Nicole Pratt, a longtime collaborator with the OHDSI community, is the Deputy Director of the Quality Use of Medicines and Pharmacy Research Centre at the University of South Australia. She is a member of the Drug Utilisation Subcommittee (DUSC) of the Australian Department of Health Pharmaceutical Benefits Advisory Committee (PBAC).
She has a particular interest in new statistical methodologies to study the effectiveness and safety of medicine use and in the development of tools for post-marketing surveillance of medicines. This interest helped lead her to be a collaborator within the OHDSI LEGEND initiative; the LEGEND hypertension study led to a 2019 Lancet publication that found that the most popular hypertension drug wasn’t the most effective.
Nicole has also been one of the leaders in the growing Asia-Pacific (APAC) OHDSI community and the leader of the Australia chapter. She discusses her own research, the developments in the OHDSI APAC community, the importance of large community initiatives and much more in the latest edition of the Collaborator Spotlight.
Can you share a bit about your background, and when you developed your interest in biostatistics?
I did an undergraduate degree in Mathematics and Computer Science. I have always liked math but fell in love with statistics because I saw its real-world application particularly in the field of medicine. Actually what I really wanted to be was an artist but didn’t think there were that many jobs available – so now instead I love to create visuals with data. After university I started working as a consulting statistician (more than 20 years ago!). One of those consulting jobs was to design the evaluation of a new program called the Veterans’ MATES program (www.veteransmates.net.au). That was the first time I was introduced to medicine safety research and pharmacoepidemiology and it led me to the place I am today!
As a Professor and Deputy Director of the Quality Use of Medicines and Pharmacy Research Centre at the University of South Australia, evaluating the safety and effectiveness of medicines is obviously critical to your job. How has OHDSI impacted your ability to monitor medicines?
OHDSI has been a realisation for me about the potential of worldwide collaboration to advance our knowledge about medicines risks and effectiveness. I had been working for some time establishing the Asian Pharmacoepidemiology Network (AsPEN) prior to meeting Patrick Ryan at an Asian Pharmacoepidemiology Conference in Hong Kong. AsPEN was trying to do similar work across Asia but without a CDM framework. OHDSI gave us an ability to scale up our work across the Asia Pacific Region. At QUMPRC we are working hard to translate data we have available to us into the OMOP CDM to support our work with the Veteran community in Australia.
You lead the Australia regional chapter for the APAC community. What excites you about what is happening currently in Australia, and in the overall APAC community, especially following the recent publication of the first combined APAC study?
Australia is in a very exciting place right now in term of data liberalisation. The federal government has passed legislation which means that data will become more accessible. What excited me about OHDSI-Australia joining forces with other Asian countries to form the OHDSI-APAC community is the opportunity to coordinate and fast-track the translation of Australian datasets to the OHDSI CDM so that we can participate more widely in collaborative studies. The OHDSI APAC hypertension study included 2 different datasets in Australia and the analytic package has since been deployed in other datasets so it has been a great opportunity for researchers across Australia to start their journey in OHDSI.
What is also exciting about Australia is our potential to develop a federated network approach across the individual states and territories – similar to what’s happening across the European countries. We are modelling ourselves closely on the EHDEN approach.
You have been active in the OHDSI community for years, so can you talk about what inspires your work with OHDSI, and do you feel that energy spreading more in the Asia-Pacific region?
What inspires me about OHDSI? That’s easy to answer, friendship, collegiality, working towards a common goal, fun, enthusiasm, teamwork, persistence — all these things are so important to me and have inspired me on my OHDSI journey. I think the energy is really spreading across APAC – despite the language barriers and the constraints of COVID I believe that OHDSI APAC has thrived. We are certainly looking forward to meeting in person – there is nothing better than a night out doing Karaoke to get the energy spreading!!!
You have been an active contributor in both the LEGEND work, which is now focusing on diabetes, and the EUMAEUS work around vaccine surveillance. How are these large community initiatives able to make an important impact around medical safety?
Large-scale collaborative studies are so important because they are so productive – no one can do this scale of work on their own.Many perspectives are critical to ensure that work is relevant, progresses rapidly and answers questions that are critically import to health and health care. I often sit in those teleconferences (often late at night or in the wee hours of the morning here in Australia) and marvel at the discoveries and new insights that are shared so openly. The light bulb moments that lead to fabulous discoveries! The work that has been generated in LEGEND and EUMAEUS is important clinically, it can help to update clinical guidelines and provides robust evidence for medicine regulators – but for me these landmark studies have also provided critical insights into which methodologies are appropriate under which conditions – especially the value of empirical calibration!
What are some of your hobbies, and what is one interesting thing that most community members might not know about you?
My all time favourite hobby is rose pruning! I have about 50 rose bushes. One day when it’s time to retire I shall set up my business called “Pratt’s Pruning” and I will spend my time in the garden. Pruning a rose bush is no mean feat and involves both environmental-level estimation, and rose-level prediction with many covariate including: climate, water, nutrients, species, variety, pests, sunlight, soil conditions … Mostly though I love to sit on my veranda and chat with each of my roses while having a beer or two with them.