Controversy has become commonplace for Dr. Isabelle Savoie.
As a medical consultant for the B.C. Office of Health Technology Assessment (BCOHTA) based at UBC, Savoie is responsible for evaluating research methods on topics ranging from cholesterol testing to hearing screening in newborns.
"Our work often challenges people's opinions about whether a technology works or not," says Savoie. "That can be threatening."
BCOHTA assesses a variety of health technologies upon request from hospitals, physicians, government agencies, manufacturers and the public. Technologies include everything from information systems to drugs to diagnostic equipment.
"We try to help decision-makers identify the best use of limited resources," she says. "They need to know if a technology has been shown to produce more benefits than harm."
Assessments also review how the technology compares to a placebo or to a competing alternative.
"Because we're requested to do reviews before money is spent, some people think we have a bias against buying technology. But our job is really pro-research evidence, not anti-technology."
The office receives requests for assessments almost every other week. Faculty and staff, all UBC employees, use various criteria to determine the priority and level of analysis.
Issues such as the number of users of the technology, its potential to change the quality of patients' lives, the cost of implementation and the influence of the review on the spread of the technology are all considered in determining which requests get priority attention.
Savoie, one of two medical consultants at BCOHTA, reviews literature gathered by the office's librarian and information specialist. She also speaks directly with physicians and other health-care providers to learn from them how a particular technology is working.
It takes an average of 18 months to complete an in-depth assessment.
"What we're evaluating is the quality of the research -- is it logical and thorough and are the conclusions defensible and reproducible," says Savoie.
She and BCOHTA colleagues have presented their systematic review methodology to practitioners and decision-makers at conferences worldwide. Teaching others how to critically appraise research provides much of her job satisfaction, Savoie says.
"This is not about telling doctors they're bad for using technology that is not supported by research evidence," she says. "It's about making sure health-care dollars are spent in a way that gives the greatest good to most people."
After obtaining a medical degree from the University of Montreal and a master's degree in Health Administration from UBC, Savoie wanted to contribute to making the health-care system work better. She also sought an opportunity to combine research with personal interaction.
One of her current research assessments looks at how information on heart disease is presented to women.
Social literature such as articles in women's magazines and advertising and an examination of the values women hold concerning health and disability all come under critical review.
"Women are now getting a great deal of information about heart disease," says Savoie. "Some of it is based on sound research and some is not. Our review looks at how that information affects treatment decisions for women and their doctors."
Savoie has some advice to anyone seeking a job in research evaluation. "Don't take anything for granted and don't be afraid to challenge the status quo."