Cardiology

Spotlight on Professor Dipak Kotecha, Associate Editor

Section ‘Atrial Fibrillation and Stroke’

Banner Dipka Kotecha Professor of Cardiology and Cardiac Imaging at the University of Birmingham, UK

 

Dipak Kotecha is a Professor of Cardiology and Cardiac Imaging at the University of Birmingham, UK, and a Consultant Cardiologist at the University Hospitals Birmingham NHS Foundation Trust. His expertise includes robust statistical evaluation and trial methodology, ‘big data’, cardiac imaging, therapeutics, patient involvement and novel technology. He is the Chief Investigator of the RATE-AF, STEEER-AF and DaRe2THINK randomized controlled trials, and works extensively with the European Society of Cardiology on guidelines and education.

As an Associate Editor and reviewer, he is known for his thorough feedback and valuable suggestions to improve the dissemination of research output.

1. Can you tell us a little about yourself?

I was born and raised in a town in South Wales called Caerphilly (known for its cheese and medieval castle!). My parents are Indian in background and migrated to the UK from Kenya. After medical school and junior doctor training in Bristol and the South West of England, I moved to Australia for 5 years where I started my research career. I completed my PhD at Imperial College London and my clinical training in Oxford, before moving to Birmingham to take up a clinical-academic role. My work usually involves large collaborative groups spread across the world, and I have honorary positions at Monash University in Melbourne (Australia), University Medical Center Utrecht (Netherlands) and the Oxford Clinical Trial Service Unit (UK).

2. How did you become interested in your field of work?

Similar to many clinical researchers, I got into the field of how atrial fibrillation (AF) and heart failure interact rather accidently. I had set up the Beta-blockers in Heart Failure Collaborative Group and was fortunate to be working with the world’s top heart failure trialists. We noticed a signal for a lack of efficacy from beta-blockers in the heart failure patients with concomitant AF (later published in the Lancet). This ignited my interest in improving care not only for these patients, but other places where cardiovascular and non-cardiovascular comorbidities interact. Bringing together my skills in medical statistics, patient and public involvement and research methodology, I naturally fell into designing and then running pragmatic clinical trials. The latest of which (DaRe2THINK) will demonstrate how we can embed randomised studies within national healthcare, and using technology solutions to run large efficient trials without the need to have physical follow-up.

3. Which issue do you feel is most urgent in your field and do you have any predictions for the future?

Prediction-wise, the rise of ‘big data’ analytics and wearable devices is inescapable. There is a very real potential for technological advances to bring benefit to patients and their care. But this leads itself directly to their most important limitation, which is the lack of transparency (“black boxes”) and lack of good old-fashioned validation. As a community, we also need to move away from research that primarily benefits the researcher and be aware of the consequences of our publications. An important example is the many (nonsensical) articles that use observational data to examine the impact of treatments (as we have showed with digoxin, this needs randomized trials). In addition, we need to bring in the patient voice, from concept, design and management of clinical research right through to guidelines and implementation.

4. What advice would you give to a researcher trying to write their first article?

First off, find a good mentor. I was extremely fortunate to have benefited from some great and inspiring mentors, including the late great Philip Poole-Wilson and Doug Altman. Second, be passionate about your topic; you can only excite editors, reviewers and readers if your interest is palpable. Third, remember that journal articles (just like your favourite novel) are a narration of your story, albeit with a scientific angle. Storyboard a good article and you will end up writing something that readers can follow and appreciate (oh and please cut out all the abbreviations!).

5. What are the papers that you would like to see submitted to Cardiology?

We are a very broad church here in Cardiology, which is unfortunately becoming more and more unique in our field. So we are happy to see the range of science from basic research to clinical data analytics. Whatever your topic, think about where the gaps in evidence are and try to fill them. As a practical point, check out international guidelines such as those from the ESC – not only do they list evidence gaps but there are also plenty of recommendations with only a level of evidence ‘C’ (as in consensus opinion, also known as a guess!). These are areas where your time and effort can have real impact on the care of patients and their wellbeing.

 

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