Alex Jadad

Alejandro R. Jadad Bechara (born August 9, 1963) is a Canadian-Colombian physician, philosopher, teacher, innovator and entrepreneur whose mission is to invite people - either as individuals or groups - to imagine and to create better ways of living as part of a flourishing planet. His work focuses on the creation of a pandemic of health and well-being through an approach known as radical 'glocal' innovation.[1] He is also known as the researcher responsible for the development of the Jadad Scale, the first validated tool to assess the methodological quality of clinical trials.

Alejandro (Alex) Jadad
BornAugust 9, 1963
Medellin, Colombia
CitizenshipCanadian and Colombian
Alma materXavierian University (Colombia); Oxford University (United Kingdom)
Known forJadad Scale; Conceptualization of health; Pandemic of health; Radical 'glocal' innovation; Human internet; Full life
Spouse(s)Martha Garcia (m. 1988)
ChildrenAlia Lucía Jadad-García; Tamen María Jadad-García
Scientific career
FieldsHealth; Well-being; Living; Dying well; Unlearning; Collaboration; Innovation; Love; Happiness
InstitutionsUniversity of Oxford; McMaster University; University Health Network; University of Toronto

Jadad is the founder of the Centre for Global eHealth Innovation at the University Health Network; Professor[2] and a Senior Fellow of Massey College, both in the University of Toronto; and Chairman of Beati Inc, Canada.

Early years

Jadad was born in Medellín, and grew up in Montería, Colombia. When he was a medical student, he conducted the first studies on the jargon, the chemical composition and the clinical implications of a drug called 'basuco' in Colombia, which soon became known worldwide as "crack" cocaine.[3] He obtained his medical degree in 1986 at the Pontificia Universidad Javeriana in Bogota, where he also became a specialist in anesthesiology and intensive care. In 1989, he received a grant from the British Council, and became Clinical Research Fellow at the Oxford Pain Relief Pain Unit, University of Oxford, where he trained in pain management and end of life care, and conducted research that demonstrated that neuropathic pain ("pain in numb areas due to nerve damage") could be relieved by opioids.[4] This work led to the 1992 Overseas Research Student Award from the Committee of Vice-Chancellors and Principals of the Universities of the United Kingdom, and his enrolment as a doctoral student in Balliol College, the oldest school in the University of Oxford, where he received in 1994 the degree of Doctor of Philosophy (DPhil) in Clinical Medicine. His doctoral thesis, entitled "Meta-analysis of Controlled Trials on Pain Relief",[5] was published and widely disseminated by the British National Health Service (NHS). It guided the development of new tools to identify and distill health-related information, methods to handle big data to support health-related decisions, and the validation of the Jadad scale.

The Jadad Scale

This was the first validated tool to assess the methodological quality of clinical trials in the world. As of 2019, it had been cited more than 15,000 times in the biomedical literature, being used to identify systematic differences among studies of the same healthcare interventions in more than 5,000 reviews of research in virtually all areas in the healthcare sector.[6] The scale includes three components which are directly related to the reduction of bias: randomization, blinding, and the description of dropouts and withdrawals. These are presented as 'yes' or 'no' questions and produces scores that range from 0 to 5. Studies that receive a score of 2 points or less has been shown to exaggerate the produce treatment effects that are 35% larger on average than those produced by the trials with 3 or more points.[7]

Life in Canada

In 1995, Jadad joined McMaster University in Canada, where he stayed until 1999. During this period, he was Director of the Health Information Research Unit;[8] Co-director of the Canadian Cochrane Centre and Network,[9] Associate Medical Director of the Program in Evidence-based on Cancer Care Ontario,[10] and the Founding Director of the McMaster Evidence-based Practice Center[11] (the first of its kind funded by the US government overseas), and Professor in the Department of Clinical Epidemiology and Biostatistics.[12]

In 2000, Jadad moved to Toronto as the Inaugural Rose Family Chair in Supportive Care (a post he held until 2010), which enabled work on the reconceptualization of terms such as 'health' or a 'good death', as a means to guide the design, development, implementation and evaluation of innovations aimed at allowing people, even those living with complex chronic conditions or even terminal illnesses, to consider themselves to be healthy until the end. Simultaneously, he became the Founding Director of the Program in eHealth Innovation[13] and Professor in the Department of Health Policy, Management and Evaluation (now Institute),[14] and Professor in the Department of Anesthesia in the Faculty of Medicine, and in the Institute for Health Policy, Management and Evaluation at the University of Toronto. In this capacity, he led the creation of the Centre for Global eHealth Innovation,[15] a simulator of the future, to study and optimize the use of the information and communication technologies (ICTs) before their introduction into the health system. The construction of the centre was supported by the Canada Foundation for Innovation and the University Health Network, the largest hospital in Canada, where it is located. During this time, he also led the development of virtual clinical tools to transform the encounter between patients and health professionals, and new ways of using ICTs to respond to major threats to public health (e.g., obesity, complex chronic diseases and challenges at the end of life) and to allow the public (especially young people) to guide the creation of the future of the health system. To support this work, in 2002, Jadad was awarded the Canada Research Chair in eHealth Innovation (Tier 1), which he held until 2015. In 2016, he was appointed as Director of the Institute for Global Health Innovation and Equity, University of Toronto, an organization devoted to enabling collaborative efforts to tackle some of the biggest challenges to health in the 21st century.

Global activities

In 1992, Jadad became the inaugural President of the Colombian Science and Technology Network in the UK,[16] which was part of the Caldas Network, supported by Colciencias, in order to connect the country's scientific diaspora, worldwide.[17]

In 1998, he authored the book with which the British Medical Journal celebrated the 50th anniversary of modern clinical trials.[18] A new edition, co-written with Murray Enkin, was published in 2007.[19]

In 2008, Jadad led a global conversation about the meaning of health, supported by the British Medical Journal.[20]

In 2010, he was the Editor-in-Chief of "When people live with multiple chronic diseases: A collaborative approach to an emerging global challenge, one of the first books in medicine co-created globally using digital technologies. The same year, he chaired and convened the Global People-Centered eHealth Innovation Forum in the European Ministerial Conference;[21] the First International Youth-Led Innovation Forum to promote entrepreneurship among millennials and centennials[22] in Brussels and Extremadura; and the First International Summit on Family-Centered Health, supported by the government of China[23]

In 2011, the global conversation on the meaning of health generated a new conceptualization of the term as 'the ability to adapt and manage' the physical, mental or social challenges faced by individuals or communities throughout life.[24] This approach is guiding collaborative efforts to identify what causes health, and innovative ways to make a pandemic of health possible.[25] In 2018, such efforts led to the description of an integrated network of services that enabled 88.6% and 93.1% of its users to experience positive levels of self-reported health and well-being, while ranking first when compared with the performance of the health systems of the 36 countries that are members of the Organization for Economic Cooperation and Development (OECD). Trust among payers, service-providing institutions, professionals and users of health services was the key to achieving these results with only 25% of the average expenditure across the OECD (US$500 per person annually. This is equivalent to US$860 when adjusted for purchasing power parity).[26]

In 2020, building on the experience with this integrated healthcare service network, an ecosystem for sustainable well-being was incubated in collaboration with a non-profit entity serving over four million people affiliated with 95,000 organizations. This enabled more than 12,000 employees to transform their workplace into an incubator of massively personalized well-being prescriptions, à la carte, for themselves and their loved ones, which could then be offered to the organizations they serve. Lastly, it was possible to transform a large housing project for 100,000 members of low-income families into a leading-edge community-based living laboratory in which to nurture collaborative projects and scalable social enterprises that could contribute to the emergence of cities of well-being.[27]

During the COVID-19 pandemic, he built on his experiences during the SARS and N1H1 outbreaks, on hospital protection[28] and national preparedness,[29] and on how to unleash counter-pandemics of positive health,[30] to support mitigation and containment efforts internationally.[31][32] In addition, in collaboration with a group of collaborators, he identified opportunities to future-proof health systems by proactively mining, synthesizing, cataloging, and evaluating the off-label treatment opportunities of thousands of safe, well-established, and affordable generic drugs.[33]

Honours

In 1997, he received the Order of the Knight Commander by the Xavierian Union and the Society of Jesus, and the National Health Research Award by Health Canada for his work on evidence-based decision-making.

In 1998, he was named as one of Canada's Top 40 Under 40; and received the Jose Maria Cordoba Medal in Science and Technology in Colombia, and the Premier's Excellence Award of Ontario.

In 2001, he was designated as the Spinoza Visiting Professor at the Academic Medical Center and the Faculty of Medicine at the University of Amsterdam in The Netherlands, and the Inaugural Art McGregor Lecture speaker at the University of Victoria in British Columbia in Canada. That same year, Time magazine (Canadian edition) selected him as one of the 7 new Canadians who will shape the country in the 21st century The following year, this magazine selected him as one of the 6 most prominent innovators of the country in the area of health. In 2002, Jadad received the New Pioneers Award in Science and Technology in recognition of his contributions to the country as a new immigrant. That same year, he received the American Academy of Pain Medicine Award and was visiting professor at Johns Hopkins University in the US.

In 2004, Jadad received the Latin American Achievement Award as the person who made the greatest contributions to relations between Canada and the sub-continent. In 2005, he was selected by fellow recipients of the Top 40 Under 40 Award (over 500 at the time) as one of five "Best of the Best" for achievements in science and technology. The same year, he was identified by his peers in Colombia (and Portfolio Magazine and the newspaper El Tiempo) as the scientist who had had the greatest impact in the country's history.

In 2006, he was awarded the Distinguished Speaker Award by the Federal Ministry of Health of Canada. In 2007, he became the first Hispanic member of the Canadian Academy of Health Sciences, and was selected by leaders of the mass media and the community as one of the 10 most influential Hispanic Canadians. In 2008, he received the Order of Congress (equivalent to the Order of Canada or a knighthood in the United Kingdom) and the Medal José María Córdoba in his native country.

In 2008, he received the Bicentennial Medal Antonio de la Torre and Miranda, from the city of Monteria, where grew up; the Grand Cross Medal by the Department of Córdoba (equivalent to the Order of Ontario in Canada); and the Gold Medal for Lifetime Achievement from the University of Cordoba and the University of Sinu (equivalent to honorary doctorates).

In 2009, Jadad received the Felix Restrepo Medal for his contributions to Science and Society by Xavierian University in Colombia. This distinction was granted again in 2012 in the category of Learning and Education.

In 2012, he was made Honorary Fellow of the School of Clinical Sciences and Community Health at the University of Edinburgh in Scotland; and he was honored as the first recipient of the Pioneers for Change Award, which recognized five Canadians born abroad who had have made extraordinary contributions to the country and the world.

In 2016, he received an Honorary Doctorate of Laws by St. Francis Xavier University, and was elected as Senior Fellow of Massey College. In 2017, he was awarded a doctorate honoris causa by the Open University in Catalonia, Spain. In 2018, he received ASMEDAS's Award for Global Impact on Human Well-Being.

In 2019, he was invited to be a member of the Council of the Wise (or Mission of the Sages) by the President of Colombia. This is a group that was asked to generate recommendations to help guide the country's future in the following 25 years, as part of the celebration of its bicentennial. At the end of that year, he was Guest Editor of the 20th anniversary issue of the top peer-reviewed journal on digital health, reflecting on two decades of efforts to transform the health system and proposing an agenda for 2039.[34]

Books
  • Jadad AR. Medical education, professional practice and drug abuse among physicians [Educación médica, práctica profesional y abuso de drogas entre los médicos] Xavierian University Press, Bogota, 1988
  • Ruiz AM, Jadad AR. The neurosurgical patient: anesthetic and intensive care: Copilito Press, 1989 [Original title in Spanish: El paciente neuroquirúrgico: manejo anestésico y de cuidados intensivos (with Mario Ruiz Pelaez)
  • Jadad AR. Randomized Controlled Trials: A User's Guide. London: BMJ Publishing Group, 1998
  • Jadad AR, Enkin MW. Randomized Controlled Trials: Questions, Answers and Musings. Wiley, 2007 ISBN 978-1-405-13266-4
  • Jadad AR. Unlearning: incomplete musings on the game of life and the illusions that keep us playing. Foresight Links Press, 2008[35]
  • Jadad AR, Cabrera A, Martos F, Smith R, Lyons RF. When people live with multiple chronic diseases: a collaborative approach to an emerging global challenge. Granada: Andalusian School of Public Health, 2010
  • Jadad AR. The Feast of Our Life: Flourishing through self-love. Beati Press, 2016
  • Herrera-Molina E, Jadad-Garcia T, Librada S, Alvarez A, Rodriguez Z, Lucas MA, Jadad AR (Editor-in-Chief and Senior Author). Beginning from the End: How to transform end of life care by bringing together the power of healthcare, social services and the community. 1st edition. Seville, Spain: New Health Foundation, May 2017
  • Jadad AR (Editor-in-Chief and Senior Author), Arango A, Sepulveda JHD, Espinal S, Rodriguez DG, Wind KS. Unleashing A Pandemic of Health from the workplace: Believing is seeing. 1st edition, Toronto: Beati Inc., December 2017.
  • Serra M, Ospina-Palacio D, Espinal S, Rodriguez D, Jadad AR (Editor-in-Chief). Trusted networks: the key to achieve world-class outcomes on a shoestring. 1st edition, Toronto: Beati Inc., December 2018.

Personal

Jadad lives in Toronto with Martha Garcia, his wife, whom he started dating when he was 17. They have two daughters and two grandchildren.

Scopus Profile = Author ID: 35430539800

References
  1. Kotha, S Rani; Jadad, Alejandro R.; Hu, Howard (2015). "Creating a pandemic of health: Opportunities and lessons for a university initiative at the intersection of health, equity and innovation". Harvard Public Health Review.
  2. "Institute for Global Health Equity and Innovation". www.dlsph.utoronto.ca. Archived from the original on 2019-05-01. Retrieved 2019-05-01.
  3. Jadad, AR (1985). "Basuco (Free-base cocaine)". Revista Colombiana de Anestesiologia (Colombian Journal of Anesthesiology). 13: 257–267.
  4. Jadad, A.R; Carroll, D; Glynn, C.J; McQuay, H.J; Moore, R.A (June 1992). "Morphine responsiveness of chronic pain: double-blind randomised crossover study with patient-controlled analgesia". The Lancet. 339 (8806): 1367–1371. doi:10.1016/0140-6736(92)91194-d. PMID 1350803. S2CID 24856536.
  5. Jadad AR-Bechara. Meta-analysis of Randomized Clinical Trials in Pain Relief. DPhil thesis, Balliol College, University of Oxford, 1994 https://books.google.com/books?id=3OXXSgAACAAJ
  6. https://scholar.google.ca/scholar?cites=12978060954018601874&as_sdt=2005&sciodt=0,5&hl=en
  7. Jadad, Alejandro R.; Moore, R.Andrew; Carroll, Dawn; Jenkinson, Crispin; Reynolds, D.John M.; Gavaghan, David J.; McQuay, Henry J. (February 1996). "Assessing the quality of reports of randomized clinical trials: Is blinding necessary?". Controlled Clinical Trials. 17 (1): 1–12. doi:10.1016/0197-2456(95)00134-4. PMID 8721797.
  8. http://hiru.mcmaster.ca/hiru/ Health Information Research Unit
  9. http://ccnc.cochrane.org/ Canadian Cochrane Network and Center
  10. Program in Evidence-Based Care (PEBC) (Program in Evidence-based Care of Cancer Care Ontario)
  11. http://www.fhs.mcmaster.ca/ceb/acts/epc.htm McMaster Evidence-based Practice Center
  12. http://fhs.mcmaster.ca/ceb/ Department of Clinical Epidemiology & Biostatistics
  13. "EHealth Innovation".
  14. http://ihpme.utoronto.ca/
  15. "EHealth Innovation".
  16. http://opencharities.org/charities/1047026 Colombian Science and Technology Network
  17. Granes, J.; Morales, A.; Meyer, Jean-Baptiste (1996). "Potentialities and limitations of the Caldas network of Colombian researchers abroad : case studies of joint international projects". International Scientific Migrations Today : New Perspectives.
  18. Jadad, AR (1998). Randomized Controlled Trials: A User's Guide. BMJ Books. ISBN 9780727912084.
  19. Jadad, AR; Enkin, MW (2007). Randomized Controlled Trials: Questions, answers and musings. Wiley. ISBN 978-1-405-13266-4.
  20. Jadad, Alex (December 10, 2008). "A global conversation on defining health: Alex Jadad and Laura O'Grady".
  21. Novillo-Ortiz, D; Jadad, A, eds. (2011). The Global People-Centered eHealth Innovation Forum. London: BMJ Group.
  22. http://www.extremaduraeuropa.org/descarga.php?tipo_descarga=novedades&file=1731 Archived 2016-03-04 at the Wayback Machine Youth-led Innovation and Entrepreneurship
  23. http://coinfo.istic.ac.cn/heh2010/index_1.html Archived 2016-03-04 at the Wayback Machine Summit on Human-centered and family-focused eHealth
  24. Huber, M.; Knottnerus, J. A.; Green, L.; Horst, H. v. d.; Jadad, A. R.; Kromhout, D.; Leonard, B.; Lorig, K.; Loureiro, M. I.; Meer, J. W. M. v. d.; Schnabel, P.; Smith, R.; Weel, C. v.; Smid, H. (2011). "How should we define health?". BMJ. 343: d4163. doi:10.1136/bmj.d4163. hdl:1885/17067. PMID 21791490. S2CID 19573798.
  25. Jadad, Alejandro R. (2016). "Creating a pandemic of health: What is the role of digital technologies?". Journal of Public Health Policy. 37 (Suppl 2): 260–268. doi:10.1057/s41271-016-0016-1. PMID 27899800.
  26. Makanda, Françoise (February 14, 2019). "Achieving World Class Health Outcomes on a Shoestring". www.dlsph.utoronto.ca. Retrieved 2019-05-01.
  27. Espinosa N, Anez M, Serra M, Espinal S, Rodriguez D, Jadad AR (Editor-in-Chief). Toward sustainable well-being for all: People, communities, organizations, societies and creatures. 2020. Beati Inc.
  28. Rizo, Carlos A.; Lupea, Doina; Baybourdy, Homayoun; Anderson, Matthew; Closson, Tom; Jadad, Alejandro R. (2005). "What Internet Services Would Patients Like From Hospitals During an Epidemic? Lessons From the SARS Outbreak in Toronto". Journal of Medical Internet Research. 7 (4): e46. doi:10.2196/jmir.7.4.e46. PMC 1550678. PMID 16236698.
  29. Ritvo P, Wilson K, Gibson JL, Guglietti C, Tracy CS, Nie JX, Jadad AR, Upshur REG. Canadian survey on pandemic flu preparations. BMC Public Health 2010; 10:125
  30. Gurnani, Muskaan Vineet; Agarwal, Arnav (2014). "Healthy lives for all, until the last breath: An interview with Dr. Alejandro R. Jadad Bechara". University of Toronto Medical Journal. 92 (1): 20–24.
  31. Webster, Paul (April 2020). "Virtual health care in the era of COVID-19". The Lancet. 395 (10231): 1180–1181. doi:10.1016/S0140-6736(20)30818-7. PMC 7146660. PMID 32278374.
  32. Jadad AR, Arango A, Sepulveda JHD, Espinal S, Rodriguez DG, Wind KS. Unleashing A Pandemic of Health, from the workplace, Believing is seeing. Beati Inc., 2018.
  33. Rogosnitzky, Moshe; Berkowitz, Esther; Jadad, Alejandro R. (2020). "Delivering Benefits at Speed Through Real-World Repurposing of Off-Patent Drugs: The COVID-19 Pandemic as a Case in Point". JMIR Public Health and Surveillance. 6 (2): e19199. doi:10.2196/19199. PMC 7224168. PMID 32374264.
  34. Jadad, Alejandro R.; Garcia, Tamen M. Jadad (2019). "From a Digital Bottle: A Message to Ourselves in 2039". Journal of Medical Internet Research. 21 (11): e16274. doi:10.2196/16274. PMC 6858618. PMID 31682578.
  35. Jadad, Alejandro R. (2010-04-26). Unlearning: Incomplete Musings On The Game Of Life And The Illusions That Keep Us Playing. lulu.com. ISBN 9780557015085.
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