In Chapter 8 of 10 in her 2010 Capture Your Flag interview with Capture Your Flag, health economist and comparative effectiveness researcher Clara Soh Williams shares how she deals with being unpopular as a comparative effectiveness researcher. Soh, who majored in molecular biophysics and biochemistry at Yale, follows her passion to research drug effectiveness compared to alternative drugs. Based on research into Vioxx and health implications, she believes she saves lives by providing patients and providers tools to make correct decisions when choosing medication. Additionally, Soh applies her passion for science and research to educate a vulnerable, marginalized population who could use the information. Soh holds an MPA in Public Health Finance from New York University and a BS in Molecular Biophysics and Biochemistry from Yale University.
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Transcript:
Erik Michielsen: How do you deal with being so unpopular in what you do for a living?
Clara Soh: I could sort of joke about that and say that being a science nerd prepared me for unpopularity. The way I deal with being unpopular as a comparative effectiveness researcher, I think a lot of that comes with some of my background. I have worked through being a total science nerd. … We are never the most popular people in the class.
Growing up it doesn’t pay to be smart. It pays to be athletic and pretty and a cheerleader. Taking every science class that your school offers is never a way to garner popularity. [laughing]
Joking aside, I really have a lot of passion for what I do. I feel that the services that myself and other researchers in my field offer can really help save lives. One of the things that we found is, in our studies with Vioxx, we found that it causes Cardiac events and heart attacks at much higher rate than other painkillers. We found this out years several years in advance of when the national media was picking it up and when the FDA finally pulled the drug off the market. So, I don’t feel I’m going out on a limb when I say my work saves lives.
I don’t want to be paternalistic in that I’m making decisions on behalf of people. I try to empower people to make decisions but I do think a lot of what of what we do is to provide people the tools to make correct decisions that are best for them. One of the real challenges in the U.S. health care setting is that drugs are only ever compared to a placebo and new medical interventions are usually only compared to placebo. There are never head to head trials. So when a new drug comes out you don’t know if it is any better than a former drug, you only know that it is better than nothing.
We are really giving patients and providers the tools they need to understand if you should move from Drug A to Drug B. There is constant innovation happening and we are not trying to stifle that. We are just trying to make sure that the right technologies and innovations go to the right population.
One of the other challenges that we face that really helps sort of keep me going in understanding this is that in clinical trials it is a lot of white males who are enrolled. There is a severe deficiency of sort of marginalized poor and ethnic populations.
It is something that the NIH has picked up on and has really tried to increase enrollment.
So, a lot of times we have this idea of efficacy versus actual impact. So, in a clinical trial, something might work very well but then when you get to a real-world setting someone might not have a good prescription drug benefit so they are splitting pills or they are only taking one every other day or they are choosing which of their drugs to buy. So, we try to incorporate a lot of those aspects into the research we do where we say “In an ideal setting this drug might work but in a real life setting it may not work for you because of a particular situation you are in.” So, I like to think that I am taking the research and giving it to some of the more vulnerable populations who could really use this information.
