One of the things I love about being part of a healthcare-focused marketing agency is the seamless blending of art and science. Creativity is the basis of everything we do, and we’re routinely challenged to arrange the optimal marriage between these often conflicting worlds.
Art is emotional, nebulous, and often very personal. In contrast, clinical data is cold, factual, and nearly always collective. Despite this dichotomy, elements of both are absolutely necessary to effectively communicate with our audiences of healthcare providers and patients.
An eye-grabbing creative campaign is the centerpiece of any good agency pitch. However, that endeavor needs to be built on a solid foundation of clinical and market research data or it will quickly fall apart under scrutiny. Likewise, a campaign is worthless if it doesn’t result in measurable feedback that allows a company to make data-driven decisions and evolve a brand strategy based on new learning.
The same idea applies in the medical world. Once considered primarily an art, scientific medicine is now used to inform treatment decisions and drive clinical outcomes. This modern-day focus on evidence-based medicine has led to standardized treatments—ensuring that only those interventions supported by solid evidence are recommended and implemented.
While an evidence-based approach is critical to providing the best care, it’s important not to lose sight that each patient is an individual. Not all medicine may result in the optimal individual outcomes. That’s why art and science blend in physician offices every day, as evidence-based treatment approaches are fine-tuned to meet the holistic needs of each patient.
At some point, almost everyone in the agency world has positioned themselves behind the market research glass. When I’m in this situation, I’m often reminded of the axiom, “Garbage in, garbage out.” When providing background for research, we often share the product information that we think is most important. It’s no surprise, then, when the research subjects parrot back that information, confirming our preconceived notions about its importance. This confirmation bias is important to recognize and take into account when evaluating data that impact our marketing decisions.
Evidence-based medicine is also subject to biases that require mitigation. For example, artificial selection of clinical trial participants based on very specific inclusion (or exclusion) criteria, failure to publish negative clinical trial results, and limiting audience access to important data are each shortcomings of a system that strives to provide the best available information.
In much the way that agency staff continually strive to recognize where we are susceptible to certain biases and come up with ways to avoid them, medical researchers seek ways to improve the implementation of evidence-based medicine. Here are a few of them, which may strengthen the foundation on which treatment decisions are often based:
- Report clinical trial results quickly. Information sharing is essential because incorporating the latest knowledge into clinical practice relies on access to data. The results of clinical trials should be made publicly available as soon as possible so that all available information can inform clinical guidelines and treatment decisions. GSK has done an excellent job in making summaries of its clinical trials publicly accessible in a consistent format through Clinical Study Register.
- Publish negative data as well as positive data. By publishing only positive results of clinical trials, half of the information needed is lacking. Not only is it important to understand what worked for a specific condition, but also what interventions were tried and found to be lacking. Otherwise, valuable time, money, and perhaps even lives will be lost in the quest for new treatments that have already been studied and discarded. A requirement for researchers to publish all clinical trial results—both negative and positive—will better inform treatment decisions and clinical guidelines.
- Provide open access to results. Clinicians can only act upon information they know exists. Publishing clinical trial results behind pay walls limits access to the pool of subscribers—and limits our collective knowledge. Publications describing clinical study results should be made freely available, perhaps funded through a fee paid to the journal by the sponsors of the study.
- Use inclusive study designs. Unless clinical trial participants accurately represent those patients treated in the real world, the relevance of trial results may be called into question. Making an effort to enroll more real-world patient populations in clinical studies is critical to predicting real-world outcomes. Despite the strong financial pressures to study a new drug in a strictly controlled population that helps to ensure a positive outcome, a concerted effort should be made to enroll as diverse a patient population as possible while maintaining the integrity of the study goals. Perhaps as a requirement for many new drug approvals, the FDA should require Phase IV studies that include broader patient populations than those studied in the pivotal trials.
Blending art and information
In the agency world, creative teams are often pulled into a project only after the medical and strategy teams have developed a strong understanding of the clinical data, gathered all the available information, and developed a strong strategic recommendation. In this way, the critical art component is built upon a solid scientific foundation. The same holds true for evidence-based medicine: Only by getting a clear, big picture of the best clinical data in a timely manner can healthcare teams practice the art of medicine most effectively.
Ian DeMeritt is a member of the Medical Strategy team, where he puts his PhD in microbiology and immunology to good use on behalf of pharmaceutical and healthcare clients.