (TASC), the Health Informatics Centre, the Tayside Clinical Trials Unit (TCTU) and the Dundee Epidemiology & Biostatistics Unit (DEBU) explained details of how they can help support your research and what's new in each of the groups. The afternoon session was a technical workshop for people who use routine data in their work.

Dr John Halamka

The 5th Mackenzie Lecture

Professor Doug Altman, Director of the Centre for Statistics in Medicine and Cancer Research UK Medical Statistics Group, gave the 5th Lecture 'Development and validation of risk scotes: methodological issues' on Friday 28th May 2010 in the Mackenzie Building.  The Lecture was chaired by Professor John Connell, Head of the College of Medicine, Dentistry and Nursing.

The morning and afternoon sessions included a series of short talks and case studies on work using routine data. Afternoon speakers included Doug Altman, Professor Peter Donnan (Director of the Dundee Epidemiology & Biostatistics Unit) and colleagues from the Universities of Oxford, Edinburgh and Sheffield giving an overview of specific techniques including regression modelling and machine learning.

Professor Doug Altman

The 4th Mackenzie Lecture

On Tuesday 5 May 2009 HIC held its first all day HIC event, which included the annual Mackenzie Lecture and HIC Data Workshop and a SHIP Research Workshop on methods for analysing routine data.

Professor Jeremy Wyatt, Director of HIC at the time, opened the HIC Data Workshop in Lecture Theatre 3 at Ninewells Hospital and Medical School with a brief introduction to HIC. Jeremy was followed by Alison Bell, then the HIC Data Analyst/ Programmer who outlined current developments and projects in HIC, including MILA (Multi-Institutional Linkage and Anonymisation), BOXI (Business Objects XI tool) and data management for Clinical Trials.

Duncan Heather, then the HIC Operations Manager, then outlined other services that HIC provides such as mailing letters out to patients for recruitment to studies and the creation of online data capture tools. An example of these services in use Scotland-wide was then given by Professor Nigel Pitts, then the Director of the Dental Health Services Research Unit (DHSRU) who talked about the ChildSmile project. Unfortunately, due to 2 evacuations for fire alarms during the morning session, there was not much time for further discussion, but the feedback forms show that attendees did enjoy the Workshop.

After a brief refreshment break, Professor Ian Diamond, the Chief Executive of the Economic and Social Research Council (ESRC) at that time, took to the floor to deliver the 4th Mackenzie Lecture, 'Opportunities to use patient health data to improve patient care'. His key message was that linked prospective data from a variety of sources can impact hugely on understanding and informing policy imperatives, but that further capacity development is needed. He gave a number of compelling examples of the value of routine data analysis in health and social sciences research, including some from the Scottish Longitudinal Studies Centre and others focusing on the future care of the elderly.

Professor Diamond then talked about some of the challenges of doing this kind of research. He used the Million Women study on the association between recorded induced abortion history and breast cancer as a sobering example of the fallacy of over reliance on retrospective studies. He discussed some of the social issues around data sharing and the recent developments including the Wellcome Trust statement of the principles underlying sharing of GP data and the role of the OSCR eHealth Records Research Board.

Finally, Professor Diamond argued persuasively for the need to develop a new cadre of researchers with the relevant skills to complement the few islands of excellence, in which he placed Dundee.

The Lecture was followed by lunch and then a smaller group of participants attended the SHIP Research Workshop: Analysing routine data. This was the first technical workshop organised under the research capacity work stream of the Wellcome funded Scottish Health Informatics Programme (SHIP). The aim was to introduce participants to the problems faced by those analysing routinely collected data in an interactive setting and to promote better understanding of the methods used to quantify and compensate for these biases, using case studies and standard analytical approaches.

Professor Ian Diamond

The 3rd Mackenzie Lecture

The third Mackenzie Lecture, 'Best laid plans: record linkage illuminates public health, and other jurisdictions', was delivered by Professor Sheila Bird from the MRC Biostatistics Unit in Cambridge, and took place in Lecture Theatre 2 in Ninewells Hospital and Medical School on Wednesday 23 April 2008.

This event also marked the visit of Professor John Frank as Director of what was the new Scottish Collaboration for Public Health Research and Policy. Professor Frank gave a response to the lecture. The event was also chaired by another visitor to HIC, Mr Sandy Watson, the then recently appointed Chairman of NHS Tayside.

The Lecture and Response were followed by a Question and Answer Panel Session. Members of the panel included Mrs Mary Sweetland, Professor Nigel Pitts (then Director of the Dental Health Services Research Unit), and Professor Jeremy Wyatt (then Director of the Health Informatics Centre), as well as Professors Frank and Bird, and Mr Watson.

Mr Watson opened the event with a welcome to Professor Bird.

In her lecture Professor Bird gave some background information to Sir James Mackenzie. She understood that he was the third of seven children born to a tenant farmer near Scone who had a deep distrust of authoritative statement. As a busy GP in Burnley in Lancashire, long before opening UK's first cardiac department at The London in 1913, he made quality measurements in primary care where his patients' presentations differed from those described in Victorian textbooks or referred to teaching hospitals. Sir Mackenzie brought such erudition to those critical observations by the questions he posed of the data, and in his deductions, that he was appointed FRS in 1915. His data were meticulously archived and Mackenzie also contributed data: notably, he pre-arranged his own autopsy!

Professor Bird then went on to talk about Scotland's high-quality, indexed databases which range from prisoner releases to blood-borne viruses (HIV testees and hepatitis C diagnoses (HCV)), drug misuse referrals, cause-specific hospital discharges, and deaths. Indexing in these databases is by a minimum set of identifiers: initial of first name; initial or soundex or 1st+4th letter of surname; gender and date of birth; postcode district of residence. Linkage of these types of data uses probability matching.

By linking ethically this wealth of information, important public health questions can be answered authoritatively using unconsented 'virtual cohorts'. Examples include under-ascertainment of HIV transmission in jail, whether drug misuse referral mitigates overdose deaths and morbidity soon after release from prison, and the extent and correlates of liver failure in HCV-diagnosed individuals, to validate projections of Scotland's future burden of HCV disease.

Record linkage designs allow statistically powerful, non-intrusive, unbiased longitudinal follow-up of 'virtual cohorts'. But, they must stringently safeguard unconsented participants against deductive disclosures - whether to healthcare staff about ex-prisoner status, or about reckless HIV transmission via associated biological samples.

Linkage of file A to file B on identifiers, when the linking organisation also holds a names-version of file B, risks inadvertent attribution of file A status (ex-prisoner for example) to named individuals on file B. Embedding list A in a larger list is one solution. Research teams often have to rely on list holders toprogram selection of their 'virtual cohort'. Unfortunately, confidentiality inhibits cross-checking - has an error escaped detection?

In a series of seven examples, Professor Bird illustrated clearly how modern record linkage illuminates the public health, particularly so when there are associated biological samples. She also explained that respect for medical and other confidentiality means that scientists have to relinquish some rigour in the checks that can be made on data. A wealth of data does not mean a wealth of insight, however, unless - like Mackenzie - the right questions are asked and the methods of analysis are also correct. Incorrect analysis in a large database leads to very precise but wrong answers.

Despite recent data debacles, the benefits from well-designed record linkage vastly outweigh the risks.

Professor Frank then responded to the lecture by sharing some of his own insights and thanked Professor Bird for her excellent and clear description of record linkage techniques and dilemmas.

Professor Sheila Bird

The 2nd Mackenzie Lecture

The Second Mackenzie Lecture was held on Thursday 8 June 2006 at 6.00 pm. The Lecture was hosted by Mr Peter Bates, then the Chairperson NHS Tayside and held in Lecture Theatre 1, Ninewells Hospital & Medical School. Professor Jeremy Wyatt, then Director of the Health Informatics Centre, presented 'Health in the Information Age: Improving Secondary Uses of Data'. A question and answer panel session followed the lecture.

Panel members included Professor Andrew Morris (Professor of Diabetic Medicine), Dr Colin Tilley (Research Fellow in Economics, DHSRU), Mrs Mary Sweetland (Deputy Director, ISD), Professor Jeremy Wyatt and Mr Peter Bates.

Professor Jeremy Wyatt

The Inaugural Mackenzie Lecture

The Inaugural Mackenzie Lecture: "Pursuing perfection: transforming organizations into reliable deliverers of healthcare" was delivered by Dr Carol Haraden, Vice President of the Institute for Healthcare Improvement, and took place in the Ustinov Room, Bonar Hall.The Mackenzie Lecture was at 6pm on 24th May 2004.

The Mackenzie Lecture was held to mark the visit of a team from the Institute for Healthcare Improvement to Scotland as part of the Safer Patients Initiative. NHS Tayside is one of four UK Acute Services organisations which have been selected by the Health Foundation for the Safer Patients Initiative. The lecture provided an opportunity to hear about the work of IHI on the Safer Patients Initiative and on quality improvement in general. Dr Haraden's work is focused on improving patient flows and exchange of information when patients are transferred between primary and secondary care.

Dr Carol Haraden