Patrick Myers Domain Chair, Acquired Cardiac Disease
It has been a privilege to have Jan Ankersmit from the Medical University in Vienna to chair the Basic Science Task Force for some time now. He’s done a phenomenal job but had too many responsibilities at his home institution to continue chairing this task force. With Jan’s departure we took the opportunity to look again at the Basic Science Task Force and recruited a group of diverse clinicians and scientists involved in basic research to join. We also asked Juan Grau, Director of Cardiothoracic Surgery at The Valley Heart and Vascular Institute in the US, to chair it.
Among the initiatives that we have considered is a different way of integrating basic science with all the other areas that EACTS covers. For example, at the Annual Meeting each task force would usually develop its own focus and abstract sessions, and that would be the same for basic science. Although basic science can be very interesting for practising clinical surgeons, it’s often not hugely relevant to their practice and perhaps not as interesting to them as other content that they are able to engage with at the Annual Meeting. So that was something we had to think about – a lot of work goes into those basic science session, so how do we generate more interest? Linked to this, we have been seeing that the basic science that underpins interventional procedures such as TAVI and so on is crucial – the basic science of the valves and the bio engineering is vital to the development of new devices and treatments, and therefore important to the future of both specialties.
As a result, we have been working hard with Juan Grau to re-energise the approach to basic science. The outcome is that we have now basic science sessions at this year’s Annual Meeting that are integrated into the wider scientific programme. For example, a session on transcatheter valves will also look at the basic science of the valves and their application, what we know about them and what can we expect from them.
We have seen that our colleagues from cardiology are increasingly interested in this sort of approach and I think that many other EACTS members will also welcome it. Having taken this big step to integrate it with the wider programme, I feel basic science will now become much more visible and much more approachable to the practising surgeon, whatever their speciality.
Juan Grau, Chair, Basic Science Task Force
What does basic sciences do for cardiothoracic surgery? In general, I would summarise it as the following: it brings objectivity. The experimental method does not have a personality, it doesn’t have an agenda. Either things work or they don’t work. Your experiments are going to tell you whether you were correct in assuming that this is the mechanism or technique you thought it would be. Given the world that we live in today, that objectivity is crucial.
As a scientist and as a surgeon, clinical medicine is very clear. You do an operation, everything works well, and the patient walks out of hospital in better shape. Now how can you improve that? How can you make it less invasive, how can you make it more effective, how can you make it more streamlined? For that you will have to use the tools of basic science, meaning you will have to create an experiment, devise a method, test it, validate it and then implement it. These fundamental tenets of research and investigations are in general very healthy. It is a healthy reminder for all us clinicians to see and understand the bar that we have to meet. And we do have to meet that bar, and even exceed it, if we want our breakthrough interventions to become mainstream.
This is why we need to keep analysing the information and the science. Lately we have had significant issues with major clinical trials where the results were somewhat confusing or debatable. This happened because the statistical methods changed or some of the definitions were altered during the course of the trial. In the light of that, what an understanding of not only basic research but also statistical methodology gives you is the ability to be analytical and to have good judgement about the information that is being fed to you and what it is telling you.
So that is how I would describe basic science. It brings objectivity to medicine, which can sometimes feel as much of an art as a science, and it tells us what is really happening and why.
For me, this happens regularly. I can send specimens sent to my PhD students that I believe are putting us on the perfect path. But then they come back and tell me the specimens are not good enough. That is the beginning of objectivity, because you think you’re going to obtain particular results about particular issues and then you are told otherwise.
How many other areas of life can deliver that level of objectivity, telling you with certainty that something is wrong or not good enough and needs to be better? This is what my PhD students do regularly, they practise basic science, and it keeps me very grounded.